Insights From Our Editors

Actions to Take to Work ON Your Practice, Not Just IN It

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

May 22, 2019

You do important work in your practice as doctor, providing patient care. But you also need to work ON your practice, stepping back to find places where improvements can be made.

We recently read an article in which the doctor says, “The independence of private practice is rewarding; particularly as it relates to how to best serve patients. But it also can be incredibly time-consuming and exhausting, leaving little time for family and interests outside of the office.” Unfortunately, this doctor is not alone in feeling this way.

The core issue here is that most eye doctors have not been trained to be the chief executive officer (CEO) of the practice, and so they end up being the chief operating officer (COO) of the practice. As the COO, they are involved in every aspect of the practice from scheduling to finance to hiring to purchasing.

To compound matters, most eye doctors have not even been trained to be the COO of the practice. As a result, the owner COO quickly becomes overwhelmed by the enormity of the job and finds themselves exhausted with little time for family and interests outside the office. To fix this problem requires time and work upfront to get the systems into play that will change the operations of the practice, but it’s worth it because at the end will be a practice that is running smoothly and does not require the owner to be involved in managing every detail of the practice.

Here’s the path to free up your life. Start by taking one half day to work ON your practice and not IN it. During this half day, tell staff not to interrupt you. They can only come get you if the building is burning down. In every other situation, give staff the power to handle whatever “crisis” is in front of them.

Giving staff that kind of power is a big step for a lot of people. As the owner, it’s just too easy to want to micromanage every crisis. Don’t. Step back, take a big breath and trust your staff. Even if they do something different than you would have, don’t criticize them, instead, thank them for handling the crisis. Save the discussion of how you would have handled this differently for another day.

(What happens if you don’t give staff this power? You are doomed to micromanage everything forever. Keep in mind our end goal is to back you out of being directly involved in every aspect of the practice.)

What do you work on during that half day to improve your practice? Start with the most important changes needed to make the practice better. If there are holes in your boat and you are sinking, then your first job is to fix the holes. You probably already know what these changes need to be.

Make a list of the top five changes needed. Prioritize the list, then start working on the most important change needed by creating systems to fix that problem.

What is a system? According to the Business Dictionary, a business system is “A methodical procedure or process that is used as a delivery mechanism for providing specific goods or services to customers.” That is exactly what you need to spend your time on.

When you’ve worked your way through your top five changes needed, then turn your focus to the job of the CEO. Work on putting in place systems for each of the following CEO responsibilities:

1) Future planning by setting the strategy, direction and culture of the practice

2) Ensuring the fiscal health of the practice

3) Allocating resources, including capital, to the practice’s priorities, making sure practice administration is effective

4) Risk management (i.e.: insurance, legal)

5) Building and leading the senior executive team

After you have the CEO role in control, now it’s time to work on systems for the COO and actually train your office manager to become the true COO of the practice so that you can give up those responsibilities.

Delegate to staff the responsibility to manage each of these areas of the practice. In a larger staff, you can have one person for each of these areas. In a smaller staff, one person may need to cover more than one of these areas. Make sure you put in a reporting and accountability component with each staff member.

Human relations
– Hiring and Training
– HR Reporting and Management
– Firing

Procurement
– Equipment
– Clinic Supplies
– Inventory

Information Technology
– Computer System
– Telephone System
– E-Mail and Web Site Management

Operations
– Scheduling
– Examination
– Treatment and Dispensing

Finance
– Revenue
– Expenses
– Tax Reporting

Quality Control
– Staff Proficiency Testing, Education and Discipline
– Patient Quality Control
– Laboratory Quality Control

Public Relations
– Gathering Success Stories
– Internal Marketing
– External Marketing

Here are three rules to remember:
1) For every item above that you do not assign to staff, you will be responsible to manage that item.

2) Once you assign an item above to staff, take the time to train them how to effectively manage the item. This includes measuring effectiveness and weekly reporting.

3) If you assign an item above for staff to manage yet you continue to micromanage it, you will be forever in charge of managing that item.

Some will look at this project and be overwhelmed by its size. It helps to keep the end goal in mind. Making it through this project allows the owner to function as the CEO of the practice and the office manager as the COO of the practice and you, the owner, get your life back.

 

References
i. Right Buyer = Flexible, Accommodating Work Life, ROB, 5-22-19
ii. http://www.businessdictionary.com/definition/business-system.html

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