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Chapter One: It All Starts With You!

Let’s be frank.
Whatever stage of your career you are at, you, as the optometrist, have enormous power and influence. You are as they say in South Africa, ‘The Eye Doctor’. Patients and support staff alike look to you for leadership, advice and clinical expertise.

How you harness this incredible resource has a direct bearing on your success. It can happen that people allow it to go to their heads. As a consequence they give both verbal and nonverbal messages (usually unintentionally I must stress) to patients and support staff alike that they are superior beings and should be treated as such. The psychological explanations for such behaviour are that an optometrist does well at school and university, qualifies to work in a profession, and then after a year is left pretty much unsupervised and unchallenged in some cases. If you consider this scenario, it would be reasonable to understand if some optometrists felt some aspects of optometric retailing were below their dignity.

That explanation aside, what would you do if you overheard a young female optometrist, within earshot of the patient waiting area, say out loud; “I did not study for four years to learn how to make the coffee”

You can imagine the impact of hearing this on the people waiting for an eye test, not to mention the motivation level of the dispensing staff to support this individual. And speaking of performance, let’s be brutally honest. Whether you have been practising twenty minutes or twenty years, it cannot have escaped your notice that the industry has become very competitive.

The old days have gone; it is not economically viable to recommend first time presbyopes to buy ready readers from the nearest department store, or to suggest to the owner of a scratched spectacle lens that he simply has it re-glazed. This is why some of the larger UK companies have recently (2005) introduced performance related pay and appraisal systems for their optometrists. Under the new contracts, theoretically they will be perfectly able to manage out poor performing optometrists from the business. This may sound harsh, but is it becoming an economic necessity...?

It would be completely unfair to do this without offering appropriate training and coaching, but with that in place, why should an optometrist with a lower than average dispensing ratio or average order value, be allowed to under - perform consistently?

Would it be allowed in any other high street based competitive retail business? No.

So why do some optometrists think they ought to be exempt from producing the numbers simply because they are good clinicians?

The challenge, of course, is that we are clinicians, and must remain so first and always. Commercial profit must never be allowed to come before professional and clinical excellence. However, there is no reason why it cannot go hand - in - hand. We have an enormous amount of exciting innovations in the industry, coupled with fashionable, trendy and lifestyle matching accessories that our patients actually want.

The recent advancements in lens technology, both contact and spectacle has been extraordinary, and designer labels are commonplace as they endorse chic and innovative frames at affordable prices.

The problem is that most people only visit the optician every two years, and do not pay a great deal of attention to the industry in-between times unless they have a problem.
This means that a significant number of patients may not know about the recent advancements in comfort with contact lenses for example.

Unless the optometrist explores their feelings, desires and needs (not just their clinical suitability) at the next test, it may be another two or more years before they do discover what they are missing.

Please don’t misunderstand me. Most optometrists I have worked with are perfectly willing and able to ask a closed question...for example: “Have you ever considered contact lenses?”

What they are not able to do is explore needs and desires to do with eye care possibilities in a way that does not facilitate the patient shutting up shop mentally and trotting out the standard answer to the above question... “No, not really”. (We will explore the almost unbelievable power of good quality open questions at a later stage in the book.)

I am now working as a locum to accommodate my childcare needs, and have been able to observe optometrists from different organisations, both independent and multiple. My observations have shown two consistencies.

Everyone is under more commercial pressure than ever before.
Very few have been trained in the human behaviour and communication skills to balance clinical excellence with commercial acumen.

We shouldn’t feel bad about it: human behaviour is a complex business. Why should you know how to sit in silence in order to help a patient overcome his or her own fear or objection without using words, anymore than a behavioural psychologist would know how to evert an eyelid or fit a toric rigid gas permeable lens?

Why would you recognise a buying signal or a lifestyle change indicator, especially if you have not been practising very long and have never been trained to do so?
To help you with this, you will probably be glad to know, we are not going to dissect the reasons why some people perform better than others from a psychological view point. You can research psychologists like Freud, Jung and others, to your hearts desire if you wish.

What we are going to explore together is what you can do personally to get the best out of yourself, your patients and your practice.

Tiny changes in your behaviour that will have a positive impact on the work environment that will lead to happier colleagues, happy loyal patients and good quality dispensing ratio and order values. Be Aware...

Many of these behavioural traits you may have heard of before. Some of them you might already be doing, either consciously or subconsciously. All of them are common sense and so simple that you will have difficulty believing that such a seemingly insignificant thing could make such a major difference.

In order to really benefit you have to be prepared to open your mind, try new things, and practise in the same way as you relentlessly and maniacally practised refracting anyone who was sober enough to open their eyes during your final year at college.

Also, you have to be really good at making the coffee!

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