Considering hiring an optometrist? An O.D. can certainly increase the overall productivity, income and profitability of a practice. But to make the most out of this step, you must determine exactly how an O.D. would benefit your practice, and you must establish goals and a game plan.

An optometrist can be as efficient, or more efficient, than you in certain areas of your practice. If you hire an O.D. to enhance productivity, think about the role you want him to play. Will he be a physician-extender or a channeler of product sales through an optical dispensary? Because these two roles aren't fully comparable, consider your objectives.

O.D.s are mid-level providers of professional services who can free up your time to see surgical patients or patients requiring more extensive care.

They enhance your productivity by providing services ranging from initial patient workups and refractions to eye exams. In this capacity, they can direct patients to additional services, which may include glasses or subspecialty care and surgery.

Other tasks you can delegate to an optometrist include:

• Clinical services, such as refractions and detection of abnormalities, which may be handled by the O.D. or channeled to a physician.
• Seeing "work-ins" for certain problems and pre-op and post-op cases.
• Supervising technicians who are performing various aspects of routine eye examinations to enhance patient flow.
• Increasing productivity and profitability of your optical dispensary through professional, consultative sales contacts with patients. You may even decide to have an O.D. handle the overall optical business. Hiring an O.D. may be a good way to highlight this product line.

Before you take the plunge, consider the costs of hiring an O.D. A typical compensation package starts with a base salary but includes benefits and additional perks. Consider offering incentive compensation to reward productivity or fiscal results exceeding defined parameters. It's also a solid strategy to reward an employed optometrist for building relationships, promoting the practice and enhancing teamwork.

Also be sure to factor in less obvious expenses. For example, you may need more support personnel, new equipment, more examination rooms or a larger waiting room. And don't forget the costs associated with hiring a new staff member, including advertisements, recruiting expenses and time spent on the search.

Legal issues come into play as well. Be aware of the fraud and abuse and Stark laws that govern referrals and fee-splitting for Medicare beneficiaries. Similar state statutes cover non-Medicare patients. These laws basically prohibit you from paying O.D.s based on the volume or value of referrals of Medicare-covered items.

Before you hire an O.D., carefully consider your ophthalmology practice. If you rely heavily on optometry referrals, hiring an O.D. may adversely affect these referrals.

Furthermore, consider whether the other physicians in your practice agree that bringing in an optometrist is a good idea and discuss his role with them. Then decide who will train, monitor and manage the new employee.

Hiring an O.D. can enhance your productivity, income and profitability. But reaping those benefits is only possible if you define your objectives and evaluate what impact the hire will have on your practice -- before you make your final decision.