Staff Management

How & Why a $3 Million+ Practice Trains All Employees with a Goal of Advancement

Dr. Helmus (center with red scarf) with her staff. She says that providing opportunities for advancement creates a well-functioning practice with long-lasting, satisfied employees.

By Julie Helmus, OD

March 2, 2022

It’s hard to predict where a new hire will ultimately most excel in a practice. In my office, all employees start at the front desk so they are cross-trained and primed for advancement. The goal is to create employees who serve patients well, help us become more profitable and also advance in their careers.

Here is how we train employees to create a practice in which career advancement is the norm.

Leveraging New Opportunities Presented By Inevitable Change
Opportunities for growth create employees who are more satisfied with their jobs and more likely to stay long-term. However, this can give patients the impression that our receptionists are “revolving” when they are actually “evolving.”

From time-to-time, patients make the comment: “It seems like your front desk staff is always changing.”

This used to aggravate me. “You have no idea how hard it is to run a business!” I wanted to shout. “Now can we get back to your eye exam?” But here’s how I  flipped it:

“True!” I now reply enthusiastically, “Isn’t that great? That’s because seven of our current staff started at the front desk and have taken on new roles, including three that are now managers.”

My practice, Helmus Optometry, is large by private practice standards: single location with one full-time optometrist and four part-time ODs including myself. We are supported by 24 full-time employees seeing on average 210 comprehensive exams across a five-day work week, generating over 3 million in gross revenue annually. The success and size of my clinic enables me to leverage the talents and growth potential of new employees.

Passing Through the Receptionist “Gauntlet”
The staff are organized into seven teams, each with a department lead: Front Desk, Clinical Technicians, Opticians, Contact Lenses, Billing, Operations and Doctors. Even though our org chart is specialized and siloed, every staff member must be able to schedule appointments, field patient inquiries and check patients in and out.

All new hires pass through the reception “gauntlet,” whether during orientation or as an entry point into the field. But not everyone is suited for nor fulfilled by customer service. Some get drained while others thrive in this high-energy environment. “Know thyself,” I say.

Staff at the front get pulled in numerous directions at once. The best receptionists are social, aware, detail-oriented and able to multi-task. It’s akin to a hostess at a restaurant with rushes and lulls, although we’re “serving” eyecare instead of meals.

One of the ways we’ve succeeded in quieting the front desk is by creating a “call center” upstairs in our administrative wing, separate from the downstairs clinic. One full-time receptionist, aka Patient Care Coordinator, is in charge of answering calls on the first ring.

Preparing for Inevitable Staff Departures
After 36 years in business, we accept that employees come and go. At times this is necessary for a harmonious and effective team. Other times, it’s under joyful circumstances: babies, graduate school, relocating, large inheritances and retirement. Sadly, we’ve also lost staff to illness and family crisis. An employee’s departure is an opportunity for reflection and new beginnings. I take comfort knowing my team now has a solid backbone: we can withstand a trickle of flux because we have enough long-time strong players, plus proven systems.

Best case scenario, we retain, develop and promote our staff. Training and coaching the team is one of my top priorities; it is worthy of reallocating my time away from patient care for this ongoing process. We hire for integrity and attitude and teach the rest. To date we’ve sponsored courses in Leadership, Management, Optics and Billing.

A well-worn interview question we ask: Why are you seeking a change? Over and over, prospective candidates report their prior office provided no room for growth, and/or they are burned out from short-staffing.

Another patient comment I’ve heard more than once: “You have so many staff!” Again, I now respond with an enthusiastic “YES!” I am not interested in running a bare bones operation. I know what it’s like to be chronically short-staffed; the culture and care suffers. Sales suffer! We now have redundancy and cross-training.

Staff Opportunity & Growth Are Good for Both Employees & Practice
I’ve also learned that what’s good for our employees is good for the practice. That’s why I’ve given presentations during our weekly staff meetings on “How to Ask for a Raise” and financial literacy topics such as “Improve your Credit Score” and “Basic Investing.” Several are preparing for first-time home ownership, while others have recently succeeded in buying a home in our expensive and competitive market in Northern California. This brings me great pride.

So, where have these many receptionists landed? Well, we didn’t have a Billing Team before Theresa; previously we used an independent contractor with less success. Veronica wisely bonded to one of our licensed opticians and quietly took on more and more. She later brought her sister (Nancy) and best friend (Wendy) to the team, both of whom started at the front desk before discovering a passion for billing and contact lenses respectively.

Nadia and Sasha both saw an unmet need and created their own roles: Referral Coordinator and Operations Manager. Sasha is a great example: he lasted less than a month at the front before he proclaimed we needed a new phone system and new server environment. He’s since implemented both those changes, along with many more!

Sure, payroll is the biggest expense. But the team is our greatest asset.

Julie Helmus, OD, is a second-generation optometrist and owner of Helmus Optometry in Davis, Calif. To contact her:

To Top
Subscribe Today for Free...
And join more than 35,000 optometric colleagues who have made Review of Optometric Business their daily business advisor.