Eyeworld

94 | EYEWORLD | SEPTEMBER 2021 P RACTICE MANAGEMENT Contact Pinto: pintoinc@aol.com Wohl: czwohl@gmail.com packed into the day but an extra hour to spend with your family. Knowing your goals is the start of achieving them. 13. Are we extracting a full measure of value from every staff resource in the practice? Are techs standing around waiting for a doctor to emerge, or are they calling to remind the next day's patients of their appointment? Are receptionists hanging out waiting for the next patient to arrive, or are they checking insurance verifications? You wouldn't put your investment portfolio in an interest-free checking account; why would you let an $18-an-hour member of your staff not continuously provide value? 14. Are we extracting full value from every other resource in the practice? Satellite office or surgical facilities left vacant most of the week were affordable in an era of $1,500 cataracts. Today, all offices should be open full-time, and an increasing number of practices are adding evening and weekend hours to extract a full measure of value from fixed resource costs. 15. Are we even in the right business? Have we gone too far in turning a cataract practice into a LASIK practice, now that vol- ume growth is stagnating in most markets? Have we considered ourselves a surgical practice only and missed optical dispensing opportunities? 16. What's our exit plan? Smaller practices have an easy answer: Sell to another practice in the community, bring a successor surgeon in a few months before retirement, or simply close the doors. Large practices have a more complex challenge. With the advent of private equity compa- nies and ever-larger health systems, your options have broadened. In the heat of daily battle, few surgeons and few managers take the time to ask these questions, much less act on the answers. Your practice— in both clinical and business dimensions—is the most important "patient" you care for. It's certainly the most demanding. Learning to ask the right questions every day will improve your organization's treatment plan and prognosis. Too often, doctors concentrate on the more than 90-day account column when the real problem is far earlier in the revenue cycle chain, for example, a bottleneck in the insurance department, generating a delay in claims submissions. Ask staff at the front lines about the time lag from service to posting to submission. 9. How many hours do our staff actually work every day, and how many hours are they paid for? Practices, as they grow, can carry forward informal and sometimes even overly permis- sive wage and hour policies. This laxity can generate several negatives. Selected staff will abuse the system, claiming payment for extra time they didn't work each day. This costs the practice real dollars, and worse, leads to lower morale among the non-abus- ers. Valid claims could be made against the practice for violating labor laws. 10. Could we have seen more patients in the clinic or performed more surgical cases? Most surgeons end their work day with a cushion of unsold "inventory." It may not bother you that a few no-shows leave you with time to read your email. But remember that marginal, incremental revenue rep- resent the bulk of your profits, since fixed costs are already covered. Just three missed exams a day in a typical solo practice can trim $100,000 from your annual income. 11. If we ended the day providing less care— doing less work—than was possible, what could we do to improve? Giving yourself an annual pay raise could be as simple as adding one or two slots to the appointment template, calling patients 24 to 48 hours ahead of their appointment to reduce no-shows, or increasing your refraction fee by $10. 12. If we saw all the patients or performed all the cases we were capable of, what's holding us back from doing more? If growth is a goal, look for opportunities to increase everyone's productivity. Potential answers lie in back-office technology, in- creased tech training, or increased ophthal- mologist delegation of care to optometrists. Note that you may not want more patients continued from page 92

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