An office manager, such as Elsa Martinez (on left), can be a great asset if given the freedom and opportunity to do her best.
How can you build and maintain a successful practice? With the help of an effective office manager. But, once you have that manager, how do you know if you’re properly managing your manager?

If you’ve ever wondered why your office isn’t running as smoothly as you’d like, or you have the feeling that your manager is holding back or that your staff is intimidated by you, take heart. You’re not the only O.D. to be stumped by practice management.

These tips from seasoned office managers give you the inside track on how to maintain a good working relationship with your manager, improve overall morale and boost the success of your practice.

Trust is Important
Your office manager wants your trust, but it has to be earned. The ability to trust your office manager is integral to your peace of mind and to your practice’s success. “There has to be someone in your practice who you can trust. Finding the right [office manager] is imperative,” says Sandy Fuller, who’s been administrative office manager for more than a decade at Cape Fear Eye Institute in Wilmington, N.C.

For trust to flourish, you must be confident in your office manager’s integrity and ability to handle all aspects of your business—from billing to staff employment, Ms. Fuller says. At the end of the day, you need someone you can rely on to make decisions and take initiative.

Mutual Respect
If you trust your office manager enough to let her or him run your business, then you need to be receptive to your manager’s opinions and ideas on how best to do so. Your manager should treat you the same. The practice is yours, and as such, decisions that affect your bottom line should ultimately be yours to make, Ms. Fuller says.

Have a two-way conversation with your office manager, and discuss mutual expectations. Setting roles and goals from the beginning is the best way to avoid stepping on toes. If boundaries are clear, then you can avoid misunderstandings.

Mutual respect is essential for the ideal working relationship. “It is key that the doctor respects or shows respect to the office manager, or he will take away the responsibility he wants the office manager to take,” Ms. Fuller says.

Mutual respect can be as simple as just hearing out your office manager at the end of a rough day. Welcome questions and opinions. Listen to his or her concerns because your office manager has the inside scoop on the daily workings of your business.

Communication is Key
Office managers would like better communication with their practitioners. You don’t have to be best friends, but an open line of communication is key.

To facilitate ongoing discussion, Ms. Fuller recommends regular meetings; but you should also make time outside of the office to speak freely. A quick, informal lunch gives you the opportunity to relax and open up to each other about daily office issues, whereas formal in-office meetings may stifle open communication.

Practice management consultant Sharon Carter of Eye Care Optometric Consulting, Waldo, Ark., says the main battle she fights on a regular basis is to improve poor communication between office managers and O.D.s. Maintaining an open door between all parties is essential. Communication must flow freely between you and your office manager, but remember your manager must also keep the lines of communication open with office staff.

Staff Management
You want your office manager to successfully manage your business and your staff, right? Then you must let him or her do exactly that. Ms. Fuller says it’s ideal for the office manager to take full responsibility for office staff. Don’t get in the middle, and don’t tread on your office manager’s authority unless absolutely necessary.

For the practice to run efficiently, a chain of command must be adhered to, Ms. Fuller says. Members of your staff need to know that they report directly to the office manager.

A procedures manual is a handy way to relay these office dynamics to employees, and reinforce the rules. Ms. Carter says it also serves a legal purpose by protecting your practice from employment issues.

When seeking employees, the office manager should first conduct several interviews with prospective candidates, Ms. Fuller says. Once the field has been narrowed and the ideal candidate established, then the optometrist should be brought in for final hire approval. As with all things, the office manager and optometrist should work together to come to a mutual decision.

Don’t Forget to Set Goals
Get on the same page with goals. Goal setting keeps each aspect of your practice on track, provides team cohesiveness and greatly improves revenue flow, according to Ms. Carter.

“In my experience, only one out of 10 offices have any type of goals whatsoever. The rest are just functioning,” she says. If this is the case for your practice, you may be missing major opportunities to maximize revenue. For example, pay attention to your insurance receivables rate, Ms. Carter recommends; it is one place where revenue is easily found.

Make time to sit with your office manager and set realistic goals for each department. Weekly staff meetings are imperative for goal-tracking, Ms. Carter says. Use this time to discuss the status of goals and to reinforce accountability. If there is a problem, the weekly meeting gives the opportunity to identify and fix it before the end of the month. You and your office manager should be on the same page goal-wise, but let your office manager take the reins in fixing office problems.

Maintain Morale
With our current economic climate, it may be difficult to give the expected yearly raises or provide bonuses to your high-performing staff members. So how can you maintain morale? By saying a simple thank-you, Ms. Fuller says. Though you may not realize it, you as the O.D., play a big part in office morale. “The office manager can say thank you 10 times a day, but acknowledgement from the doctor makes staff feel appreciated,” she explains.

Looking for an Office Manager? Here’s Help for Hiring

When looking for an office manager, Ms. Fuller and Ms. Carter agree that you should first look to your already trained office staff, if possible. Identify whether there is an individual on your staff who you feel has the drive, sense of responsibility and sincere interest in practice management to be a good manager. Try to develop that person first, rather than seeking outside candidates. This saves both time and money, as you’ll avoid the learning curve a new hire would need to get up to speed.

If you promote from within, Ms. Carter says, it’s imperative that you announce this to the rest of staff. This helps give your new manager credence and authority to manage.

Regardless of where you look, “find someone that will look you in the eye and give you their honest opinion,” Ms. Fuller says. The ideal candidate should be able to tell you what they think and support you in your final decisions.

Other ways to find a reliable office manager:

  • Seek recommendations from doctors you know, from either networking or school.
  • Place an ad in the local newspaper. Seasoned managers in smaller communities look here first.
  • Consult with your state board of opticianry for advice.
  • Use the internet. Options include Craigslist.com (a free service), as well as Monster.com, CareerBuilder.com and OptometrysCareerCenter.org.
  • Consult the Society of Human Resource Management ( www.shrm.org) for advice on how to conduct the hiring process and for guidance on a variety of employment issues.
Ultimately, your candidate of choice should be able to make decisions on his or her own initiative, but should also realize that, in the end, this is your practice. Empower your office manager to have the confidence and respect to make decisions independently, instead of inundating you with a million small questions and problems.
Perhaps you can implement a bonus structure tied to departmental goals and the practice’s yearly financial performance. People are generally more invested if they receive a return, Ms. Carter says. A percentage-based bonus structure helps ensure fairness.

Regardless of what type of incentive you choose, it is vital that you and your office manager work together to find the best program for your practice, Ms. Fuller says. She recommends meeting with staff members to take their suggestions on what motivates them. You might be surprised by the ideas they come up with.

Focus on Business Acumen
Be open to your manager’s ideas on business management techniques. Optometric office manager Elsa Martinez has nearly 22 years of experience with Golden Optometric Group, and currently manages their West Covina, Calif., office. Ms. Martinez says her business-savvy optometrist is very receptive to technology and business management ideas, which makes her job easier.

Also, give your office manager the opportunity to stay current on a variety of topics. Allow and encourage your office manager to attend business management forums, human resource educational events and lectures on management. Optometrists benefit from continuing education—apply that principle to your office manager as well.

Provide Sales Training
Your practice is unique in that it not only provides patient care, but also serves as a retail source. So, give your manager the tools to improve retail sales, Ms. Martinez suggests. Your office manager may need time with staff to conduct sales meetings or to engage in mock sales scenarios to help members of staff refine sales techniques. If possible, try a formal training program. Look at the big picture—these investments will pay off in the long run.

Office Managers are a Resource—Use Them!   
Ms. Fuller’s next piece of advice is to remember to network—not only with other doctors, but also with office managers. Use them as a resource.

For instance, an Ohio-based O.D. who had vacationed in the Wilmington coastal region recently called Ms. Fuller out of the blue with questions about practicing in her local area. He introduced himself by saying he’d recently visited and was interested in exploring the area.

After speaking with her at length, considering her advice and obtaining other doctors’ names, he ended up moving down and eventually bought into a practice. The lesson: Don’t be afraid to get on the phone and ask around. The right office manager can be a fountain of information.

Remember to let your office manager help you build your practice. Listen to her or him—you may get good advice on how your practice can grow.

Be Tech Savvy
Listen to your manager’s recommendations on new technologies. It is their job to advise you on opportunities for business improvement. Staying aware of both media marketing and organizational management will directly impact your bottom line. Meet with your office manager regularly to discuss long-term marketing strategies.

Technology, for instance, now offers more opportunities for marketing than ever before—don’t be afraid to try something new. Ms. Martinez is experimenting with Groupon right now. “Fortunately for me, my O.D. is on board and with the times,” she says. “You never know until you try it. If it doesn’t work, don’t do it again.”


When you have the right office manager, and you make a point to work as a team, you’ll find greater success and a better working environment. Remember that respect, communication and trust helps you create and maintain a good working relationship.

As with all relationships, it’s a two-way street. Don’t be afraid to let go and let your office manager do their job. Keep an open mind to their ideas—they will appreciate your confidence in them and will reward you with a job well done.