Dr. Arnold with the former “VP of Contacts,” Alyce, at his practice. Dr. Arnold, now retired, said having this position in the practice helped maintain efficiency and a high level of care and service to patients.
Improving efficiency in optometry practices
By Thomas P. Arnold, OD, FSLS
Dec. 4, 2024
Every practice strives to be efficient. Efficiency means increased revenue and profitability.
We are all faced with the challenge of how best to organize our staff to deliver the highest-quality care in a timely and profitable manner.
Here are four ways my practice kept the pace of our patient visits and workflow moving, all the while maintaining a high level of care.
Creating Specialists in Tasks Rather than Cross-Training
In the early days of our practice, when we only had a few staff members, we thought it prudent to cross-train everyone so that if any one person was out, another could step into that role. To achieve this, we rotated positions every week (reception, cashier, doctors’ assistant, insurance, optical, etc.).
This sounded reasonable and a good idea. The reality became clear after a few months. Things fell through the cracks. Follow-up on certain tasks became difficult or nearly impossible. People forgot to follow through. Intra-office communication was poor.
Specialized testing like Optos, visual fields and topography often suffered because no one person had the opportunity to practice the necessary skills with the frequency required to develop confidence.
We also suffered from the illusion that people would become bored doing the same thing over and over. But this was not the case.
By staying in one position and becoming confident in a particular role, our employees achieved a sense of accomplishment and pride in their work. Pride comes with the ability to do things well, and this is only achieved through repetition.
By assigning and training the staff in a dedicated role with clear guidelines and achievement goals, our office hummed with efficiency even with two (and a half) ODs and a roster of 15 full-time employees.
Hire Employees from Service Industries
In our experience, the best employees for OD offices come from service industries like restaurants, hotel management and the travel profession.
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These folks are used to dealing with the public and keep a positive, “can-do” attitude. A good friend and fellow OD once told me, “You cannot train personality.” He was so right.
Most people who worked in the service industry also are experienced in the need to maintain ever-improved efficiency. They usually come from fast-paced, under-staffed work environments.
Arrange & Maintain Weekly Staff Meetings
From week one in our practice, starting in 1992, we began every Monday morning with a staff meeting of doctors and all employees scheduled to work that day. We did not require people who were scheduled off that day to attend.
These meetings provided an opportunity for several things:
- Doctors would share updates in care or treatment regimens.
- Doctors would explain the rationale and theory about the diagnosis and treatment of common conditions.
- New technologies such as profilometry, tear film osmolarity tests, contact lens impression molding, etc., could be introduced.
- Vendors who wanted an opportunity to discuss their products and share training would sometimes be scheduled in this slot.
- Every employee would be called upon to share their comments, concerns and suggestions for improvement.
The best ideas often came out of these meetings. One example was the switch from opaque to clear bags for contact lens dispense. The clear bag enabled both the front desk, as well as the patient, to see if the proper number and brand of contact lenses was being delivered. No time wasted digging around bags of solid color.
In addition, things that were not working properly like a faulty printer, a broken weather seal on the front door, or a thermostat on the fritz, could be addressed and fixed in a timely manner.
Appoint a “VP of Contacts” for Contact Lens-Intensive Practices
For a contact lens-intensive practice like ours, keeping track of orders and returns and buying in bulk for inventory became prodigious tasks.
In addition, we dealt with many specialty lenses like custom soft torics, RGP multifocals, Ortho-K and scleral lenses. Missing a discount or credit return proved costly in no time.
Managing this for a busy practice evolved into a full-time position.
This, too, is another example of improving efficiency by having just one person responsible for this highly profitable part of our practice.
Our “VP of Contacts,” Alyce, was one of our earliest employees when we began the practice. She acquired extensive experience with contact lenses as our practice grew.
Alyce was a very intelligent, responsible and detailed-oriented person. She developed a sophisticated filing system, detailed Excel spreadsheets, inventory control and oversaw all returns. No doubt this resulted in savings of tens-of-thousands of dollars annually.
Click HERE to download a PDF showing an example of the scleral contact lens services log maintained by Dr. Arnold’s VP of Contacts.
Having one “go-to” person in charge assured us that this critical area of our practice was run efficiently to the benefit of both the doctors and, more importantly, the patients.
Bottom Line: There is no Efficiency Magic Bullet; It Requires a Multifaceted Approach
There is no one “magic bullet” to increase efficiency. It is a goal requiring constant care and focus.
A Japanese concept that I became acquainted with many years ago in my previous professional incarnation in the computer industry is “kaizen.”
Wikipedia describes kaizen this way:
“Kaizen is a concept referring to business activities that continuously improve all functions and involve all employees from the CEO to the assembly line workers. Kaizen also applies to processes, such as purchasing and logistics, that cross organizational boundaries into the supply chain. Wikipedia”
健闘 (good luck)
Thomas P. Arnold, OD, FSLS, now retired, was a partner with Memorial Eye Center at Sugar Land, now a part of AEG Vision. To contact him: tarnold@aegvision.com
