Practice Management

How I Increased Exams Delivered 15%, Opened 2 New Practice Locations & Improved Social Media Marketing

An optician in Dr. Scott’s office facilitating the frame try-on and selection process. Dr. Scott says staff management changes she thought would not be well received were not only received well, but embraced enthusiastically by her team.

By Nicolette Scott, OD

Oct. 6, 2021

We have an opportunity to learn lessons that can improve patient care and profitability everyday. Here are three lessons I learned that made a huge difference to my ability to build a strong and growing practice.

Embrace Change: A New Patient Care Schedule, Elimination of Optician Commission & Remote Work
We have never been afraid of change. In fact, we have always prided ourselves on the way we handle change. That was until COVID hit. We had no idea how much we would or could change until COVID forced us to change.

When we reopened after COVID, we realized that we would have to do things differently if we wanted our practice to survive. Not only did we have to make changes, but we had to make them QUICKLY. We made changes overnight that before COVID would have taken us weeks to implement. Some key changes were: reducing late evening hours and also reducing Saturday coverage, eliminating commission for opticians and having an employee work from home.

We knew for a long time (pre-COVID) that we wanted to make changes, but we were afraid of push-back from patients and employees. We learned that there was almost no push-back as a result of shortening office hours, eliminating commission and allowing an employee to work from home. The employees (and doctors) are thrilled at the new hours, and they also don’t mind not having commission anymore. The employee who works from home is much happier and more productive. All of that agonizing for nothing!

Results: We were afraid that we would lose patients if we cut back on the prime appointment slots (evenings and weekends), but that didn’t happen at all. In fact, our exam numbers have increased by over 15 percent compared to the same time period last year. We have also not experienced any significant employee turnover as a result of eliminating commission. We found that for most of the opticians, the commission wasn’t motivating them to sell differently and it was time consuming for us to calculate. Not having to worry about it is a win for everyone.

Have a Plan (and write it down): It Could Speed Opening New Locations
As our practice grew from one location to four, so did the number of problems we experienced. We found ourselves fighting fires all day, and it was exhausting. Cue the business coach.

We completed a 12-month course with a business coach, Brian Alquist, and learned how to work on the business instead of just working in the business. Through Brian’s course (and reading the book “Traction” by Gino Wickman) we implemented a goal-making process that we follow religiously.

The partners meet annually to lay out a 12-month plan for exactly what we want to achieve, both in terms of revenue and logistics (how many staff/doctors do we want to hire? What new equipment do we want to buy? What new systems do we want to implement?).

We break the goals down by quarters. Then we meet at the beginning of each quarter with the managers to decide how we are going to achieve those goals and how to implement a plan. Finally, we meet again with the managers monthly to assess how we are doing at achieving our goals and adjust as necessary. Our office is much more organized, and we are able to offer a better experience for patients.

We learned that if we spent time writing down our goals and writing down a plan to achieve them, we were almost always successful. For example, in one of our annual partner meetings, we decided that we wanted to add another location within the next 2-3 years. We decided to send out letters to ODs in the area whom we thought would be retiring soon and expressed our interest in possibly buying their practices. We gave ourselves a deadline and the letters were sent out.

Results: Not only did we add another location…we added two within six months. Had we not taken the time to write out a goal with a plan, that never would have happened.

Introverts Can Be Great Leaders: You Could Even Change How Your Practice is Marketed
Brian, our business coach, had everyone in the office take a personality test (DiSC). I learned that my personality type was “supportive.” That wasn’t big news to me, but what I did learn was that a highly supportive person could also make a great leader.

I am an introvert, and I always thought that great leaders by default were extroverts. After going through Brian’s program (and reading the book “Good to Great” by Jim Collins), I learned that anyone can be a great leader, but you have to know when and how to come out of your comfort zone.

As I realized my hidden potential, I started taking a more active role in decision-making and administrative duties in the office including marketing and human resources. In recognizing that I had more ability than what I was giving myself credit for, I started to see that my introverted employees also had greater potential. I stopped putting people in boxes.

I was able to take some administrative duties off my partner’s plate, which was unfairly full. I also started paying more attention to areas that had been largely ignored, like marketing, because nobody had the time. We came up with a list of all of the administrative duties required to run the office and allocated them among the partners. I attended marketing workshops, so I could learn how to improve our social media presence.

Results: Before I started paying attention to our marketing, our social media presence was less than stellar. We had a Facebook page, but didn’t do much with it, and the few hundred followers we had were definitely not engaged. I decided to ramp up our Facebook page, and now we have over 3,000 followers who are engaged with our content. Thirty percent of patients/customers who interact with our practice online come from social media engagement. I always ask new patients how they found us, and often they will say, “I saw you on Facebook.”

Nicolette Scott, OD, is the co-owner of Broad View Eye Center, along with Josie Kosunick OD and Douglas Wiersma, OD. The practice has four locations in Ohio. To contact her:


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