By Dave Anderson, OD
Sept. 5, 2018
An associate optometrist can improve patient access to care, and can drive revenues in your office–if you do it for the right reasons, and are able to successfully incorporate the new doctor into your practice. Here’s how I recently added a new associate, who is now generating $550,000 of additional annual revenues.
In addition to two full-time/partner-ODs, we have two associate ODs, one is full-time and one is part-time. The part-time associate has been on staff since 2008, and the full-time associate was added in 2016. When the part-time associate was hired, she was replacing a part-time doctor who was retiring.
Pre-2016, we had two full-time-equivalent OD-owners and one part-time OD. In 2016, we hired a new FTE doctor. It took six months to have her to 75 percent capacity, and after 14 months, she is averaging $550,000 gross based on her monthly revenue.
All three doctors were booked nearly one month out before we brought her in. We are now at approximately two weeks booked out, and we are beginning to consider another associate soon.
Our practice now has 3.5 full-time-equivalent doctors and 18 support staff members.
Focus on Future Growth
My decision to add an associate in 2016 was about future growth. All three full-time doctors were at full capacity in seeing patients. We streamlined our efficiency, added extra exams into our schedules, delegated more, but soon ran out of options to increase revenue.
We were growing slower over an 18-month period, coupled with a longer wait time for patients calling in to schedule. Other metrics also seemed to have hit a ceiling, including patient revenue per exam and revenue per doctor hour. Adding another doctor would allow us to continue growing.
Were were lucky in that there was hardly any recruiting process required to add our most recent associate. She was a long-time patient of the practice, ever since she was in elementary school. She is from the area, and really wanted to work in our practice. She also worked part-time in the summers pre-testing and scanning records, so our support staff was comfortable with her.
Project & Track ROI of New Associate
My full-time associate costs the practice around $120,000 per year, which includes a benefit package and salary. The additional revenue that was brought in was $550,000, and she has not yet been fully booked on a consistent basis, but is at approximately 75 percent capacity. This is more than ample revenue to, not only pay this associate, but also enjoy an additional profit.
Our practice has been in the community for 70 years. We are trusted, and any doctor we bring in is trusted for that reason. A smaller office, or an office that is newer to a doctor’s town/location, including a practice they would start on their own, would require more time to develop the level of patients they would see in our office. An associate also has an incentive to stay with us because as an employee in a highly efficient office they can focus solely on patient care.
Our new associate sees on average 12 patients per day, and it took about six months to get to that point. She also brought in a different base of patients, as she sees pediatrics and vision therapy, so the demand for her time was different than for the docs that were at the practice already.
We pay our associates a salary plus production. This way there is a set amount they can count on for their personal budgeting, and any additional money is viewed as a bonus. This system motivates our associates to want their schedule to be full, and allows them to have an owner’s mentality about patient care and productivity.
Adjust Patient Flow to Accommodate Additional OD
The patient flow was a challenge initially. It took my partner, office manager, and I, three weeks discussing how to make it all work. We have nine exam lanes, two pre-testing rooms and 15 full-time-equivalent support staff to help with the patient flow.
We rely heavily on our scheduling to prevent long wait times and avoid patient-flow bottlenecks. For example, we create and enforce a technician schedule, so we do not have several doctors ordering extra tests at the same time.
We also stagger appointments, so each doctor is seeing patients beginning at different times. This facilitates a smoother check-in and pre-testing timeline. We also set the schedule so our doctors will not be seeing certain types of patients at the same time. We organize according to exam levels based on severity, with the higher-level patients given alternating times for each doctor, instead of coinciding with each other.
Dr A has level 3 at 8:10, Dr B has level 3 at 8:50 and Dr C has level 3 at 9:30. This is continued throughout the day. We hired three new support staff members soon after we hired our newest associate. We left ourselves plenty of time for training, cross-training, and to get them through their 90-day probation period, before the new associate’s first day of work. We didn’t want to have to worry about training new employees at the same time as we were transitioning a new associate into the practice.
What Agreements Do You Need to Make With the New Associate?
During our initial discussion and hiring process, both associates were asked if they desired partnership in the practice. At that time, neither wanted any partner decision-making requirements, and both indicated they wanted the option to consider in the future.
We had a formal employment contract drawn up by an attorney, including the pay, benefits and job responsibilities. We had a non-compete clause included, and made sure it was generous to the practice, but fair to the associate. This way they could not easily leave the practice and take their patients with them.
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