By Beverly Jue-Smith, OD, MBA
March 25, 2015
SYNOPSIS
Delegating management of the clinic staff, exam rooms and contact lens area frees the doctor to provide patient care and generate revenues.
ACTION POINTS
DELEGATE KEY PRACTICE AREAS. Clinic manager can assign staff to doctors, conduct performance reviews and ensure smooth operations.
CREATE REPORTING HIERARCHY. Teach staff to defer to manager before turning to the doctor/practice owner.
COMMUNICATE AND SUPPORT. Check in with your clinical manager daily and ask if you can lend support, offer guidance or provide resources.
Our five-OD practice, with a support staff of 18 and around 7,500 comprehensive exams delivered annually, has assigned a manager to oversee theclinical aspects of ourexam rooms, contact lens room and clinical staff. In our relatively high-volume practice, thiskind of delegationallows us to maintain our high standards of patient care and operate more efficiently.
Our office is divided into three departments. We decided to do this because our staff grew too large to have everyone cross-trained. It became difficult to communicate, train and efficiently organize the staff, and assign the staff duties, without a manager to head each section: clinic, optical and administrative. Our clinic manager manages our clinic staff, the clinic, contact lens and exam room areas.
Our current clinic manager had been a medical assistant for several years before she came to our office. She had the most clinical experience of all the clinic staff, was the most mature, professional and had the best work ethic. She was also already well respected among the clinical staff and well liked.
Smaller practices can function without separate departments, and if smaller practices cross-train staff, everyone can be more efficient. But even smaller practices should have at least one manager because the doctor simply cannot be in the exam room, and in the other areas of the office, while at the same time monitoring patient flow. I really appreciate having managers to delegate to. It allows us to be more organized, efficient, and give better service to our patients.
Manage Clinic Staff
Clinic staff members pre-test patients, help the doctors as needed in the exam rooms, and maintain the contact lens and clinical testing areas. The clinic manager is responsible for assigning each clinic staff to a doctor every day, and does a five-minute huddle in the beginning of the day so everyone knows what type of exams or appointments are coming in and if any special testing will be needed. She also assigns each clinic staff a specific list of weekly duties such as ordering clinic and contact lens supplies, or backing up the hard drives.
The clinic manager also schedules performance reviews for each of her staff on a six-month basis, keeps records of their attendance and tardiness, and monitors the maintenance of all clinic and exam room instruments and equipment. She is also in charge of making sure all the exam rooms are well stocked , clean and in working order. She trains new clinic staff so everyone does their job in an identical fashion. She relays any information from the owners to the clinic staff about changes in office policy, protocols, or information about new products from the doctors. She organizes our monthly “lunch and learn” meetings, and makes sure all the patients in the clinic area are taken care of in a timely manner. She may delegate or assign some of these tasks, but she is responsible for them.
Dr. Smith with her clinic staff. Dr. Smith says having managers for each area of your practice ensures excellent service in each aspect of your patients’ experience.
Delegating Provides Hands-On Management
Since I am often seeing patients myself, I don’t have as much time as our clinic manager to train clinic staff, assign and manage their duties, oversee their performance, and maintain our clinic inventory and equipment on a regular basis. Our clinic manager is always interacting with the clinic staff and can manage the clinical areas much more efficiently and better than I can. She is essentially my eyes and ears while I am in the exam room. She can direct traffic and maintain a smoothly run clinic better than I can because she can roam the area all day.
Know What NOT to Delegate
Our doctors do not delegate any examination, refraction, slitlamp procedures or contact lens fitting tasks to our clinic staff. In the past, we trained one clinic staff member who passed the NCLC exam and fit contact lenses, but the doctors still finalized the fit and final contact lens choice. We believe that it is our responsibility as doctors to spend enough time with our patients to get to know them as individuals in order to properly diagnose and make recommendations appropriate for each unique individual.
Set Salary for Manager, Motivate
The salary range for a manager varies regionally and by experience level. In our area, outside of San Francisco, cost of living is high, so the range might be from $16-$20/hour.
ROB EDITORS NOTE: The median annual salary of an office manager, among 1,900 independent practices surveyed in 2013 by the Management & Business Academy (MBA) was $42,598 or $20.48/hour.
Incentives are only effective if each employee generates their own incentive program. Each individual is motivated by something unique to their own values and situation. If you can accommodate their motivator, you will most likely have a very happy and long-term staff member. Our clinic manager said that it is important for her to have the time off to take her daughter to Girl Scout events whenever they come up or to be able to stay at home with her daughter whenever she is sick. I felt that request was doable. She has been our clinic manager for about four years, does a great job, and seems very happy.
I also make it a point to keep communication lines open by keeping up to date how she is doing, how the staff is doing, how smoothly the clinic is running and if there is anything she needs from me. I think keeping in touch with our managers on a daily basis is important. I hope that if I can keep her interested by learning new things, and meeting or exceeding her needs for occupational satisfaction, I have more of an opportunity to retain her.
Set Manager As First to Handle Staff Challenges
I encourage our managers to make their own decisions in managing their staff and their schedules. Our practice is flexible–as long as our patients are well taken care of and our service is not negatively impacted. Our staff and managers are encouraged to work things out themselves. I get involved only when there is an impasse. I try not to micro-manage because it is important for our managers to maintain control and authority within their respective groups. If a staff member comes to me, I always direct them back to their manager first. In this way, managers are encouraged to be better leaders because they know I trust them.
Evolve Role to Changing Needs
As the field of optometry continues to progress rapidly, the development and availability of more technologically advanced instrumentation, and the need for expertise in using the instruments, will increase. Our clinic manager is our expert in using technology to gather patient data. I rely on her to train the other clinic staff and the other doctors. She often becomes better and faster than the doctors at gathering data using our computerized testing instruments. I am certain that the clinic staff will eventually perform more of the examination process as more of it becomes computerized. I am hoping to train our clinic manager to be a scribe in the exam room in the near future to find out if this would allow me to see even more patients. If this works out, each doctor would have their own scribe, and we would have additional clinic staff perform the pre-testing.
Beverly Jue-Smith, OD, MBA, is the owner of San Ramon Family Optometry, Inc., in San Ramon, Calif. Dr. Jue-Smith also is owner of Optometric Consultants, a private practice consulting firm.To contact her: srfoptometry_drb@yahoo.com
