Managing a single optometry practice can be difficult.  There is the patient management aspect (being a doctor and caring for patients), employee management, information technology (IT) management, software updates, creating processes, and assuring profitability.  This is only a fraction of the responsibilities that an owner has to manage as each one of these topics can be expanded into several subcategories.  When you take into consideration expanding this to multiple locations, you can quickly see how logistically it can very quickly become a complex situation.  Although every situation is very different, here I will share several things that seem to make managing multiple locations obtainable.

Leverage the benefits of multiple locations

The larger an optometry practice is, the greater the buying power of wholesale goods and other office supplies.  When you consider purchasing for several locations, you very quickly understand how the volume of business generated from multiple locations provides you leverage with your distributors because now you represent a larger percentage of their business.  

This is what we oftentimes refer to as partnering with companies.  This initial inclination is to lower your wholesale cost on the products that you purchase.  Certainly, that is one of the benefits, but there are others as well.  Partnering with these companies oftentimes provides the opportunity for them to help your offices with much more than simply a lower cost of goods.  They can help in providing additional training on their technologies and oftentimes can help your office be the first to have new technologies as they emerge.  

Set consistent policies but allow local flexibility

Policies are critical for any office.  As you are aware with a single location it can be difficult to manage processes and multiplying it by several locations can be a daunting task.  We currently have high-level policies that are consistent for each location.  For example, employee policies, eligibility for vacation, and benefits are consistent.  The vendors that we order from, the software that we use, the nutritional supplements that we offer from our offices, and the diagnostic equipment that we use amongst all of the offices is relatively consistent.  But, the choices of frames, ophthalmic lenses, and contact lenses that are utilized at each location are left to the discretion of each of the locations.  This provides the office structure but also gives the employees at the respective locations the freedom to make decisions locally.

Share responsibilities

Owners have a passion for controlling and setting the course of the practice.  This involves a lot of additional time and effort to successfully manage an office.  As you own multiple locations, the logistics increase substantially.  There are only so many hours in a day so the owner(s) must become more selective with what they spend their time and effort performing in the practice.  The good news is that there are benefits to scale and something that is being performed for one office can oftentimes be performed for multiple locations.  By distributing responsibilities and centralizing them, one individual can be responsible for the specific task for all of the locations which frees others up at the other locations who do not have to perform those same tasks.  

As a specific example, every office will have bills every month that need to be paid.  An individual at each office will need to pay those bills.  If there are two separate offices that are owned by different individuals, there is someone in each location that has to make sure that the bills are being paid.  If there are now two offices but they are owned by the same person, there is one person that can be responsible for paying the bills for both locations.  Additionally, often times your vendors can centralize the billing so that you receive one statement for both locations.  This is one example of the benefit of centralized processes but there are several other processes that can be centralized amongst multiple locations to help with efficiencies. 

Consider outsourcing billing

Medical billing and coding can be a time-consuming endeavor.  Translating what is done in the exam room to the appropriate diagnosis and procedure codes is critical.  But that is just the first step.  The appropriate diagnosis codes need to be linked to the appropriate procedures, and they then have to be submitted to the medical insurer (usually through a clearing house), the explanation of benefits from the insurer then needs to be reviewed and appropriate payment needs to be posted to the patient’s account.  If there are any errors in the submission, those then have to be re-submitted to the insurer.  This all needs to be done accurately or it could be costing an office a significant amount of money.  This process could be done internally but if employees leave, there have to be other employees that can immediately pick up the responsibilities of the employee that left.  Understanding how important consistency in this process is and concerns about employees being completely up to speed on the processes, we decided to have the billing outsourced.  It has truly streamlined the process and allowed more time in the office for employees to work on other tasks.

Get into the weeds

One of the challenges with understanding what is occurring at the individual locations is being there to see what is occurring.  Although it is best to be at the specific office, it is difficult to be in two places at once.  Fortunately, advanced technologies have provided us the ability to have greater insights into what is occurring at various locations.

Networking offices together is now a real possibility with IT and software advancements.  We can run reports and immediately see what the offices have produced for any given time period that we specify.  Additionally, we track our patient’s journey throughout the office in our optometry software.  So at any given time, we can see that in our software.  As an example, from one office, we can see where patients are in their journey within the office at other locations.

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Additionally, with software advances, we can also see things like the phone call load at other locations as well.  Sometimes, the schedule that is in the electronic health records isn’t the whole picture in terms of how busy the office is because they may be working with a greater-than-normal phone call load for that day.

There are several things to consider when managing multiple locations.  Keeping these things in mind will help manage them more efficiently.