Does your practice crackle with excellence?

This new use of the word crackle reminds me of a virus because what causes it is often hard to pinpoint; yet, the results are easily seen.

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by business coach and trainer, Donna A. Suter, Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.


Crackle: verb  To show liveliness, intensity, energy

I am writing this from the OptiCon, ABO/NCLE national conference and just learned the new millennium, “hip” use of the word crackle.

Major educational events are filled with energy. What makes this conference crackle is its dedication to education. OptiCon could be defined as the education of opticians in dispensary profitability, refraction and visual acuity, spectacle lens technology and problem solving concerning the wear and use of all modalities of contact lenses. It crackles.

This new use of the word crackle reminds me of a virus because what causes it is often hard to pinpoint; yet, the results are easily seen.

As I look through the  audience, I see faces motivated to become better at helping patients see clearly  all life’s visually challenging situations.  They crackle.

Did you know that the referral of new patients by loyal established ones is still the biggest source of patients for most practices? All practices enjoy some of this word-of-mouth growth, but some are masters at cultivating it while others get a basic trickle of referrals. Which practices do you think crackle?


The way to achieve maximum word-of-mouth is through excellence in patient care. Sure, part of that is ensuring the health of the eye; but the patient is a consumer.

Consumers only crackle in when there is a presence of excellence in customer service. An outstanding patient experience creates a patient who tells co-workers and friends about the practice. The happy patient becomes a walking, talking, no-additional-cost, advertisement for your skill and the expertise of your employees.

Patients infected with your practice’s crackle of excellence return more often and spend more money. More than just what their plan covers in the optical. Purchasing more than one pair of glasses.

Customer service is almost too talked about. It is too talked about because it can be taken for granted. That is because the only patients who give “good” practices unsolicited feedback are patients who have had positive experiences, and that sometimes leads to physicians and staff becoming blind to their faults.

Then physicians and staff who think they are good in surpassing patients’ expectations gradually let it fade from “good” to so-so. They never crackle with excellence.


Each day, my consulting office receives calls from dispensing ophthalmologists who are frustrated with the lackluster performance of their optical shops. When asked to elaborate, physicians often talk about optical staff who take advantage by arriving late, leaving early and refusing to use their recently purchased optical management software; or, are struggling with the virtual ordering of optical product through various vision plan portals.

Indeed, at times, the optical employees, practice administrator and physician-owner feel besieged by criticisms, demands and sub-par financial performance.  The energy oozing from these practices is negative and probably does not attract word-of-mouth business.

Faced with such management dilemmas and without guidance, most leaders seek to gain control by pinpointing where the problems lie and then imposing corrective actions. While identifying root causes is paramount, taking control is not recommended.

According to business guru William C. Byham, PhD., helping employees take ownership of their jobs so that they take, for example, personal interest in improving the performance of the optical dispensary, is fundamental to success in the new millennium.

In other words, increasing management’s control over the day-to-day running of the dispensary is not the best route to financial success and increasing patient satisfaction. Neither is putting the responsibility to improve on the practice administrator’s shoulder.


This is good news. After all, physicians are far too busy being physicians to assume the responsibilities of growing the optical as well.

The keys to obtaining improved performance lie in providing clear goals, firm guidance and optical employee empowerment. By definition, “empower” means to give power or authority to someone.

Empowerment is the act of empowering or the state of being empowered. For the optician to be empowered, he or she must first know precisely what is expected.

Stress research has shown that when people feel they have at least some control over their work situations, their blood pressure will rise temporarily when faced with a challenge but will subside rapidly when they lack control or perceive that they do. When employees remain stressed, among other symptoms, they are likely to interact discourteously with patients and co-workers.

Empowerment often begins with delegation. When co-workers or team leaders delegate properly, your peers rightly feel worthy of the responsibility. Delegation is not only beneficial to the “delegatee” but is also necessary for the full effectiveness and efficiency of the “delegator.” It is interesting that physicians frequently voice a desire to delegate and employees tell me they are willing for the physician to delegate. A spirit of commitment to this concept is essential.

The steps are straightforward. What I would like to briefly touch on is the dynamics of the process. Delegation is a complex, often emotional process involving two or more people, each with different abilities, insights, levels of confidence, anxieties and habits.


If they are to succeed in this special aspect of workflow called delegation, they must appropriately communicate, coordinate and cooperate during a period of transition.

For example, the delegator will be losing the automatic awareness of the task’s status. This made lead to helicopter behavior. How about the feelings of the delegatee?

If I were that person, more likely than not I will want to prove to you that I am worthy. This feeling, mixed with a normal amount of pride, is likely to cause me to want to go off on my own, complete the assignment and deliver it back.

In other words, I will avoid you until it’s done. Do you see how very natural emotions might cause conflict?

The delegator will be nervous in the absence of information, so has a need for more information between us. On the other hand, my striving to excel, providing less information than might normally be expected leaves us in a real teamwork challenge. 

Add to this process an under-performing optical. Management may be feeling the financial pressure to increase profitability of close it down. The employee knows the basics of good customer service but, just like the analogy of crackle to a virus, cannot pinpoint exactly what causes the consumer to be so impressed that he or she is not only willing to spend more on product upgrades but brag about the dispensary to friends and family.

When helping a practice improve performance, I use the acronym SMART as my guideline for goals:


  • S is for specific. The more tightly defined the goals, the more focused employee actions will become.

  • M is for measurable. Goals must be measurable. If the practice hopes to benefit from tracking metrics and consumer feedback, employees and management must agree on what is being measured.

  • A is for aggressive and achievable. Especially if the practice is losing patients, it is important to push employees beyond their comfort zones. Goals are a stretch; but within reach if 100% effort is given.

  • R is for relevant. Goals should pertain directly to your situation. What is your biggest performance challenge or weak spot? A patient care/customer service survey often offers insights.

  • T is for time. A reasonable but firm deadline is essential. Without a time deadline, employees have no built-in performance accountability.

What if the practice has set appropriate goals but is still not seeing results? This is where empowerment come in. The optical employee given the task of improvement should be able to count on employees in other areas of the practice to assist. Conversations should focus on the expected end result, major policy ground rules, and intermediate checkpoint expectations.

For example, the optician should be able to enlist the help of technicians and front desk personnel in tracking prescriptions with a refraction change and talking about how pleased patients getting eyewear from the onsite dispensary are with their sharper vision. Empowering responsibility without authority to marshal the practice’s resources toward goal achievement creates the kind of frustration and stagnation that causes employees to lose interest.


When it comes to running a profitable dispensary, knowledge is not only power, it is empowerment. The empowered optician must be aware of the explosive advancements in spectacle lenses technology. 

OptiCon and other educational meetings rekindle employees’ love for the profession. They will come back to your office incredibly motivated and refreshed.

Conferences expose them to other eyecare professionals and a multitude of vendors and products in the exhibit hall.

It is extremely expensive to bring a renowned expert speaker to your office, but your staff can attend many excellent presentations at these meetings. A well-trained staff is a better reflection of your standard of excellence.

The opportunity to travel and attend a major conference becomes an incentive. The return on the investment is very high from the standpoint of improved job performance and sales.

The re-energized employee returns and is positively crackling.


Remember, management and the physician shouldn’t run the practice, they should empower employees to ensure that patients leave smiling. Understand them and empower them to run toward the success you crave.

As General George S. Patton suggested, “Don’t tell people how to do things. Discuss what the end result should be and they will then surprise you with their ingenuity”.


Donna Suter

P: 423/400-3626


Suter is an internationally recognized authority on the unique practice management issues that face dispensing eyecare practitioners.




Related Videos
Related Content
© 2023 MJH Life Sciences

All rights reserved.