“Staff are as important or more important than the doctor,” says optometrist Aaron Werner of El Cajon, Calif., who started out working at the front desk at his father’s optometric practice when he was in high school. 

In other words, a patient may come to a practice for the clinical skills and reputation of the doctor—but an unpleasant experience with a front desk staff member may keep him or her from coming back. 

How to Hire the Right ‘Girl’ “Dr. Ross was a bombastic, domineering oral surgeon who was lucky to keep an assistant for three months. He had a busy practice, so he reluctantly accepted the agency’s choice: a mousy-looking spinster with a hair bun and steel-rimmed glasses. She’s been on the job for more than two years and both Dr. Ross and the girl are happy.” This is an excerpt from the July 1969 Review of Optometry article, “Hiring the Right Girl.” Although some of the article’s descriptions are now dated and sexist, much of the article’s hiring advice is still true—specifically, making sure the front desk staff person and the doctor have complementary personalities, says Pamela Miller, OD, JD. It’s important for these two positions in the office to not clash, but to each make up for what the other may lack. “It’s a lot like a happy marriage. You don’t want to hire someone just like you. If you have a quick temper, you don’t want someone like that at the desk.” Dr. Miller offers these other modern day hiring tips:  • “Your front desk staffer should mirror your patients.” In other words, don’t hire someone with multiple piercings and tattoos unless that’s the fashion statement most of your patients are trying to make. “If you’re a class act, you can’t hire someone who’s not a class act. At the same time, your front office staff person should be a reflection of the patients coming in to see you.” • “Experience is important, but don’t forget to check references.” Once you confirm the work history from a candidates’s former employer, ask the employer if they would hire the employee again. If they say no, ask them why not. If they won’t give an answer, you can infer a great deal by the person’s tone on the other end of the phone, Dr. Miller says. So how did Review of Optometry’s 45-year-old article—which offered hiring nuggets such as, “If the girl will be visible to your patients, forget about her new hairdo or stunning dress. Visualize how she’ll look in a plain skirt and blouse”—hold up today?  “The article is still pretty darn good,” Dr. Miller says, although she adds that it’s not appropriate to use the term “girl,” and skirts and blouses are probably replaced with pants and a top or scrubs. Still, the core of the article rings true: Take the time to get to know the person during the interview and verify the candidate’s skills before you make an offer.

“Docs do not like hearing this because we want to believe that patients come to us for our exceptional clinical skills, and they do,” Dr. Werner says. “But, patients come to the practice for the complete experience. The front office staff is the face of the practice and is the first interaction a patient has during their visit and also the last.”

So, make sure your patient’s first and last interaction at your front desk isn’t also their last visit to your office. Carefully consider the skills, traits and training for this key position in your practice.

Front and Center
“Your front office staff can make or break your practice,” says optometrist Pamela Miller of Highland, Calif. “They are the first point of contact and can often times be the determining factor whether a patient returns.”

Adds Jason Miller, OD, MBA, of Powell, Ohio, “It truly is the front line of the office and, many times, the first impression a patient has of your office. As the saying goes, you never get a second chance at a first impression.” 

When hiring for this position, look for these key traits:

• Friendly demeanor. No shrinking violets here. “The front office staff must be people persons,” Dr. Werner says. “They are the face of an office and set the tone for the visit. They need to be welcoming and friendly.” 

Front desk staff members are also the last to have contact with patients as they leave the office. So, the front desk staff person also reinforces the excellent experience the patient had, the quality optical purchases made, and even should be able to promote new contact lenses, Dr. Werner adds. 

• Juggling and multitasking. At any given moment, an employee in this position may have to greet patients, check out other patients, answer the phone, order contact lenses, input insurance forms and handle billing. “There are a gazillion things going on at once, and they need to be able to handle it,” Dr. Pamela Miller says.

• Self-control and self-motivation. A front desk staff person must be able to handle—and often times defuse—difficult patient situations, says Dr. Pamela Miller.

“I look for an outgoing personality who can control a situation,” adds Dr. Werner. “The front office staff works with a wide demographic of patients in a wide variety of interactions. They need to be welcoming, but also have a strong personality to handle challenging patients and keep office flow moving.” 

When Dr. Werner interviews individuals for this position, he wants to know how candidates can handle a conversation. “I look for friendly, confident, self-motivated individuals with a big smile. I don’t want someone who needs constant direction, is a chatterbox or doesn’t have a welcoming sense about them.”

Front office staff need to be welcoming, but also have a strong personality to handle challenging patients and keep office flow moving, says Aaron Werner, OD.
Front office dog Angel greets patients—along with employees Effie and DeNese—at the practice of Pamela Miller, OD, JD.

• Quarterbacking staff. Front office staff set the tone for the practice. They direct flow and make adjustments as needed. For example, if there is a long wait, the staff person can tell the patient that the doctor is running behind because of an emergency, and they can start their visit in the optical, Dr. Werner suggests.

“Everything may work out from the playbook during a scrimmage,” Dr. Werner says. “But on game day, things may change and you have to be able to think on the fly.”

Training is Key
At Dr. Pamela Miller’s practice, training is ongoing. “I believe in cross-training—including the doctor,” she says. “I expect staff to train me. If there is an area in my practice that is not working right, I want to know. A great office is a happy office.” 

When a new employee is hired at the front desk, Dr. Pamela Miller gives the individual a training manual for staff that she authored. The manual consists of short, easy-to-digest chapters.

Front office is not an easy job and requires a lot of attention, adds Dr. Jason Miller. To ensure the employees in this role are prepared at his practice, they are versed in office policies and then educated on proper phone technique. “Additionally, it is important that they experience what happens throughout the office. That enables them to field questions that may arise either in person or on the phone,” he says.

During the second day on the job in Dr. Werner’s practice, all new hires are treated like a regular patient and have a full eye exam. “This allows them to not only see but feel the experience we expect all patients to have. If they require corrections in their contact lenses, we make the changes needed,” he says. 

He also encourages staff to take advantage of online learning courses on topics ranging from phone etiquette to ocular anatomy.

Additionally, Dr. Werner trains front desk staff on the nuances of contact lenses. This can prevent the practice, and the doctor, from losing valuable chair time by having the patient return for numerous follow-up visits. For example, a well-trained staff member can field a call from a patient having trouble with a new monovision lens by asking appropriate questions to fully understand what’s causing the difficulty. The staff can then review the case with the doctor, thus saving valuable chair time.

Tales from the Dark Side: Staffing Nightmares If you’ve been in practice long enough, chances are you may have had an employee who wasn’t exactly a good fit at the front desk. Veteran optometrist and attorney Pamela Miller offers a few frightful stories from her practice through the years: • Dr. Miller thought she had made a good hire for the front desk. The individual was outgoing and happy, but one day she failed to show up and never returned. “One year later, I got a call from the unemployment office and the employee claimed I fired her.”  • Dr. Miller was attending a meeting in another city, and suddenly had a bad feeling. She called the office and spoke to her front office employee, who had worked at the practice for only a few months. “The staff person said, ‘I’m leaving and not coming back. I just told a patient to go to hell.’”  • Another time, Dr. Miller noticed her front desk employee seemed upset. Dr. Miller asked her what was wrong. “The employee said she saw small people hiding in the trees and they were laughing at her. I had to let her go, and she took me to labor court.” • A different front desk employee stole from Dr. Miller, which taught her a valuable lesson. “I’m the only one who makes bank deposits now.” • Yet another bad situation between front desk staff had to be worked out. Two staff members were arguing in front of a patient. Dr. Miller confronted the employees about it and later found one of the employees in question was very distraught. She informed Dr. Miller that the other employee told her she would kill her if she made her lose her job.  There was a happy ending. Dr. Miller required both employees to talk to a therapist. “I wound up keeping both of those employees for a long time, and one has now been working for me just over 20 years,” Dr. Miller says.

When Training Pays Off
Recently, while making phone call appointment confirmations, a long-time patient—who also happened to be Dr. Werner’s former high school English teacher—informed the front desk staff member she was not happy with the experience she had with an optician the year before, and would not be returning for her annual visit. 

“My wonderful team member took time to talk with this patient and inquire about her concerns. What she did next though was astounding,” Dr. Werner says. “She apologized for the less-than-exceptional experience the patient had and asked her to be sure to let us know at any time should her experience ever be less than expected.” 

The staff person also took time to share positive attributes of the optician with whom the patient had a negative experience, Dr. Werner says. And, to avoid any potential problems in the future, the staff person informed the patient she could be paired with a different optician, if she preferred, because her satisfaction was high on the practice’s priority list, he adds.

In this one conversation, Dr. Werner says, his staff member retained a patient who had already decided to go elsewhere and reinforced the practice’s philosophies to the patient, while building up the other team member with whom the patient had a negative interaction. Additionally, the front office staff was able to emotionally tie the patient back to the office––so much so that when Dr. Werner saw the patient on her return visit, his former high school English teacher had nothing but wonderful things to say about all of his team.

Front office staff is critical to the health of any practice. “They get hit from lots of different directions and are often blamed for things when they go wrong,” Dr. Jason Miller says. “Being able to handle people and understanding how to have fun can make a big difference in the culture of a practice.”