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Thread: Advice needed on how to service patients faster in optical

  1. #1
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    Advice needed on how to service patients faster in optical

    We currently only have one optician in our optical shop. He services roughly 7-10 jobs/day. He also has to input all the VSP data, interface with frame reps, manage and order all the frames. In short, he has to take care of all the tasks associated with the optical shop. He does not do any billing at all other than VSP. He is very conscientious and spends a lot of time with each patient. I would guess that he averages half an hour or more per patient (although I've seen him spend as much as an hour or more). He tends to bring out multiple frames for them, watch them trying everything on (with advice and comments), exhaustively explains all the options and goes through the finances of their purchase. The only problem is that he is unable to get through his patient load. Patients are left waiting for long periods of time, VSP billing goes unbilled, frames languish for a long time before being marked and placed etc. In short, he appears unable to not have the time to run the optical shop. Unfortunately, our optical shop appears to be busy enough for one optician but I don't think that it's busy enough for two. This is part of the advice that I'm seeking. I was hoping to gather tips for him that allow him to streamline his process and cut down on the amount of time that he spends with every patient. He is a good optician and I don't him stressed out or unhappy; but I think he may need help in managing his time. All advice would be appreciated.

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    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    He doesn't need help with time management....he needs help via an assistant. He's running a dispensary, not a factory.

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    Master OptiBoarder OptiBoard Gold Supporter DragonLensmanWV's Avatar
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    Hire someone to do just the billing to free him up to do his job better. Even a part-timer for billing would help.
    DragonlensmanWV N.A.O.L.
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    Hire.

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    Master OptiBoarder Striderswife's Avatar
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    Quote Originally Posted by CuriousCat View Post
    He doesn't need help with time management....he needs help via an assistant. He's running a dispensary, not a factory.
    I agree. I'm in the same boat in my office, plus I edge lenses in-house. I have some backup from the technicians, but they have their own jobs and are frequently already with a patient and can't leave to come help me.

    I don't see my docs justifying another full-time optician, but I'd love it if they'd hire someone to work under me, but have the ability to be pulled away for other office duties when he/she wasn't with a patient (front desk, for example). Every time we hire someone new, it's a technician position, then they cross-train to do other jobs around the office. We have plenty of techs, but that is their priority, not Optical.

    So there's my suggestion for you. Hire an optician, but cross-train to help out elsewhere. But make sure that Optical is the priority for that individual.
    It's nice to be important, but it's more important to be nice.

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    Well, obviously I know that hiring another assistant would help. In fact, hiring 2,3 or 4 more would also help. What my question is getting at is the issue of benchmarks. Should a sole optician be able to process 7-10 jobs per day or is this too much? Obviously, the only time that can be salvaged here is the time spent with the patients. Is it normal to spend half an hour to an hour with patients? Or is 5-10 minutes the norm? For example, I've been seeing 30 patients a day for the past 15 years. I have a colleague who is unable to crunch through more than 10 in the same time period because she gets bogged down. The overall quality is care is the same but the output is very different. Is this what's going on in the optical shop or is it truly too much for a sole optician to handle the volume I've just described?

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    Master OptiBoarder OptiBoard Gold Supporter DragonLensmanWV's Avatar
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    IMHO 5-10 minutes per customer is not enough time to acquire info from the customer, find, fit and measure frames and lenses.And to do billing on top? Kudos to your guy for surviving so long.
    DragonlensmanWV N.A.O.L.
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    ABO-AC, NCLE-AC, LDO-NV bob_f_aboc's Avatar
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    I think 30 minutes per patient is completely acceptable. It sounds like your optician is very thorough and makes the patients feel comfortable with their purchases.

    I have two questions for you:
    Is this optician making money for your office? and Would you be OK with your optical sales dropping by 30-40% so your optician can rush through to keep up?

    My recommendation would be to hire a part time person to handle the billing and frames, or allow your current optician to stay late each night to finish all of the clerical work and be happy paying the overtime.
    A lack of planning on your part DOES NOT constitute an emergency on mine!

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    idoctor:

    There is no one on this Earth that can answer this without watching the optician in action for a few days!

    Anyone who provides an "answer" has not really given it any thought at all... and anyone asking the question has not given it much thought either...

    Patients?
    Computer system?
    Optician skills?
    Sales good or bad?
    Store layout?
    Triage protocol?
    Staff support?

  10. #10
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Actually, my first thought was that the MD probably has an army of staff engaged in assisting him to do his job, but has given little thouht to what it really takes to run a competitive dispensary. The fact that patients are willing to wait for attention from the Optician says volumes about their perception of his skills and personal attention. The Optician needs clerical help to free his time to do his job...perhaps a small army of one.

    The fact that the MD is looking here for FREE advice speaks volumes as well.

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    Quote Originally Posted by John@OWDC View Post
    idoctor:

    There is no one on this Earth that can answer this without watching the optician in action for a few days!
    I agree many factors go into this and only a supervisor could really diagnose any shortcuts he might use to save time. I can tell you that each patient will take up as much time as they need, I've had patients take hours of my time or minutes. It also depends on what kind of store you want to have. When working in a corporate environment they really stressed me to not spend time with patients and my average was probably 10-15 minutes. Now I'm at a private practice and I spend as much time with the patient as necessary about 25-35 minutes on average. I do find that my patients now are much happier not only because they feel they aren't being pushed out the door, but their understanding of what they're getting and the quality of what they get is better when i take more time with one patient.

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    30 minutes per patient is, IMO, not a whole lot of time. I work at a CHAIN, am usually working by myself, and I normally will spend a MINIMUM of 30 minutes per spectacle purchasing patient. And yeah, it DOES take time away from deserving patients when I have to answer the phone, etc. on top of it, confirm next day appointments, etc, and yes, some non-immediate things (like CL trial orders, insurance, etc) will be left for the next day if I am busy enough. We don't have enough volume to justify another person if we don't have an OD in, but if we do, we have a nearly 100% capture rate and need another person. We are all trained and so we will take alternating patients and answer the phone and do the clerical things while the other person is with their pt.

    In your case I would hire a part timer, say a college student 4 hours a day 3 days a week to do the clerical duties only. That way you don't have to pay another optician salary, your patients receive the same excellent level of care, and you're out say 8 bucks an hour for 12 hours a week. NOT a bad trade-off.

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    Another example of where Opticians should be independent and able to hire thier own help.
    Have you tried asking your optician what needs to be done?

    Chip

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    You cannot benchmark everything, particularly the amount of time the customer will take to decide everything. It isn't your Optician who determines this.

    Maybe you could try the cattle-call school of retail, where DIY reigns. Pick your frame (hope it fits!), choose the lens parameters from a wall-sized menu, step up for 10 seconds of measurements, and out the door; kinda like the on-line model.

    Otherwise, make it possible for your Optician to work with more than one customer at a time. Another table for deciding between those last 2 or 3 frames while the first table has an adjustment or delivery, or another frame selection. My own productivity would be most enhanced by a phone person; walking away from a nearly completed transaction to answer a phone means a loss of momentum, another excuse for stalling by the customer.

    By the way, in my practice we have 4 MD's. Two are good at answering patient questions and imparting confidence. Two are good at getting them out of the exam room PDQ, which means that I spend a fair amount of time explaining basic things about vision, surgery, medical diagnoses. I shouldn't be explaining what a cataract is, or what to expect after extraction/IOL, or what 20/50 means, or that elevated pressure and glaucoma aren't necessarily the same thing. Is that why you can whip out so many patients, because you give them the rush and let someone else's benchmarks suffer?

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    I agree, you need to talk to your optician and see what he thinks he needs. A second table if there isn't one is a great idea. Sometimes when a person is taking a lot of time I will excuse myself while they are looking and do a dispense or adjustment. He might need to learn to do this, it's okay to leave for a little while.

    Really, 5-10 minutes is not a lot of time to sell and fit glasses. Sometimes I can sell and fit a pair of glasses in 10 or 15 minutes from start to finish, but sometimes I take an hour or even more.

    Does he answer the phones? Does he have to check the patients out on the computer after the fitting is done?

    If you hire someone to help him part time consider a real optician. That way you have coverage for vacations and sick days.

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    I also work in a busy MD office. What separates us from our competition is our expert staff and our commitment to educating our patients about the best way to meet their needs. It takes time to explain the benefits of free form lenses, ar, etc. We believe that we have the best products and staff, and that our patients have chosen our practice for a reason. For many patients, their glasses are a big purchase, and it's not fair to rush them. We also have to troubleshoot problems when our rx was filled by another shop. I can't tell you how many times I have had patients tell me that they should have come to us in the first place because we take the time to listen to them--especially if they have had non-adapt issues.

    Having an admin person to help with the phones is HUGE. Patients will understand the inturruption the first time that the phone rings, but the worst thing is when they take the rx and say "I'll come back when you you are not so busy." Customer service is a big deal, and it's hard to provide the best service when your optician is spread so thin. Hire some help.

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    I have the opposite problem. One of our doctors insists on booking three exams per hour and can barely get through one and a half. I can close a sale pretty fast so I wait and I wait and the patients wait. I pre-sell when I can and chat them up but many patients simply won't look at frames before their exam for some reason. I believe my doc needs a pre-tester as much as your optician needs a cheap assistant.

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    I'm sorry to harp on a post a second time, but this one pushes one of my buttons.

    An MD, working by appointment, shielded and covered by a staff, with patients sitting in little rooms awaiting them, able to control their pace, who can walk into an exam room 30 minutes late and still have the patient say "Thank you, doctor", wonders why an Optician has little control over PPM (patients per minute).

    Try practicing in the waiting room sometime, with every waiting patient giving you the Death Stare, with the phone ringing and the patient controlling the pace, and every other patient hanging on your responses and composing their Yelp missives based on your rather public tap-dance.

    By the way, do you schedule and process patients to help the optical department, or do you line them up and release many patients within minutes (just before lunch?), creating a logjam in optical?

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    Gee Coco:
    Sounds like you have a doctor that really likes his work. Most of them today schedule four per 15 min, spend 5 min personally with the patients and rely on techs for the rest. Learn to love him. He might even care for patients as people.

    Chip

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    Quote Originally Posted by chip anderson View Post
    Gee Coco:
    Sounds like you have a doctor that really likes his work. Most of them today schedule four per 15 min, spend 5 min personally with the patients and rely on techs for the rest. Learn to love him. He might even care for patients as people.

    Chip
    My OD spends at LEAST 30 minutes with each pt, does the pretesting and everything by himself, and even does the I&Rs if he has time. If his patients call with problems or even just questions, he personally calls them back and spends time on the phone and invites them in for as many follow-ups as it takes. Again, I work at a chain -- and I thank the Lord every day that I am privileged enough to end up at the one store with an OD like this.

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    Quote Originally Posted by chip anderson View Post
    Gee Coco:
    Sounds like you have a doctor that really likes his work. Most of them today schedule four per 15 min, spend 5 min personally with the patients and rely on techs for the rest. Learn to love him. He might even care for patients as people.Chip
    He really is a good egg Chip, very thorough and concientious. It's just the patients who have been waiting up to an hour past their scheduled appointment time get angry, sometimes walk out and yell at us. We are supposed to schedule every 15 minutes (per corporate) but we try our best not to.

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    Master OptiBoarder cleyes's Avatar
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    In an optical being fed a steady stream of patients, one person CANNOT do it all. Orders are delayed, things are forgotten, quality suffers. Patients come first, but the business side suffers, then the patient suffers. All you see is the new sales, not the myriad of adjustments, repairs, phone calls from/to lab, frame suppliers, patient inquiries. Incoming jobs need to be checked, patients notified, jobs tracked. That's just for starters.
    I cover our optical when ours is on vacation, it is not a one person area of our practice. Assistant does all of the above when patient load is high, organizes frames, invoices, CLEANS frames, answers constant phone calls, helps patients with frame selection if I'm with another one, even does minor repairs. This helps keep things moving, orders tracked, less stress on everyone involved.....no-one walks out with Rx because of back-up.
    In an ideal world patients would come in one at a time, understand what they need, know what they want, not need exhaustive explanations of questions that went unanswered in the exam room. Get this one armed bandit an assistant!!
    WE SEE THINGS NOT AS THEY ARE, BUT AS WE ARE..... Anais Nin

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    Quote Originally Posted by idoctor View Post
    We currently only have one optician in our optical shop. He services roughly 7-10 jobs/day. He also has to input all the VSP data, interface with frame reps, manage and order all the frames. In short, he has to take care of all the tasks associated with the optical shop. He does not do any billing at all other than VSP. He is very conscientious and spends a lot of time with each patient. I would guess that he averages half an hour or more per patient (although I've seen him spend as much as an hour or more). He tends to bring out multiple frames for them, watch them trying everything on (with advice and comments), exhaustively explains all the options and goes through the finances of their purchase. The only problem is that he is unable to get through his patient load. Patients are left waiting for long periods of time, VSP billing goes unbilled, frames languish for a long time before being marked and placed etc. In short, he appears unable to not have the time to run the optical shop. Unfortunately, our optical shop appears to be busy enough for one optician but I don't think that it's busy enough for two. This is part of the advice that I'm seeking. I was hoping to gather tips for him that allow him to streamline his process and cut down on the amount of time that he spends with every patient. He is a good optician and I don't him stressed out or unhappy; but I think he may need help in managing his time. All advice would be appreciated.
    Wow. No offense, and I have worked for many MD's but your analsys is off. You are looking the problem being the Optician, frankly its not. I do practice consulting all over the US, and the problem my friend is with you. Its a management issue, not a time management issue.

    Your Optician is doing a great job, in fact, if you are looking to get a new one I have about 25 offices that would love to hire yours. You can find a faster Optician to be sure, but remakes will soar, capture will plumment and previous progressive wearers will be walking out with straight tops with no AR. Basically your optical business will take a bath

    Think about it from your side for a minute. You probably have two to four tech's doing the pre-testing, NCT, Visual fields (the Humphrey's take forever) fundus photography, B-scan, topography, VA's, IOT's, dialting, scheduling surgeries, and even refraction. You may only spend 10-15 minutes with each patient but reality your delagating most of your time consuming tasks out. Your persceptive is that if you can see 5 patients an hour so can your Optician, its skewed a little. If take one day and test and pre-test every patient you see yourself, and you will have an idea of how your optician probably feels.

    The first thing you can do is make sure that when your patients leave your exam they have all their questions answered. Having worked in huge multi MD Opthalmology practices for many years, only one MD that I have worked for adequetely explained to the patient what is going on with their eyes. It ended up falling on the Optical staff. The patient was handed their RX and sent to Optical. Often a lot of the time spent by Optical was explaining what Glacoma, Cataracts and AMD were, what the patient could expect, and how the Dr was going to treat their condition. Often time we had to track down the chart and then decifer the Drs hand writing to tell the patient what was going on with their eyes. All huge time sucks.

    The second thing you can do is make sure your RX's rock. Frankly MD's are often terrible refractionists, but congrats to you if you are the exception. In fact, in many MD practices have a 20% RX change rate. For every RX redo you have your Optician just lost about 1 1/2 hours of their time that they can never make up. If you don't like refracting make sure you have a Tech that can do a great job, or as many MD's do, hire an OD for refractions. OD's are more subjective and won't change a 90 year olds axis by 45 degrees without thinking about the consequences, as I have seen MD's do a hundred times.

    Your optician needs help. Your dispensary is often still the most profitable area of your business unless your doing a LOT of glacoma surgeries. If you can't hire another optician, your first choice would be to train a COT in Optical, one of yours might already have experience. If not, hire someone part time.

    The final thing you need to do is congratulate your Optician and give them a fat raise, you won't find many like yours. You just described the perfect Optician who is doing an amazing job with the skills of a true professional. Opticians have a very difficult task: they have to make the Dr., the Patient, and the Insurance company all happy. That is in an impossible group of people to please 10 times a day, and yet they some how pull it off. Opticians have to be engineers, fashion consultants, and accountants all with the listening skills of a bartender. It's a small group of people that can do all those tasks well. You seem to have one of the best, I would keep him/her if I were you.
    Last edited by sharpstick777; 06-28-2011 at 04:07 PM.

  24. #24
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    And I repeat myself...

    EVERYTHING you state above is made on assumptions at best!

    You have NO IDEA what takes place in that office.

    There is no one on this Earth that can answer this without watching the optician in action for a few days!

    Anyone who provides an "answer" has not really given it any thought at all... and anyone asking the question has not given it much thought either...

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    Quote Originally Posted by John@OWDC View Post
    And I repeat myself...
    EVERYTHING you state above is made on assumptions at best!
    You have NO IDEA what takes place in that office.
    There is no one on this Earth that can answer this without watching the optician in action for a few days!
    Anyone who provides an "answer" has not really given it any thought at all... and anyone asking the question has not given it much thought either...
    You are correct, but since we were ASKED for advice and were not invited to sit in someone else practice for a few days, it's the best anyone can do. He asked for advice, we gave it imperfect as it is. Are you willing to sit there for 3 days?

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