Dispensing Frontiers
Change and Communication
Recently added an optical? Addressing the new situation makes all the difference.

Adding and optical to a practice creates a whole new entity with a very different kind of patient flow. If this change isn't addressed, ophthalmic staff are likely to remain stuck in routines that no longer work. Plus, they may have their own ideas about how the dispensary should operate, leading to disagreements.

What to do? Communication is the key.

THE HEART OF THE MATTER

Here's a step-by-step process you can used to resolve these issues:

• Step 1: Remove the mystery. Call a meeting and flow chart exactly how patient care is now being delivered -- from the patient's point of view. Explain that you want to clarify and resolve problems with office procedure -- not issues such as personality conflicts.
  Have each staff member (including you) explain what he or she does for the patient. Encourage questions. (You may find that your optician doesn't have a clue how medical services are delivered, or your ophthalmic team doesn't understand why it takes longer to get AR coated lenses.)
• Step 2: Pinpoint problems. Problems that frequently crop up will be brought out, usually by the person whose routine may be contributing to the problem. (Ask each group to pinpoint problems in their own process, not others'.) It should become clear that everyone shares the same frustrations.
  Don't mention your concerns until your staff has finished. By letting them identify problems in their own areas first, you let them own the problems. That makes it much more likely that they'll work to solve them.
• Step 3: Generate solutions. Each staff member should discuss solutions for problems in her own area. Meanwhile:
  • Make it clear that it's OK to say, "I don't know what the solution is."
  • Ask what (if anything) they've already tried as a solution.
  • Ask whether they rejected any possible solutions before implementing them, and if so, why?

Only after each person has explained how she's tried to solve problems in her own area should others offer suggestions.

• Step 4: Discuss the impact of each possible solution. Will this solution improve patient care? Will it cause other patient care problems? If so, can these be easily resolved? (If not, the suggestion may have to be discarded.)
• Step 5: Define roles and responsibilities. For each procedure on your flow chart, ask the following questions:
  • "Who is responsible for this step?"
  • "What should that person do if a problem occurs?"
  • "Who can help that person if she becomes overloaded?"
  • "What should she do if the patient won't (or can't) cooperate?"
  • "When should the doctor become involved?"

Record the answers. Later, revise your procedures manual accordingly.

BACK ON TRACK

It will probably take several meetings, but as your team comes to agreement on how to deliver care, they'll define their own job descriptions in ways that best serve the patient. This will put an end to most misunderstandings and help to eliminate apathy.

Then you can get back to growing your practice. 

Leona Meditz has 25 years' experience opening, owning and operating dispensaries. If you have questions regarding this article, please e-mail her at leona@getnet.com.