How I Stepped Away from Full-Time Patient Care to Build a Business that is Constantly Expanding

by | Nov 10, 2022

In my view, a successful practice should constantly be improving and growing to remain healthy and relevant. Since my husband and I opened Advanced Family Eye Care in 2004, our practice has expanded from two doctors to five doctors, with a sixth to be added soon. A primary reason for our rapid growth is that we are always on the lookout for ways to strengthen the business. We leverage metrics to help decide where we should focus our attention to drive the maximum growth.   

This focus on improvement and growth has opened up the opportunity for me to step away from full-time patient care and into the role of CEO of our business. I am able to help the practice build a better patient experience and spend my time creating and implementing initiatives that drive our profitability. The first step is always to identify where we can improve. In my role as business manager, I am always looking for those chances to make the practice stronger.

Finding Our Optical Opportunities

Although our practice has flourished and achieved tremendous clinical success, we realized about a year ago that our optical KPIs were relatively weak. We targeted several areas that needed improvement, including non-glare treatment, zero-dollar (free-to-patient) frames, patients’ own frames, and average frame sale. Each of our opticians was given realistic goals to strive for in these areas and was also given access to our business analytics software to track their own numbers. Each optician was charged with reporting their numbers each month. We then had the best and worst performers share their verbiage or system with the others. This provided direction for training and goal-setting. The results were telling; for instance, we set a goal of >85% of jobs to have non-glare treatment and we now consistently meet or exceed that goal every single month.

One particularly important discovery we made as a direct result of managing with metrics was that we were selling too many zero-dollar frames. (These are frames that are fully covered by managed vision care, and cost the patient nothing out-of-pocket.) Seeing that statistic pop up each time we accessed the optical numbers caused us to re-evaluate our frame boards. Our team worked with our frame vendors to develop a static frame board using prior sales reports to identify our most valued frame lines. We developed frame and lens packages to encourage the purchase of a full frame and lens product. Lastly, we started tracking the data and talking about it in our optical meetings. With these changes, we reduced patients’ own frame sales by 34% and zero-dollar frames by 25%. We also increased our average frame sale by approximately $9.00. With 4225 frames sold annually, that translates to a $38,000 increase in revenue by itself. These modifications have resulted in a tremendous improvement in our optical over last year. Understanding the numbers has helped drive change, so we know we are working smarter, not harder. 

Rethinking Our Frame Management

Comparing performance with others in my study group also made us aware that our Cost of Goods for frames was too high. Our remediation plan was to buy smarter with fewer partnered vendors. Our analytics reports helped us determine what frames our patient base seemed to gravitate toward. Preserving those designs was a priority for us. Sharing hard numbers helped our opticians understand that if a frame line isn’t selling, it actually costs us money to have it on the boards. Seeing numbers helps employees overcome their emotional response to change.  Additionally, we found that when we sold off the boards our best-selling frames were gone most of the time, leaving us with depleted inventory and unhappy patients who couldn’t find what they wanted. 

I love beautifully merchandised boards and I found myself walking into the optical only to see gaping holes where frames were sold off our boards. Additionally, shipping and ordering processes were costly and cumbersome when we sold off the boards. We now maintain fully stocked boards, and we have aligned with vendors who support our static frame board goals. Our team can easily locate frames on the boards and we can now sell the same frame multiple times per day. As a whole, we rarely find that we don’t have something on our boards for every patient’s desire. Our complete pair sales have increased versus patients using their own frames or leaving to shop elsewhere. This certainly impacts overall revenue. 

Keeping Metrics into Constant View

Since our very first business day in 2004, I kept a spreadsheet to track our metrics. I’ve always felt the need to see performance numbers to encourage action on my part. My husband and I have also learned lessons the hard way at times by trying something new, then realizing it was not the best solution. In those instances, metrics helped guide us as we kept modifying our process until we met our goal. As helpful as analytics data was, it was still a chore to gather the data and update the spreadsheet. Three years ago, I made it a priority to find a way to make our metrics data more accessible and easy to use. Now that we have business analytics software that integrates with our EHR, I can access the numbers I need in just a few seconds from almost anywhere. Even when I am out of the office, I can easily run an up to date report to see where we are at any time. During the study group meetings I attend, I can run comparison numbers to see statistically how we compare with other similar practices. I am always looking to see where our weaknesses lie so I can develop a new strategy or goal to improve upon. 

The Power of Sharing Metrics with Your Team

Our KPIs tell a story about our business. The ability to easily share that data with our team helps us to get them engaged and give them a feeling of ownership in our business processes and success. The more educated our team is on metrics, the easier it has been for them to recognize issues, diagnose the problem and get their departments back on track. I feel that keeping the team in the dark with regard to KPIs would be a crucial error and would prevent us from unleashing the full potential of our team and reduce their personal commitment to the practice. 

Adopt a CEO Mindset

Our 18-year-old practice now provides full-scope care including dry eye therapy, myopia management and aesthetics. We also have a specialty vision therapy practice (SightWork). Our expansion can largely be attributed to our proven method for making improvements: tracking KPIs, adjusting processes, then setting goals to achieve results.

The most valuable decision I have made in my career was to spend more of my time working on the practice and less of my time seeing patients. It is impossible to know what is going on in the practice when you are in the exam room all day seeing patients. We have amazing doctors in our practice so I have no problem feeling confident that our patients are getting the level of care that they deserve. This frees me up to focus on creating the patient experience, attend study groups and monitor the health of the business. I spend 90% of my time as the visionary and integrator and 10% as the doctor. The decision to become more CEO than provider has been key to our expansion over time.

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