By Rachael Click, OD
April 12, 2017
Hiring an associate increases your exam capacity and potential for profitability. But it’s a big step for a small practice, so choose an associate with two key aspects in mind: complementary skills and good timing.
First, choose a candidate with optometric skills that best complement your own strengths, so your practice grows. Second, look to hire not when you absolutely need someone, but ahead of that time; allow time for the new hire to settle into your practice and generate exams.
I hired an associate, Elizabeth Braun, OD, when I was pregnant, and knew that I would need a full-time associate during and after my maternity leave six months later. My business goal has always been to be a multiple-doctor practice. I wanted to hire an associate as soon as possible for that person to have time to get acquainted with staff, office procedures, patients and our mission before my maternity leave began.
At the time of hiring, the associate worked two days a week, but as demand increased, we added additional days to her schedule. She was full-time by the time I departed. This was important to me, as I wanted to make sure that it was a good fit as soon as possible.
To Ensure ROI, Ask Associate to Build Own Patient Base
With Dr. Braun, I take the approach that each of us builds our own practice within the one practice. I did my business planning thinking of the associate as an OD opening a practice cold turkey, but made the time to break even more aggressive. I have planned for her to break even and become profitable within the first year of being full-time.
Dr. Braun’s salary costs the practice the equivalent of a full-time OD. Thus, during the first few months of her joining the practice there was a negative ROI. However, as she has become involved in the community, and the practice, she is now breaking even and becoming profitable. I have planned that our receipts will increase between 35-40 percent in 2017, which equals about a 10 percent practice growth rate once expenses, contribution margin and new capital expenditures are taken into account.
Choose OD Who Understands Business
We completed an office expansion project at the beginning of 2016 in which we doubled the optical square footage in our office, and added an exam lane and an auxiliary testing room for our new Optomap Daytona and OCT.
I knew from the projection planning done in 2015 that I would have to start looking for an associate in 2016. I wanted the first associate to be complementary to me, and someone who wanted to have a part of the business, eventually becoming a partner. I wanted and needed someone who I could strategize business and patient care with.
The practice is located in a high-growth area of the city of Mount Pleasant, S.C., population 75,000, and we service a lot of families. I wanted the new associate to be able to work with me to find new ideas to better serve these families. The associate had to be comfortable with kids, but also have a good foundation in all of optometry.
Gather Referrals from Other ODs
I was lucky in that I met a few potential candidates through referrals from colleagues in my area. Dr. Braun was from a direct referral. From time to time I receive a resume from someone moving into the area. I know there are many resources available through AOA, job searching web sites, such as Local Eye Site and optometry schools, but I never had to use those resources.
Ask Questions to Determine Right Fit
One of the first questions I asked the candidates was about their professional goals. Another first question was their availability. I couldn’t afford to hire someone full time immediately, but I had a defined plan to reach full time. I didn’t want to waste anyone’s time if they needed immediate full-time work, or if our long-term goals were not compatible.
I had face-to-face meetings within a couple of weeks of the first conversation. The first meeting was an office visit in which the potential new associates met the team and myself. We also did an office shadowing, and each of the candidates and I had a one-on-one lunch. As the interview process progressed, I asked my consultants to schedule a phone interview with the final two candidates.
The final two candidates were very different. One was a new graduate who just completed her residency. The second was a young, yet experienced, OD, who relocated to the area. I ultimately chose the experienced OD because her practice philosophies matched mine better. She was also more complementary to my personality.
Work with Lawyer or Consultant to Draft Agreement
A written contract is necessary when securing an associate. I relied heavily on my consultants, which included a legal expert, to draft the official agreement.
For the first six months, we had an informal verbal agreement that was based on hours, per diem payment and bonus structure. After 4-5 months, we knew it was a good long-term fit for both of us, so we started drafting the official full-time agreement. This agreement included benefits such as continuing education, vacation, health insurance coverage, as well as the agreed-on salary.
Monitor Closely & Review During First Months
I did performance reviews often in the beginning to determine if it was a good match. I also shadowed Dr. Braun a few times to make sure she was living our mission. Now that I am back from maternity leave, we are meeting one hour each week to get caught up, but the plan will eventually be to meet one hour a month. While those are formally scheduled meetings, we also talk, critique and brainstorm during our non-peak times. In addition, the new associate has regularly scheduled calls with my practice consultants.
Introduce Associate to Staff & Patients
Dr. Braun met the staff at her formal interview with me. During the hiring process she shadowed me to familiarize herself with practice operations and our staff.
Dr. Braun met the patients in several ways. First, she worked off of my schedule in the beginning. This was great because, as I progressed in my pregnancy, the patients were seeing my personal changes and it allowed me a way to directly introduce her to them. Secondly, we sent a letter to our patient database introducing her. Third, we sent a letter notifying the patients of my absence, but it also reinforced the associate’s skills and chair-side manner.