Practice Transitions

3 Things Decades in Optometry Taught Me About Boosting Profitability & Happiness

Dr. Arnold with his staff, most of whom have been with him for years. Dr. Arnold, recognized as No.5 in Newsweek’s 2021 America’s Best Eye Doctors, has been in practice since 1984. He has announced his retirement from optometry to focus on other professional and personal interests.

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By Thomas P. Arnold, OD, FSLS

Sept. 22, 2021

As I prepare to retire from clinical practice to concentrate on writing, speaking, education and becoming more active in AEG Vision, the organization I happily sold my practice to in 2019, I have a few thoughts to share.

I hope some of these reflections inspire you to think about what you most want from your professional life and the paths you could take to reach those goals.

You Can’t Do It All: Delegate
I was fortunate early in my career to work in several ophthalmology groups before starting my own private practice in 1992. One of these groups was located in a university setting, one in a large medical group, of which ophthalmology was a part, and the last in a busy cataract and refractive surgery practice. One thing our ophthalmology colleagues do well is delegate. Technicians are responsible for virtually all aspects of the work-up in an OMD practice, sometimes even refraction.

While I prefer to perform my own refractions, as I feel this a skill set unique to optometry, I evolved my practice operations to have all other special tests conducted by staff. This allowed me to see more patients daily in an efficient manner (easy to track number of patients daily/weekly) without a loss in patient satisfaction. A Net Promoter Score (NPS)-style survey can be used to monitor this important metric.

To delegate effectively, your staff must be well-trained. Set aside time on a regular basis for your doctors’ assistants to practice on all the equipment used in patient work-ups. The optometrist can share tips and tricks so that quality data can be gathered. Train your staff to examine the data to ensure that the results are useful.

It is not enough to just “run the test.” Be sure to reinforce good results and thank the assistant when a job is done right. When critiquing, avoid being overly critical. A cooperative and supportive demeanor is more likely to be well-received. Phrases like, “Next time, here’s what we can do…” convey a positive, non-judgmental approach. Enabling responsibility in a staff member leads to a sense of pride and a positive self-image.

You Can’t Train Personality: No “Splitters”
An enthusiastic, pleasant and positive personality is much more valuable to a business than a person with an impressive resumé who is glum and not a team-player. A person who wants to learn with a good work ethic will learn the necessary skills to become a valuable, contributing member of the practice.

No one wants to associate with someone who is negative and constantly kvetching.

Similar to the negative personality is what is known as a “splitter.” This is a person who gathers a following among the staff and uses that power to turn against other employees. The result is a lack of harmony and a decrease in job satisfaction. These cliques will not run the office in an efficient manner and patients will pick up on the tension in the office. No one, neither patients nor employees, want to be in an environment sparking with negativity.

Splitters tend to be charming to those in positions of influence (the doctor(s) or office manager) and prickly with everyone else. Although sometimes difficult to do, it is important to identify these persons early and let them go. If allowed to stay, it is often the staff members you love who will quit.

Take Time for Your Personal Happiness
“Might as well share, might as well smile. Life goes on for a little bitty while.” – Alan Jackson.

When I entered optometry school in the fall of 1980, my career seemed to stretch out before me beyond the horizon. Like many of the marathons I have run, it never seems like you will get to the finish line. Yet here I am. To have a successful practice and career, there is no doubt that hard work and dedication are required. At the same time, however, it is important to keep in mind why we do what we do.

To what purpose? Many of us will marry and raise a family. We want to provide for them and give them all the experiences, opportunities and comforts we can. The most important thing you can give your family, though, is you – your time and attention.

No amount of material success can replace that. In the case of children, time is limited. You only get one chance to see that school play, that dance recital, that baseball or soccer game. Don’t miss it.
Careers are long, but time with the family is short and can never be recovered. Be present, not only in body, but in mind. It is you who are the blueprint, the role model. Children become reflections of their parents, not just what they say, but what they do.

Family vacations are important. They can clear your head and help you to recall who you really are, which is much more than a sign on a door or a list of degrees.

Take time to travel, to explore and just relax. Warren Miller spent a career filming ski and surfing movies in exotic locations all over the world. Near the conclusion of the films, he urges the audience to visit whatever location is featured. He challenges us with the question, “If not now, when?” I think that is a very good question.

Thomas P. Arnold, OD, FSLS, is a partner with Memorial Eye Center at Sugar Land, now a part of AEG Vision. To contact him:


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