Glens Falls, N.Y.
Dr. Roy Kline has been in practice since 1978 and has owned his current practice since 1986. Growing his practice has meant taking on the responsibility of managing more staff, purchasing more equipment and owning his facilities. Along the way, he has learned to delegate so he can concentrate on his own professional growth.
Making Time, Not Finding Time
How do you know when it’s time to expand and take on a partner? For me, it’s when I am feeling guilty for taking any time off from work, because income is not coming in because I am not there. When it feels impossible to take time off, that’s also an indicator. That’s when you know you have to bring in another optometrist.
I attend to a lot of continuing education, about four times the required amount. I also lecture, and I am a clinical investigator, as well. I am out of the practice about 80 days a year. Given all of my professional development activities, I took on a partner 13 years ago. About six years ago, we added an associate optometrist.
Benchmarks for Partnership
Each practice has different circumstances, but I think that when optometrists finds themselves consistently booked with patients 2-3 weeks in advance, that doctor is probably ready to take on a partner. Monetarily, if you are taking $600,000 gross, and maxing out your time, that combination is also a signal that you should consider taking on a partner or hiring an associate.
Run Your Business as a Business
Most ODs coming out of school have little business sense and tend to learn as they go. However, there are CE courses relating to the business side. I also recommend the business programs offered by CIBA VISION and Essilor (Management & Business Academy for Eye Care Professionals).
When you oversee a pretty big organization, it helps to have business skills behind you. If I were younger, I would consider going back to school for an MBA. I think younger ODs should at least consider taking some business courses.
Expanding In Space, Dispensary and Testing Equipment
Whenever another optometrist asks me, “Should I expand?” I usually say, “Do it. You can never go wrong.”
About seven years ago, I decided to expand my facilities. I had already paid off the building, so I took a $700,000 loan to build onto our facilities and to purchase equipment. We took the original 5,000-square-foot area and made it the professional side of the building. The new 5,000 square feet we added was devoted to a new frame dispensary and a separate area for sunwear. The new front office area is also part of that expansion.
We had always dispensed frames, but after building the addition, we went from displaying 700 frames to 1,500 today. We now have an inventory of 300 sunglass styles.
When we added to the building, we were also able to add a second testing room. This meant doubling the testing equipment. I bought a Marco 5100 refraction system and refractive equipment. We also added electronic medical records in 2004, and it has streamlined the practice. But, it was an investment–about $100,000 to cover computers, software, and training for the staff. Overall, the information technology has given us a better grasp of our demographics and lets us target our marketing more effectively.
Delegate As You Grow
Since expanding the physical building, we also added more staff. We doubled our full-time optician staff to a total of four. We also added more front office staff and technicians.
My son has an MBA, and he suggested hiring and office manager with an MBA, which we did six years ago. You need to delegate responsibilities when you get to a certain size. With a staff of 15, an optometrist definitely benefits from hiring someone else to manage the office and the staff.
Realty Check
Optometrists starting out usually have loans to repay, and renting makes sense at that stage. But every situation is unique, and when your business has grown to a certain point–for example, you have a partner and a larger staff–owning your facilities is a reasonable goal. You have total control over what you want to do, but it is your responsibility, too.
One of the factors contributing to our growth as a practice has been getting more medical cases in the past four to five years. The three of us are doing much more than we ever did. It’s a benchmark of success, and it is key to have the supporting staff so we can take a medical emergency case without disrupting the flow of the day. We had been treating glaucoma before, but when we doubled our testing room we added an OCT. Being a specialty contact lens practice also helped us grow.
Building the Right Relationships
Our older patients are suffering more macular degeneration and medical issues. And with the advent of doing more medical work, we see more referrals from primary care physicians, about twice or three times what we saw five years ago.
We have excellent relationships with local primary care doctors, many of whom are also our patients. We have fostered these relationships by having our office manager visit them at least once a year, to keep them updated on what we are doing for our patients. Of course, we always follow up referrals with letters back to the primary care doctors, so they know how we helped the patient.
We have a good relationship with two local ophthalmologists, and we do post-LASIK follow-up with their patients. We have been doing LASIK follow-up since the days patients had to go to Canada for the surgery. (We are 180 miles south of Montreal.) We also get diabetic patients referred to us.
Kids: Growing a Patient Base
Building repeat business helps if you start with new, younger patients. It’s the life blood of a practice. We tell parents to bring in their kids and start early, before kindergarten.
We have an infancy vision program. We have benchmarks and tell parents how to avoid problems before they start by treating them at the onset. Some states mandate eye exams for school-age children, but New York does not.
Treating children represents a tremendous way to grow your practice’s business, but working with children is not for everyone. You must enjoy working with children (believe me, parents will know), and also enjoy treating their vision problems.
Dr. Roy Kline practices at Drs.Kline and Boyd, PLLC, in Glens Falls, N.Y. He can be reached at drrkline@drsklineandboyd.com.
