Sept. 21, 2020

Cold Start: So Many Choices, So Much Control! - E10

Cold Start: So Many Choices, So Much Control! - E10

Cold Start: So Many Choices, So Much Control! - E10

One of the biggest adjustments you will find after coming out of undergrad and optometry school to starting your own office is the amount of choices and control you have. Up to this point we just did what we were told and we knew the end game was getting your doctorate and seeing patients. Well now you make all the decisions and everyone is looking at you for that sense of structure and “normal” day to day life. This can be kind of overwhelming, so I wanted to share some perspective I have acquired over the years.


In my early days, I saw staff as a line item. They were my biggest recurring expense and I managed them like I would the heat in the winter. If we did not have patients in the morning, they would start late and if we got done early, I sent them home. This was great on the budget, but awful in regards to their perception of the job and subsequent staff turnover I was constantly managing. You make all the choices and have to manage expenses, but make sure you still take care of your people. To grow you need a great staff that knows your office culture. High turnover makes a great culture hard to build.  In the end, know the hours they are going to work, hire them for those hours and stick to it. They want, more than anything else, consistency and routine. Choose that now.


Early on, you can easily be convinced that late nights and weekends are the only way to be successful. I am not going to argue. In fact, I am still fighting this battle. Patients love them, but your staff and eventually even you will grow to resent them. It is hard to have a great work life balance when you go so extreme and you will burn your staff and yourself out. Fight hard to find a happy medium that works for you and your staff and still accommodates patients. You want to make decisions based on the long game. Being too short sighted will grow the office, but if it's not sustainable long term, is it worth it?


This may seem odd when you are trying to grow, but remember you control the patients you choose to see. Let me explain, you are inevitably going to get a patient that has 15 pairs of glasses, all of which never worked and he is going to give you a try (lucky you!) or the one that has been to 4 doctors, takes xiidra, and wants another opinion about their dry eye. Before we go any further, you know a trainwreck when you see one and do you think YOU are going to make either of these patients happy? I used to try my hardest and it usually ended up in refunds, some kind of dispute, or just an unhappy patient that cannot be good for growing your office. You do NOT have to see them. You can refer them out or straight up tell them after your exam, you do not think you can make any change that will help them. Still give them a great exam, but actually talk to them and let them know your limitations. It will save you a headache later on. Your time, effort and energy needs to be devoted to the people and patients you have a passion for. If its peds, dry eye, or glaucoma, know what you enjoy and find a way to see more of those patients. Let the others go and save yourself the headache!

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