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It Ain't Got No Compression!

I enjoy cutting my grass. 

As a student in optometry school, I was able to help pay the bills by cutting grass for a few local Memphis families.  I have always said that if this optometry thing doesn’t work out, I can always open a lawn care company. 

But as a busy professional, I was forced to give up the weekly summer task and I hired someone to care for my lawn.  I am fairly particular about my lawn, so I have had several individuals help with my lawn.  Coincidentally, my son, Samuel became a teenager at a time that a lawn care change was needed and we decided it was time for him to learn.  He was happy to learn that I would be working beside him to assure he is not missing any steps. 

 Rothschild and Son Lawn Care has functioned for a few years without too many dilemmas until the blower stopped working recently.  It’s a nice blower.  Samuel and I compared the various solutions of repairing the blower or buying a new one.  We decided that getting it repaired was the best option. 

I tried to fix it myself but failed to even get the plastic cover off of the unit.  I called the manufacturer and was disappointed in the advice they gave me.  I Googled small engine repair but these companies don’t worry as much as we do about their social media presence.  I finally “asked around” and was able to find someone with a great local reputation who could “fix anything.”

I enter the repair shop to find all types of shiny new lawn care equipment on display.  I also see a section of refurbished equipment available too.  I am carrying a big backpack blower but don’t know where I should go.  Finally, across the showroom, I see a desk with two men, chewing something and looking at me. I cautiously decide to approach them. 

As I walk up to the desk, their expression never changes, nor the pace at which they chew whatever it is that is in their mouths.  Are they eating breakfast?  Is that gum?  I smile and ask the gentlemen how they are doing.  The small one replies, “Alright.  What can we do for you?”

I explain my dilemma and he startled me by sternly asking, “Well, are you going to let me see it?”  Suddenly I realized that I will not be experiencing a high level of customer service. 

I smile nervously and say, “Sure, help yourself.” 

He takes my blower away, leaving me to fumble around while the big one continues to watch me and chew.  I ask him if I should just wait.  He shrugs his shoulders.  I wonder over to the blowers to see how much a new one costs.  I become an expert at blowers and continue to look around.  This is taking longer than it should and I am getting a little more tense.

I see the repairman return with my blower to announce, “It ain’t got no compression,” then he stares at me.  Obviously it is time for me to respond with some course of action.  He is looking at me, waiting – what do I say? 

Finally I reply, “I don’t know what that means.” 

He said, “9 times out of 10 that means somebody ran pure gas through it and 9 times out of 10 the carburetor has gone bad but it could also be bad coils.”  I still don’t comprehend what he is saying so I continue to look at him.  Then finally he asks, “Do you want to buy a new one?”

I ask, “Is that my only choice?”

He replies to me with a tone that shows I have irritated him with my stupid question, “I mean, I guess I could charge you $30 to see exactly what’s wrong but 9 times out of 10 a new carburetor is almost as much as a new blower and it will take me about a week to know anything.” 

I have a rule to not make a financial decision when I am excited, angry or drinking and this guy made me angry.  I asked him if I could think about it.  His disgusted departure away from my blower suggested that he was fine with my decision to leave. 

So I thought about it.  I calculated the time I had invested in the repair, the various places I could buy blowers, the business lesson for my son and calmly made a decision.  But this made me think about how easy it is for us to operate our practices like this “repair” shop.

We work there every day and know how things are supposed to operate, but is it clear for someone coming in the first time?  Are we ready to receive people when they enter the doors to our practice?  Do we ask them what they need, when we already know?  What about our beautiful frame boards that we make people pass to check in? 

I also began to think about how we communicate the testing we do to our patients.  We do a lot of very complicated, technical work that can be tough to understand.  We just don’t have time to explain it completely to everyone, so we tend to stop trying.  Is our process making our patients feel safe during their time with us?

Sometimes we express concern and explain it to the patient by gravely saying, "Your pressure is a little high today and the visual field may have changed some."  Not everybody knows why that matters.  Most people don't know the difference between progressives and transitions yet we talk to them like they should.  

And what about your recommendations?  Are you making it clear what you think your patients’ need or are you leaving it up to them to make uneducated decisions? 

Periodically, we have to take a look at the path through our practice through the eyes of our patients.  Many like to use “secret shoppers” but I prefer to just talk it out with the entire team.  Compare how you want it to be with how it really is and fix what you can.  The path begins with communications with the practice prior to their visit and continues until all of their eye care needs are completely met. 

If you look away from your customer service strategies too long, you will be more like the small engine repair shop than you care to admit. 

Truly yours,
Mike

p.s. To see an example of what I consider to be acceptable service in small engine repair,Watch This.

Don't Get Bullied

Are they trying to bully you too?

When mail comes from an insurance company, I expect it will be a check and checks make me happy.  But when it is something else, it always seems to be something that makes me unhappy.  I have found that “news” from a third party payer is rarely good. 

In the recent months, some insurance companies have been sharing some news with me that I, at first, thought was good.  They let me know that compared to “other physicians within my specialty,” I bill at a higher level.  This is good to know.  I feel like we deliver high quality care and accept a lot of complex cases.  We are diligent, we work hard and here’s proof that we do it better than others.

But the letter was not to congratulate me on my diligent care, it was to threaten me.  The letter went on to say that they are going to keep watching and if I don’t fall in line with everyone else, they might be forced to investigate.  They then said that this investigation would be disruptive to my business and if they catch me doing wrong, I would be in big trouble. 

We work hard to make sure that we are billing appropriately.  We take classes, read updates, and use software within our EHR to ensure that our coding is correctly done.  We don’t do unnecessary tests, we incorporate testing protocols and we do what is right for the patient, every time.  We utilizeRevAssure, which audits a sampling of our records every month and incorporate changes based on feedback from our specialist. 

So, here is the journey through my reaction to this bullying letter:

  1. Pride“Thanks insurance company for acknowledging our excellent work.”

  2. Disappointment“Hey, you’re not being cool about this.”

  3. Fear“I don’t want my business disrupted or to be punished”

  4. Doubt“Maybe we should start billing with lower codes?”

  5. Awakening“Hey, wait a minute, they are just trying to scare me, and it worked.”

  6. Anger“I am from the South and I will whip your ass, bully insurance company.”

  7. Realization“This is just an intentional, controlled tactic to reduce their expenses.”

  8. Defiance“They are not going to scare me into breaking the rules for their benefit.”

  9. Self – Confidence“We work hard to do it the right way and we do it well.”

  10. Dedication“Let’s use this as an opportunity to stress to the team the importance of billing.”

  11. Commitment “We will stay focused on doing it well with the partners we have in place.”

  12. Welcoming“Come sip some sweet tea while you investigate all you want. Sorry about #6.”

Here is the lesson: Don’t back down just because a bully comes knocking. Do be ready to stand up to him by making sure you can back up your billing with solid documentation.  Bullies are less scary when you are ready to stand up to them - just be ready.

Keep up the good work, 
Mike

p.s. I am sure that I am not the only one receiving these letters. Share your story here.

Are you ever really ready?

Are you ready?

There are many moments in a person's life where they are presented a challenge that they may not feel ready for. There is one moment that exemplifies this more than any other…..the birth of your first child.

Many have had this experience and most everyone knows someone who has. There are months of preparedness, education and celebration getting ready for this special day. We had done it all, went to the hospital, followed the directions, greeted family. We were all ready.

And there she was!  

I can recall an unrecognizable, yet very strong emotion that contained elements of joy, excitement, love and fear. The fear was not being ready for this.
Whatever we had done to prepare was suddenly inadequate and I knew it. I clearly remember thinking, "I am not ready, I haven't done enough, I need more time. And hey, I thought it was supposed to be a boy?"

That baby is now a senior in high school and we are preparing for another life altering event, sending her to college. We are preparing, but I know I won’t be ready. I anticipate the same thoughts as she drives away next Fall.

This fear of not being ready often spills into our professional lives. No matter how much logic we can bring into our preparedness, the things that most often hold us back is emotion. It’s the fear of not knowing what to do.

Not knowing is OK

Just like it is unrealistic to expect to know everything about parenting when your child is a newborn, you rarely need all the answers to make a big change.

Practice Ownership decisions are the most common that are not made in due to fear of the unknown. Buying / Selling / Starting / Partnering / Soloing - all full of unknowns. There are formulas and criteria that are frequently published, but there are no guarantees.

Other big decisions that often don't happen in our practices because of fear:

  • Hiring a new associate

  • Buying new equipment

  • Offering new services

  • New location

  • More staff

  • Less staff

  • Staff Development

I understand that you want all the answers, but you almost always have to move forward without them. Do your research, make a decision and go. It’s ok that there are still some unknowns.

Moving Forward......

“What’s the worst thing that can happen?” Most ask it all the time, but rarely answer it.
This time, stop and really answer it. “What is the worst thing that can happen if you...open a new practice?...... hire a new associate? .... buy that new equipment?"
Then decide.

You can do it, 
Mike

p.s. I would love to hear what decision you are not making, because you just can't decide.  If you are willing to share, just COMPLETE THIS FORM.  We will share comments in an upcoming message, protecting your privacy of course.  

Look at me when I'm talking to you!

Look at me when I'm talking to you!"  

Do you remember hearing this demand when you were a kid? Or do you ever just stop talking until someone looks up at you? It is natural to want to be looked at when you are saying something that matters.

Looking at someone when they are talking to you is a big deal and we all know it. We all grumble when we talk to the top of someone's head while they are staring down at their phone. And we are all guilty of thinking that we are engaging in two conversations at the same time, when we really aren't in either.

Do our Exam Rooms make this problem worse?
My grandfather was an optometrist and today's exam room looks just like his did 60 years ago. Except now, exam rooms have a computer where my Granddaddy kept his cigarettes. 

As more doctors bring technology into the exam room, more of us are turning a cold shoulder to our patients. We all worry about it and say that we aren't doing it, but we are. Using laptops and tablets helps some, but the reality is that if we are using a computer in the exam room, we are turning away from our patients more than they like.

I visit a lot of practices and nobody is doing it well. Everybody says, "Well, I sit like this and twist my body so I am facing blah, blah, blah......"  No, Doctor, you stick your nose in that computer and ignore your patient while you try to find that button that gets you MU points.

We have tried it all
We have been experimenting for the best way to overcome this challenge in my practice for well over a year. I have seen many concepts and tried them all.  

We built a "robot" to act as a computer stand that rolled around the room, but we kept bumping it into things. We mounted a monitor to the pole in the exam lane, but the patient kept looking behind them to see what we were looking at. We tried balancing laptops, but I am clumsy. Tablets were OK until you needed to type something, plus you have a tendency to stare at that thing longer than you think.

I have come to the conclusion that the big desk in the exam room is the real problem. In every exam room, the desk is against the wall and that's where you put the computer.   A quick Google search of Optometrist Exam Rooms proves scientifically that all rooms have the same design since Granddaddy's time.  

Here is a solution that really works:

We removed the desk and replaced it with a small, rolling computer desk that can be moved around the room.  We put the monitor on an arm that protrudes from the wall. The wireless keyboard is on a tray that can be placed comfortably in our laps or stay on the rolling desk top. Since the big desk is gone, we can put our backs to the wall, face the computer and the patient.


And if we want to show the patient the monitor, we just shift it. The arm has enough flexibility so the uncorrected myope can lean in to see it.

We keep a second keyboard in the room for the scribe to use. (Two keyboards/1 computer -- it works.)  To hide all the junk that was in the desk, we keep a little drawer cabinet, and put a printer on it, so we won't try to use it as a desk.

I tried to create a professional diagram showing you our new concept, but I've got stuff to do. So, here is a quick sketch for you.

Let's "show" our patients we are listening again.
Optometrists have always seen themselves as doctors who "get to know their patients." It is time for this big data collection "experiment" to come full circle. So we have collected and entered all of the necessary information to get paid and meet MU requirements. We know the meds, the conditions and the A1C. But now, let's concentrate on the person again and look them in the eyes when they are talking to us.

Let's talk soon,
Mike
P.S. If you want one of those big refraction desks, I have a couple for sale.  And some computer robots.

Old Blogs

Here are some Classic Messages

Summer is winding down and for the first time I can remember, I find myself longing for the routine of Back to School.  We have had a summer that has been unimaginably busy, almost.  

I feel compelled to deliver meaningful content to our newsletter subscribers on a regular basis. I know that you get enough emails, so we make a point to not send the same message over and over. But sometimes, everybody goes through a writer's block.

With that in mind,  I am reaching out to our members for help and I am taking some time to re-think my practice and share those thoughts with you.   

In the meantime, I want to share some of our classic messages that are always available on the website.
Enjoy:

  • Everybody wants to be Rocky - This message was our second most popular ever. I now play Rocky music in my office. LeadershipOD.com/blog/461

  • Close Your Eyes. Then Open Them - This New Year’s Eve message really should be read every year. LeadershipOD .com/blog/445

  • Do You Want a Raise? - We adjust salary's every summer in our practice and here's how we do it. LeadershipOD.com/blog/360

  • Showrooming - This topic is finding its way into circulation again. Read this "classic" message from Leadership OD. LeadershipOD.com/blog/285

  • My Hair! - It is a sad fact that this message from 2 years ago remains the most popular blog entry. LeadershipOD.com/blog/218

  • Are you buried? - This message came two years ago to the day and I feel exactly the same way today. Is this a coincidence or do I need to change my summer routine? LeadershipOD.com/blog/198

  • Thinking like a CEO - This valuable lesson came to me too late and I have been trying to spread the word for a long time. LeadershipOD.com/blog/52

  • Motivating Your Team - Every office I have been in has helped me realize the importance and the challenge of this daunting task. If there is anywhere that we all need help, this is it. Yes? LeadershipOD.com/blog/59


Mike Rothschild
p.s. If you are interested in contributing some messages to this newsletter or participating in an online discussion, let me know......please.

It is finally starting to "click"

What was the first video game you played?  Since Santa Claus is awesome, I actually had an Atari game system in my house with a joystick controller and a paddle wheel for Pong.And I recall putting all of my quarters into Space Invaders at our local skating rink. I spent a lot of time in the arcade because I couldn't skate backwards and was scared to ask a girl to “couples skate.”  

The secret to Space Invaders, like most video games, is in the “clicking.” You've got to use your fastest hand to click the shooting button. Because the faster you clicked, the higher your score. You could always spot the lefties, because they played the video games cross-handed to maximize clicking speed. Not all games require reckless clicking, but most did and still do.   

I never became much of a gamer.  I still like a video game for a few minutes, but once I got facial hair I was able to give it up for the most part.  Hopefully, I was good enough to regain my “clicking” ability, because we are going to need it.  

Lately, I have been writing about my recent revelation about what is happening to our profession and what we need to be doing to get ready. This has led to many deep conversations with a number of our Leadership OD members and I want to share some details about what I am continuing to learn.  

But I can sum up in one short sentence what we need to do...Get good at clicking.  

There are three things that will control the future of healthcare - data, data and data. The doctors that are going to thrive in the near future will be the best at collecting it, sharing it, and showing that they got it.  And you can be one of them, if you get going now.  

So why are we talking so much about clicking?

The clicking matters because the only data that will matter is what goes into the right spot in your record.  We all understand the need to dilate a diabetic patient and carefully evaluate for retinopathy.  But it is becoming equally important to “click” G8397 before you file the claim and/or “click” the appropriate button when filing to their vision insurance.  And sending that letter to the PCP is also good, but you have to click the button that says you sent it.  

I am actively looking for buttons I am supposed to be clicking in my EHR and finding ways to start clicking them.  And I have finally stopped complaining because they are not automatically clicked for me.  I just have to get over this for now...Just Click It.

What are our Members Saying?

Instead of sending out another impersonal survey, I decided to try to talk to as many Leadership OD members as I could.  While I didn't talk to everyone, we were able to have several conference calls and some one on one.  In these calls, I wanted to better understand two things:

  1. Which Leadership OD member services are most valuable?

  2. What we are doing to get ready for the wave of healthcare changes?

To read my full summary of these calls, just Click Here.

Like you, I am a little nervous about the unknown of what these changes mean. But sitting around waiting for things to happen just doesn't help. Let's get busy and we will be ready.

Have a great weekend,

Mike Rothschild, Leadership OD

 

Survey Results

We had a really high response rate to our survey.  There were some results that surprised me, but mostly my presumptions were confirmed.  
And our diversity of musical tastes were also confirmed.  At the end of this email you will see the winner for the Song of Summer.

First the surprise

Almost all (92%) of those who responded to the survey have already adopted EHR into their practices and most of them are not looking to change.  Of the 8% who responded they had not yet taken the plunge or are looking.  
I was surprised how high these numbers were.  Does it mean that subscribers to this newsletter are more likely to incorporate new technologies? Or is it that people who tend to reply to online surveys lean toward technologies?  Nonetheless - pretty cool!


3% of the responses came from Canada and Meaningful Use doesn't apply.  For the rest of us, 23% have no intention of following MU because it is “too much trouble.”  

 

Our Opportunity

The following results are where I think we have the biggest opportunities.  They are related to communications with our patients and their primary care physicians.  

How do we decide when to send reports to other doctors? After thorough analysis of the data, the answer is, “it depends".  But only 3% responded that they send reports to PCPs for “Almost all patients of a certain age.”

 

90% of us are interested in communicating with our patients directly through our EHR.  But when asked how we are doing, most of (58%) responded, “Not really - I can and want to, but don’t much.”  That says to me that many of us are under-utilizing one of the most powerful marketing tools in our practices.  


This is where I want to focus the continuation of this conversation.
We need to have some real conversation about getting the most out of all of this that we can. There are opportunities for better marketing and improvements to patient care.
But HOW do we capitalize?
We will be setting up some calls with our members to get a better take on what we are doing and what we can do.
Not a member of Leadership OD yet? Don't worry, we will share with you the results of our calls right here. But to make sure you contribute to the conversation, just join. It's easy and we would love to hear what you have to say.

 

And the Song of Summer

 Last year, it was very clear the winner would be a country song and last year’s winning song, “Cruise,” received two votes this year.  There were a handful of other country music votes, but not many.  We did get several votes for Beach Boys songs and tracks from the “Frozen” soundtrack.  

 

Some will be working on building their faith this summer with “We Believe” and “Strong Tower” getting some votes.  While others seem to have intentions to be a little naughty with a vote for “Talk Dirty to Me.”  There was one paying respects to our profession by choosing “I Can See Clearly Now” as their song of summer.  

 

The overall theme was fun, optimism and relaxation.    Votes for “So Happy We’re Together,” “Play It Again,” “Cruel Summer,” and “Girls Just Want to Have Fun.”  There was even one for the Michael Jackson hit released posthumously, “Love Never Felt So Good.”


This year’s winner - There was only one song that received more than a handful of votes.  It supports the theme that most of our votes represent and will serve well as Leadership OD’s 2014 Song of Summer.  

“Happy” by Pharrell Williams.  

To coincide with the single release, the website 24hoursofhappy.com was launched featuring a visual presentation of "Happy" advertised as being "the world's first 24 hour music video".

 

Happy Summer,

Mike

p.s. Members - be on the lookout for some upcoming calls about our new project.

Ready for Healthcare? Survey.

Last week, I sent a message about some lessons I learned about what is coming in healthcare. I was impressed by the conversation that this message created.  It seems like many of us are anxious about these changes.  There is a general sense that we need to "do something - but what?"I would like to keep the conversation going, so I put together this 5 question survey to get a feel for where we are on this path to the future.  I would appreciate it if you took a minute (literally) to answer these quick questions.  I will share the results next week and see where we need to focus future messages.

I added a familiar summertime question, just for fun.

Thank you, Mike

Take the Survey

What I Learned @ 2014 PIO

I had the opportunity to facilitate the Partners in Optometry conference put on annually by PEN. This year's conference concentrated on the impending changes coming to our profession and to all of healthcare. These topics were TOUGH, but made me realize, I may have my head in the sand on this.

My job was to help the attendees know what we should do with the new information and to be funny.

The first speaker was Dr. Chuck Posternack who is a practicing gastroenterologist.  He is a specialist in the demographics of the healthcare crisis in America and the Affordable Care Act. Clear statistics made a strong case for the necessity of the changes. He demonstrated that too many Americans are without healthcare and that the fee for service model is on its way out.

Then we had an enlightening lecture from Steve Baker on the availability of new technologies affecting how we practice. From communication tools to data collection to applications that collect and share medical data. We talked about how fast it is coming and what we can do to try to keep up.

The major insurance companies are looking for optometrists who can work within their systems to collect and communicate medical data effectively. Drs. Richard Hom and Howard Braverman are OD's who are big shots with two of these companies. Both are actively involved in developing the programs that will dictate how we deliver care to our patients in the future.

Dr. Hom's biggest take home point for me was the amount of data they collect and how far they will go to get it. I realized that coding just to get paid is not going to be enough in the future. To be attractive to insurers, we are going to have to be good at sending data - lots of data.

Dr. Braverman's message reminded us what got us here in the first place. Continue to work to make your optical and your contact lens practice becoming profitable pieces of the puzzle. We know how to do this, but we find ourselves worrying about all of these healthcare changes, and we sometimes forget what we do well.

Take Home Points:

  • Everybody has to have EHR now - All insurers are going to want more information than you can provide if you are not using EHR, get it now. (Let me know if you need help picking one)

  • I have to get good at EHR - Regardless of MU, we have to figure out how to populate every field in our EHR, including height and weight.

  • We all need to be great at sending reports to other doctors.

  • Learn how to become a "Physician Extender" - and don't take it personally.

  • Almost everyone will have insurance now and very few people are going to be retiring with a lot of money.

  • We need to find new ways to deliver great care, not just repeated office visits.

  • Get good at communicating with patients via your EHR - if yours doesn't have a secure patient portal, start looking around.

  • Settle in to these changes - they are here to stay

In the near future, providers will not be chosen based on how good of a job they do but more of how good of a job they do reporting the data. I don't have to be the best at it, I just have to be better than my competition. And I will be.

You Must Know The Players

Know the Players

John C. Maxwell has written a lot of books. Many of them have been instrumental in helping many business owners understand how to be better leaders of people.  We based our entire Leadership Team program on one of his books.

A while back, I bought his book The 17 Indisputable Laws of Teamwork.  I was captivated by the title, but hesitant to get started.  Sometimes these guys who write a lot of similar sounding books start sounding like they are just looking for new ways to say the same thing.

But, I always want to do everything I can to strengthen my team.  Ultimately I relented and decided to crack open the book.

For doctors who want to build a stronger team, I do recommend the book.  If you don't want to read an entire book, let me give a quick summary:  Building a great team takes a lot of work and you can never stop working on it.  

I particularly like the Law of the Niche, covered in Chapter 3.  The concept is that to reach their full potential, every team member needs to be in the place where they can make the biggest difference.  The same concept is discussed in Jim Collins' book, Good to Great when he talks about getting people in the right seat on the bus.

Maxwell says to get the people in their right place, you MUST:

  1. Know the Team - Classic "Vision" Blog

  2. Know the Situation - "Open Your Eyes" Blog

  3. Know the Player - Classic "Listening" Blog

How do you "Know the Player"?  

Most of us have the tendency to treat all of our team members the same. But the fact is, every person is different and responds differently.  Getting to know our team is something we could all do a little better.

At Leadership OD, we offer an in-depth Personality Test called the CPI 260.  It gives an intensive look into the work styles and motivations of any individual.  The test reveals an exhaustive evaluation into any personality.  Knowing the differences and similarities of a team allows a greater understanding the team.

Here is a look at my results from a few years ago.

We review every test with the doctor;  here are my notes about my own results.

While the test is available to everyone and includes a review with one of our consultants, our members receive a free test and big discounts on additional tests. When you decide to invest in "knowing your players," we recommend letting everyone on your team take this test.  We are doing it in our office now.

Purchase Personality Tests (Non - Members)

Membership Login Page

During a recent presentation I heard a profound statement from my friend, Dr. Amir Khoshnevis.  He was lecturing on the power of a strong culture and how a unified staff was an integral part.  He said that dealing with staff issues and attitudes was at one time the most challenging aspects of managing his practice.  Now that he routinely puts time and energy into staff development, it is one of the most rewarding.

He uses personality tests in his office.  I'm just saying.......

Have a great weekend,

Mike

Get out of the weeds

Get out of the weeds

Spring is the time of year for gardening.  Flowers begin blooming, the grass starts getting green again and the trees are putting on a new coat of leaves. Nature seems to be waking up.  Spring is the season of growth, the season when plans made during the quiet of winter come to life.

Spring is also the season of weeds.

Weeds have plans of their own during this time.  My botany professor said, "Weeds are plants whose beauty has not yet been discovered."  Weeds are a problem in every garden and in every lawn.  There are different ways of dealing with this problem but the traditional method is to pull up the offending plant by the roots.

I am certainly no gardening expert, but I have pulled some weeds in my time.  Some say it is therapeutic work - I do not agree.   There are some measures you can take to prevent weeds, but every garden gets some.  And the best time to get a handle on your weeds is early.  If your weeds get out of hand, you won't have a garden at all.

Sometimes, I feel like I am spending all my time working in the "weeds" of my office.  I go to work with a prepared list of things to accomplish and never look at my list.  Other days, the only thing on my list is to make a list, and I don't even get that done.  But I work hard all day.  A day like that every once in a while is ok, but doesn't it seem like every day is like that at times.

I call those times being  "Caught up in the Weeds."  It's during these times of no real productivity that I feel unfulfilled with my daily work.  For me, the "weeds" represent the unplanned issues that arise due to my lack of preparation.  The day to day problems that require my immediate attention.  Staff who are complaining about each other, patients complaining about their wait time and insurance companies that don't seem to know what they do and do not cover.  Not to mention ICD-10, Windows Vista (or is it XP?) and the taxes that are due this week.

"Weeds" sometime seem to overwhelm and every moment is spent dealing with one little issue after another.  I solve one, then three more seem to pop up and just when I see the end of the problems, you turn the corner and see everything is covered with new "weeds", new sets of problems that got bigger because I was too busy "pulling weeds" in another section of the office (or do I mean garden?)

If you are in a leadership position and your entire day is spent dealing with issues that pop up, you are "caught in the weeds."  You are hurting your practice and yourself by dealing with issues that need to be dealt with by other members of your team.  Stop weeding, get up and take a look around the practice.  The "weeds" that you left, who else could be helping with that?  What is being left undone, what future plans are not being developed because you are concerned about to many minute details.

Leadership OD members have access to the BluePrint™ program which we designed to help practices with this very issue.  It works and we are finding that it works over and over.  Members of my team have begun the BluePrint™ program for the third time.  The newest team members have heard us talk about it, but will be experiencing it for the first time.

To get out of the "weeds", follow these steps:

  • Realize what you are doing

    • Step 1 in solving any problem is realizing that you have a problem in the first place. The single most common comment I hear from overwhelmed doctors is, "I have so much to do that I can't get anything done."

  • Stop it

    • Often the most difficult part is to stop spending so much time doing things that you think have to be done now and have to be done by you. Practice saying this, "I am sorry but I can't think about that right now. Do what you think is best."

  • Revisit the Vision / the Mission of your practice

    • BluePrint™ Alumni can log back into their program and read the Executive Summary, page 1. There is the Vision of the practice. Others can go out to the reception area to read that Mission Statement. Others just take a minute to reflect on the reason you have a practice in the first place.

  • Look at the current situation through realistic viewpoints

  • Make a list (include the weeds)

    • Only after you have reminded yourself of the overall vision of the practice AND been realistic about your current situation can you make a meaningful task list. I like a old fashioned flipchart, some like notepads, others like computers. Just document all you need to get done, including those "weeds."

  • Communicate the plan to the team

    • Don't try to do all of this alone. If you don't have regular staff meetings, then call one. If you can't do that, send some sort of mass communication to let everyone know the plan. Include in the plan how you will delegate various parts and how you will monitor progress.

  • Get to work

Happy Gardening,

Mike

 

p.s. Just another reminder that the BluePrint™ does all of this for you and yes, I really took a class in botany.

Everybody wants to be Rocky

On Being "Rocky"

"Everybody wants to be Rocky at the end of the movie."

I first heard this phrase from Dr. Kent Edwards years ago and I recall it whenever I am going through a phase where I gripe about how tough things are at any particular moment.

Anyone who is a fan of the original Rocky movie quickly understands what Dr. Edwards means by this statement.  For those who are new to the Rocky concept - a quick tutorial.

Rocky is a movie about a down-on-his-luck boxer who is close to giving it all up as his career looks like it's going nowhere.  He earns a meager living breaking thumbs for a Philadelphia loan shark, but dreams of making it big as a boxer.  He's paid his dues.  He has a good record fighting in smoke-filled arenas bringing home pennies to get his head knocked in.  Rocky had it rough.

Then, he gets his big break.  The world champion, Apollo Creed, offers Rocky a shot at the title and Rocky takes it.  He makes the most of his shot and his goal is to "go the distance" so he can prove that he wasn't "just another bum from the neighborhood."

In 1976, Rocky was nominated for 10 Oscars and won three, including Best Picture.  Still today, people run up the steps at the Philadelphia Museum of Art, standing at the top, arms raised high, sharing a moment of glory, like Rocky.

Everybody wants to be the Rocky who has given it all and stands there calling out for the love of his life, Adrian.  Everybody wants to be the Rocky who inspires millions to be better, to keep trying.  We all want to run up the stairs and bounce on the top with confidence and enthusiasm.

But none of us talk about being the Rocky that is filled with doubt and fear.  We don't want to be the guy who runs half way up the stairs, grabs our side in pain and has to walk back down in humiliation.  Nobody strives to be a gentle hearted thug who lives in the slums with only a dream to one day work his way out.  We never want to be the guy who gets beat up night after night for the hope of a big break.

But Rocky continued to pay his dues with no promise of a future.  He continued his dismal life, working for that big chance.  He never gave up.

The fact is that nothing worth having is easy or fast.  We all have aspirations that can be symbolized by Rocky's celebrations.  But it always comes with work, and usually the work is not glamorous and is not celebrated.

Most of us have a vision of a strong practice that operates efficiently and allows us to build relationships with our patients.  We dream of being stopped in town and being thanked publicly for changing someone's life.  We spend the money that we know we will make and accept awards with honor from our various associations.

Many times, success seems to come naturally to others around us.  They seem to have been given a big break or have a God given talent that gives them an unfair advantage.  But the truth is that more times than not, the most successful just didn't give up when others did.

Sometimes things are tough and plans don't always work out like they should, but keep fighting.  Things can change so quickly and sometimes we feel like everyone is out to get us.

Just know, Leadership OD is always in your corner.

Go the distance,

Mike

p.s. Rocky is now a Broadway musical and I was lucky enough to see a preview with my wife on Valentine's Day.  (It is often called a "love story.")

I am no expert on musicals - but we loved it!

Here's what a real critic had to say about it.

Red Sky At Night, Sailors Delight

In this message I want to talk about 3 things:

  1. The Weather (big topic these days)

  2. Benchmarking

  3. A Membership Benefit

Years ago my dad taught me this little weather forecasting poem:

Red Sky at Night, Sailor's Delight

Red Sky at Morning, Sailors Warning

According to that poem, a beautiful red sky can predict the weather based on whether you are seeing it at sunrise or sunset.  This rule of thumb dates back over 2,000 years.

Does it work? I don't know.  I recall that poem every time I see a red sky, but always forget about the sky by the time I can test it out.

Weather forecasting has come a long way.  After the poem, early forecasters predicted weather based on cloud patterns and changes in temperature, humidity and barometric pressure.   Then came radar and live satellite images and constant computer models.

 Atlanta's Channel 11 used to advertise that they would show the weather forecast in the first eleven minutes of every newscast. Another station had a "ding, ding, ding" sound that played to get everyone's attention when they gave the 7 day forecast.  They know all we care about is the weather.

Now that we all have the weather on our phone, who even watches the news?

Forecasting in our optometric practices has also come a long way.  Today's practice software programs have every imaginable piece of data about our practices. But unfortunately, most of us don't know how to use the data.  The problem is there is so much data and information, it is hard to know what to pay attention to.

We may as well be using poems.  How about this one?

                                      Tonight's deposit was pretty big, I think I am going to dance a jig.

                                     Yesterday I only deposited a little, so for the week - we are in the middle.

 

Forecasting and Benchmarks

Most business consultants establish a set of benchmarks to measure and monitor how things are going with the practice.  The best set of benchmarks looks into the future to pick up on problems BEFORE they occur.

What to measure

It is important to maintain a good strategy on collecting and evaluating data from your practice. There is a balance of how much to measure and there is no set of data points that is perfect for every practice.  If you don't look at any data, you will eventually run into trouble.  If you look at too much data, then you aren't really looking at any data.

 I have come up with over 100 benchmarks that all individually make sense to monitor within a practice.  But only two are for every single practice:

  1. Number of exams

  2. Income per Exam

For the rest, some need to be monitored constantly in some practices and occasionally in others.  Figuring it all out can be a daunting task.

                                                          Leadership OD Membership Service

This month, Leadership OD members are invited to log onto their membership page and schedule their own 45 minute Benchmarking Call with Dr. Mickey Kling or Mike Rothschild.

 Mick has taught me a lot about setting up financial strategies for practices and we confer with each other regularly about the best methods. We don't always agree with the best measurements to make, but we do develop a strong plan for any practice.

If you are not a Leadership OD member follow these steps to set up a benchmarking system:

  • List all the distinct areas of your practice that generate significant income.  Some examples are Clinic, Medical Testing, Surgical Co-Management, Contacts, Optical, Lab, Vision Therapy, and Administrative (insurance).

  • Identify 1 or 2 key indicators in each of those areas to measure their effectiveness.  Find a quick, easy way to routinely measure those benchmarks.  Most of ours come from a report, but some involve a stopwatch.  I think it is a good idea to get information from a variety of sources.

  • Try to think of something that happens when problems are coming. This is an art and the real challenge in tracking data.

  • Create a system to look at the data, follow the trends and react accordingly.  The report system is the most common failure point.  If you look at the data when you think about it, then you look at it only when it is too late.   I usually recommend reporting on 2 - 4 benchmarks at weekly staff meetings.

Looking at historical data may be my least favorite part of owning a practice.  I think it is because I like looking forward so much more than looking backwards.  But I do know how easy it is to get off course and I realize how important it is to monitor progress.

So for me, I work hard to make it easy, effective and fast.  And I will keep trying until I hear "Ding, Ding, Ding - The forecast for the practice is good."

Happy Valentines Day,

Mike

Pay Attention!

My professional strength is finding new, better ways of doing things.  I put a lot of effort into looking at how things are done, comparing that to how I wish it was done and finding a way to bridge that gap.  Some say, it is my passion.

But it takes a lot of effort to stay focused long enough to get it done these days.

Let me share an example of how sometimes struggle:

Monday morning, I came into the office with a well prepared list of things I needed to get done.  My list included talking to various staff members about projects they were working on, accomplishing some nagging tasks that were overdue and reevaluating our optical strategy to explore how it fits into this changing world of managed care.  

 As usual, before I start the day, I stop to give my email a quick check.  Nothing major in the email, but I do need to go ahead and reply to a few, so I do.  Some require that I look at my calendar, so I do that and I realize that the Spring is really filling up quickly.  

 For a minute, I gaze at my calendar wondering how am I going to do all that I am supposed to do this Spring without putting a strain on my family or my practice.  We will all band together and we will get it done.

 Back to the emails. A quick look under the "Promotions" tab, those usually all get deleted in mass, so this will literally take two seconds.  

 Jessica drops in at this moment and asks if this is a good time to review the frame count.  I say, "Yes, I am almost finished here."  Jessica leaves to gather up some people to talk about one of the things on my to do list. 

 One of the Promotions email was about 360 Business Tours for Google Maps.  I have seen these before and must say they are pretty cool.  From the Street View, some businesses allow you to go inside virtually.  Hotels have been using this technology for years.  Then real estate companies and lately, I have been noticing some restaurants with them.  My memory does seem to recall seeing an optical shop with this technology, but is that a real memory?

 Let me explore for just a minute - so Google and I do a little research.  I want to know which Atlanta area businesses have these 360 tours.  

So I punched something into Google about Atlanta area 360 tours.  This brings up a sketch from SNL about the Southern gentleman who lashes out about how Georgians were crippled by the recent 2 inches of snow.  While I must admit it was funny, I began to wonder, does everybody think all Southerners are Colonel Sanders from KFC?

 After a good laugh, I was reminded that I heard snow is forecasted again for this weekend.  Is that true?  So a quick check of local weather revealed that we will be fine this weekend, highs in the 50's.  

But there are so many things to look at on this weather website.  I checked out a video about a man that was at sea for 18 months and there is an advertisement about Rocky on Broadway.  

 Now, we are going to New York to see that on Valentine's Day, very cool!  Should I watch that trailer again?  

 Now I have three patients waiting. I guess we can talk about the frame count later.....

Routinely, I catch myself doing things that I don't need to be doing and this is one of those times.  I am using emails as a Procrastination Tool.  I tell myself that I need to check in to make sure I am not missing out on anything.  When in reality, rather than doing what I need to do, I am trying to see what everyone else wants me to be doing.  I am not paying attention to what matters most.

Time for this to stop.

Starting now, I will check my email for the first time at lunchtime.  If you need me before lunch, you should call.

In the BluePrint, we help our members differentiate between what is important and what is urgent.  It is a classic lesson from Stephen Covey's original Seven Habits book.  It is a tough concept to comprehend, and it is easy to forget.  My habit of keeping my nose in emails is the excuse I have been using to find "urgencies" to distract me from "important" tasks.

I have renewed my habit of planning my day, working on my tasks, then at lunch, I will see what everybody else wants.

Wish me luck,

Mike Rothschild

p.s.  Yes, I do understand the irony of sending this message via email.

"Panicked Excitement"

glasses-laptop-woman.jpg

On a Strategic Escape follow up call, there seemed to be a general sense of  "panicked excitement."  After a few initial log in issues, it was nice to catch up with each other's progress since our two day meeting before the holidays.

In November Sad Steve had the weight of the world on his shoulders.  His staff was rebelling against him and personal misfortune was keeping him sluggish.  But since the meeting, he has been busy rebuilding his team and is ready to start this year off with renewed sense of energy.  Sad Steve now is Super Steve and is ready to begin his BluePrint.

Suzie D has also transformed her office since the meeting.  She was struggling with keeping her schedule full and, as a group, we discovered that her recall system was simply not working.  She had it on auto-pilot for so long, it had lost effectiveness.  A little tweak and she was back at it.  She had her staff retreat the day before the call and used her results from the BluePrint to lead the discussion.  Now she's got a strong plan and a motivated team ready to support her - no matter what.

Root Beer is also fresh from his staff retreat.  He went all in with two complete days of intense work on making the practice a better place.  They talked about areas they could improve and made sure everyone's concerns were heard.  They gave the office a deep cleaning, because you can accumulate a lot with 2 generations of doctors.  They even found time for a little mini-golf.

K-Witty could simply not sit still for the conversation.  (It's hard to hide when you are on a video call.) While others were talking, she was either re-wiring her stereo system or vacuuming, although she denied all of this.  K-Witty coined our theme of "panicked excitement."  She has a good thing going on but is losing a key staff person and we all helped her with her plan to get ready.  But the fact is, she is going to be fine.

Kay-Kay didn't make it, but we were all anxious to hear about the results from his ambitious plans from the meeting.  This guy is not going quietly into the night.  We'll hear about it next time.  And we were also missing our adopted child, The Newlywed.  His unique perspective was valuable during our meeting and missed on the call.

And finally, Leadership OD consultant, Mickey Kling is in a constant state of improvement. He even came to the video conference surrounded by flip-chart sheets.  Not sure if they were real or just there to impress us.  Doesn't matter - it worked.

These hour-long conversations at the end of a long day are not a substitute for getting together and really digging into the changes we need to be making.  But we are finding these follow up calls to be a valuable component of the Leadership OD membership program.  It helps us maintain the energy to keep going until we get together again.

Have a great week,

Mike

The Energy Bus

I just finished another non-optometry book that I would like to share with you.  It is called The Energy Bus by Jon Gordon.  I just bought a copy for every member of my team.

I get asked a lot how I keep my team caring, enthused, happy and motivated.  It is a difficult question to answer, but the simple answer is to never stop trying.  This book does a great job of helping give the answer.

The Energy Bus is about George who is having another really bad day.  He has it pretty tough.  His marriage is crumbling, he is close to getting fired at work and now his car is in the shop.  So George has to take the bus to work for while but he is lucky enough to find himself on ---- The Energy Bus.

It is a good read for anybody who works as a part of a team.  It is essential for anyone who struggles to keep that team moving in a positive direction.

On the bus, George learns the 10 Rules for the Ride of Your Life.(Printable Full List)  I won't list them all, but I do want to bring your attention to two of them:

  • Rule # 2 ; "Desire, Vision and Focus move your bus in the right direction." So many of us are going like crazy, making changes and updating things with no clear idea of what we are trying to accomplish. As many of you know - this is why defining your Vision is the first step in the BluePrint program.

  • Rule #10 : "Have Fun and Enjoy the Ride." - Enough said.

TheEnergyBus.com

Have a great week,

Mike

End of the Year Blowout

At the end of every year, we get ready for a rush.  We cancel meetings, try not to start new projects, and maybe bring in lunch.  We know it is going to be busy and we do our best to get ready.  This year I felt good about our preparations, but we were much busier than I anticipated. For some reason, my patients are procrastinators.  Many have Flexible Spending Account dollars all year long and wait until Christmas to start thinking about it.  And we do our very best to help them all out.

True story from my practice 

Monday, December 30 was our last FULL day in the office for the year (we opened for a half day on New Year's Eve).  The schedule was full, full, full.  I was fighting to keep up. This is the kind of day where all of the patients seem to be in holiday party mode and want to talk about football, trips and grandkids.   And I make it worse, because that's what I want to talk about too.

So when two "walk-ins" showed up on the books, I almost blew a gasket.  But the staff was ready.  They watched me come to the realization that they were new patients, they had been waiting too long and were not originally on the schedule.  I felt my blood pressure go up, gritted my teeth and said, "Come on guys!  What the ......"

I was stopped and Aerial explained, "This is a neurologist and his wife from North Carolina.  They are visiting family and need to spend all of their Flex Money today by getting some new glasses and contacts.  So we made the call to work them in."

I stopped, complimented the wise decision and smiled as I entered the room to greet my new friends.  My staff never fails to impress me.

I haven't had time to really look at it yet, but I think the two biggest days of 2013 were the last two. I would love to hear how your year ended.

Now onto 2014 

This is the time of year for New Beginnings and a renewed dedication to what matters most.  The biggest unknown for all healthcare providers is the new Affordable Care Act.  While I am certainly not an expert on the topic, I do think it will be both good and bad for our practices.  But I know that we need to keep our eyes up for changes that will be affecting our practices and we need to be ready.  I will be sharing with you what I learn.

Must Do:

It is very likely that you do not have a budget for the upcoming year and it is time to get one.   This is the most neglected aspect in the practice management realm.  A budget is a very basic executive tool that is a first step in giving you control of your practice.  Without it, you are just giving money to anybody who asks for it.

To help you out, we are offering limited access to our online Budgeting Tool.  You can use it to enter historic data to measure how you are doing and projected data so you can better control your expenses.  Please use it!

Upcoming Events:

Last year, Leadership OD held its first educational event as an experiment and plan to expand the program this year.  While we got a great response to our Executive Retreats, the biggest impact came from the lessons through the BluePrint program and the Strategic Escapes.Here are some highlights from last year.

 

Leadership OD Membership Program:

At one of the Strategic Escape events, the members came up with the idea of a Premium Level Membership Program.  So we begin a beta testing a Membership Program and are now ready to offer that benefit to you.

For $200 a month, Leadership OD Membership includes a personal username and login with access to all of our products and services.  The secure membership page will give you ongoing access to your BluePrint program and all of its features, like the Executive Summary and the Responsibility Grid.  Our online tools will be unlocked so you can archive entries to your budget and your marketing calculators.

Leadership OD Members will have special registration rates at all of our events. Registration for the Executive Retreat and all webinars will be absolutely free for all Leadership OD members.

Other benefits include access to our team of consultants with an online call scheduler and regularly scheduled Face 2 Face online group discussions.  Availability to our collection of resources that have helped us in our practices.

Basically, we want the Leadership OD program to be a place where you can go when you need some extra support.

Sign Up Now

2014 will be a year of New Beginnings.  I look forward to continuing to build these programs and working with you to move you toward your Ideal Practice setting.

Happy New Year,

Mike

Close Your Eyes - Then Open Them!

Dreaming is an important facet of success.  Without a dream, there cannot be a vision foryour practice or your life. When I close my eyes and dream of my ideal practice, I see all smiling faces.  Smiling staff, smiling patients and I can't help but grin a little myself when I see another huge deposit from the day before.  In my dream, I have a few minutes before the next patient, so why not a quick check of the email, maybe someone sent something funny.

Even in my dreams, email is the best way to quit thinking about what matters to me and see what matters to everyone else.  While reading my emails, I am quickly reminded of my real practice situation and it is not all smiles.

The New Year is a very natural time to compare the real to theideal and decide how to take steps to get the two closer together.  Here is my plan for the New Year and I recommend something similar for you.

Turn it all off and revisit your vision.

Try to block it all out, for just a little while. If you haven't definedyour ideal life yet, this is going to be harder.  But for me, it is a matter of re-visiting the work that has already been done.  I can only concentrate on four areas at a time, so have to break everything into quadrants.  I try to envision a perfect balance between my professional and personal life and I strive for a nice blend of community involvement with comfort at home.

It is important that I do this BEFORE checking your email and I must leave my phone in the other room.  (Trust me on this: you are not so important that you can't be unreachable for an hour or so.  Turn it off - you will be ok.)

Enjoy the Dream.

For just a few minutes, I will imagine my perfectly balanced life.  I will close my eyes and dream of the smiling faces at work.  Everything is done and the patients just breeze in and out, singing our praises.

And we are all smiles at home too.  My family laughs harder each time I tell the same story saying, "that one never gets old."  My teenage children are always saying, "Dad, we are so lucky to have the coolest dad in town."  (Remember - it is a dream.)

Explore the Reality.

Now that we enjoyed the dream, it is time to open my eyes and face reality.  There are real challenges out there.  It is time to look at some of the routine aspects of business like the standard benchmarks but especially the budget.

I also take some time to look at the less measurable aspects of the practice - staff morale, exam efficiency, and office appearance.  And I will also analyze the profession from an overall perspective.  There seems to be a lot of attention on regulation lately and I think it is getting worse.

At home, the time constraints seem to be getting bigger and bigger.  When school starts getting in the way of family time I can't help but think this education stuff is so overrated.

Look at the Ideal and the Real at the same time.

This is where it starts to get tough, but it is at this point that you begin defining the rest ofyour life.  It is here that you can direct where you are going.  Be realistic as you compareyour current situation with your dream and identify how real your ideal can be.

Identify the steps that can get you closer to the ideal.

  • Record the steps.

  • Prioritize.

  • Commit.

  • Start trying.

  • Keep trying.

Leadership OD is Here to help.

This stuff is so easy to say.  I should know because I have said it over and over again.  But it is hard to do.  I know this too because I have failed many times.

Leadership OD continues to develop tools to help you get it all done.

The Vision Builder app asks a few questions and walks you through the process of defining your view of success.  The BluePrint takes your Vision and puts it to work.

We continue to build specialized applications to help you make sense of all the information and apply it to your practice.

An Exclusive Membership Program starts next month and will help bring a core group of like minded doctors together who can help each other continue to grow.  Here is a Sneak Peak.

For 2013, my theme was "No Excuses."  This year, I am pondering something a little more inspirational, more positive.  "New Horizons," "New Frontiers," "Reaching New Heights." Something like that, but nothing is hitting home.  I am asking for your input.  If you have any ideas, I would sure love to hear about it.

I look forward to the upcoming year and wish you all the happiness and success that you deserve.

Happy New Year,

Mike

Getting in the Zone

In life, as in practice, there is a difference between the "Ideal" and the "Real."  The ideal is the vision of who you strive to be; your dream.  The real is what you actually are; based on the real life circumstances you are dealing with.  Practicing optometry, running a business and just being a person is the constant progression from the real toward the ideal. In my practice we have recently redefined the "departments" to better reflect the balance between our ideal practice and our current reality.  Throughout the upcoming cold months, I want to share some details about this experience and how our mistakes can make YOU better.

For now, I simply want to introduce to you the overall concept:

Every task within our practice falls into one of five different Executive Zones.  Each zone has a leader who is simply responsible for getting the things done in that zone.  Of course there is a lot of overlap, so the doctors' role is to keep everyone communicating.

Five Executive Zones 

Scheduling - Keep the schedule full.  This involves marketing, recall and organizing all the different ways people expect to be able to schedule appointments these days.  Patients schedule online, in person, and on the phone.  Some patients come back in a year and others need to return tomorrow, and then there are emergencies.  Keeping it all straight is not as easy as it used to be.  And it really is the whole purpose of all marketing efforts.

Distribution - When you call it a "lab," it suggests that you make something.  We have a nice edger that we never use (Click Here to purchase).  Most of our lenses are personalized progressive lenses or another type of specialized lens.  We are not really in the glasses making business anymore and I have forgotten what a radiuscope looks like.  And, we are not very good at the non-optical products our patients need like nutraceuticals and contact lens solutions.  I am hoping this zone shift will help us with that.

Front of House - We believe that our adherence to the Three Steps of Service have helped build our reputation of excellence in our community.  They are 1) Warm Greeting, 2)Anticipate Needs and 3)Fond Farewell.  This matters most in the optical area which is dominated by a front desk.  Processes include Check In, Check Out, Frame / Lens Selection, Price Objections, Explanation of Insurance Benefits, Scheduling, Dispensing and Adjusting.  We need to do a better job making people feel at home in this critical area of our practice.

Financial Integrity - Money coming into and going out of your practice is getting more and more complicated.  Almost every insurance "check" we get now is in the form of an Electronic Fund Transfer (EFT).  Other forms of payment are credit card, Care Credit, debit card, old fashion paper check and cash.  And let's not even mention all the sources where the money goes.  It doesn't take much inattention for the Cash Flow to become difficult to maintain.  This doesn't leave much attention for improvements.

Patient Care - There is a delicate balance between efficiency and good care.  There is equilibrium between respecting your patient's time and earnestly listening to their needs.  Ultimately, our job is to take care of our patients' visual health and visual performance.  The Eye Exam is still the cornerstone of our business.  It needs constant attention to maintain the balance of quality and trust. Just do the patients right.

Alright then,

Mike

Ever Heard of "Soft Skills"?

The term "Soft Skills" has been used for several years, but I have just recently been introduced to the phrase.  It is defined as the group of personality traits and communication skills that characterize your relationships with other people.  In other words, "Soft Skills" are those difficult to define and difficult to measure qualities that make a person successful.  Soft skills are more about interpersonal interaction and less about the technical expertise required to do your job. In the corporate world, Human Resources directors are putting more emphasis on hiring for soft skills and development teams are budgeting more to improve employee soft skills.  It is a growing area of interest and study.

In optometry school they said that "A" students make good professors, "B" students make good doctors and "C" students will have buildings named after them.  Of course this is a silly generalization, but it mirrors the concept that the students who have a lot of fun in optometry school have well developed soft skills and tend to do very well in business.

Various sources identify different skills as "soft":

  • Communication

  • Good Listener

  • Enthusiasm

  • Teamwork

  • Positive Attitude

  • Networking

  • Problem Solving

  • Time Management

  • Professionalism

  • Work Ethic

  • Flexibility

You can easily see how difficult it is to measure any of these or for that matter, how to teach them.

Measuring Soft Skills

It is easy to put an ability score on certain tasks, you either know how to work an autorefractor, or you don't.  We have a defined scoring mechanism for "Dependability," and we have worked this into our Salary Adjustment systems.

Some use personality tests during the hiring process, but I have never found that to be effective.  But we do get a lot of value from our Personality Test among the existing members of our team.

The internet shows many organizations developing a way to score soft skills, but nobody has done it yet.

So for now, your best judgement will have to do.

Developing Soft Skills

Even though you can't measure it, there are things that you can do to improve soft skills.  And just like everything else in life, the way to get good at something is to practice.  It is that simple.

How to Practice Communication

We have a short meeting everyday, and a different person facilitates that meeting each day.  We do this because it forces us to develop our communication skills.  You've heard it said before that more people are more afraid of public speaking than death.  So if your staff is too scared to speak each other, how can they explain that we are out of network for their insurance or the difference between our glasses and those you get off the internet?

And we critique each other on presentation skills.

How to Practice Listening

Weekly, we have one hour staff meetings and do not begin until everyone has something to write on.  The expectation is set that each person takes notes, and we have a designated note taker.  We have found that setting this expectation assists everyone in attendance to stay focused.

The members of the Leadership Team work to repeat what we heard the others say.  It is amazing how much can change by the time it goes from my head to my mouth to someone else's ears and then into her head.  Simply by saying it back, these small misunderstandings can be caught before any harm is done.

Building Teamwork

Building a strong teamwork mentality is essential for an optometric practice to run well.  Not only can you not grow or improve without strong teamwork, you can't even maintain your current level.  To build teamwork skills, you simply have to be consistent in being a team.

The culture of "Our Risks - Our Rewards" must be throughout the entire organization.  We all pay for each of our mistakes and we all benefit with each success.

I have found the creation and development of Leadership Teams to be invaluable in team building.  And in times of crisis, this commitment to the foundation pays for itself over and over.

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I plan to keep learning about soft skills and how to use them in my practice. My consulting friends who focus on balance sheets and capture rates like to call these topics "fluffy." Boy, do they have a lot to learn.

Happy Labor Day,

Mike