Practice Management

Practice Efficiency Innovations that Took Us from 12 to 25 Patients Per Day

By Nicole Lovato

June 23, 2021

As a practice manager, I have learned that the patient care and office experience we deliver has to be accompanied by an efficient work process if we are going to be successful. Here are a few of the most important ways we have spurred efficiency so both our patients and our practice benefit.

Delegate More Heavily to Optometric Technicians
Delegate everything you legally can to an optometric technician. This is one of the best ways to increase practice efficiency. Doing this allows the doctor to see more patients without increasing the number of OD hours in the office. When our practice decided to begin delegating more to our techs, the only struggle was making the decision, and sticking with it. We found that simply making the choice and putting it to use was key for success.

Getting the doctor on board was priority one and that was an easy decision for our OD as it would increase revenue by about 50 percent in our office. Once the OD decides it is in the best interest of the practice then everything else falls into place effortlessly. Having a dedicated optometric tech/scribe is the only added cost. We already had one on staff, however, we were not utilizing this employee to the best of our abilities–or hers. Now our tech is our busiest employee, as she should be for maximum efficiency on the clinical side of the practice.

The patient experience is greatly improved because our patients appreciate getting in and out of our office faster. Our OD was originally concerned that our patients would feel they did not have enough face-to-face time with the doctor. This complaint comes up on the rarest of occasions, however. The vast majority of our patients comment on how quickly they were able to get in and how well organized our office seems to be.

We were able to double the number of patients we see in a day, thereby increasing our revenue by nearly the same amount. Initially the schedule didn’t fill up immediately, but we were able to capture all patients wanting to come in on the same day, as well as walk-ins. In time the practice continued to grow and our OD was able to do the work of two doctors. Before the change of delegating heavily to our technician, we were seeing approximately 12-15 patients per day. Now, on average, we see about 25 per day. We dedicate 20 minutes of our schedule to each patient and the doctor spends about 15 minutes with each one.

Appropriately outlining your expectations for your staff is necessary to be successful. It’s not a matter of “can we do this?” It’s deciding that “we will do it” and knowing the staff is capable of handling double the workload.

Cross-Train Your Staff to Reduce Downtime
Cross-training the majority of your staff is another effective way to increase efficiency. In our practice, making this decision came as a result of being tired of seeing valuable employees on the clock without important tasks to do. Even in the busiest of practices properly trained staff will have downtime.

We see roughly 130 patients a week with six doctor days and six staff members working every day, including myself. I have worked in practices with double the staff and half the revenue. The most obvious differences between those previous practices and my current one are low expectations, poor management and too much downtime. People like to be engaged at work. Playing on your phone or computer should never be acceptable. Staff with that level of downtime leads to what I refer to as “time card theft” and it creates an environment of boredom, which leads to gossip, and, ultimately, unhappy staff.

Cross-training and proper time management allows staff to stay busy, which makes the days fly by and increases staff efficiency and reduces staffing expenses. I have had new hires complain that my expectations are too high for them to achieve and there is too much work for them to do in a day. I always assure them we are a team and we are here to help. After proper training and adequate time to allow them to adjust to the expectations, they rarely fail to surprise themselves. In our office every staff member, with one exception, knows how to do more than one job. The only person I do not cross-train is my lead optometric tech. I need that person’s entire attention dedicated to keeping the clinic running on time and efficiently.

All our staff members can pull vision insurance, run the front desk and dispense glasses and contact lenses. Two of them can pull medical insurance, three can scribe for the doctor and do complete work-ups on patients and two are opticians. Most really small offices employ 1-2 employees who can do every task needed in the office. It’s important to maintain this concept as the practice grows.

Teamwork and having a staff that is dedicated to helping one another is crucial to successful cross-training. Running your practice in this manner requires no additional cost. In fact, we have greatly reduced the pressure on the staff budget. The impact on patient experience/care has been an extremely positive one. Now patients experience little-to-no wait in having their needs and expectations met since nearly all staff members can help. By limiting free time, staff members are happier because they feel more productive and less bored.

Use a Messaging App
We utilize a messaging app in our office. We were interrupting each other too often to give and receive information. This disrupted patient flow, led to decreased face-time between patients and the doctor and made us appear disorganized.

Implementing the messaging app into our office was simple. We already had computers in all of our exam rooms and offices. All that was necessary was to download a local area network (LAN) messenger onto all of the computers. There were no additional costs for us since we already heavily rely on computers in all areas of our office, and a reliable LAN messenger can be found free online! The impact on the patient experience from making this change has been great and our in-office communication has significantly improved.

We are now able to quickly provide answers to our patients while the doctors, opticians and technicians are working with other patients. We are able to provide high-quality, timely service.

Nicole Lovato is the practice manager of Azle Vision Source. During her 20 years in the optical industry, she has worked alongside several doctors and acquired a variety of tools and business skills. 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.