Practice Management

3 Practice Mistakes Costing Me Thousands of Dollars that I Turned Around

Dr. Horie and her staff. Dr. Horie says that changing her staff management approach, along with other key changes, dramatically improved her practice performance.

By Tia Horie, OD

Feb. 16, 2022

Practice mistakes can be costly. They can result in a patient experience that isn’t at the level it should be, and can lower profitability. Here are a few approaches to practice management I decided were mistakes, and how I course-corrected to do much better.

Not Utilizing Lab & Frame Reps
During the pandemic, it became difficult to see lab and frame reps in-office. Appointments were cancelled or pushed back, and meetings moved predominantly online. When the reps are in the office, there is always pressure to buy their products or buy more. Sometimes the reps are seen as more of a nuisance than a benefit to your practice.

During the lockdown, I lost touch with many of my reps and paid for it financially. I ended up paying more on my lab and frame bills. I lost my split-billing options, which would have been a huge benefit during the lean lockdown months. I missed out on warranties for defective products and on returns of slow sellers. I lost the perspective of the frame reps that helped to keep the bestselling products in my office. I was unaware of changes to rewards and rebate programs.

Once I began seeing reps again in-person and via Zoom, our finances began to turn around. I was offered split billing whereby my bills were spread out over a few months to help with budgeting and cash flow. My slow sellers and defective, or discontinued, products were refreshed and exchanged for products that moved better. The biggest benefit to correcting this mistake, however, was taking advantage of the rewards programs that frame and lab reps help facilitate with knowledge and enrollment.

Two specific rewards programs that I took advantage of were Essilor Preferred Rewards and VSPOne lab rewards. With the aid of my lab reps, I maximized my reward dollars. On Essilor Preferred Rewards, I went from getting $796 in rebates for 2019 to $1,583.76 in rebates for 2021. By customizing which lab I sent my jobs, and working with the Essilor rep to create packages for customers, I was able to maximize my benefits. Without her help, I would have lost half of my potential rebates.

By utilizing VSPOne lab rewards, I was able to increase my rebate by 30 percent from 2019. I received extra training on the newest products and learned ways to package my lens options to achieve the highest rewards.

Patients benefit from the new inventory and the updated knowledge of doctor and staff. When we fully understand the newest products we sell, we are better able to educate patients about those products. When patients better understand what they are buying, they feel more confident about their choices.

Not Being a Part of a Professional Network & Not Participating in Programs that Help Capture Sales
I did not sign up for, or meet all the requirements, to take advantage of programs that could help my practice capture sales. I did not always keep up-to-date with expiration dates for programs and pass those savings on to the patient.

I lost out financially. I own a small private practice, and often lose patient sales to the “big box,” or franchise, multi-million dollar corporations.

I am now a Vision Source member, and I participate in many programs, including VSP Premier Platinum and EssilorLuxottica360, among other programs.

Our office staff now breaks down the rebates and rewards of patient insurance. We offer incentives of our own, by discounting multi-frame or contact lens purchases. We offer perks, like free shipping, and make full use of coupons, free contact lens solution and rebates from contact lens vendors. VSP, for instance, has periodic rebates that can be passed on to the patient. A key way to compete with multi-million dollar corporations is to utilize rebates and rewards.

Often, a patient can receive an additional $100 off a pair of glasses which they were going to purchase anyway. When utilizing these rebates properly, I was able to help patients see the value of the products they were purchasing and decrease their total out-of-pocket costs with the rebates. Frequently, with the addition of the rebate, we were able to match what “big box” stores were offering.

Being a part of Vision Source enables me to receive discounts from vendors and labs on top of benefiting from in-house programs. I receive a percentage back for contact lens sales every quarter, and am able to increase my lens rebates because I am a Vision Source member. My rebates alone for 2021 were $7,864, and the discounts received on frames, lenses, equipment purchases, continuing education and lab services were at least twice that amount. After membership fees based on practice revenue, I estimate that I received $5,000 back in discounts and rebates in 2021.

Thanks to these cost-savings, I was able to remain open and make dearly needed upgrades to the practice, like installing new carpeting and purchasing new equipment.

I was able to use the money to enhance my practice to remain viable in this volatile COVID market and set my practice up for more consistent longevity. Overall, the savings I received from Vision Source and rebate programs allowed my practice to thrive and survive in a climate in which many practices are closing. I am now able to better compete with bigger stores and offer a more personalized touch in my private practice.

Keeping Toxic Employees
One huge side effect of the pandemic is the ongoing “Great Resignation.” My practice definitely felt the effects of this challenge. At first, the resignations caused panic from staffing shortages. I lived with the constant fear that the few staff remaining would come down with COVID and I would need to close my office. The struggle was real.

Understandably, with the nation and the world facing such an unprecedented event, COVID sparked a reevaluation of priorities and goals. I lost some employees to this shift in thinking, and was manipulated by some of the employees who remained. Unfortunately, some people like to take advantage of dire situations. I received a Paycheck Protection Program loan during the pandemic. It has since been forgiven in full, but at the time of receipt, I was concerned that I needed to keep a stable number of employees, or else. This led me to keep toxic employees who did not help the business or office mental health.

I gave in to demand after demand for more hours, more money, more flexible schedules and more health benefits. On the surface, these demands appeared reasonable, but giving in created problems for my practice. I found that work was not being done to completion. Hours were wasted doing nothing, rather than being used to complete assigned tasks. Overtime was being falsified, and there was psychological abuse of other employees that caused them to resign.

Normally, this kind of behavior would not be tolerated, but during COVID things changed. It was hard to find quality candidates to hire. I was faced with flaky employees who wouldn’t show up to work, employees who would argue with other staff or patients. Finding good employees was hard.

During the end of 2020, I decided to cut ties with all toxic staff. I chose to focus on different hiring tactics and limit hours of operation to help accommodate a smaller staff size. I focused on hiring college graduates and students. I used the nearby University of California, Davis to find employees who were reliable and intelligent. I increased the hourly wage by 25 percent and added bonuses for sales and other work-related accomplishments.

Since shifting my hiring focus, I have found exceptional employees. I was able to go back to my full schedule, and office mental health is at an all-time high. I implemented an open-door policy for suggestions and complaints, and I am more involved in managing my staff’s day-to-day activities. My hiring criteria is more strict. I enacted a three-month probation and terminate employees who show signs of toxic behavior early.

This change in my approach to workforce management has been complimented by both patients and employees. The positive attitude in the office boosted staff morale and confidence. I think this confidence helps patients feel more comfortable and happy to return to my office.

Bottom Line: Course-Correcting Mistakes Provides a New, Brighter Outlook
Fixing the mistakes outlined in this article helped me become a better business owner. It is difficult to juggle the roles of private practice owner and optometrist. The pandemic made me aware of my shortcomings and pushed me to rectify problematic situations. I am hopeful for the future.


Tia Horie, OD, is the owner of Horie Optometry, a Vision Source Signature Eye Care practice, in Vacaville, Calif. To contact her:


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