Practice Management

Hiring an associate OD - why, when, and how

Many eye care practices reach a point where the schedule is so packed that coming up for air to work on the business is impossible because all your energy is spent working in the practice. This has become something of a trope in eye care conversations everywhere, but how do you address that problem?
Published 11.20.2023

The good news is that congratulations are in order! Your practice is so successful that it’s time to enter a new phase: expanding your optometric staff to take care of patients and reduce your wait times. The great news is that this decision doesn’t have to be as hard as some people make it out to be; let’s get down to the essentials and examine the different considerations of hiring a new OD.

Signs you may be ready to hire an associate OD

If you’re booked solid and your patients are experiencing long wait times, it’s a clear sign that your practice could use an additional optometrist. Keep in mind that longer wait times for your patients decreases their satisfaction, their likelihood to recommend you to their friends, their likelihood to return next year, and even their willingness to purchase eyewear at your practice.

One survey found that 14% of patients experience frustration after less than a 15-minute wait, and 24% are unhappy with a wait time between 16 and 20 minutes. In contrast, 3% of surveyed patients don’t become frustrated until they hit the 40-minute mark.

Along similar lines, if your appointment book is locked for the next few weeks, another associate may be the right decision for you. Generally speaking, existing patients are willing to wait a few weeks to come to your practice and see you when you’re available, but what about new patients? If new patients are calling but don’t schedule an appointment, you’re actively turning away new business. The value of bringing in new customers cannot be overstated, and the loss of that opportunity is immeasurable.

When your workload becomes overwhelming, the quality of care you provide will suffer; even if your patients aren’t saying so to you or your team, an overworked team will take shortcuts and the end result won’t be ideal. Hiring an associate will help maintain your high standard of care and improve morale in the office.

Also, don’t discount your own desire for growth: if you have ambitions to expand your practice or offer new services, an associate optometrist can activate more exam lanes or offer new services that your patients would benefit from. Seeing your business from this perspective will allow you to be proactive in your staffing decisions and plan far in advance of needing to hire an associate.

But remember, in order to improve your business, you need the time and headspace to work on it. If 100% of your working time is spent on patient care and putting out fires, you cannot focus on the growth or expansion of your business.

Financial Health Assessment

Before diving into the hiring process, it's important to conduct an assessment of your practice's financial health. This involves a review of your financial reports, including profit and loss statements, balance sheets, and cash flow statements.

Getting an accurate financial sense will make sure you understand whether or not your business can afford to hire an OD. If this assessment says you’re not ready, it should indicate what steps need to be taken to get you there.

Examine your revenue trends over the past 12-24 months. Ensure that the practice is consistently generating sufficient income to cover existing expenses and has the potential for growth. First, pull a profit and loss statement for a twelve month period and look at the growth from month to month and see if your net operating income is growing consistently.

Assess your profit margins to understand how well the practice is operating. Look at whether there is room to absorb additional costs associated with hiring an associate (including and especially in the initial period of training and mentoring).

Analyze your cash flow to determine if there's enough liquidity to cover not only your immediate but your ongoing expenses. Then factor in the additional salary, benefits, and overall burden rate.

Take a look at any outstanding debts and their impact on your ability to invest in the practice. Consider whether your current financial standing allows for the additional financial commitment associated with hiring.

The national average salary for an associate optometrist in the United States typically is around $150,000 give or take $50k, this will vary based on location and experience. Be sure to budget for benefits like healthcare, malpractice insurance, continuing education, and retirement contributions, along with other generalized overhead costs.

ProTip: whether you’re looking to hire an associate optometrist or not, it’s good business practice to maintain a financial buffer to cover unforeseen expenses and potential fluctuations in patient volume. Aim for something in the range of $20,000 to $50,000.

Once you’ve found the right person, you’ll need to invest in their training and onboarding. Training will look different compared to other roles in your practice. An associate optometrist will require more extensive clinical training, especially if your practice has a specialty or unique piece of equipment. Even basic equipment varies office to office and each manufacturer has its quirks.

The cost of training an associate optometrist can vary depending on their level of experience. Consider not only the direct costs of training but also the cost of your time spent mentoring. Think of this as the overall burden rate (OBR) which is the entire cost of onboarding. The OBR includes salary, benefits, training costs and a production onramp as your new hire gets used to your practice. It’s important to understand that the longer the onboarding period lasts, the more costly it becomes.

Tips for a Smooth Onboarding Process

Create a detailed written plan that outlines the training process, objectives, and timelines. This helps both you and your new associate stay on track. Don’t forget, no matter how much clinical experience they have, your office’s common procedures and overall expectations are all nuanced and new to them.

Provide mentorship and guidance by making yourself available for questions and feedback throughout the onboarding period. Strong mentorship will significantly enhance not just the training process, but your ongoing relationship with your new associate. Allow your new associate to shadow you with your patients to provide them with hands-on experience and a thorough understanding of your standard of care.

Foster a culture of open communication where your new associate feels comfortable discussing challenges and seeking clarification. Regularly assess your associate’s progress and ask them for feedback as well. Give them a sense of ownership over their own training and be open to adjusting your training plan. Even the best laid plans need to be tailored to the individual.

Wrapping up

Hiring an associate optometrist can be daunting and even a little scary. Instinctively, it may feel easier to just work those clinical hours yourself and avoid the more extensive process; however, with the right planning and a clear strategy, it will no doubt be a valuable investment in your practice’s future success.

By creating and following a structured onboarding process and fostering a supportive learning environment, you can set your new associate up for success and ensure a seamless transition into your practice. Doing this effectively will alleviate some of the warning signs we discussed at the outset and should get your practice on track to its next big milestone, whatever that may be!

Amanda Collaso
Amanda Collaso, Founder Bookkeeping for Optometry
Amanda Collaso brings 14 years of optometry expertise, excelling in training, technology implementation, and billing & coding. In the summer of 2022, she founded "Bookkeeping for Optometry," a company empowering eye care professionals with financial insights for informed business decisions. Amanda's commitment to enhancing financial literacy reflects her passion for supporting professional success. With practical expertise and forward-thinking solutions, Amanda aims to make a meaningful impact in the eye care industry by facilitating informed choices and financial empowerment for professionals.

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