Getting Started: Hiring Staff

By Ian Davies, OD February 26, 2020

OK, so you have the OD certificate neatly framed, state boards passed, couple of years retail experience under the belt and now it’s time to open your own office. I mean that was always the goal wasn’t it, to own your own optometric practice? All those nights of studying, the hours in the optometry school exam lanes and the mounting college fees, they all culminate in this point, Your Name OD, Independent Doctor of Optometry. Sounds good? Secured the premises? Now you just need some staff.

Just need some staff. Sounds so simple doesn’t it? But in all the exams that you took, classes that you attended, and CE credits that you have accumulated to date, no one has ever taught you how to hire staff.

Hiring the right staff is arguably the most important decision that any practice owner has to make. Very few patients will be able to tell the difference between a good and an excellent retinal examination, but most will be able to tell the difference between a good and excellent welcome to your practice. Your front office staff members set the tone for your practice, from making appointments to managing billing and being the 1st line of defense when a patient has a complaint. It doesn’t matter how brilliant you are as a clinician; your front office staff have the power to make or break your business.

Scared? Don’t be. Let’s start at the beginning:


Competency is defined as the ability to carry out a task successfully or (and I’m going to argue) efficiently. Defining the competencies that you need for your business is critical in defining the skills that you need to be looking for in your staff and the number of people that you will require to carry out the tasks. Defining the competencies is not a trivial task. You need to take time to think it through. You should pull on your own experience to date and speak to colleagues who have successful practices. What is important is that you write down the competencies that you need and distinguish them from the attitudes that you wish your staff to have. So, for example, the ability to manage an appointment book is a competency. Having a positive telephone manner is an attitude.


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The attitude of your staff will go a long way in creating the culture of your business. While most of the attitudes that you will want are pretty obvious; friendly, confident, polite … it is worth committing these to paper so that you, and your staff are clear about what the expectations are.


They say you can’t buy experience. Well maybe not your own, but you can buy someone else’s. Should you? As in most aspects of business, it depends. If you are starting out by yourself, having experienced front office staff will save you time to focus on your patients and getting the business established. Experienced, well trained staff will cost you more, but consider the opposite. Would you want to have inexperienced, badly trained staff as the window to your office? Ideally, if your business will support it, you want a blend of experiences, but make sure that the critical competencies within your office are staffed with the people who have either the experience or training to do them well.

Job Description 

Every job should have a job description which should be available to every applicant. The job description should clearly denote the competencies, attitudes and experiences that are required in addition to the basic information around salary, working hours, and any benefits. It is rare to get a candidate to fulfill every element of the job description and so it’s important to clearly delineate which elements are essential and which are desirable. For example, it may be viewed as essential that someone has experience in medical office managing appointments, but desirable that it be in an optometric practice.


So, who to interview? This is where the job description starts to come into its own. A simple table with the essential competences, attitudes and experiences down one column enables you to score each candidate against the criteria that you are looking for. Don’t over complicate, 0 means no evidence of the criteria at all (don’t even interview) 1 = some evidence, 2 = moderate, 3 = significant. Add up the scores and then look at the ranking. Interview the highest scoring candidates. If you are stuck between candidates, then you can look at the “desired” elements to act as a tie breaker. Make sure that you have a manageable choice of interviewees. Don’t forget that some may not want the job after meeting you, even if you want them.  Personally, I like to interview around 5 candidates for any job. Less than 3 really doesn’t give you a lot of choice and more than 7 can become unwieldy.

Now how to interview; this is a topic on its own, so here are the basics:

·         Always set aside dedicated time and space to interview. Make sure that you have no distractions.

·         Try and interview with someone else, it can be a partner, colleague or trusted friend. Two views are always better than one.

·         Put the candidate at ease before you start asking questions, show them around your office (if appropriate), tell them about yourself and your goals for your business, sit in an environment conducive to a relaxed and open dialogue – you are not doing an interrogation! Explain how the interview will run.

·         Good practice is to ask competency-based questions, i.e. ask for specific example of when someone has carried out a particular task, it enables honest and authentic assessment.

·         Take notes – this is when having 2 people is a good idea. Have a sheet of paper with the criteria that you are looking for written down so that you can make notes next to each.

 ·         Give time for the candidate to ask questions.

 ·         Be very specific about the next steps.


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Select and don’t settle. Always choose the person who meets your criteria. If no one does, don’t settle for the one who comes closest. It may be tempting but you are just creating problems for yourself in the long term. The old adage applies, “hire slow and fire fast.” Find the right person. Then, all you have to do is offer the job and get them on board.

Practice Pearls:

·         Always define and record the competencies that you are looking for from your staff.

·         Be clear about what criteria are essential vs. desirable for each role.

·         Select the people who meet your criteria. Don’t settle for the one who comes closest.


Ian Davies, OD

Ian is an independent optical business consultant, motivational speaker and coach with over 30 years’ experience working in the global vision care business. He has a unique perspective on eye care having worked in all major markets around the world. He is able to combine his clinical knowledge and experience with insights into business gained through executive positions in one of the world’s biggest health care businesses. He is a sought-after speaker, having lectured around the world and given key note speeches to audiences of up to 25,000 people. Ian supports innovative start-up companies in the development of commercial propositions and is a regular consultant to investment analysts on the global optical business. An optometry graduate, Ian worked in hospital, private practice, academic research, and teaching roles before going into the contact lens industry. Ian is currently Master of The Worshipful Company of Spectacle Makers, the oldest optical professional body in the world.

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