Keys to Creating a Budget & Patient Scheduling Matrix

By Steve Sunder

July 17, 2019

The number of patients you see is a key factor in determining how profitable you are. When you learn how to create a practice budget, and then to create a patient scheduling matrix based on that budget, you are able to better serve patients, and to grow financially by enhancing your efficiency.

Why Do I Need to Budget Before Creating a Patient Scheduling Matrix?
As the management thinker, Peter Drucker, once said: “If you can’t measure it, you can’t improve it.” He meant that you can’t know whether you are successful unless success is defined and tracked. Without a formal process to measure your income and expenses there are no financial performance controls. The practice budget is the formal financial management process that outlines your financial and operations goals. Once you have that baseline information, you will know the patient volume necessary to cover your costs and be profitable.

The practice budget is created for adoption for the next business year based on historical practice performance with new financial objectives and goals. The budget should be assessed at mid-year and amended for the second half of the year based on the first-half performance. So, it is a “hybrid” biannual static-dynamic process.

How do you know if your practice suffers from “practicea inefficoccus,” also known as practice inefficiency? By creating and using a practice budget!

The creation of your budget is an easy process utilizing tools that may be already at your disposal such as your accounts payable, captured daily revenues, your payroll, as well as an accounting program like QuickBooks or Wave.

Here is an outline of the budget categories:
Practice Revenues
Gross revenue
• Professional Revenue
• Optical Revenue
• Contact Lens Revenue

Cost of goods sold
• Laboratory bills, uncuts, etc.
• Frame purchases
• Contact lens purchases
• Allocation of lab floor space if you have an onsite lab
• Lab equipment, edger, surface unit, dye unit
• Full-time lab employee salaries and benefits
• Pro rata share of optician’s salary for lab work if they perform this work

Practice Expenses
• Staff salaries and benefits
• Occupancy costs
• Patient-care equipment
• Marketing and promotion
• General office overhead

Net Income
Net income is found by taking sales revenue. Sales or revenue is the money earned from the company providing its goods or services subtracted by Cost of Goods (COGS) and Selling, General and Administrative Expenses (SG&A).
Reference: Net Income – The Profit of a Business After Deducting Expenses

>>Click HERE to download an example of a comprehensive practice budget.<<

Your Budget First, Now Your Patient Scheduling Matrix
Your budget will tell you what your financial needs are to stay profitable, and, therefore, how many patients you must see per day, week, month and year.

To create your appointment scheduling matrix, you also need to understand your daily visit capacity, as well as your average patient revenue and your exam allocation time.

Now, add up the total number of exam slots per day and multiply that number by 65 percent. This will be your number of complete exams per day. The other slots would be set for follow-up appointments and emergencies.

Here is what a patient matrix would look like:

After the Matrix Is Created, What Do I Do?
After collaborating with your office manager in the creation of your patient scheduling matrix, you will need to create a scheduling “template” in your practice management system and open the template up for future appointments.

After the template has been created, the office manager will need to educate the front desk staff on how to make the appointment for the correct visit-type slot. Once that’s done, you’re ready to implement the new scheduling plan.

I recommend that the office manager, or another practice leader, review the future appointments to ensure the appointments are being made correctly and in the right slot.

What Do I Have to Gain?
The minimum 65 percent complete eye exams versus a non-schedule matrix generates an increase in actual revenue. A practice I worked with had historical revenues of less than $700,000 without a scheduling matrix, and after implementing the 65 percent CEE scheduling matrix, experienced a 9.5 percent increase in revenue.


Steve Sunder is a health-care consultant with over 40 years experience in the eyecare industry, including over 20 years at a multi-location practice, and years of work as a consultant to other practices. To contact him:

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