Insights From Our Editors

5 of the Biggest Problems Facing Practices & What to Do

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

Part 1 of a two-part article. Click HERE to read part 2.

August 17, 2022

There are many challenges currently facing practices. Here are some of the biggest, along with solutions to help your practice meet those challenges, and do even better.

The 10 biggest problems are:i, ii
1) Communication Problems

2) Not Using Technology

3) Money Management Problems

4) Workflow Problems

5) Risk Management Issues

6) Supply Chain Issues

7) Employee Retention Problems

8) Sales Problems

9) Not Asking for Help

10) No Exit Strategy

We will address the first five of these problems in this article and the other five in a different article.

Communication Problems
This remains a significant problem. There are many facets to the communication problems that exist, but the one that stays at the top of the list is the inability of many doctors to directly prescribe solutions for patient problems, even though there is a lot of evidence that when doctors prescribe in the exam room, more patients will get what the doctor prescribes and the patient will spend less time in the optical. Good communication results in more effectiveness and more efficiency.

The fix for this is simple: doctors need to prescribe in the exam room then communicate that to the opticians/optical technicians in front of the patient.

Not Using Technology
Here’s an interesting question: Are you still practicing like optometrists did 30 years ago? What technology is being used to do refractions? What technology is being used to analyze your practice numbers? What technology is being used to communicate with patients?

Here is a series of five additional questions that technology will answer relatively easily:

• How many patients, who call into the office to make an appointment, actually schedule an appointment?

• What are the best and worst productivity differences between doctors working with different doctor – optician combinations?

• What are the best- and worst-producing frames in your practice?

• Which opticians are the best and worst at selling multiple pairs to patients?

• What is your actual profit per patient for each third-party where you are a provider?

The fix is simply to decide what technology is most important and then introduce it to your practice. (For those who feel they cannot afford to add technology, the more important question is can you afford not to?)

Money Management Problems
Cash-flow problems are the number one most common issue among small and medium-sized businesses. It generally occurs when the practice management is not paying attention to the cash flow through the practice. Income and expenses through a practice do not occur evenly. Some months there is more income and other months less income.

Likewise, some months there are more expenses and other months less. Tracking the flow of money in and out of the practice is a must to accurately predict cash flow. A problem can occur when you are waiting to receive cash flow reports a month or more after the events occur.

The fix is to track income and expenses in real time. There are software solutions for this.

Workflow Problems
Workflow describes the sequence of tasks. Most practices have not gone through this important step to improve the effectiveness and efficiency of the practice. When asked about why something is done the way it is done in a practice, the most common answer is: that’s the way we’ve always done it.

A better answer is: Every year we take a day and analyze every workflow in the practice and ask the question: How can we do things more efficiently and more effectively?

Here’s how to create a workflow for your practice processes:iii
• Identify resources

• List out tasks to be accomplished

• Discover who is responsible for each task

• Create a workflow diagram to visualize the process

• Test the workflow you created

• Train your team on the new workflow

• Deploy the new workflow

Risk Management Issues
Most practices are reactive rather then proactive in risk management. Taking a proactive approach to risk management is the best way to keep the practice safe.

Practice risks can be divided into the following categories:
1) Strategic risks (e.g.: are you targeting the right patient populations, frame-board display?)

2) Compliance risks (e.g.: third parties, HIPAA, government, IT exposure)

3) Financial risks (e.g.: practice growth, business dashboard, vendor relationships)

4) Operational risks (e.g.: human error, technical error, flow gaps, fraud exposure)

Your fix is to sit down at least once per year with your practice’s trusted advisors, which should at least consist of your insurance agent, practice attorney, banker, practice accountant, a successful entrepreneur from a different profession, an IT expert and a mentor. One of the questions for this group is: where is the practice exposed and what is the best way to protect the practice?

>>Click HERE to read about the five other biggest problems facing practices>>

i. 6 Biggest Problems Facing Businesses Today | The Kickass Entrepreneur

ii. 9 most common business problems companies face (

iii. How to Create and Document a Workflow | Smartsheet

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