How To Determine If Your Office Is Under- Or Over-Staffed

One of today’s biggest challenges for eye care practices is finding and keeping staff.  Nearly every practice has been impacted by staffing shortages, and you have likely wondered if you truly are under-staffed... or could you be over-staffed? Let’s review some of the factors that can get you that answer.

Identifying an appropriate level of staffing isn’t determined with a universal answer and greatly depends on both the short- and long-term goals of the business.  If you are growth oriented, staffing levels should reflect the office you are becoming, rather than the office you have been — this might lead to feeling over-staffed on slower days, but just right on busier days.  Conversely, offices that prioritize financial efficiency over growth would run leaner on staff — resulting in the busiest days being a little more chaotic, but having a more profitable practice.

Number Of Employees

From a head count perspective, a general guideline for a mature practice with one full-time optometrist is 4-5 FTE (Full-Time Equivalent) employees. In a smaller office, some of these roles may be combined. An example of a practice with one full-time optometrist would have staffing like:

• (1) Front desk person
• (1) Technician
• (1) Optician
• (1) Biller
• (1) Team Lead/cross trained for all positions

If you are having challenges with staff turnover, consider hiring a ‘floater’ — a person who is cross-trained, able to onboard new staff, fill-in as needed or can replace a staff member who has left, until the position is filled.  If you have multiple locations, an advantage would be to have a float team with persons that can fill-in at any location as needed.

There are a few different metrics you can evaluate to help you determine if you are appropriately staffed. Since these aren’t plug-and-play solutions for every single practice, it’s worth figuring more than one metric — you can also have a discussion with a PECAA Member Business Advisor.

Metrics To Figure Staffing

Utilizing your previous year’s Profit & Loss/total collections, here are two different financial metrics you can calculate from that same report:  

1)    Add up all of:

• Staff only wages
• Bonuses
• Benefits
• Payroll taxes 

(Do not include any doctor wages, payroll taxes or benefits.)

Divide that total into the total collections amount from your previous year’s P&L to get a percentage. 

The industry average for a practice is between 24-28%.  

• Being above this range can indicate that the practice is overstaffed or potentially has the right number of staff, but the practice is not generating the revenue needed to support their current compensation.  
• Being below this range can indicate that the practice may be understaffed, and an additional hire may be needed.  

2)    For every $150-200k in collections = one FTE staff member.

Additionally, while you’re pulling the previous year’s numbers, also retrieve the same reports for this year — year to date. Looking at both your previous year end P&L totals, and how your current YTD is shaping up, this can identify a trend so you can more accurately forecast the rest of the current year.

Other Considerations

Many other factors can come into play when determining staff levels so rather than making this decision based on formulas, also ask yourself: 

• What services do you offer?
• Are you high medical or have an older patient demographics?
• Are your appointment slots every 45, 30, 20 or 10 minutes?   
• Is your appointment schedule working for you or might it need tweaks to create a smoother patient flow? 
• Are staff able to complete all administrative duties within the expected timeline?  

It is important to note that a practice will never be perfectly staffed. For lighter scheduled days, you’ll be over-staffed and for fully or over-booked days, you’ll be under-staffed.  What’s most important is to align for what you need on most days and to make sure that the quality of patient care does not suffer on the busiest days.

Brainstorm with your team on “How can we do things differently in order to help ourselves and provide the best patient experience?” After all, it is much easier to keep existing patients than to find new ones!

If you need help with staffing challenges or business operations, PECAA’s Business Operations Advisor, Kathy Long, is here to help. As a PECAA Max member, you can receive expert advice from PECAA’s Member Business Advisors at no additional cost! Already a member? Book a meeting with Kathy here to get started. Not a PECAA Member? Contact us to learn how PECAA can help your practice thrive.