Staff Management

Staffing: When It’s Time to Add More & How to Do It

By Steve Sunder

August 1, 2018

Your staffing needs are fluid, with upticks in patient volume, and profitability, sometimes prompting the need for more people to deliver exceptional care. Here are strategies for determining when the time is right to expand your practice team.

What Do the Numbers Tell You?
It’s tempting to go with your gut in deciding when it’s time to add more staff members, but there are formulas that have already been developed to help you make that decision.

According to the Management & Business Academy, there are four key staffing metrics to keep in mind:

• Staff salary expense ratio should be 18-24 percent of overall practice expenses.

• Revenue per full-time-equivalent (FTE) staff member per hour should equal $80-$83, or annual revenue per FTE staff should equal $130,000.

• One optician per annual sales revenues of $225,000.

Source: Management & Business Academy

For a practice with $1,000,000 gross revenue collected, it would work like this:

  • 18-24% x $1M = $180K – $240K
  • $1M/$130K = 7.7 FTE staff members
  • $1M/$225K = 4.4 Opticians
  • Therefore, 7.7 – 4.4 = 3.3 non-optician staff members

What Does Feedback from Patients Tell You?
There are staffing-level red flags to be aware of. Start to worry i
f phone calls too frequently roll to voicemail, patients are walking out of the reception area or optical due to wait times, or you get social media complaints about the wait times in your office. These issues indicate declining customer service, and jeopardize the quality of the patient experience.

Consider Temp-to-Permanent Hires
One of the practices I work with was experiencing about 20 percent front-desk staff attrition. We needed to shore up and improve our retention, so we met with a local temporary staffing agency’s recruiter to discuss how they could help with our recruitment.

We presented our job descriptions, and more importantly, the requirements we were looking for, such as prior customer service experience, personality and team players, who did not need to be from eyecare.

The temp agency composed the job posting and presented it for our review and approval. Eventually, this staffing recruitment was successful so that, after the temporary period, we were eligible to hire staff directly. We had employees found through the agency who became certified para-optometric technicians, licensed opticians and office managers.

In other words, after careful review of our staffing needs for front desk, and the personality type, we then created the job posting that was approved and published that generated qualified prospects. This process of assessment and qualification is what made this process successful.

Multiple Places to Post Online
If you do decide to recruit on your own, you have many online options, including Facebook, Indeed, LinkedIn and other job boards like ZipRecruiter. However, if you’re looking for specific eyecare recruitment, Local Eye Site is the best choice.

How Many Resumes Do I Need to Collect?
On average, corporate job openings attract 250 resumes, but only four to six of those people will be called for an interview, and only one of them will be offered a job, according to Glassdoor for Employers. My experience is that the numbers are often similar in optometry when job openings are posted.

To make the task of reviewing resumes easier, be sure to include qualifiers, such as experience in customer service, health care or a strong track record in sales.

4 Key Questions to Ask in the First Interview
When you meet with potential new hires, there are important questions to ask. Here are several good ones to be sure you ask:

• What one skill makes you the most qualified for this position?

• What professional achievement are you most proud of?

• Can you tell me about a time when you overcame a challenge?

• Why are you leaving your current employer?

Best answers:
“I have a track record coordinating large projects with other members of staff driving success through team work, affirmation and rewards.”

“I work on cross-functional teams. I work with product development managers and programmers to provide technical help and support. I also customize software to fit the company’s needs, resulting in cost savings.”

Bad answers:
Telling a life story
Reciting a list of random strengths that are not job-related
Giving a list of boring personal information

Important Questions to Ask in the Second Interview
Second-round interviews can give your team members the opportunity to interview the candidate(s). You want to ensure new staff personalities fit in well with your current employees, so productivity isn’t negatively affected.

Click HERE to download a PDF guide to good questions and answers for the more in-depth second interview.


Steve Sunder is a health-care consultant with over 20 years experience in the eyecare industry at a multi-location practice, and as a consultant to other practices. To contact him:  

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