From left, Kim Walstra, CPO, optician; Dan Dibble, ABO, optician; Ashley Van Bergen, scribe technician; Amber Miller, optician and technician; Lorrie Darwin, CPO, front desk coordinator; Doug Totten, O.D.; Sam Darwin, CPO, optician; Chanel Malone, front desk associate; Allison Cooper, scribe technician; Stacey Kennedy, CPO, scribe technician
Excerpted from page 34 of the April/May 2019 edition of AOA Focus.
Not very long ago, Jacqueline Bowen, O.D., of See Life Family Vision Source in Greeley, Colorado, went out of town. She informed her patients of her absence and urged them to call the office if something happened.
"Something did happen," Dr. Bowen says. And it happened when none of the other doctors were available at her group practice.
And so ensued seven phone calls between her staff as they tried to piece out how to get the patient the care she needed. By the time Dr. Bowen learned there had been an issue, it was over.
When she called her patient to follow up, the patient noted that the solution provided by the staff "seemed like it was an easy fix."
"Now, it was chaos in the office," Dr. Bowen says. "But that's the goal—to have a team that can handle the chaos without it feeling chaotic to the patient. I will speak for my partners and for myself: We sleep a lot better at night knowing we have a staff of people who care about patients as much as we do."
Behind every doctor of optometry is a team of employees who keep the practice running smoothly—at least that's what every practice works toward. Whether you're starting a practice or have been serving patients for decades, it's always the right time to think about staffing.
A visionary team
Think of your optometry dream team as a League of Extraordinary Eye Experts. They are what keeps the practice of Doug Totten, O.D., running smoothly.
For him, that means two front-desk coordinators, three scribe-technicians, three opticians, a floater and an insurance expert. But small practices can get by with hiring and cross training a smaller staff that includes some combination of front desk, technician and optician staff members.
But the AOA members who spoke to AOA Focus describe some team members who have been integral to their ability to provide excellent care. For Dr. Totten, it's been the scribe/technicians he's hired who have really made a difference in his practice.
"Electronic medical records have provided some efficiencies," says Dr. Totten, who practices in Michigan. But it's scribes, he says, who streamline the office visit and "virtually eliminate bottlenecks."
For Dr. Bowen, the biggest revelation came last year, when her practice hired its first patient communications coordinator. This coordinator is "solely responsible for keeping the schedule filled."
She's the keeper of a list of patients who are seeking the first available appointment, and the keeper of another list—one of patients whose schedules are not flexible and can't be moved around. She owns the schedule, Dr. Bowen says, and makes sure there aren't dead zones in the middle of a doctor's day.
Even though the coordinator had only been on staff for three months, she was already earning patient trust with incredible feedback: "I called at the last minute and said I couldn't come in. She was so nice about it and helped me reschedule." Or, "I couldn't get in before the end of the year to use my flex benefits, and I got called right away when something opened up."
"You can't ask for feedback like that," Dr. Bowen says. "It's so worth the investment."
Hiring for team spirit
There are specific skills to hire for. For instance, these days, Dr. Totten has all his job candidates, no matter what their role on the team, take a typing test. He's found that the work goes more smoothly when everyone can do some data entry.
Most doctors of optometry say, though, that building a dream team may be less about technical skills and more about attitude and the right fit for the right role. Bruce Trump, O.D., and his paraoptometric staff supervisor Troy Cole, head of human resources for the 750-person multisite group practice, say that in some cases, they hire people who don't have any medical experience at all.
"We're not always able to find someone who's an expert in optometry," says Cole. "If, for example, they have experience in retail but have that need to want to serve or help others, that's what we're looking for."
And when Dr. Trump hires, he's also looking for a kind of "it factor": the combination of a drive to help, a collaborative nature, the desire to keep learning and growing and the right sensibility for the right job.
For instance, Dr. Trump says he's found that people with a more sanguine personality and an attitude of fun almost invariably do well as opticians. Someone who's more detailed and a bit of a perfectionistic might thrive as a scribe.
And then once they are hired, Dr. Trump says, it's the doctor's job—or the job of the office manager, if a practice is large enough to have one—to make sure the job a team member has is the job they can thrive in.
"If you hire someone and put them in a role and find out later that they are not successful there, that's partly your fault," says Dr. Trump. "That person could be really good in a different position. That's part of leadership, to find a way to help them be successful."
Dream team goal: a growth mentality
Another way that Dr. Trump's practice upholds its duty to help team members be successful is a dedication to paraoptometric training. All paraoptometric staff of AOA-member doctors may become AOA associate members and have access to AOA Paraoptometric Resource Center member benefits and services, at no membership cost to the paraoptometric and no added membership cost to the AOA-member doctor. This means access to programs and services that offer education and staff training, significant discounts on education materials for purchase, discounts on registration fees for Optometry's Meeting®, and information communicated through AOA publications. Doctors can enroll staff.
Dr. Bowen's practice rallies around that same growth mentality, too. Every quarter, she says, three staff take a certification test.
"Everyone commits to it," she says, "and we pay for the test materials, for the testing fees, and we give a bonus when they pass the test, and another six months later." Likewise, Dr. Trump's practice pays for staff members to take certification exams and, when they pass, they receive a raise. They tell job candidates during the interview about the expectation that they will continue to grow in their skills. People who are excited about that stand out. At the end of 2018, 225 of the staff were certified.
"It's a huge percentage of the practice," Cole says. "Hopefully that inspires the person to love taking care of people."
And while all this is designed to provide patients with the kind of care that will improve their vision and their lives, that's not all a dream team does. Indeed, Dr. Totten, chair of the AOA's Ethics and Values Committee, says having a good team is linked to the reduction in burnout among doctors of optometry. Because burnout is linked to both professional and personal difficulties as well as increases in medical errors, putting together a dream team is no minor matter.
"Many docs stay later to perform duties that could be handled by a staff member," says Dr. Totten. "The goal should be for staff to handle most tasks in the office and allow the doctor to be the decision maker for treatment plans and office policies."
But when you come out of optometry school, you don't know any of this.
"We went to school to learn to do what we do in a little, dark room," jokes Dr. Bowen. "We didn't learn how to hire or fire people."
So part of the journey as a doctor of optometry also is learning how to be the kind of leader who is dream-team-worthy. Even with his practice's large size, and with additional team members who oversee the optical, clinical and business operations, respectively, Dr. Trump says his job is not only to see patients.
"It's the leadership of the doctor to help define the practice, to create the culture of the practice—to review processes, elevate and coach," he says.
Becoming a practice that's a great place to work can require that kind of mindset shift, says Dr. Totten.
Back when he started his practice 33 years ago, Dr. Totten says he operated on the motto that the patient was always right. But the side effect of that, he found, was "possibly taking our staff members for granted."
Today he serves patients better by being the leader his team needs.
"I work very hard to encourage them in their work and also help them grow in their abilities and skills," Dr. Totten says. "I find a lot of satisfaction at the office, watching the team take great care of our patients. I can sense the 'buzz' when things are going well and patients are being delighted."
It's fun, he says, "to be part of a great team."
The AOA will use the time to evaluate its collection efforts and create a registry for the future that is most useful to improving eye health and vision care. The AOA launched the registry in 2015.
Even if you’re choosing to disengage, today’s politics have a way of finding you. What are the ground rules for approaching political debates in the practice?
Under new rules for the 21st Century Cures Act, doctors of optometry will need to prepare for changes going into effect April 5. Doctors should check in with their health IT vendor in order to make sure they meet the new requirements.