What was your biggest challenge in 2022?

Without question, the biggest challenge we’ve had in the past year is staffing. We have about 85 employees between our 5 offices, Pre-COVID. If we had 3 employees leave over the span of a year, that was a high number. In this past year, we had about 1/3 of our staff leave. When you have that much turnover, you wind up in an adrenaline-filled, get-me-through-the-day mentality, because you’re in a constant state of training and interviewing, on top of your other daily duties.

A number of our regular staff were pulled away from their regular duties to help interview and screen applicants. The entire situation just trickled down and impacted our whole system.

How did you handle that challenge?

We realized that the way we addressed our staffing issues, our entire hiring system, was inefficient. Duties for the hiring process were not being handled smoothly, applicants were passed from person to person for each step of the process, and it was just slow and bogged everything down. We came to realize that, in today’s market, where we have to hire more people than we ever did before, we needed to completely re-engineer this system, and close the gaps and delays between each point in the process.

We actually created a separate “hiring team” that became their own department. With frequent meetings, they were able to really streamline the hiring process, and eliminate or handle most of the challenges in working the applicants through the steps. They were also able to turn their attention to alternative sources for candidates, and helping us differentiate our practice as an employer.

When you review your metrics for 2022, what went really well?

With all of the challenges that last year produced, when we review the metrics, one thing that jumped out at us was the Clinical Revenue per Exam. We know that, as the American population is aging, the incidence of a number of age-related eye conditions – cataracts, glaucoma, diabetic retinopathy, etc. – is also rising rapidly. So we know we have to respond in a medical management mentality and we have to do it better than anyone else. We’ve built our entire clinical approach around that, and we’ve also created a very effective screening program, with OCT and Optomap.

We knew we were moving in this direction; our clinical revenue per patient has always been high. According to our metrics software, we’ve always been in the top 25% of practices on this KPI (Key Performance Indicator). In reviewing our 2022 results, we found that we had increased our clinical revenue per exam by over $10 per patient exam. That was really moving the needle, and we felt great that we were responding well to the increased demand from patients, and providing the sort of enhanced care that would lead to better patient outcomes.

Was there a particular strategy you leveraged to grow your clinic revenue?

1. Wellness Program

I think one of our main strategies was continually “tweaking” the wellness program. We ensure that our technicians are using the right verbiage, explaining the costs and benefits clearly to the patients. We continually work on that.

2. New Technology

We also purchased a new Retinogram unit that we’re using for glaucoma, but more particularly for diabetic retinopathy. It really enhanced our understanding of those eye diseases. Evaluating and bringing in new technology for the benefit of our patients has helped us tremendously.

How does that growth in clinic revenue impact your practice?

In terms of profitability, that uptick in clinic revenue was huge. It wasn’t without its challenges – we had a simultaneous drop in our optical revenue, which could be related, or even just a natural byproduct of the patient diagnosis. The question we’re facing now is how to stimulate growth there that keeps up with our clinic revenue. In terms of overall profitability, the clinic KPI paid off huge rewards, our overall revenue increased, even with the drop in optical revenue.

What are you planning for 2023?

The number one thing that we want to focus on in 2023 is our Optical Capture Rate. Historically, that’s run at about 45% for us, which is decent, considering the practice model. Compared to other practices it may be low, but for us, that’s been about our average performance. More recently, we’ve seen that drop into the low 30’s. That’s a big decline, and we want to understand the reasons for that.

Staff Turnover

The rapidity of turnover, particularly with our optical staff, has contributed a lot to this decline. It just takes a certain amount of time for an optician to come up to speed in the practice and we also lost touch with some of the systems we had in place for handoffs to make that transition more successful.

To respond to the challenge in 2023, we’re going to revisit the optical program and renew some of the past successes. We’re also planning to expand our training programs for technicians and optical personnel to improve those outcomes.

What’s your advice to practitioners who are planning for 2023?

I would say “we feel the pain.” 2022 was a tough year. But, out of all the health care professions out there, I think optometry is poised to jump in and take the lead. The medical system right now is a bit of a mess, but in optometry, we’ve always made our living based on great patient service. That’s what differentiates us from many other providers. We are poised to not only care for our patients well, but even improve that standard of care. Optometry needs to continue to move toward the medical model, in my opinion. So many patients need care that we are uniquely positioned to provide, and we have a great opportunity to help and educate them.

About Dr. Michael Cymbor

Mike Cymbor, OD is a managing partner for Nittany Eye Associates in Nittany, PA, where he has practiced for more than 25 years. This five location practice has 12 providers, and supports a team of 65-90 staff members. They serve patients in 20 exam lanes at the 5 locations.

Dr. Cymbor has been using metrics seriously for about 5 years now. He tracks his Year Supply Sales and Optical Capture Rate very closely on a regular basis. He began using metrics because he wanted to work on standardizing performance across their multiple locations. He was hoping to consolidate resources and support in order to realize better volume discounts on products, while still providing great patient outcomes.

“Optometry has a big role to fill in 2023, and I think we’re more than up for the challenge.”