By Miki Lyn D’Angelo, OD,
and Jessica Fulmer, OD
Nov. 30, 2016
When we opened our two-doctor independent specialty practice in Riverhead, N.Y., in August 2015, we knew we had complementary strengths and working styles. Between the two of us, we knew we could build a practice that was both profitable and allowed for work-life balance.
We opened the practice cold while continuing to work elsewhere. We covered for each other as we grew our practice, and ensured that our work weeks were fully covered.
Different Perspectives & Experiences
Both of us are passionate about providing vision therapy services. Our respective residency programs gave us a different perspective and experiences with those needing vision therapy and rehabilitative services. (Dr. D’Angelo’s residency and previous employments at private practices allowed her to treat a large age range of patients including infant vision therapy and pediatrics. Whereas, Dr. Fulmer’s residency program was completed at the Northport VAMC where the youngest patient was in their early 20s.) Additionally, both of us have had extensive training with the traumatic brain injury population and the respective rehabilitation that comes with them. (Dr. Fulmer also specializes in low vision.) With our combined experience, we feel completely comfortable treating the full spectrum of patients from infancy upwards.
Find the Right Partner: Share Vision & Values
The most important thing about entering a partnership is realizing that you are entering a marriage of sorts. You spend more time with your colleagues at work than you do at home with your family. Only enter a partnership with someone who has the same goals and values as you.
Something that drives both of us is honesty, integrity and a strong family life. We want to provide the best care to our patients while also being able to be present for our families.
Our first decision as partners was not to have Saturday hours, which seems like a big risk for a new optometric business. We felt this time should be dedicated to our families. Can you imagine if one of us was driven by money and the other by family? One partner would resent the other for not wanting to make more money, and the other wouldn’t be able to understand why her partner didn’t want to spend time with her family.
To sort out such work-life balance issues, we recommend “What Matters Most: Thinking about Your Roles, Values and Primary Aim” by Hyrum Smith. —Miki Lyn D’Angelo, OD, and Jessica Fulmer, OD
Work as a Team
We have found a good system where we often work in conjunction with each other, believing that two minds are better than one with our often-complicated patients. Our vision therapy patients are encouraged to attend sessions twice a week. Since we are typically at the office at different times, most of our patients will see one doctor for the first session and the other doctor for the second session. We find this gives patients variety and enables us both to build a relationship with each patient.
It should be noted that we began this journey into partnership after realizing that not only are our core values the same, but our doctoring style was very similar. Because our approach to patient care is one in the same, this gives rise to the fluidity of our office. We often joke to our patients that we are the same doctor, just with different color hair and eyes.
Split Pay 50/50
We believe that in a strong partnership everything should be split 50/50. We pay ourselves an equal salary on a bi-weekly basis. In addition, we always keep bonuses and increases in salary equal between us. Bonuses or increases in pay are based on updated profit/loss statements on a quarterly basis.
Create Balanced Work Schedule
When we first opened our practice, our hours per week were primarily dictated by the other part-time jobs that we had while planning the opening of our office. Both of us maintained approximately 20 hours a week at our other jobs and approximately 25 hours at our own practice.
This has been re-evaluated over time and adjustments have made as needed to both our own office schedule and our part-time jobs. We sit down on a quarterly basis and assess how far out we are booking in the schedule and current revenue for the office. Once we reached the point when we were booking appointments two weeks out we both added more hours to our office and started taking hours away from our other jobs.
Provide Maximum Patient Coverage
Both of us switched our part-time jobs schedules around to ensure that we would both be in our office three days a week. We found this to work well at the beginning as both of us had to continue working outside of our own practice for additional income. By scheduling ourselves each three days a week we were able to maintain a Monday through Friday schedule. We both had two days in the office by ourselves and one day where we both were in the office. We felt it was important to have a shared day at the office to ensure adequate face-to-face communication with each other. With the specialty of vision therapy we also have the ability to run double doctor schedules. One provider can be performing primary care exams, or vision therapy evaluations, in the exam room while the other provider performs vision therapy in our separate therapy room.
We recently passed our first anniversary, and with that milestone we have shifted our schedule so that we are in-office two full days together and one additional half day together. This change in our schedule, as mentioned above, was precipitated by a steady increase of patients and the demand for more exams and vision therapy time slots.
We maintain a set schedule within the office. We are open Monday through Friday and have set days that we are scheduled to come in. If one of us needs a day off the other doctor provides coverage if they are available. We find it works best for both patients and staffing to keep a consistent schedule.
Additionally, we believe in supporting one another and finding the balance between life and work. Neither of us take off an exorbitant amount of time; just when something important comes up, and we both support each other in taking that time.
We have access to the office voicemail through our practice e-mail, and are able to check for messages after hours or on weekends and can reach out to patients if needed. We both also have provided patients with our cell phone numbers on an as-needed basis. Dr. D’Angelo also conveniently lives in close proximity to the practice and has been able to see emergency patients over the weekend.
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Use Support Staff to Enable Flexible Doctor Schedules
We are lucky enough to have only one staff member who performs all reception and pre-testing duties. As we are only open Monday through Friday, she can work every day from open to close, maintaining a schedule of around 40 hours. If she requires a day off, we have to wear many hats and cover the front desk, pre-testing and exams by ourselves. We also have called on support from our family members to come in and cover tasks such as answering the phones and scheduling appointments.
As a new business, payroll is a huge expense, and we must be conscious of how much is going out each month. It took many months to build up our schedule so one employee was more than capable of handling the workload. We are planning on hiring additional staff in the coming months as our office continues to grow.
Miki Lyn D’Angelo, OD, and Jessica Fulmer, OD, are co-owners of Twin Forks Optometry and Vision Therapy in Riverhead, NY. To contact Dr. D’Angelo: DrDangelo@twinforksoptometry.com. To contact Dr. Fulmer: DrFulmer@twinforksoptometry.com