Staff Management

How We Cut Our Hourly Rate in Half & Saved 50% on Staffing Multiple Positions

Front of optometry office in Wichita, Kansas.

The front of one of Dr. Fleming’s offices. He says that the practice has seen substantial cost savings and an increase in productivity since starting to work with remote employees.

By Chad Fleming, OD, FAAO

July 12, 2023

Staffing is a huge challenge, both in terms of finding the right people for the jobs you need done, and in terms of keeping costs down. My practice has discovered great value in both efficiency and cost savings by hiring remote employees.

These individuals may be based anywhere in the world, but you and your patients would never know it because they do such a great job. Here’s how it works.

Adding Remote Employees to Your Workforce
We have 45 staff across five locations, and four of them are working remotely.

We have two individuals who are working full-time remotely from home within the U.S., and we have two individuals working for us through a staffing agency for remote employees, who could be based anywhere in the world. We pay the staffing agency a flat rate for 40 hours per week of work. The two full-time remote employees working within the U.S. are employed by our practice, Wichita Optometry, and have full benefits, while the other two employee work for us via the staffing agency and are not provided by us with benefits.

Editor’s Note: Check with your human resources and compliance resource to make sure you are following all applicable employment laws when working with remote employees.

Easy to Recruit & Hire
It was amazingly easy to hire our remote employees. There was no classified cost, no searching resumes. The staffing agency lined up 3-4 interviews over Zoom that met the criteria that we gave them. Some applicants had experience in the healthcare field, had been to the U.S., and many have college degrees. Our manager logged onto Zoom and then was introduced to each applicant. The interviews took about 10-15 minutes with specific questions about the job and previous experience.

Identifying Tasks for Remote Employees
We have a team of communication specialists in our office who answer all of our phone calls and incoming text messages. This team works together and communicates via Google Chat to coordinate their work, which our remote employees contribute to. If protected health information is necessary to share, they utilize our EHR to communicate.

The remote employees are included in all staff meetings, and they feel a part of our culture. We have a remote individual working out of Brazil who has insurance experience and has been filing our vision exams for managed vision care and secondary vision plans. This individual will also be trained in filing claims for our glasses and contact lenses.

We have been amazed that these individuals’ past experience has prepared them to be up and fully trained to work for an optometry office within a couple of weeks. We have seen training take the same amount of time whether in-person or remotely. The insurance filing position is the one that we have been most surprised at how well it has been working.

A Cost-Efficient Hiring Solution
The cost savings of remote employees for us are 50 percent less, so we can hire two individuals to the typical cost of one. The rate is $1,600 per month at the staffing company we use, and we get an employee for 40 hours per week without the additional costs of healthcare, other benefits, and taxes.

High-Quality Employees
Our remote employees are extremely efficient, have a college degree and are, in general, sharp individuals. I have traveled internationally, and there are so many beautiful people across the world who would be super-grateful to have work that provides a better life for their family. We know that this job is providing a better life for those in other countries.

One of the individuals who works for us through the staffing agency had lived in the U.S. for a while and moved back to Brazil to be with family. What the staffing agency can pay them relative to other options in their country makes the job opportunity a gem for them to get. They are readily available and have access to technology that does not slow them down one bit.

I do a “Discover Wichita Optometry” class for all new hires on Zoom, and if I didn’t know better, I would think our remote employees were just across town.

Another bonus of our remote employees is there is never interpersonal drama or push-back. They work hard and are EXTREMELY grateful for the opportunity. These are grateful employees with no sense of entitlement.

Training Remote Employees
Our managers can call the remote employees and ask them questions like they are a patient in order to train them on common questions they will have to answer. We can test them if and when necessary. However, once you engage with an individual everyday in training you get a quick feel for how they are going to behave, and you have the added safeguard of your staff interacting with them through video conference and listening in on conversations with patients.

Our remote employees are in constant communication with us, and they are in our EHR system, so we can see exactly what they are doing and the kind of notes they are making in the charts. The training is no different than training someone based locally. We have had employees at home over the past 2-3 years, so our staff has adapted to not having all colleagues in-person. As the CEO, I often interact with staff and doctors through digital communication that does not require my physical presence.

Ending the Employment Revolving Door
Our staff and doctors, who have been slogging through an employment revolving door for the last couple of years, are more than excited to find people who want to work and are enthusiastic about doing everything they are asked to do.

It’s sad to see workforce behavior in the U.S. change like it has over the last few years. As a practice leader, I must innovate and be in front of finding solutions to ensure future success for our staff and doctors, so we can continue to provide the care and service our patients deserve.

Chad Fleming, OD, FAAO, is a partner with Wichita Optometry, P. A. in Wichita, Kan. To contact:



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