By Brian Chou, OD, 
FAAO
Do you have a sneaking fear that your office would not (or does not) run efficiently when you are not there in person? It is important to manage effectively, including implementing strategic delegation, so that your practice isn’t dependent on your in-office presence.
What would happen if humans suddenly disappeared? The popular non-fiction book, The World Without Us, written by Alan Weisman, describes how residential neighborhoods would turn into forests, and subways would flood with water. Ignominiously, plastics and radioactive waste would linger as the evidence of human existence.
Create an office that runs without your in-office supervision
Keep operations simple. I referenced this in an earlier “Jack-of-all trades” blog, which suggests that a restaurant with too many items on the menu can’t possibly make each dish well.
Standardizing operations. Ensure that everyone in the practiceoperates inthe same, consistent way. A well designed facility will enhance this, as well, where the physical space helps to reaffirm operational flow.
Having a partner who shares management duties. Also, a partner must beon the same wavelength. The alternative is having a non-doctor manager, yet it is a rare breed of individual that can fill these shoes with the skill set and loyalty to the practice that a doctor/co-owner typically possesses.
A similar thought experiment of The World Without Us can be applied to the optometric practice. What would happen if management of an optometric practice suddenly disappeared? In most practices, I’d predict that the facility and practice would deteriorate fairly quickly. Here is one scenario:
• Sales representatives redecorate the office without constraints, dropping off copious point-of-purchase displays. Within a few months, thereis a jungle of visual clutter, promoting several products unharmonious with the practice.
• New diagnostic contact lens fitting sets accumulate, including ones that don’t get used, taking up valuable space while compounding clutter.
• Frame vendors drop off more frames than originally allotted by cutting deals under the table with opticians to sell their products in exchange for gift cards or free frames.
Patients are given a bevy of different lifestyle questionnaires at the reception desk, at the behest of various ophthalmic companies, whethermanufacturing a need for their punctal plugs, ophthalmic lens treatments, nutritional supplements, multifocal contact lenses, or diagnostic tests. Patients feel like they are getting sold unnecessary services and products and express disapproval of the lengthy registration process.
• Business profitability plummets. Frames marked for returns and custom contact lenses for return credit gather dust. Staff work unauthorized overtime hours and don’t clock out for lunch.
Employees take time off when patient volume is high, yet are in the office when patient volume is low. Staff shortages when patients are ready to purchase product lead to patients walking out because of long wait times and poor, rushed service. Overstaffing during downtime permits gossip, surfing the internet and checking personal social media on office time.
• Operational inconsistency flourishes, ranging from each staff member quoting different fees for the same service to performing the pre-examination differently.
Erratic service, undermouth and poor online ratings and reviews, harming patient retention and pushing prospective new patients elsewhere.
• Maintenance items accumulate, ranging from a broken front door to a leaking toilet and soiled carpets.
Sadly, elements of this hypothetical neglected practice are reminiscent of many practices today, even with management in place. This is nothing to be ashamed of, in my opinion, as this fact underscores the complexity of running a successful optometric practice and the continuing need for owners to learn about business from their peers and resources like Review of Optometric Business and the Management & Business Academy.
What tips can you offer for creating an office that is efficient and organized enough that it runs well–with or without you there?
Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.
