Office Staffing Question

**bob_f_aboc** · 03-12-2008, 10:32 AM

Just getting some input from the vast resources of the Optiboard!

In a 3 doc practice (2 OD, 1 MD) with >$1M annually and a finish lab, what do you feel the staffing should be? We average 4 comp exams and 3 follow-ups per hour. I am asking about total staffing for everyone except the docs.

Thanx.

**cocoisland58** · 03-12-2008, 12:43 PM

How many exams per hour do you do? You want each patient to have an optician or dispensor ready to take time with them. Three on the floor perhaps would do it. Two if they are really good. A receptionist, biller, lab tech. It really depends on how busy you are and how many hats each person can wear.

**bob_f_aboc** · 03-12-2008, 01:14 PM

Originally Posted by cocoisland58

How many exams per hour do you do? You want each patient to have an optician or dispensor ready to take time with them. Three on the floor perhaps would do it. Two if they are really good. A receptionist, biller, lab tech. It really depends on how busy you are and how many hats each person can wear.

Like I said, we average about 4 comp exams and 3 follow-up exams per hour.

Currently there are 4 of us. 1 front desk/check in/check out/insurance/customer service, 1 optician/lab tech/sterilization tech/backup tech, 1 optometric tech/contact lens tech/contact lens trainer/backup front desk, and 1 optometric tech/backup optician/Spanish speaker. And our doctors think everything is staffed just about right and can't figure out why we can't get everything done.

**Fezz** · 03-12-2008, 01:20 PM

With the little bit of info that you gave us, I think you are understaffed.

Some questions come to mind:
1.) What is your capture rate?
2.) What is your frame inventory and mix?
3.) Contact sales versus eyewear sales?
4.) Amount of lab work done in office versus sent out because of various insurances, level of difficulty, etc?
5.) How far out are you booked?

**Happylady** · 03-12-2008, 01:37 PM

When we have two doctors per hour we do 4 exams and 2 followups in that hour. For that we have 3 or 4 opticians, 1 or 2 receptionists. One of the receptionists also does contacts and sometimes pretests.

All the opticians do pretests and one also does finish lab work. We also have a bookkeeper/insurance person that works here 3 days a week and will sometimes help out on the front desk. She also works at home.

**bob_f_aboc** · 03-12-2008, 01:38 PM

I knew "The Great And Powerful Fezz" would help me on this one.

In response to your questions:

We have a capture rate of around 72%.
My frame inventory is about 850 frames ranging from Altairs at $135 to Exottica at $570.
About 65-70% of our patients get glasses. Around 40-45% get contacts.
I edge all non VSP and non drilled frames in house, which accounts for about 35% of our total.
And we are booked about 2 weeks out solid.

I will give you a few moments to crunch the numbers before you post your analysis.

:DThanks:D

**Fezz** · 03-12-2008, 01:41 PM

Originally Posted by bob_f_aboc

"The Great And Powerful Fezz"

I may have to change my The Man, The Myth, The Legend now!

;):cheers::cheers::cheers:;)

**john-atlanta** · 03-12-2008, 03:22 PM

I do around 3 exams and 1 short per hour by myself and we have 2 front desk, 2 optical, one pre-test and one special test/contact lens. That may seem like a lot, but to generate the best revenue, you have to have a high service feel. The key benchmark is what you pay your staff (not including doctor or lab optician) as a percentage of collections. If you keep that number too low, service suffers and undermines the practice.

Read this great tip from Neil Gailmard, OD.

**HarryChiling** · 03-12-2008, 05:03 PM

An old rule of thumb that gets passed around is for every $150K you should have one full time employee, however; nowadays with insurance eating up profits and premium products doing the same you should figure about one full time opticians for every $200 - $225K. So a million dollar practice should have at least 5 full time opticians.

One of those would be in the lab of course, the other 4 on the floor, tech and reception should be seperate and whalla you have your team, now at 4 exas and 3 follow-ups between 3 doctors your not utilizing your techs to their fullest, train them better and allow them more repsonsibility and have the OMD working 2-3 rooms with techs fully working-up and your number of exams will increase of course this is if you have the demand for more exams, being that your booked solid two weeks you should be able to increase your exams per hour utilizing the techs more and if the capture remains consistent that will mean more revenue. Just a thought.

**obxeyeguy** · 03-12-2008, 07:20 PM

Originally Posted by bob_f_aboc

Like I said, we average about 4 comp exams and 3 follow-up exams per hour.

Currently there are 4 of us. 1 front desk/check in/check out/insurance/customer service, 1 optician/lab tech/sterilization tech/backup tech, 1 optometric tech/contact lens tech/contact lens trainer/backup front desk, and 1 optometric tech/backup optician/Spanish speaker. And our doctors think everything is staffed just about right and can't figure out why we can't get everything done.

I'm confused. Is the total practice the > 1 mil, or the dispensary? Looking at the staffing above, I see 1 optician, with other duties, and backup optician with other primary duties. With that amount of Rx's per day, and not even 1 dedicated optician, I think I'm missing something.

**Johns** · 03-12-2008, 07:32 PM

We use a $225K rule, for the dispensary only. Not that they don't support the exam side, but we generate no income from exams, as we are optician owned. I'd say closer to $300 per if you are including the exam side.

**MarcE** · 03-12-2008, 07:54 PM

your understaffed. Just one optician would be able to increase your revenue by way more than their staff. The tip from Dr Gailmard linked above is good.
With that kind of Dr staffing, you could be pulling $1.8M ($600K per). The problem is that you don't have enough techs. 2 techs per Dr during patient hours, 1 front desk, 1 optician, 1 optician/floater/insurance, 1 lab/sterilizer/whatever = 10 techs divided by $1.8M = $180K/tech.
It all equals happier techs and happier owners/Drs

The owners are missing out on some income.

In case you don't believe me, lets do it another way. Average pt spends $225 (that's true for us and many others) * 8000 exams/yr (shouldn't be an issue w/ 3 Drs) = $1.8M divided by $180K/staff = 10 staff.

**cocoisland58** · 03-12-2008, 08:42 PM

We are a five year old practice doing about 700K per year. We see 2 exams per hour, sometimes three with contact lens follow ups and Rx cks in between. We have two full time dispensing opticians(one is me, the manager) and one part time lab guy. We two dispensers run the front desk, do insurance, run the sales floor, do contact dispenses, run the lab when needed, do all frame buying and inventory control, etc. We also clean the office. Sometimes we get behind but always catch up during a slow hour. I'm not sure I'd want another employee right now. We think it's manageble. But are we understaffed? I like it when all the employees are completely cross trained so we don't have to worry about pinch hitting. If we get busier and I can hire someone should it be just a generic receptionist/biller?

**bob_f_aboc** · 03-12-2008, 09:43 PM

Originally Posted by obxeyeguy

I'm confused. Is the total practice the > 1 mil, or the dispensary? Looking at the staffing above, I see 1 optician, with other duties, and backup optician with other primary duties. With that amount of Rx's per day, and not even 1 dedicated optician, I think I'm missing something.

The entire practice is ~1.1M after all the insurance adjustments and chargebacks and payments. About 70% is the dispensary. It is nothing for me to have jobs sit for 3 or 4 days waiting to be checked in and pts called because I can't get to the lensometer for more than 5 minutes without being pulled away by the docs.

That was the main reason for my post. I wanted to make sure that we weren't just a bunch of whiners. (Not that we don't all enjoy a little whine now and again:hammer:) We all feel like we are beating our heads against the wall and the owners want to expand much bigger and bring on an additional 1 or 2 people with no experience.

Just like everyone else we all feel we are underpaid for what we do and expected to do too much for it. (Especially after reading some of the recent salary posts.)

With the above staffing, it is obvious how happy co-workers are if someone is sick or wants to take a vacation day.

Thanks for the advice everyone!!!!!!

**HarryChiling** · 03-13-2008, 08:57 PM

Originally Posted by bob_f_aboc

It is nothing for me to have jobs sit for 3 or 4 days waiting to be checked in and pts called because I can't get to the lensometer for more than 5 minutes without being pulled away by the docs.

Holy crap, your shooting yourself in the foot. If you had just one more person there to make sure all jobs get cheked in on time your customer service would dramatically improve and sales would soon follow. I wouldsay about 5-10% of my patients will purchase a second pair after having the first pair delivered, if we drop the ball with timely delivery we don't get the second pair sale.

As an optician explain to your bosses that your duties in the office come first and untill jobs are all checked in hey cannot be pulling you away from this task especially if it's 70% of your practices revenues. Sounds like you have an opportunity to be a super star. Take the reigns and whip that pony.

**bob_f_aboc** · 03-13-2008, 09:45 PM

Originally Posted by HarryChiling

Holy crap, your shooting yourself in the foot.

Take the reigns and whip that pony.

Sometimes it feels like the head. I was just, after 2 years, given the ability to meet with frame reps without the doctor being present and giving the ok. I had to beg reps to come back to our office to meet with me. They would only place a 12 piece order once or twice with the reps and cancel numerous appts the morning of. I could not reorder frames as they sold. I was told to fill the holes with the sale frames that they bought on ebay in lots of 500 for next to nothing. The office I came here from had medicaid frames that were nicer than those.

In my first 2 months of frame buying, frame $ sales year over year are up over 60%. I am hoping they will soon trust my business sense enough to give me some help.

This ain't no pony, it's a whole lotta bull that I'm trying to control here.:shiner:

**HarryChiling** · 03-13-2008, 11:39 PM

Originally Posted by bob_f_aboc

I was told to fill the holes with the sale frames that they bought on ebay in lots of 500 for next to nothing. The office I came here from had medicaid frames that were nicer than those.

I got a funny story for ya, when me and my wife got married we went to the bahamas for our honeymoon (junkano beach awesome) anyway my wife hated my favorite pair of shorts beacuse they were ripped on the bottom, but they were hella comfortable. Anyway she decides that while I am at work she would replace them with a pair she went to Walmart and bought for $8.00. So we fly down there and I hit up a few locals for a REAL spot to buy REAL cuban cigars and I get me some fine rum and I get bakc to our hotel after a fun excursion and I go to throw on my shorts and low and behold we have an $8.00 pair of shorts, so I aks my wife where they came from and where my comfy shorts were, she sayd she finally threw them out (not even a week married and already the womens dressing me, :D) anyway I try the shorts on and guess what she overpaid for them, the crotch must have been down to my knees, well with a few shots of rum in me and a cigar in my mouth I'm runnign around our hotel room like a penguin dying laughing, I guess the chinese think we need a lot of room for our very large well you know.:D

Anyway so now when I say to my wife "those _______'s (fill in the blank with whatever item) have a whole lotta crotch in 'em" she laughs and puts them down. You get what you pay for, doesn't mean that their aren't deals to be had out their, but you do have to scrutinize them. So good luck with your endeavor and enjoy all those ebay frames with a whole lotta crotch in 'em.:D

**cocoisland58** · 03-14-2008, 05:21 AM

Originally Posted by HarryChiling

Anyway so now when I say to my wife "those _______'s (fill in the blank with whatever item) have a whole lotta crotch in 'em" she laughs and puts them down. :D

Harry, you should have been flattered that she thought you needed a "whole lotta crotch in 'em". :bbg:

**Ladyoptician** · 03-14-2008, 07:07 AM

Originally Posted by HarryChiling

Holy crap, your shooting yourself in the foot. If you had just one more person there to make sure all jobs get cheked in on time your customer service would dramatically improve and sales would soon follow. I wouldsay about 5-10% of my patients will purchase a second pair after having the first pair delivered, if we drop the ball with timely delivery we don't get the second pair sale.

As an optician explain to your bosses that your duties in the office come first and untill jobs are all checked in hey cannot be pulling you away from this task especially if it's 70% of your practices revenues. Sounds like you have an opportunity to be a super star. Take the reigns and whip that pony.

Woooo Lordy, my sentiments exactly! My rule of thumb has always been whatever day the glasses come in is the day the patient gets called. And that is one of those top priorities.

**bob_f_aboc** · 03-14-2008, 07:29 AM

Originally Posted by HarryChiling

So good luck with your endeavor and enjoy all those ebay frames with a whole lotta crotch in 'em.:D

My frame board is hung like an elephant.

**Johns** · 03-14-2008, 09:25 AM

[quote=HarryChiling;233424] I guess the chinese think we need a lot of room for our very large well you know.:D

/quote]

This post alone is worth the price of admission! (Oh..we're in the free part?)

You'll never know hw much mnoey you just saved me! I've been having to get my shorts custom tailored all these years!!

Thank you WM!

**Fezz** · 03-14-2008, 09:38 AM

Originally Posted by HarryChiling

I guess the chinese think we need a lot of room for our very large well you know.:D

Wallets?

;)

**HarryChiling** · 03-14-2008, 10:49 AM

Originally Posted by bob_f_aboc

My frame board is hung like an elephant.

LOL :cheers:

You should have seen the way I got rid of 'em, if you've ever seen the Farley bit on SNL where he does the fat guy in a little coat routine, imagine that with a pair of shorts and me squatting, if I remember correctly my wife peed herself laughing so hard.

**braheem24** · 03-14-2008, 10:50 AM

With 3 doctors you should be in the 2-3 Million vacinity with the correct staffing, scheduling and reimbursments in place.

**jediron1** · 03-14-2008, 11:02 AM

Originally Posted by braheem24

With 3 doctors you should be in the 2-3 Million vacinity with the correct staffing, scheduling and reimbursments in place.

I agree! Somethings wrong if your not generating more. Harry was right you need more help. Also a capture rate of 72% even though good should be at least 8 to 15 points higher. I believe if you have the right people in place and the right mix of frames and services your capture rate will rise.

just my 2 cents :D