EYECARE BY THE NUMBERS

Tick Tock

The economics of time and what you can do to manage it

as the saying goes, “time is money.” But more than just money, time is the Achilles heel of many of your initiatives. It’s finite. Once spent, it can never be recovered and, thus, it must be spent wisely. In our work helping develop successful optometry practices, our reviews often begin with a look at time and how this critical asset is deployed in the practice.

In the sample practice we’ll analyze here, our fictitious Dr. Samuels is an average O.D. She generates approximately $330 per hour and sees patients approximately 32 hours of her 36-hour scheduled work week. Her schedule has her seeing patients on three days of the work week for eight hours and for four hours on the remaining two days.

CURRENT PRODUCTION

She takes four weeks of vacation and CE time annually, so her practice grosses a bit over $500,000. She sees about 1.1 full exams per hour, generating approximately $306 per exam. In between patients, and for a single four-hour period once a week, she’s engaged in myriad projects involving management, operations, and practice development.

ACTUAL CAPACITY

A deeper look at Dr. Samuels’ schedule shows that she schedules patients every 20 minutes. Assuming that 25% of the available appointment slots are reserved for medical office visits and follow-up care, she actually has capacity for over 2x the number of exams that she’s currently producing.

This excess capacity is a time suck. It sounds OK on the surface, as the practice can easily accommodate the infrequent walk-in, and during those times when she doesn’t have a patient, the team can perform the many non-patient-care tasks that every practice must handle. But, in reality, the excess capacity is a drag on practice performance.

It manifests itself in holes in Dr. Samuels’ schedule, which I describe as “garbage time.” Sure, she can return a phone call in a 20-minute slot, assuming that the other party’s available. But the reality is that Dr. Samuels accomplishes little in these time periods; there’s no concentration time, and she certainly can’t do what is really necessary to grow her practice “between patients.”

DRIVING OUT GARBAGE TIME

Applying some simple math, we can see that Dr. Samuels is scheduling patient care time far in excess of what’s required, resulting in the many holes in her schedule. Further, these holes are also holes for her staff, driving down productivity throughout the practice. As the chart below shows, instead of requiring a five-day patient care schedule, the practice currently requires less than two days per excess for medical visits.

Armed with this information, Dr. Samuels worked with her team to crunch her patient care schedule to 2.5 days per week, which leaves plenty of room for growth. She now comes to the practice four days per week, 1.5 of which are totally devoted to growing her practice.

FOCUS ON BUSINESS

The result of this relatively small change in the practice schedule is that Dr. Samuels and her team now have concentrated periods of time where they can focus on the business of the practice. Dr. Samuels now has time to become more engaged in the community, and to focus real energy on figuring out where she can obtain the 300 additional patients she hopes to see in the coming year.

DIVIDING THE TIME

Dr. Samuels has crunched out the “garbage time” from her schedule. She sees patients 2.5 days of her four days in the office, leaving 1.5 days for growing the business. Here’s how the practice divides its time.

• INBOUND PATIENT CARE: On the days she sees patients, her entire staff is focused on what I refer to as the “inbound patient”—handling exams, eyewear selection, and direct patient care.

• OUTBOUND PATIENT CARE: On the days when she’s not seeing patients, the entire practice is focused on the “outbound patient.” It’s on those days that special testing (by staff) is handled, eyewear is delivered (through optical dispensing appointments), products are ordered, claims are processed, administrative duties are performed, phone calls are returned, and sales people are seen.

As the practice gets booked out, it closely monitors the number of open appointment slots. And, because Dr. Samuels is on site for four days, she can handle the occasional emergency without stress.

With this new schedule, the staff is more productive and happier, as they’re able to focus attention on duties required to run and grow the practice. And patients experience a busier and more efficient practice, since patient care time has been crunched. The result is that patients perceive the practice as busy, successful, and growing. That’s important because, as they say, “no one likes to eat in an empty restaurant.”

Time is the most valuable asset we have. ROT (return on time) is hugely improved with focus. Crunch the holes out of your schedule and redeploy that time to practice development. You and your staff will be far more productive and operate with less stress. Most important, your practice will grow as a result.

— Alan Cleinman

Alan Cleinman is owner of Cleinman Performance Partners, a business consultancy specializing in the development of high-performance optometry practices. © 2015 Cleinman Performance Partners, Inc.