January 14, 2015
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BLOG: Rational staff bonuses, part 2

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Remember that as with any antibiotic therapy, there are “responders” and “resistors” to the whole notion of bonus compensation. For example, I’ve seen some optometrists who continue to plod along putting out about the same work volume whether they’re on a fixed wage or a percentile productivity bonus. “Responders” — and these people tend to be found in optical sales, senior vision screening programs, outreach staff, LASIK surgical counseling and similar areas of your practice — should be incentivized if at all possible. One example: For LASIK counselors, a $10 bonus for every LASIK consultation appointment booked and kept.

There are only two possible contraindications for such bonus programs. The first is legal. In at least one state jurisdiction, according to attorneys I’ve spoken with, it is apparently not permitted to directly incentivize employees to generate larger clinical or surgical volumes. The second possible reason to avoid bonus programs aimed at just one or two areas of the practice is that this can generate significant jealousy among non-bonused staff. In my experience, this downside is outweighed by the benefit of stronger sales in most settings.

Any static bonus — for example, $50 per cataract surgery pooled and split up between staff, month after month, forever — very quickly becomes an entitlement and no longer evokes performance improvements. Such programs, if present in your practice, should be phased out and replaced by a more dynamic approach.

Bonus programs should be reviewed and revamped at least annually (quarterly is better in most settings) to keep things fresh and to manage expectations. Example: Announce in May, “We will put $20 in the pot for every patient visit in July 2015 in excess of our July 2014 baseline and divide this equally among all staff who work the entire period; part-time staff get a half share.”

John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology and a new book, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.