No matter how new or old your practice, how experienced or inexperienced you are as a practitioner, or how engaged your team is, there will always be opportunities to do more and achieve more.
The thing is, where do you start? How can you identify the opportunities… and how do you prioritise them? One great first step is to undertake a SWOT.
A SWOT is an analysis of your business’ Strengths, Weaknesses, Opportunities and Threats. It can help you analyse what your practice does best and work out a successful strategy for the future.
Your SWOT should encompass every aspect of your practice – from your location, and external presence, through to your in-store look, feel and layout, your stock, customer service, clinical expertise, technology, delivery of products and services, and your competition… the list goes on.
A SWOT should be a team effort because this is a process that requires diverse thinkers to consider all aspects of the practice – from the most creative through to the most analytical
A SWOT should be a team effort because this is a process that requires diverse thinkers to consider all aspects of the practice – from the most creative through to the most analytical. Done well, within an environment where ‘every contribution is a good contribution’, it’s also a process that has the power to engage, energise and build a sense of ownership at a time when many are feeling burnt out. Importantly, this process will begin to generate a stream of viable ideas.
You can start your SWOT by creating a grid (Table 1), onto which you and your team can bullet point the Strengths, Weaknesses, Opportunities and Threats you perceive.
Consider the following:
Strengths – positive factors within your control e.g., what does the practice do well?
Weaknesses – negative factors within your control e.g., what doesn’t the practice do well?
Opportunities – positive factors out of your control e.g., what are the big possibilities for the practice?
Threats – negative factors out of your control e.g., what could potentially harm the practice?
Once you’ve worked through the process, you and your team will have a clear understanding of the current situation, and some big picture ideas for growth that can be researched and further analysed. You will also gain insights about the areas of the practice that excite team members – insights that will be invaluable when you’re ready to delegate projects to work on your finalised growth strategy.
BRINGING IT BACK TO PRACTICE
With all of this in mind, let’s now look at some specific steps optometrists around Australia have initiated to grow the potential of their practice.
Investing in Technology
There’s no doubt that as the scope of optometry expands, so too does the importance of investing in technology. However, acquiring technology is not without risk. You need to be sure you get a return on your investment over time, it will integrate with existing equipment, be user-friendly to improve workflow efficiencies, and enhance your clinical expertise for improved patient outcomes.
This is something that Nasen Udayan is very much aware of. As the practice owner of Eyecare Plus in Toronto, New South Wales, he has always been passionate about investing in technology – in fact every year his practice makes a point of acquiring at least one new device.
“We had a retinal camera in 2005 when most practices didn’t, we added electronic letter charts in 2006, and in 2011 we installed a Zeiss OCT (optical coherence tomographer) when most ophthalmologists didn’t even have one,” he said. “We’ve had intense pulsed laser to help with dry eyes for over six years, a Clarus Ultra-Wide Field was added in 2020, and just lately we have upgraded to the new Zeiss 6000 OCT with Angio Plex. Of course, you can have all the equipment in the world but it’s not going to help you unless you’re a good optometrist and offer patients the best possible solutions.”
Toronto is a small town on the shores of Lake Macquarie, between Sydney and Newcastle. It’s hard to imagine that this investment in technology would deliver a financial return, however Mr Udayan begs to differ.
“The technology we invest in differentiates us from our competitors. We find people travel from many suburbs away to see us and they have no problem paying for the services we provide. We get referrals from ophthalmologists who want us to co-manage patients using the same equipment they use. Then there are optometrists who kindly refer their patients to us for specific examinations because they don’t have the required devices.”
To keep the patients flowing through the practice, Mr Udayan has an optometric assistant doing all the pre-testing.
It’s not only the consultation rooms that are equipped with the latest technology.
“Our five TAFE-qualified optical dispensers use Essilor’s Visioffice 3 to customise our multifocal lenses – it’s the only one in Newcastle. Of course, premium lenses come at a higher price. Sometimes we lose patients to the competition but, when they realise what they’re buying elsewhere can’t compare, they often return to our practice”.
According to Craig Spiegel, Co-founder and Head of Sales at Credabl, the decision to invest in technology should definitely form part of a practice’s SWOT.
“In many instances, a simple ROI calculation is feasible, in other words, return on investment. By way of example, if you were to acquire a piece of equipment that allowed you to bill the client say, AU$50 per scan and you scanned two patients a day, this would equate to income of approximately $2,000 a month.
“In financing terms, you could acquire technology for over $100,000 which may equate to several pieces of equipment. Notwithstanding the monetary side of things, investing in technology can be critical to retaining staff and keeping the team engaged with new learning and growth.
“Now is the time to review your practice as the full depreciation measures come to end on 30 June 2023,” Mr Spiegel added.
Of course, new devices take space and require planning to ensure their placement in practice enhances workflow. To make space for all the equipment Mr Udayan has acquired over the years, he has expanded his premises from 60m2 in 1997, to 105m2 in 2013, and further, to 185m2 last year. He regularly refreshes the fit-out.
“When you’re not in a shopping centre, you’re not forced to upgrade, so it can become easy to be complacent and let things slide. Looking up-to-date is important – it’s a reflection of how your practice keeps up with trends, providing the leading edge in eye care and eyewear,” he said.
Mr Spiegel says continually investing in your work environment can contribute to staff attraction and retention.
“A ROI calculation is not as simple with equipment. However, if you are considering an additional consulting or treatment room which requires renovations, then you can do some calculations in regard to increased turnover/ income versus the cost of fit-out and equipment. Allowing your team to have input in some of the fit-out decisions can be a great opportunity for team building. A consistent team means more engagement with your customers and less time spent training new staff, which is ideal for continued growth,” he said.
Down on the Mornington Peninsula in Victoria, a formalised ‘onboarding process’ has been integral to achieving significant growth for George & Matilda Mount Martha. Practice founder Kirsty Banfield joined the George & Matilda Eyecare group in 2020, and for an initial two-month period, was supported by a dedicated business manager who helped identify specific opportunities for growth.
The support and mentoring continues, albeit on a less intensive basis, and the numbers speak for themselves. Mount Martha experienced double digit revenue growth year on year from 2020 to 2021 to 2022, and 27% overall between 2020 and 2022. This was despite being impacted by Melbourne COVID lockdowns, which extended to the area. EBITDA was up 48%, year on year.
Justin Smith, a George & Matilda Regional Business Manager, said a key to this success has been a focus on the ‘lens value proposition’.
“At G&M we position ourselves at the premium end of the market – it’s a competitive environment, so we don’t try to play high volume, low cost; we focus on the patient, on giving them a superior experience in the test room and giving staff outside the test room, enough time to carry on that level of service and education. The lens value proposition is all about offering premium lenses and coatings every time. As a consequence of doing this, we’re finding the average ‘basket value’ has gone up 30% since Mount Martha joined our group.
“Our key lens partner is Zeiss and they have been really supportive, providing education and support to stores as a group and individually. Mount Martha has reaped the benefits, despite having been a Zeiss store prior to joining G&M, the support and education they’ve been given has translated to further growth.”
Another key to the practice’s success has been a willingness to embrace change. “Kirsty is a leader in the industry… and her team is such a cohesive unit – everyone is pulling in the same direction – so the communication between staff and with patients is consistent all the way through,” said Mr Smith.
Ms Banfield agrees that good communication within the team and with patients has been critical to the growth achieved.
“Often new patients to the practice, who’ve had a bad experience elsewhere, come in feeling wary – they’re concerned that they’re going to be pushed into something they don’t need or want, or be given a recommendation that won’t solve their problem. So, it’s about listening to their problems, then taking the time to explain our findings, why we’re making a particular recommendation, and why the spectacles – or treatment – we’re offering will turn that problem around. Then it’s about making sure we’re clear when passing this information through to front of house staff. Once we’ve built trust with a patient, they feel confident about our advice and they become our best advocate.
“I’ve been here for 24 years, people come in and they trust me and my staff – they trust in the advice we offer, and that transfers to better dispensing sales.”
Whenever she has time, Ms Banfield says she involves herself in the patient dispensing process. “People have known me for so long, they’ll often insist on me giving them a second opinion on their frame of choice,” she said.
The communication doesn’t end at the point of sale, with every patient contacted three to four weeks after a frame is dispensed. “We reach out to make sure they’re happy and give them the confidence to come into the practice to get an adjustment – having spent all that money, we don’t want them to put their glasses in the drawer if they don’t feel good when wearing them.”
The importance of clear, honest, and regular communication was something that optometrists and business partners, Dr Katherine Duong and Dr Anna Tang, were intentional about when they started planning their own practice in Five Dock, New South Wales. Part of the ProVision group, Theia opened in late 2021 and the two the practice owners – who are friends from university days – knew that a formalised process would be essential to success.
“We’ve been really good friends for a long time but being business partners is different,” Dr Duong explained. “With two people you’ll always have different opinions, and texting or leaving messages to each other on the phone often results in miscommunication.
“We get around this by having a day each week when we are both in the practice together, so we can have a mini staff meeting. We discuss what’s been happening over the past week and what we want to work or improve on. We also break down our goals and allocate jobs, then write everything down so we don’t get any cross over. We check back the following week to ensure we’re being productive.”
Playing to their strengths, Dr Tang has taken on managing staff and rosters as well as the accounting side of things while Dr Duong manages the marketing, frame choices and deals with suppliers.
“The person who deals with the job makes the final decision,” Dr Duong said.
To maintain their friendship, the two business partners make a point of spending time with each other outside work hours; attending pilates and boxing classes, and playing badminton together.
When working on a larger scale with multiple employees, formalised processes for communication and leadership are critical to building successful teams.
Award winning Specsavers Hervey Bay Partners, Gabriella Pezzuto, Natasha Cannan and Sarel van Westhuizen, explained the effort that has gone into ensuring their clinical, dispensing and retail team members work as one.
“We work as a well-oiled machine, with every person understanding the value they bring in making a difference to people’s lives. From the team member who greets and triages a patient, to the person who conducts the pre-test, through to the test room, we all bring something to make the eye health journey as supportive as possible,” says Ms Cannan.
“As leaders, we listen to the team and do what we can to remove barriers to make doing their jobs as easy as possible. We invest in new technology to streamline processes and provide the best technology for our patients, making it easier for team members to do what they do best in supporting our patients.”
Daily huddles to share case studies, discuss challenges, listen to feedback and communicate goals and focuses clearly, are paramount to this team’s success.
“We make sure everyone, even locums, are rostered and paid to start 15 minutes early every day to attend the daily huddle – it is that important to us,” said Ms Pezzuto.
BENCHMARKING FOR CLINICAL SUCCESS
To build on clinical achievements, the partners review their weekly optometry benchmarking reports, identifying areas for improvement and putting processes in place to ensure the team has the resources and support to achieve those goals.
These processes include the education of the front of house retail team members to ensure they understand the value that particular services can provide, and work together to support patients.
Another element of the store’s business plan has been to bridge the gap between GPs, optometry and ophthalmology, to form a collaborative care eco-system to support patients’ eye health.
“Trust is paramount to successful collaborative care,” said Ms Pezzuto. “We worked with our clinical team to ensure patient notes, referrals and feedback were shared with GPs and ophthalmologists, so they knew they’d be kept up-to-date on a patient’s eye health journey. The positive from this has not only been excellent patient care – the trust has led to GPs and ophthalmologists referring patients to us directly, knowing their patients will be in safe hands.”
GETTING PATIENTS IN AND BACK
Getting patients into a practice – and then getting them back – is of course essential to any business. Aside from networking and winning the trust of referring colleagues, marketing is a key tool. A practice needs to build awareness of its presence, then educate and remind prospects about its products, services and expertise.
Acquiring new customers can cost five times as much in marketing and business costs as maintaining existing customers. Additionally, research undertaken by Bain & Company found that increasing customer retention by 5% increases profits by 25-95%.
MyHealth1st’s online booking and patient communication platform has become a proven tool for attracting and retaining patients, and for maximising practice potential. According to Klaus Bartosch, Managing Director of MyHealth1st, practices that have adopted the platform report several advantages.
“The no-show rate from the industry standard of 10-20% improves to less than 1% for all patients who book online through the platform. We also know that the use of the MyHealth1st EasyRecalls system usually doubles a practice’s recall conversion rate and that the MyHealth1st.com.au marketplace delivers, on average, one third of the new patient flow they see through their own website. Finally, for the first time, a practice can identify the actual source of all new patient appointments and therefore the effectiveness of their marketing investments – all too often practices have either no or poor data on this.”
Mr Bartosch said the typical percentage of consult bookings that practices take through the platform changes over time.
“When a practice first starts using the service, they see 10% pretty much straight away. Over the next two to three years that will progressively move to between 50-75%. However, all of this can be achieved more rapidly if a practice ‘actively’ promotes the MyHealth1st online booking service to all their patients. The MyHealth1st EasyRecalls system is the easiest and best way to do that.”
In a busy practice, setting up MyHealth1st is not onerous. In fact, Mr Bartosch said, “It can be completed in 30 minutes. We do all the work for them. Gaining access to their servers and scheduling the training can take time to arrange, but the setup process occurs quickly and efficiently.”
Optimise Your People
Mr Schaffer recommends practice managers start by doing the following:
- Refine your processes regularly and remove the redundant ones while resisting the temptation to add more,
- Quantify tasks as far as possible by listing repetitive jobs you or your staff do daily, weekly or monthly,
- Automate or outsource those tasks, either to software or to an external company where practical. He says practical ways to automate things are:
- Ask your laboratory to provide software to trace job status online – this will save phone calls to the lab for status updates,
- Set up your point of sale (POS) software to automatically email your frame and or lens order directly to the supplier,
- Send a patient information form automatically via SMS or email it to new patients so they can fill in their information before they arrive for their appointment,
- Use rostering software to ensure staff know where and when they are rostered on, and
- Use online bookeeping software that is integrated into your POS.
“The right POS software will help you to automate your most common tasks and thus help free your humans to do what they do best: interact and help other humans. “Most importantly, speak to your people and ask them how you can make their lives easier – it is a simple question that can have huge benefits,” Mr Schaffer concluded.