So, youve been thinking about initiating performance reviews, but youre hesitant because, if you do, your employees will likely expect a pay increase when you are already struggling to meet the payroll. Or, you might dread an encounter with an employee if it is not going to be completely positive.

Despite these common concerns, performance reviews are important because they provide your employees with input that helps them grow and develop their skills, as well as support you in meeting your practice goals. The following review tips can encourage employees to do their best, enjoy their work and be motivated to help you grow your optometric practice.


1. Be Fair and Consistent

Include all employees in the performance measurement and review process. Sometimes managers omit tenured employees, family members or friends. However, all employees can grow and develop their skills based on feedback. Also, use the same review form for all employees.

If you employ other optometrists, review their performance twice a year. Observe the O.D. during several patient encounters in the exam room. (Also, do this prior to hiring to ensure that the O.D. is compatible with your patient-care practice philosophy). In your review, consider these skills: clinical, patient communication, time management, chart documentation, relationship with the support staff and contribution to the practices profitability.


2. Provide Employees With Review Criteria

Prior to holding performance review meetings with your employees, hold a staff meeting at the beginning of your financial year, and hand out job description forms and the performance measurement and review form that you will complete (see Why Job Descriptions are Important, below). This way, all employees hear and receive the same information.

During the meeting, ask employees to review their job descriptions to ensure that their descriptions reflect their tasks. Then, review each category on the review form. General categories should include:

         Personal abilities. This category covers enthusiasm, courtesy, friendliness, greeting and managing patients, telephone skills, house-keeping, personal appearance and confidentiality.

         Dependability. This category covers absenteeism, compliance with time allocated for lunch breaks, following instructions, and the ability to prevent personal problems and challenges from interfering with the job.

         Cooperation and teamwork. This category covers positive interaction with staff members and patients, helping other staff when appropriate and accepting direction and constructive feedback.

        Quality and accuracy. This category covers detail-oriented errors, thoroughness, and minimizing repeated mistakes.

         Productivity. This category covers addressing volume of work, compiling tasks in a timely manner, steadily applying oneself to tasks, and refraining from wasting time.

         Job knowledge. This category should be customized based on job title. For example, a technician should know the brands and parameters of contact lenses used in the practice and the recommended care products for each lens. A technicians job knowledge should also include his ability to effectively train a patient to apply and remove contact lenses.

Why Job Descriptions Are Important

A job description is a written document that lists and briefly details an employees primary and secondary job tasks. It serves as the foundation of the required skill set for a job. Employers use the job description as a recruiting tool for writing a job advertisement, during interviews, as part of performance measurement standards and as the core of the performance review format. If you want to create and customize job descriptions, ask your current employees to list their primary and secondary tasks. Next, look for missing tasks, and identify and eliminate overlapping job duties. Then, narrow down the job description to a one-page document. If your practice has an employee manual, add the job descriptions to it.

Tell your employees that you will assign a rating of one to four in each category based on their performance level during the rating period. One point equals unsatisfactory performance; two points reflect a performance that needs improvement; three points indicate that the employee fully meets the job requirements and provides a solid performance; and four points indicate that the employee almost always exceeds what is expected.

About a week prior to the performance review meetings with your employees, ask them to complete the review form (i.e., rate themselves in each category), and submit it to you. Therefore, you will have time to review their perception of their performance, and you can compare it to your own observations. You might be more likely to remember mistakes than jobs well done, so having your employees perception prior to the review can enhance your session together.

I have found that seven out of 10 employees rate themselves lower than their O.D. manager rates them. When you rate employees higher than they rate themselves, you have the opportunity to offer them unexpected recognition. This recognition is rewarding for them and can make it easier to discuss an area in which you think the employee can improve.


3. Separate Pay Raises And Reviews

Pay raises are typically based on the financial performance of the practice and an average performance review score of at least three points. If the practice had a good financial year, it is customary for employees to receive a pay increase or an incentive payout. Be sure to communicate this information to your staff when discussing the performance review process.


4. Separate Discipline and Reviews

Disciplinary actions are best managed during one-on-one meetings after a situation occurs rather than during a performance review. Managing a disciplinary problem immediately can prevent it from recurring. 

If problems related to behavior, attitude, absenteeism and tardiness do recur after speaking with the employee, document them on an employee counseling report form (see Employee Counseling Report Form, below). The purpose of this form is to provide written documentation of a problem that requires discipline and its effect on the practice and other employees.

You also should state the improvement you expect from the employee and the time frame in which it should occur. Place the employee counseling report in the employees file for your reference.


The Professional Challenges of the Eye Care Business

Because the eye care business offers several different services, including providing health care, selling eyeglasses and contact lenses, and buying and reselling prescription products, employees must be highly skilled. Some important employee skills include being:




         Technically inclined with fine-tuned selling skills.

5. Communicate Clearly

Clear communication with employees is always important. However, it is more important during an employees performance review meeting because this is when you can recognize her areas of strength and those that require growth and improvement.

During the review meeting, address employees actions and how they affect the business. For example, if an employee is consistently late or absent, tell her, When you arrive late, it creates a hardship for the other technicians and results in a lower level of patient services.


6. Ensure Privacy Without Interruption

During your performance review meeting with each employee, focus entirely on the employee so he feels important to you and to the practice. I have observed thousands of doctors during the past 28 years, and I have found that those who are the most appreciated and respected by their patients are those who give their patients their full attention. This also applies to


7. Set Aside Sufficient Time

Each review should take about 30 to 45 minutes. Meeting before or after work or during lunch will ensure that you and your employee are not distracted by patient needs.


Employee Counseling Report Form

Name: _________________________    Location: __________________________

Position: ________________________ Manager: __________________________


o Behavior                                               o Oral Warning

o Attitude                                                o Written Warning

o Absenteeism                                        o 2nd Written Warning

o Tardiness                                              o Suspension

o Other                                                     o Termination

                                                                   o Other

 1.  Describe the action and effect on employees job and/or practice:

2.  Expected improvement and/or standards for the future:

3.  Date for next review:

4.  Next action if employee does not meet the improvement/standard required:

5.  Employee comments:

6.  Managers comments:

7.  I acknowledge that the above evaluation has been discussed with me and my signature does not imply agreement or disagreement.

____________________________      ____________________________
Employees Signature                                 Managers Signature

________________________               ________________________
Date                                                               Date

8. Be Prepared

Prior to meeting with your employees, determine their strengths and weaknesses based on your observations of their performance and their feedback. Then, create possible solutions for their weaknesses.


9. Assess Performance, Not Personality

I consulted with a practice that employed an optometric technician who had high energy, was enthusiastic, outgoing, charming, interesting and fun. However, this employee decided, without permission, to draw smiley faces or frowning faces on patients records depending on whether or not she liked them. She also regularly misfiled patient charts.

On the other hand, another employee who was a highly skilled and licensed optician was unhappy, negative, rude, and unkind to his colleagues. His eyewear sales were the lowest in the group. However, he was reserved and respectful to patients.

Although employees with a good personality and highly developed skill set are preferred, they are rare (see The Professional Challenges of the Eye Care Business, above). Therefore, stay focused on the categories on the review form to attain and maintain balance.


10. Offer Insight, Not Indictment

If you determine that an employee is responsible for a problem within your practice, ask him for feedback and insight, rather than blame him. This tells the employee that you are aware of the problem and want his input to solve it. In turn, he will feel like part of the team, rather than being accused of a mistake.

I previously worked with an O.D. who noticed a decrease in exam volume for two consecutive months during the summer. When she reviewed her schedule for those months, she noticed that the last appointment of the day was either a no show or a reschedule. The O.D. began to believe that her employee wanted to cut the last appointment so she could leave early or exactly at closing.

The O.D. approached the employee and said, Our exams have been down, so I reviewed the schedule and noticed that eight out of 10 times, the last appointments of the day have been no shows, reschedules or were not scheduled at all. Do you have any ideas about what is happening?

The employee admitted that she had to pick up her child from day care by 5 p.m. during the summer. She did not want to tell the doctor because she had committed to working specific hours when she was hired and feared jeopardizing her job.

The doctor explained to the employee the effects of her actions on patients and the practice. She then suggested they work together to find a solution. The employee arranged for alternative day care two nights a week, and the doctor opened her practice an hour earlier two days a week and closed right at 5 p.m. on Fridays during the summer. After these changes, exams increased by 11% for the next three months compared with the previous year.


11. Develop Rather Than Discipline

The O.D. mentioned above could have gotten angry with her employee or terminated her. However, she instead explained the effect of the employees action on her practice. This helped the employee understand the importance of her job. Then, the no-show rate decreased, and the employee even attempted to move patient appointments up when patients did cancel. The O.D. developed this employee by focusing on the future and not the past.


12. Focus on Discussion

Dialogue should not be one-sided. So, if you are the only one talking, assess your ability to ask questions and listen to answers.


13. Watch What You Say and How You Say It

Instead of addressing what an employee did wrong, suggest a more effective way she could have handled the situation. For example, rather than tell her, You dropped the ball in this part of the job, say, Lets discuss your strengths and areas of opportunity.

Also, instead of asking, What problems are you having on the job? ask, Do you have concerns about the work you are doing?


14. Challenge Employees to Be Their Best

In most optometric practices, career opportunities are limited because there are four or five basic jobs. Motivated employees who want to grow professionally and financially may perceive this as negative.

Employees who are not challenged may begin to take it easy. For example, some may call in sick because they are bored of the daily routine. In turn, the service level your practice provides to your patients drops off, you and your staff become stressed, and product sales decrease.

In a recent study that I conducted on the purchase patterns of 511 patients, those who spent time in the office longer than 57 minutes prior to going to the offices dispensary spent an average of $30 less in the optical shop than patients who spent time in the office for less than 57 minutes.

The study also found that patients who spent a great deal of time in the office prior to going to the offices dispensary were more likely to leave the office without making any purchase.

Employees who miss work can affect patient wait times, which can result in aggravated patients who would rather leave the office than fill their eyeglass prescription with you.

During your performance review meetings, ask your employees about their ideas for helping your practice grow. Then, allow them to research and develop a plan that you will review and consider implementing. This experience can help them feel career fulfillment.

These 14 tips can help you develop and motivate your employees. As you begin planning for 2007,
create job descriptions, customize your review form, arrange a staff meeting to introduce your employees to the review process, and hold your first review meetings three months later. Youll see positive results in no time.

Ms. Juneau is a lecturer and the author of Performance Reviews Made Easy: A Turnkey Office System. She lives in Bangor, Pa. You can e-mail her at


Vol. No: 143:08Issue: 8/15/2006