Insights From Our Editors

Do I Need a Practice Consultant?

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

March 13, 2019

A small business, like an optometric practice, requires so much attention–from financial management to marketing to office decor updates–that outside help from a consultant can be useful. The question is: How do you know when you don’t know enough, and could use expert guidance?

In the broadest terms, the four issues that face a practice owner are:
1) Starting a practice
2) Managing a practice
3) Growing a practice
4) Transitioning a practice

Let’s take one of those issues and examine it more closely. Let’s look at managing a practice. In managing a practice, one way to answer the question of “how do I know when I need expert guidance?” is to look at the building blocks – the systems – that are involved in every business. Since a practice is a business, a practice is made up of systems. These systems include: Operations, IT, Regulations, Purchasing, Inventory Management, Marketing, Human Resources, Finance and Executive Functions.

It often is helpful to re-imagine these business systems into language that may be easier to absorb. Here is what that would look like:

1) Executive functions
2) Preparing the office to see patients
3) Recalling established patients for examinations and care
4) Examining patients
5) Getting paid for care
6) Delivering care
7) Quality control on everything done in the practice
8) Getting new patients into the office

Now, think of these business functions as existing in a circle where every part impacts every other part. Since a circle never ends, there must be constant attention to each part of the circle to keep it rolling smoothly. If your business is not rolling smoothly then maybe your circle is warped.

Based on the systems we’ve discussed above, answer the following questions to see if your circle needs attention to roll more smoothly.

Executive functions

Is your quality of life what you want it to be?

Do you feel like your practice is under excellent control and moving in the direction that you want to go?

Do you have a three-year written plan for your practice?

Are you managing risk in your practice appropriately?

Do you have a panel of trusted advisors? How often do you meet with them?

Is your practice optometric net 35 percent, or greater, as a percentage of gross revenue collected?

Is your practice optometric net on track to be 10 percent higher over last year?

Preparing the office to see patients

Are you constantly running out of items you need?

Do you have an effective purchase order system in your practice managed by one person?

Is your staff fully trained?

Is your practice HIPAA compliant?

Is your HIPAA Privacy Officer answering the five questions that must be answered each week?

Is your practice HR compliant?

Has it been longer than seven years since you remodeled your practice?

Is your office flow efficient?

Do you have the right equipment to effectively manage patient care in the 21st century?

Is your practice management software helping you to manage patients or is it a source of frustration and anger?

Are your patients utilizing a patient portal in your practice to access their health-care information?

Recalling established patients for examinations and care

Do you have an effective recall system?

What percentage of your established patients return yearly?|

What are the top three reasons patients give to not schedule a return appointment? What have you done to address these issues?

Examining patients

Does your practice have effective systems to “pre-set patients to purchase” before they get to the exam room or optical?

Do you prescribe in the exam room versus recommend, suggest, or offer?

Do you prescribe optical solutions for medical conditions (e.g.: ARMD, dry eye and cataract)?

Do you prescribe for each patient for all four arenas of life: home, school, work and play – or do you just do one prescription?

What percentage of your prescriptions do patients accept in the exam room?

When was the last time you took a class or read a book on how to effectively communicate with patients, including how to effectively close?

Do you review your optical reports to determine your prescribing habits?

Getting paid for care

Have you made it easy for patients to pay? Have you asked patients if you have achieved this?

Is your annual total accounts receivable less than 7 percent of your annual gross revenue collected?

Are all deductibles and co-pays collected at time of service?

Are your daily business books closed at the end of each business day?

Do you spot-check the practice business day-sheet in front of staff so they know you are looking?

When was the last time you had your practice audited by your CPA to make sure everything is being done correctly?

When was the last time you looked at the hidden audit trail in your practice management software to check on who is deleting information – including deleting payment information?

Have you talked to your bank about business systems you can put in your practice?

Do you have a separate checking account for refunds and returns from the account that you use to pay your bills?

Are you current with all your local, city, state and federal obligations?

Is your practice on track to have an increase in gross revenue collected of greater than 10 percent over last year?

Delivering care

Staff
• Does every staff member have a written position agreement?
• Does every staff member understand what they produce for the practice (what is their end product)?
• Does every staff member have specific goals for their end products?
• Has staff been trained to use consumer language rather than billing language with patients?
• Have your staff and doctors been trained on how to use effective closing techniques?
• Have your staff and doctors been trained on how to overcome objections?
Patients
• How easy is it to make an appointment in your office?
• How long does a patient have to wait to get in for care?
• What is your turnaround time for delivering product to patients?
• Do you offer packages
• Do patients feel you are delivering excellent care to them? When was the last time you asked?
Lab
• Are you working with your labs in a symbiotic fashion?
• Have you asked your labs how you can work better with them?
• Are your labs meeting your expectations?
• Do you view your lab reps as partners in your practice?

Quality control on everything done in the practice

Staff
• Do you have the right people on the bus and the right people in the right seats on the bus?
• Do all staff love their job? When was the last time you asked?
• Have all staff been proficiency tested this year?

Patients
• What percentage of your established patients are returning to your practice versus going somewhere else?
• Is your Net Promoter Score 90 percent or greater?

Labs
• What is your return rate for jobs with lab errors?
• How quickly are your labs getting jobs to you?
• How easy is it to work with your labs?

New patients

Have you defined your exact target market for new patients – who you want as new patients in your practice – and do you have an effective plan for reaching these people?

Do you have an effective marketing strategy that generates 25 percent new patients or more?

Is your digital marketing strategy being efficiently managed?

Do you have an effective system in place to determine the effectiveness of each marketing strategy you employ in your practice?

Do you have an effective reward system for thanking people for sending you new patients?

If you found areas of your practice that need attention, do you want to try to fix this yourself or do you want professional help to get the problem areas resolved and your practice rolling more smoothly? A smoothly rolling practice means a better quality of life for everyone.

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