The optometry field constantly changes, and lately more so than ever. Obamacare, EHR, Internet-capable glasses, ICD-10, vision plan contract changes… stop this treadmill, I want to get off!

Despite the flurry of changes, there is one thing that has remained constant for practice owners—you have the ability to determine the level of happiness that exists within your own business. You can ensure a high level of enjoyment in your practice by handpicking a quality staff and selecting the type of patients you want to visit your office.

Cultivating a Better Clientele
What does it mean to pick patients who are the right fit for you? Let’s use the Ritz-Carlton’s business model as an example. Its motto reads, “We are ladies and gentlemen serving ladies and gentlemen.”

In only serving ladies and gentlemen, the Ritz creates exceptional service and memories for not only their guests but their employees as well. By excluding uncouth behavior, it has deliberately chosen the clientele it wants to attract. When achieved, both the guests and the Ritz employees are happier. This is a business model you should follow as a practice owner. 

ODs can mimic the Ritz model by putting a stake in the ground and saying, for example, “We want to cater to patients who really value our services and aren’t choosing us solely based on our being in their insurance plans. So, we will offer special concierge-like services to those patients who show up on time, refer others, spend more than $X per year, are compliant and are a sheer joy to work with.”

Those concierge services would be things like preferential parking, appointment times, expedited eyeglass delivery, notification of new frame styles the patient has previously shown a predilection for, early notice to trunk shows and new contact lens offerings.

Assessing the Problem
On a daily basis, you regularly encounter two groups of people: your staff and your patients. Because you spend so much time dealing with these parties, it’s important that your interactions with them are enjoyable, not just tolerable.

For example, if an employee’s behavior is starting to drive you crazy, it is important that you deal with it the instant this becomes evident. Don’t dwell on your staff’s shortcomings if you’re not willing to take the time to assist in fixing them. If there are no alternatives, it may be in your best interest to fire the offending staffer; don’t let the problem linger. Dismiss the staff member sooner rather than later. Once you’ve successfully dealt with this problem, you and your staff will be much happier.

Take this same approach with your less desirable patients—the abusive, abrasive and chronically non-compliant ones. What possible benefit is there to you, your staff or even the patient to continually engage in this lose-lose scenario?

Repeatedly dealing with this type of patient will quickly wear you down emotionally. In fact, without even realizing it, one difficult patient can impact your interactions with non-problematic patients. When you see the offending patient’s name on the schedule for 2:15 p.m., that interaction will be the only thing on your mind during every exam leading up to that dreaded appointment. Afterwards, you’ll spend the rest of the day mentally dissecting the interaction, negatively affecting your afternoon appointments as well. Is this extra level of stress worth it? It may be best from a common sense standpoint, as well as a financial one, to just cut the cord and dismiss the patient altogether.

Yes, there is a financial gain from firing a patient—your energies and focus are not drained and drawn from the rest of your day. Also, your staff will be more supportive of other efforts to grow your practice if they see you supporting them by firing patients like this.

Does Fire = Fail?
Most people reflect on successes as personal accomplishments, but view failures as the work of others—e.g., “I successfully fit that very tough keratoconic” but “the reason we had a poor revenue generating week was because we saw a lot of patients from XYZ Plan.”

Highly successful practitioners define both successes and failures from their own vantage point. They don’t view firing as a failure because the patient is crazy, but rather as their failure to properly cull the right mix of patients in the first place. The ensuing success comes when the doctor steps up and takes responsibility for dismissing the patient. The same thoughts go for firing staff members who aren’t a good fit.

These über-successful doctors use personal failures as learning experiences, and turn them into later success stories—one fired staff member and patient at a time.