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Re-Think, Re-Tool, & Re-Engineer
Donna Suter
Suter Consulting Group

Donna SuterJust as the scope of optometry has changed, so has the marketplace. Some days, it may seem like patients are just interested in discount prices. Other patients seem to be insisting you only perform tests discounted through their managed care plan. And, just when you didn't think life could not get any more complicated, your optician leaves for lunch and doesn't come back.

If you feel inadequately prepared to "deal," you are not alone. It is extremely difficult to maintain profitability and attract and keep quality employees in today's cutthroat environment. Competition is fierce. I've noticed, and I'm sure you have too, that while many eyecare practitioners and practices might be struggling, there are also practices and doctors flourishing.

I've also noticed some fearless habits shared by practices and doctors who seem to be doing well. Here are three that stand out:

1) Fearless enough to re-think their strategic positioning. No practice is static. Since change is continuous rather than a single event, entrepreneurial doctors understand the dynamics of change. Unplanned change is chaotic and stressful, and it forces the practice into a reactive rather than a proactive position. Doctors not afraid to re-think the "way we've always done it," don't get so busy putting out fires that they aren't watching the changing marketplace. They note what is happening in other service industries and develop strategic plans that respond to change before reduced patient flow or revenue forces unforeseen change onto the practice. Although it's true that when a boom is going on the entrepreneur-minded doctor is often leading the way, I've also noticed that when the water is high (things are going good), everything tends to even out (everyone seems to be doing well). But, when it all starts to go south, it is then that entrepreneurs can rise more quickly and distinguish themselves.

Their ability to re-think the way they deliver eye health care and to take risks, be decisive, recognize and seize opportunity, and to basically "change," allows them to find a way to make things happen.

Recommendation: Be fearless and re-think your practice philosophies and business plan on an annual basis.

2) Fearless enough to re-tool their leadership skills. How many, if any, of the problems you are experiencing in your practice are of your own doing? What can you, the doctor, do to remedy the situation? Which of the following is an issue in your practice?

Common Problems
Staff/Personnel

  • Difficulty finding competent employees
  • Too much staff or not enough staff
  • Feel like an alien in my own office
  • Constant turnover

Office/Business Management

  • Loss of control
  • No uniformity in office procedures
  • Low productivity
  • Poor net income
  • Disorganized

Patient Relations

  • Not seeing enough patients
  • Patients have to wait too long
  • Patients aren't buying into your services

Examine this common problem list. Place a check next to those areas for which you feel personally or indirectly responsible. Are you surprised to see how many items you checked? I'm not saying that you would deliberately create a problem, but stop pointing fingers at others for office difficulties. Realize that as the boss, the owner of your small business, many frustrating situations occur because of your own personality and behavior.

Industrial psychologists say that the more we know about ourselves, and understand our own personality profile, the better we interact with personnel and patients. This, in turn, leads to increases in effectiveness and efficiency. A good place to start is to take the Myers-Briggs Type Indicator. This table was designed to outline the concepts of psychological types. - The results reveal both your attitude and typical behavior style.

Let's consider this scenario: Doctor A has a warm and confident personality, but she is impatient. People translate her personable nature into being nice and friendly, but the impatient side leads to a demanding temperament. Doctor A is puzzled as to why she can't keep an assistant. Is it because she has such high expectations for herself and those around her? Does she become impatient when a job isn't completed as soon as expected? Is her impatience fueled by her lack of time? The doctor is entitled to have her way, but to be fair, she needs to ask herself these questions:

  • Was proper training provided?

  • Do you have a procedures manual for staff to follow?

  • Did you or an office manager communicate your dissatisfaction and explain specifically how to correct it?

  • Did you take the time to compliment the employee on other jobs they did well?

This doctor expected employees to meet her job expectations, yet hadn't taken time to train them for their positions. This is a no-win situation for an employee. Because the employee is unfamiliar with the office procedures, he or she will either have to ask a lot of questions or waste a lot of time figuring out how to complete the task. Either way, the assistant will appear lacking in capabilities or slow in performance. In most instances, the employees leave, not because they don't like the job, but out of pure frustration.

In reviewing the common office problems listed above, you can see how your personality and attitude play a role in the overall management style and success of your practice.

Part of the challenge of pulling a team together is the diversity of its individuals. This diversity provides opportunities as well as challenges. The combination of talent and challenging personalities is infinite in the way they could react to each other and to patients. You or any person on your team may reach differently, and unpredictably, on any day and play a different 'role' in different circumstances. As the leader, your challenge is to control your own emotions; and, to not try to change what employees may be feeling or thinking. Instead, concentrating on improving employee performance.

Knowing and understanding your personality traits begins this process. Once you learn to enjoy the "Vive la difference" of your employees, it is time to heed the succinct motto of the Three Musketeers: "One for all and all for one!" With all the differences in personalities, teamwork obviously requires high priority and much attention if it is going to work.

Delegating authority and responsibility will never mean that you yourself are relieved of ultimate accountability. But there are ways to make the road to victory less stressful. Eyecare practitioners all across America are discovering the virtues of empowering teamwork and leadership.

The empowered leader and teammate provides for the participation and involvement of everyone - not just in the doing, but also in the thinking. Those who seek to empower others recognize that people are more inspired to implement and complete those things that they have helped create.

James L. Lundy wrote about empowerment in his TEAMS books, Together Each Achieves More Success (TEAMS). He points out that the root of the word empowering is "power." And we can gain more power when our employees become involved in the delineation of plans, decisions, and strategies regarding matters on which they are expected to contribute.

Within the word power is "we." Clearly, no one is as powerful as all of us together. We marshal our power more effectively in environments that are characterized as empowering !

Recommendation: Take no less than one eight-hour leadership development/employee management course a year. These are typically offered locally through colleges, Careertrack, Fred Pryor or Rockhurst University Continuing Education Center , just to name four sources.

3) Fearless enough to re-engineer their patients' experience. The most successful practitioners actively seek ways to enhance their practice's ability to exceed their patients' expectations.

Peter Drucker, author of The Effective Executive, claims that an effective executive is the key. He is the profit center of his business and from him all profit flows. This may come as a shock to you, doctors, but the profit center of any eyecare business or practice is not the optical or medical testing and procedures. You, the doctor, are the profit center. You are the one who can or should generate the profit through your direction and evaluation of services needed for each patient. - If this were not true, retail outlets and multi-location discount operations would not be employing optometrists. - Did you realize that even though eyecare providers spend 75 percent of their time examining patients, professional fees typically generate 50 percent or less of a private practice optometrist's income?

Remember, from you all profit flows, and remember too, being results-oriented is not being greedy. It's the fastest route to realizing that recommending the best for your patients is good for you. Be honest and comfortable enough with each patient to prescribe care as you would for your mother. (For mom we never hold back; she gets the full treatment and is scolded if she doesn't return for on-going care.) This is performing your role as the profit center. How then, do you become an effective executive?

Create a Game Plan
Successful executives get what they want because they know what they want. Knowing makes the difference. They can determine the most direct route, and are disciplined enough to implement their ideas. Doctors who are profit centers use their time effectively in building their practices.

Be The Doctor
Don't try to be all things to all people. Concentrate, rather, on making the best use of every minute you spend with your patient. Ask yourself, "Am I using my time with each patient effectively?" Ask yourself frequently throughout the day, "Is this the best use of my patient time?" Focus your attention on the jobs in the office that no one else can do, the job you were trained for:
  1. Examination
  2. Evaluation
  3. Recommendation

Whenever you avoid recommending, you've short-changed your patients. You haven't given what they deserve and you haven't given them a reason to come back to you. You must agree wholeheartedly to be the doctor. Not the office manager, not the greeter, not the lab technician, not the pretester, but the doctor.

When you divert your energies and slip into one of the other roles, you water down the end results. Being the doctor needs concentration to be effective.

Doctors who delegate produce more income, more effectively, in a more efficient environment, in the same number of workdays. It's the 20-80 rule. You can accomplish 80% percent of the office work in 20 % of the time, if each person is held responsible for specific duties.

The quantity of time the doctor spends with a patient isn't synonymous with the quality of care a patient receives.

Patients perceive quality of care on trust, understanding and confidence. This can be accomplished by what you say and how you say it, not on the length of time it takes you to say it.

  • "Mrs. Lindsey, your eyes look healthy. I'm proud of the way you're taking care of yourself."

  • "Do you have any questions for me?"

  • "If your prescription eyewear needs any adjustment, I need you to return here, because it's our job to keep you happy and comfortable."

  • "If you have any additional questions about your new contact lenses, feel free to call and ask for me or our contact-lens technician, Robin."

  • "Our staff is professionally trained to help you select a frame that will be comfortable and attractive for you."

Enumerate the Options
Sometimes the doctor is oversensitive to cost, so she is hesitant to tell the patient all his or her vision-care options and, too often, the patient doesn't get the total care because of it.

  • Tell new presbyopes that they might be happier and more comfortable with progressive lenses than regular bifocals.

  • Inform computer users about specialty lenses that help reduce eyestrain and stress.

  • Recommend polycarbonate lenses for active children.

  • Recommend ultraviolet (UV) coating for adults who are concerned about macular degeneration or the development of cataracts.

  • Instruct each contact-lens patient on the need to have sunwear to reduce the more-obvious glare they get with contact lenses.

  • Recommend to someone with night-driving problems, for example, that he or she should consider non-glare lenses.

Recommendation: Consumers busy with their own work and family pressures seek eyecare professionals whom they can trust to be responsible for them. Someone who relieves them of the burden of another decision. Someone who not only has a doctor's degree, but who isn't afraid "to be the doctor." Some one who, to coin a phrase from a well-known greeting card company, "cares enough to recommend the very best."

Becoming More Fearless In Your Pursuit of Excellence
Are you fearlessly looking for ways to reinvent your practice? Re-thinking your business and marketing plan? Re-tooling how you relate and motivate employees? Re-engineering the patient experience to create that WOW factor that makes you immune to cut-rate prices? Maintaining a competitive edge doesn't happen by accident. It takes laser-like focus and purposeful actions.

Being fearless means management by objective and not by where you "think" the practice is heading. It means re-tooling how you offer correction to employees and learning to speak with information, not opinion. It means encouraging patient feedback and not seeing the chronic no show or poor paying third party as the problem but looking at the processes and policies in the office that might encourage these types of annoying occurrences.

Being fearless means looking at yourself with a critical eye. Honestly, how good are you at dealing with an awkward situation and striving to not get defensive yourself? Can you evaluate internal weaknesses without playing the "blame game?" The good news is that today is a new day, a new opportunity.

Re-think, re-tool and re-engineer. Use these fearless habits as the framework to reinforce protocol and process improvement. Top performers do not get complacent. They do not rest on their laurels. And they don't decide, that because they are experiencing less than 10% growth each year, or are on top, that their practice is "good enough."

Re-think, re-tool and re-engineer. The idiosyncrasies of your marketplace may distract from agendas and impede progress; but don't allow minor goals and objectives take up the majority of your time. Underlying any effort must be an objective .

What goals are you pursuing? Translate your practice's mission statement into daily activity. Align your activities with what you are trying to achieve. Peak performing teams realize that if teammates and leaders have time to react to crises and to fix things that go wrong because they weren't well planned, then there must be time to do more planning and be more principled at the onset. Become more principled in allocating time to teach your employees effective processes while being sensitive to building positive interpersonal interactions.

Many eyecare professionals latch onto basic concepts that help them understand and undertake beneficial behavior changes. They find it helpful to increase their awareness of these basics through analogies or catchy labels. Just think, for example, of the Blanchard and Johnson concept of the "One-Minute Manager." The delegation concept of "put the monkey on someone else's back." Or, Jan Carlzon's "moments of truth" that refers to every instance of customer or patient contact.

Some of your colleagues may feel they are good managers if they respond well to a crisis. Right thinking suggests that an effective manager, in contrast, is described as the one that avoids crisis while resolving conflict.

Once a conflict is solved we often think we have failed when the same or similar conflict reoccurs. Change your thinking. There are constant changes in practices that require us to rethink answers. The very word, "resolution" broken down, is re -solution. Doing it again is okay as long as it is done differently and in accordance with the current environment.

The best resolution is one that is discovered before the conflict develops. Aggressively look around and ahead. Even a huge boulder in the road up ahead is manageable if you see it soon enough to change course.

Maybe you have noticed that between "resolution" and "revolution," there is only one letter that is different. One small thing can make a huge difference in results!

 

Donna Suter is President of Suter Consulting Group. She offers full-service consulting for eyecare practitioners across the US and Canada . She can be contacted by calling 1-800-249-5201 or www.donnasuterconsulting.com.

 

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