Practice Management begins in the Exam Room

To effectively run an eye care practice, many active processes, run by a variety of people have to be coordinated and constantly honed.  It is important to avoid duplication and contradiction in the process.  From Scheduling to Check-in, from Pre-Testing to Exam Room; from Contact Lenses to Optical and to Check-out.  It all has to work together.
Not to mention all the work to be done after the patient leaves to order product and to get paid.  

Where do you start?
Most practices have a set of processes that “evolve” over time.  As times change and as our practices grow, we make changes to our processes.  Sometimes a new employee comes along who “does it a little differently.” Inevitably, these small changes lead to problems in other zones because it is all connected.  In reaction, adjustments are made or breakdowns occur.  

Decrease Variation (starting in the exam room)
There are a multitude of vision tests that can be done to help us with our diagnosis and treatment plan for any given patient.  Some of these tests are typically performed by doctors, others can be delegated to staff members. All variations in technique decrease your efficiency in the exam room method.  

Some examples of exam technique variation are: 

• Stereo testing on all patients under 17

• Applanation tonometry if over 50

• Pinhole if VA less than 20/60

• Color Vision on all boys - new patients - under 10(*)

All rules of variation are put in for good, logical reasons.  The problem is that we keep adding variations without fully considering the impact on the entire exam flow.  This leads to inconsistencies and discombobulation that spills into every aspect of the practice.

There is a good argument for not performing stereo on an 84 year old, one-eyed, exotrope, (**) but I would like for you to consider the benefits of keeping the test in the routine for the sake of decreased variation.  This is an excellent exercise that should be completed by the entire team periodically to continuously refine the exam process.  

Consider your scheduling methods.  How much time is spent trying to match a particular type of patient with the corresponding slot in the schedule?  Do you instruct your team to schedule “older patients” earlier in the day because they take longer? (“Besides, they like to get up early.”)  

Consider pre-testing technique.  We all recognize that kids, contact lens wearers, glaucoma suspects, presbyopes, cataract survivors and esophores all have different needs.  But many of our patients fit into multiple categories…..then what? Sometimes more time is spent trying to decide if you need to do topography, then just doing topography.  

Consider exam room technique.  The advent of EHR has made the idea of an exam room scribe become the norm.  By always doing the same tests, in the same order makes it easier and quicker for your in-room support.  Not to mention - more accurate. Develop a system so everyone knows what everyone else is going to do.  

This is just the beginning.  
You can see where the decreased variation helps the exam flow better.  You can also see how it bleeds into other areas of the practice. After the Patient Care zone is addressed to your satisfaction - move to the Front of the House.  

(*Three variations in one)
(**I recognize that you can’t be “one-eyed” (aka monocular) AND an “exotrope” - but sometimes you just have to write things that make your point. Just imagine her prosthetic is misaligned.)

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.

Debra Turco - Metrics Webinar

"What gets measured, gets done."  

Peter Drucker is often credited with this old business acumen, but my research is far less clear about who said it first.  Another variation of this wisdom is "If it can be measured, it can be managed." 

The point is that for a long time, we have known that consistent measurement of our business performance is critical to making it better.  If we want our practices to be more profitable, we must begin by measuring our profitability.  

One problem: For many of us, it is harder than it sounds.  We know we need to do this, we just aren't sure where to start.  While there are countless services that promise to make it easier for us, the fact is we usually just need a little help getting started.  

In this Featured Presentation, we have Debra Turco, who is the Office Operations Manager for a large, multi-doctor practice in Toronto.  Her practice is a member of Leadership OD and her input in our our small group discussions has been invaluable.  We were thrilled when she agreed to teach us how to really use metrics in managing practice performance.

In this presentation, Debra explains the importance and value of using metrics in the management of the practice.  In simple to understand details, she explains what information matters and how to get it.  Then she describes what to do with the information to make an actual difference in the practice.  

Please enjoy, 
Mike

p.s. If you want to see the oldest quote I could find about measuring your work,
-CLICK HERE-

Featured Presentation: 
Using Metrics to Grow Your Practice

Non-members may register for most online events for a small fee.
LOD Member? Watch Here

Are You a Good Doctor?

As an optometrist, I have always thought I do a good job.  I listen to my patients' concerns, use high tech equipment, work with a very talented team and make strong recommendations.  I have always tried to honor our mission statement by always carefully monitoring each patient’s visual development, function and preservation. 

In general, my patients feel like they were well taken care of and keep coming back.  If you go by the diner in Carrollton, GA and ask, “Hey does anybody know if Dr. Rothschild is any good?”, you will probably get a positive response. 

So what?

In tomorrow’s world, we will be paid based on our merit (Merit Based Incentive Plans (MIPS)).  I shouldn’t worry, because as I just explained, I practice with substantial “merit”.  However, in the very near future, I will have to demonstrate that merit based on someone else’s scorecard.  (I don’t think they will be polling the diner.)

Many people feel like the changes that are coming our way will have a positive impact for those who are ready.  

Last month, Dr. Brett Paepke released for us a Featured Presentation titled, "MU, MARCA, MIPS and More....OMG!"  If you don't understand the title, then you have some catching up to do.  

Dr. Paepke is the Director of ECP Services for Revolution EHR and an authority on the new payment models and requirements that we are all facing.  We are releasing his video again and hope that if you haven't seen it yet, you will take the time to watch it now.  

Happy Memorial Day, 
Mike

Featured Presentation: 
MU, MACRA, MIPS, MORE...OMG!

Non-members may register for most online events for a small fee.
LOD Member? Watch Here

Links to Articles

Great Content from Leadership OD

Earlier this year, Review of Optometric Business attended our  and was impressed with the level of expertise from those in attendance.  Afterwards the editors followed some Leadership OD members home and asked for more.  

We would like to bring your attention to some recent ROB articles by Leadership OD members.  Great insight from a variety of perspectives!

Dr. Scott Huffer from Nashua, New Hampshire shares the value of meetings in getting his large team on the same page.  Learn what kind of financial impact this has on the practice and if it's worth it.

See the Article

Lisa Greene from Asheville, NC shares how she decides when to invest in new equipment.  Often, it is a struggle to just make this decision.  Learn how she weighs the pros and cons and ultimately makes the call.

See the Article

Leadership OD founder, Mike Rothschild was also featured recently on ROB with an article on Empowering the Staff.  Learn how he strives to enable his team for success.  

Six Fundamentals Work for Taxis too.

Last week, I was able to once again attend Vision Expo East in New York.  I had the pleasure of presenting several classes this year, including one of my favorite titles, The Six Fundamentals of Practice Success. 

During my visit, I noticed a big difference in the service I received in taxis this year compared to last year’s trip to the city.  The service from taxis have been "Uber-ized."

Last year in New York, everyone seemed to be attacking the Ubers.  The cabbies were angry, the bellman were running them away from the hotels and it seemed you had to meet Uber in a back alley to avoid the authorities. 

I went into New York with a bias and didn’t investigate my ground transportation choices, I just took Uber.  I later learned that my Uber ride cost double what my flat rate taxi ride would have been.  

On my first local cab ride, I was able to get a Fare Estimate from Uber, and chose a taxi.  This time, I made the right call because the taxi cost me less that what Uber would have charged.

While in the cab, I learned about some new services available from “Yellow Taxis.”  They now have an app that you can download to call a cab, see where available cabs are and even pay with your phone. 

Based on my very limited study, I think Yellow Taxis of New York are beginning to follow our Six Fundamentals of Success.

1. It Doesn’t Matter Who is to Blame – A year ago, taxis were blaming Uber for their lack of business. They were asking for new regulations to stop their competitors.

2. Create a Vision – I don’t have a great example for this one.

3. Find Opportunities in the Barriers – Uber created a barrier between taxis and their riders. They finally seem to be finding opportunities to improve their services.

4. Face the Facts – The fact is that nobody challenged the taxi industry for a long time and they had developed some hubris. It seems they are paying attention now.

5. Market Consistently – Taxis have never needed to promote their services from inside their vehicles. Now, they do and it seems to be making them better.

6. Strive for a Better Team – I think cab drivers are better than they used to be. Not once in New York did a driver give me trouble for not using cash, nor did I feel like I was being taken the “long way.”

A word about loyalty. 

We have all seen images from New York City for generations that included a lot of Yellow Taxis.  It is a big part of the landscape of the city.  The marketing from within the cabs also used the line “Real New Yorkers Ride Yellow.” 

A great strategy to capitalize on whatever emotional connection they can use.  Will it work?  I bet it will. 

Happy Travels, 
Mike

p.s. Here is a nice Wall Street Journal article about the subject.

"TCI" is "That Crappy Insurance." Do you take it?

The ongoing question in all of eye care: “Should I accept (or drop or keep taking) TCI?"  T.C.I. is an acronym for “That Crappy Insurance”; you can insert any of the ones that we consistently discuss here.  The reason we continue to discuss it is that it isn’t clear what will happen if we change. 
 
Here’s what we know:

1. They don’t pay enough for the services we provide and they often create limitations in what we are able to provide to our patients.

2. Many of their clients will choose someone else for their eye care if we are not on the list.

Like the little angel on one shoulder and the devil on the other, we argue with ourselves, unsure of the right decision. 
 
I have never heard anyone say, “We dropped TCI and it was the worst thing we ever did.” 
 
In its simplest form, the decision to be in or out of a given network depends on two factors and can be decided with a simple four quadrant grid – also known as a Kapperman Grid.  The two questions are: Does the given insurance pay well or not well? And - Is the practice patient schedule full enough or not full enough?As illustrated on Table 1, you can see that an insurance that pays poorly in a practice who has a schedule that is full enough lands in Quadrant 1.  The obvious decision is to Drop the Plan.  Whereas a plan that pays well in a practice that needs to fill up its schedule lands squarely in Quadrant 4, making the decision easy to Keep the Plan.  Quadrants 2 and 3 are less clear about the decision.
 
Note that this grid gives you the decision in its simplest form.  There are many other factors to consider in a given community and practice.  These factors may include how many people in the community have TCI or what medical plan is associated with it. 
 
Private Pay patients are not yet a thing of the past, but they are becoming less common.  We must be careful to not let our practices become enslaved by these plans that tighten the reigns more and more every year.  If you find yourself cutting corners so you can take more plans, consider that you may be doing a disservice to the people that are willing to choose you over their plan. 
 
If you do decide to drop a plan, read this idea about how to capture as many of those patients as you can.
 
Thanks,
Mike
 
p.s.  Have you done this lately?  We would love to hear your story…...

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Easy is Better Than Good.

This news article really caught my eye. 
 
Pizza Hut has been losing business to Domino’s in the last year.  The new CEO sends the management team on a retreat to clearly define their vision and create a clear brand identity.  The result:  Pizza Hut has put so much energy into being "better," they have fallen behind in making it "easier." 

Have you seen the recent tv ads for Domino’s?  They hardly mention the product they sell.  The focus of the ad is on the many ways you can place an order from Domino’s – so easy!  Is it any good?  Who cares – it’s easy. 

Pizza Hut is losing ground to its competitor and is being forced to react and play catch up.  It will be interesting to see what happens next in the Pizza Wars.
 

The Lesson for Us

The motto for my practice has always been “Quality Eye Care You Can Trust.”  Like many of you, I have always strived to be better.  Should we be worried that our competitors are finding ways to make it easy?  Are we willing to sacrifice the quality of care we provide so it can be easy?  If we don’t make it easier for our patients, who will?

Some areas of our practices that could be “easier”:

• Contact Lens Fits– If you are still insisting that your patients return in 1 week to evaluate the fit of a daily disposable lens before you finalize the prescription – you are not being easy.

• Contact Lens Dispensing – We mail almost all contacts to patients’ homes. We tried mailing to the workplace...too much trouble.

• Eye Wear Turnaround Time – It is not acceptable to tell people buying eye wear from us that they need to wait two weeks. The “specialized, high tech” argument is no good.

• Available Appointments – Our target is to be booked at 80%, not 100%, to always have some openings today.

• Appointments – I am not ready for this, but someone is going to solve the problem of needing appointments for eye care. Why can’t I go when I am ready?

• Wait Time in the Office – From the time they walk in for an exam, if your patients aren’t shopping for eye wear in 30 minutes, you have room to improve.

• WiFi Available – Give it to your patients. You can do it safely without a password.

• Easier / Faster “Paperwork” – that feeds into the patient record – We have to collect a lot of information that we need to give a complete eye exam. Ask it once and make it easy to answer.

• Online Scheduling that’s easy – I can book a trip to San Diego in January, with hotel and rental car, easier than I can schedule an exam at most optometry offices.

• Online Information – We need to be the “go to” when people have questions about their eyes. Easy to find, easy to read and easy to get help.

---

Greg Creed is the CEO of Yum! Brands, the parent company of Pizza Hut.  He is the one who locked the Pizza Hut executives in a room until they figured it out.  Creed, no relation to the famous boxing dynasty, has a leadership style that I like a lot. 

When the facts show that his company is losing ground to the competition, he faces the facts and is not afraid to admit the weaknesses of his company.  I don’t know what this means for Pizza Hut, but I am interested to see how they change their tone.

Creed is also responsible for Taco Bell’s “Think Outside the Bun”campaign.  

-Mike

Three Words. Results.

The Results are In.

Last week, I sent you a message, asking you to share the 3 words that best described the practice you are building.  The response was great and this exercise generated a lot of thought-provoking conversation.  

The image that you see above is a word cloud of all the words from your responses.  The larger words were included the most often.  

We were forced to remove some profanities from some of our members that must be going through a tough time right now.
 
Dr. Kerry Salsberg in Toronto stepped it up a notch.  He put his 3 words to video to very clearly demonstrate what he and his practice are all about.  

 

So What?

This exercise helps you hone in on what truly matters to you and your practice.  It allows you to focus on work that makes a difference and helps you stop getting distracted by things that don't.  

At the Executive Retreat, we will use this as a starting point and build on it to show you how to have a meaningful impact on your team.  

-Mike

Personalized Building Blocks - Highlight Video

Recently, I told you about a Personalized Building Block exercise that we unveiled at RevYOU, the RevolutionEHR National User’s Meeting.  It was a big hit, so we will be using it at our Executive Retreat in January, but we want to iron out a few wrinkles first. 

This unique tool is kind of tough to explain, so I have put together this short video message trying to explain how it works.  

We are sending enough Blocks to every member’s office, so they can utilize the technology with their own staffs.  Then, we are asking the members for input and we are asking them to help facilitate at the Executive Retreat.   
 

We hope to see you there!

-Mike

"Personalized Building Blocks" are Revolutionary

"Personalized Building Blocks" Revealed at RevYou

At Leadership OD, we are always looking for new ways to keep us focused on what matters most.  In the BluePrint, we begin the program with a Vision Builder which is designed to help give you clear direction about your unique practice.  In the Building Blocks Membership program, each Block begins with a Vision Leader survey to ensure that each practice’s individual needs are met.  There is no “one-size fits all.”

RevolutionEHR holds an annual users meeting called RevYou for its community to connect, learn, and advance their knowledge of RevolutionEHR to enhance their practices. Prior to the meeting, they hold a bonus practice management workshop and this year, Leadership OD was asked to deliver an impactful message that would last.  

The workshop began with a summary of the Five Zones of Eye Care by Mike Rothschild. Then Mick Kling discussed the need for a Strong Financial Foundation, and Amir Khoshnevis delivered his signature message on Creating a Culture of Excellence. The attendees were then put to work to create a Block that was special and unique to them. 

Introducing the "Personalized Building Blocks"

Those in attendance at RevYou
were the first ones to see the Personalized Building Blocks in action.  The impact of customizing your own Block must be experienced to be fully understood.  It is a palpable experience that leaves the builder with a reminder of the overall vision of the practice.  The finalized block shows each zone with the Financial as the foundation that holds up the rest.  The most important aspects of each zone are decided by the builder and recorded directly on the Block, itself.
 

(Remember I said, it “must be experienced to be fully understood.”)

When finished, everyone had worked diligently on their Block which was not like anyone else’s.  For those in the same practice, big differences in the Blocks meant conflicting missions that need to be cleared up before they can move on.  For others, it clears up why we keep doing these things every day in the first place.  The Block is a clear reminder of the purpose of our practice.

The inside of the Block is a bit more personal.  While the outside is what you will project as a practice, the inside of the Block is dedicated to what you, personally will do (or stop doing) to make the practice all it can be.  The fact is that for our practices to be the best, each person that makes up the practice needs to be their best too.  This is your reminder to bring your best every day.

Completing the Blocks was thought provoking and fun because it had us moving around.  

Dr. Jodie Larson of Madison, South Dakota said, “I loved the box and the lectures. Very good, and makes you start thinking about what is really important for our practice, patients and staff. Thank you! Do the boxes at future lectures!”
 

Leadership OD Members will all use the Blocks in their own practice.

In October, the Leadership OD membership webinar will be an online “training session” with Mike Rothschild on how to utilize the Personalized Building Block with their staff.   He will review the method used to facilitate completion of the Block as a group and share his secrets to get people to open up. 

This will be followed by a Face2Face discussion about how it went in our practices.  Together we will improve the process each time. 

We also plan for the Personalized Building Blocks to be a big part of the Executive Retreat in San Diego this January.  Everyone will create their own Block and we will circle back to it throughout the meeting. We can't wait to see you all there!

The Rhythm is Going to Get You

GETTING INTO RHYTHMS HELPS US KEEP OUR LIVES RUNNING. 

We all know the basic work week rhythms for our families and we try to balance them so we have time together.  These rhythms are made up from dozens of smaller rhythms, like an orchestra.  We even have a rhythm to our wake up routines in the mornings.  We try to instill rhythms in the work day to maximize our efficiency or to keep the team connected. 

These rhythms are good because they make our lives more predictable and it's easier to accomplish things.  Runners strive to get into a rhythm so they can run past the fatigue and keep going.  Running coaches teach methods like counting steps or matching your breaths to your steps.  This forces you to concentrate on your rhythms rather than your tiredness. 

But rhythms can also cause us to get into a rut.  Rhythms can become mindless routines which can become tedious and mundane.  Like the runner who says, “I run 5 miles every day.”  While that is an impressive discipline, I wonder, “Why not run 6 miles sometime?”

The recent fire at my office caused a significant disruption to my rhythm.  Suddenly, my business hours didn’t exist.  Do you realize how much of your life revolves around the opening and closing of your practice?  There was no meeting time, no planning time, no patient care time, no frame inventory time, no review financials time, no exercise time, no meal time, and no family time. 

Because of this disruption, we are being forced to ease back into the business, bring the old rhythms back slowly.  Watching the rhythm of the practice build, you can balance the old, established rhythms that help make you good.  At the same time you can stop the ones that were holding you back.  And by not adding back everything, you can put in new systems that you have been meaning to all this time.   

Without this disruption, we would have kept doing the same old things we have always done.  We may have tried new things here and there, but mostly it would have been the same old routine.  But by taking it apart and putting it back together again, you realize that you have a lot of extra noise that is keeping us from growing. I will continue to share with our members the things I find that have been holding us back as we rebuild our rhythm.

Song of Summer

All of this rhythm talk reminds me that we have not yet had our annual vote for the Leadership OD Song of Summer.  Just for fun, we poll our readers for a song that will represent your summer. Most years, I vote for something about putting my toes in the sand, or riding around in a pickup truck.  But this year I will be voting for The Rhythm is Gonna Get You by Gloria Estefan and the Miami Sound Machine.  (If you miss the 80's - Listen to This)

I hope to see you soon, 
Mike

A Little Less Conversation

It was Elvis Presley who first called for, “A Little Less Conversation – A Little More Action.”

In our office, this has been a time to just get some stuff done. Our “To Do” lists were long and getting longer and it was starting to feel like we just kept talking about someday.

Last month, we committed a cardinal sin for a Mike Rothschild practice. We CANCELED a staff retreat!

If you have known me very long, you realize this is a big deal. I have written, lectured and filmed videos on the necessity of off-site retreats to ensure that the entire team is on the same page and all are motivated to work hard to accomplish the mission. But my gut was just telling me, "Now is not the time." I don't always do what my gut says, but I did this time.

Instead we scheduled an in office work day. We asked for everyone’s “buried” lists and compiled a big Master Task List. We itemized, categorized and prioritized, and we went to work. We moved furniture, threw stuff away, painted, sanded, broke and built. Basically, we had a Spring Cleaning.

It’s All About the Team

Running a quality practice is not possible without the hard work of a strong, coordinated team. Teams are made of people and people are people. People have concerns outside of the practice and levels of dedication can vary wildly. Situations are always shifting and it is a challenge to keep up with what is always best.

The secret to having a strong team that cares is to never stop trying to make your team better. Our staff development "framework" calls for two planning retreats every year. But sometimes, we break that rule if the situation isn’t right. But we always do something!

We have training plans, education days, processes, and policy manuals. We give personality tests, performance reviews, salary adjustments and give occasional “prizes.” We have staff parties, attend conferences and facilitate online learning programs. All to try to make the team better.

This month’s Building Block will focus on our framework for building a better team. I call the mission and values a foundation, because it is what we build on. It is solid. But a framework needs enough flexibility to bend to the person and to the situation. There is room for improvement AND mistakes.

                                (READ ABOUT our Framework for Staff Development) 

We will deliver a webinar about developing an Orientation program and facilitate an in-depth dialogue about what works in our members' practices. This is a topic that always draws a lot of attention. I am sure this will be no exception.

I hope to see you soon,
Mike

P.S. My daughter's high school graduation is stirring up some significant emotions. This singular event has our family entering a new season of life. We have spent a lot of time reminiscing lately and have enjoyed looking back and are trying to get ready for whatever is next.

This makes me realize that practices are much like families, that also go through seasons. Understanding this concept helps me realize the delicate nature of keeping it going the best we can.

Turn, Turn, Turn by the Byrds says there is a time for everything under heaven, including a time to cast away stones and a time to gather stones together. The lyrics from this song are actually from Ecclesiastes. (I wonder if Elvis' lyrics are biblical?)

Now Amir is Preaching

Dr. Amir Khoshnevis and I recently had a chance to catch up.  Amir is passionate about communications with patients and with all of the developments in how we communicate; he helps me understand how to stay in touch.

Review of Optometric Business just released a conversation I had with Amir about staying in touch.  Amir has always called me “The Reverend” due to my southern preacher method of delivering a message.  While he taught me a lot about staying in touch with patients, watch this video to see what I am able to teach Amir. 

Amir, and his practice partner Dave Lupinski, have also taught me a lot about maintaining high quality in the optical area of my practice. 
I have been involved in optometry since childhood and there has always been some “villain” who is trying to take away our business.  When I was a child, I remember my uncles complaining about Pearle Vision and now we are worried about Warby Parker. 
The fact is that since the beginning of business, there has always been someone who is looking for a way to do it better.  When someone is taking your business, it is simply because they have found a better way – at least for some of your “customers.”  So you can plop down and cry about it, or you can get to work. 

 

I say "Let's Get to Work"

Trust me when I tell you that your optical needs attention.  They all do.  We all neglect the optical from time to time.  It is usually ok for a while because we tend to put strong team members in the optical areas of our office that can keep us afloat for a while.  But the industry is changing so fast that we must stop from time to time to get a handle on it.

In the month of May, our Building Block will work to improve our performance in the optical. Leadership OD members will have an opportunity to focus on the optical in this month’s Building Block.  We will begin the Block with a webinar by Jennifer DaQuano from NuVue Optical in Charlotte.  She pioneered the methods used in this high end eyewear practice that sets the standard for the rest of us to strive toward.  Jennifer will share proven techniques to  implement strategies for long term success in the optical. To prepare for our Face2Face Block discussions, Vision Leaders and optical staff will receive short surveys to inquire about the issues most pressing in our opticals today and compare that to our goals.  After the Leadership OD team has compiled this information, we will meet online to bring it all together in a plan.

I always feel a sense of renewed energy in the Spring and this is no exception. I look forward to working with our members this month while we bring that energy into our optical. 

-Mike

April Fool's Day is a great time for discussing money.

When it comes to spending money, I have my quirks. 

I tend to buy nice things, I don’t like to use coupons and I would rather do without it than settle for low quality.  On the flip side, I refuse to waste money.  I will put paper back in the printer that has something printed on one side and I would rather replace the soles on my shoes than buy new ones.  It is tough for me to explain the “logic” I use for spending money.  
 
At the Executive Retreat in January, Dr. Mick Kling helped me understand some of my quirky financial habits in his lecture, The Emotional Impact of Money.  He taught us that most of us make financial decisions based on feelings more than rationality.  
 
The most common emotional factors in our financial management are greed and fear.    When managing the finances of our practices, we too often allow our feelings to make those decisions for us.  Sometimes it’s fear that prevents us from making that investment we need to grow.  Other times, we spend too quickly because we get excited at a trade show and sign up for that new service that just doesn't make sense for us. 
 
We also avoid uncomfortable conversations about money which is why most of us fail to always make good recommendations to our patients until we know how much they will have to pay “after insurance.” It is also why we give broad percentage raises to all staff regardless of how well they perform individually.

(Here’s on old BLOG about giving raises)

 So how can we overcome this tendency to manage by feelings?
 Our surveys show OD’s consistently ranking their own management of finances lower than any other area of the practice. On a scale of 1 – 9, we rank ourselves at an average of 4.88 in Financial Management - compared to a 7.76 in Patient Care. 
 
At Leadership OD, we have put together tools to help bring some of the logic into your financial management strategy.  Our members always have access to their budgeting calculator, and now we are releasing a tool that we use at WGEC to track all of the metrics we can think of within our practice. 

USER GUIDE

 And on April 14, our own Dr. Mickey Kling will host a webinar helping us gain control of our Cash Flow.  The title is “Where did all the money go?” and attendance is free to members.
 
Our Face2Face meetings this month will focus on financial management, bringing doctors and staff together to talk about real challenges we are all facing and how to improve. 
 
We still have more opportunities for than barriers.  We just have to keep working on it.
 
Happy April Fool’s Day,
Mike
 
p.s. To have a better understanding of your Money Personality, some say it is a good exercise to recall your very first memory of money.  I will tell you my first memory….if you tell me yours.
 

Are You Staying Busy?

Staying busy is one of the most discussed business topics in all of optometry.  Usually, when optometrists talk about how busy we are, we are referring to our appointment books.  We also discuss how far we are “booked out,” indicating how long I would have to wait if I wanted to schedule an eye exam in your office. 

It is critical that we have steady traffic in our offices to keep things flowing properly.  There are multiple strategies and services that we employ to keep our appointment books filled.

A primary component in every marketing strategy is in earning the loyalty from patients so they will decide to choose us again next year. Degree of loyalty is quite variable and strongly determines the likelihood of a patient’s return to your practice year after year.

“Recall” is the term most practices use to describe the system they use to administer their loyalty programs.  It always begins with a strong recommendation to return from the doctor then may include a pre-appointment, a postcard, an email, a text message and a phone call. 

Recall systems have undergone a lot of transition in the last few years due to changes in insurance coverage, electronic medical records, transient lifestyles, and the huge shift in the ways we communicate.  There are multiple services now available that can dig into our records and automatically send messages to bring people back.  Some are run by people and others by technology. 

We have tried to make a number of adjustments to our system and have settled on a recall system that seems to be working well for us.  Here is a LINK to our current recall system.

Take care,

Mike

Optometric Management

Do you ever have problems with your staff?  

Leading a team to excellence is more of a challenge than ever before.  Communicating your vision, motivating the team to care and keeping them inspired through tough times requires constant attention.  And frankly, most of us are too busy to dedicate the time and energy needed to succeed.  So we continue to settle.

This year can be different.

At the Executive Retreat, we hold each year, we introduce and explore proven techniques of building strong leadership teams within your practice.  
 

Thank you to the editors of OM for publishing Mike's article on Staff Leadership.  This article gives a sneak peak of the methods used in his practice to consistently get the most from his team.
 
If you can't make it to the Executive Retreat, at least read this article.  It is a great place to get started.