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Practice Development


Rev Up: Maximizing Your Therapy Performance

Third in our 4-part series, Startup, Ramp-up, Rev-up, and Wrapup


By Amee and Thomas Lecoq

Ok, therapy in your practice is going along pretty well.  Your staff is performing effectively, your therapists are producing consistently good patient outcomes.  But you’d like to dramatically increase income, grow the number of VT patients you and your staff help each week and have more free time for family, travel and non-optometric fun.  In other words, you want a staff-run practice that operates whether or not you are there.

It can take years to organize the practice and its structure and direct the internal and external marketing effort required to keep it busy.  Only about 20 percent of VT practices operate at or near this level.  A few rare ODs accomplish this on their own, but ask the highest performers and you'll find nearly all got outside help.  Not many VT ODs build this level of practice on their own. 
There are some commonalities among the top 20 percenters:

1)  They have stopped managing and supervising and become LEADERS.

2)  They clearly communicate their vision for the practice to everyone

3)  They use systems to assure every potential patient gets the same powerful message.

4)  They have given authority AND responsibility to key staff members

5)  They invest in extensive training and development of their staff

6)  They make sure the actions that generate referrals and new patients get done.

7)  They put the wellbeing of the patient before ALL other considerations

If you are considering making this move, here’s some detail about each of those points:

1)  They become leaders.  Our single most successful client ever said the most important thing he got from his consultation is being a leader.  The job of the leader is to call forth leading from those around him or her.

How do you develop a VTA as a leader?  In our consultation, we spend several days working with staff and teaching the communication process called the RTEC.  Although there is a starting script to help, the secret is a high level of listening to discover what the parent is really dealing with.  Rehearsal goes over this process again and again until the VTA and other staff become good at it.  Training takes time and education.  It is all too easy to assume anyone knows what the parent is contending with, but the RTEC gently gets down to the specific issue for that parent or patient.  Until that issue is illuminated and addressed, there is not much motivation to “spend so much money on something I’ve never heard of.”  Each of our courses and consultation units covers the RTEC conversation.  Doing so educates staff about the consequences of NOT doing VT, and is part of leading by inspiration. 

2) To lead means to be the one who knows and clearly communicates the destination, or desired end.  Leaders do not waste time hoping their staff will be concerned about income and sales.  Vision Therapy results are inspiring.  Seeing children and adults go from inept to excellence will motivate staff to use their own initiative.  One of our best clients had a chief therapist who took it upon herself to develop a step by step training, testing and verification process to train therapists.   

Did you know that Lecoq Practice Development has a master therapist who does on site therapist training, including a manual?  In addition, the Ideal Vision Institute is a 2 part, 6-day course that trains doctors and therapist in a basic VT program for testing and treating learning-related vision problems.  

3)  Systems:  Systems can give you freedom, but only if it covers the entire intake and therapy process.  Start with an overview of what needs to take place at each step. Our system’s documentation includes 8 detailed manuals, training videos and hundreds of digital documents, forms, PR and other materials.  Developed over 36 years of working with VT ODs, there’s too much to fit here, but explore idealvt.com and you’ll find ample information about the system.  Without a system, every minor glitch becomes a major problem that eats doctor time and patience.

4)  Giving responsibility without authority as well is a formula for staff rebellion and sabotage, something we see surprisingly often.  The problem is that once staff is trained and the system is in place, doctors often step in whenever they see a problem.  It is generally better to let staff work out solutions, after all, they have to live with the solution and they’re more likely to create a simple solution than the doctor’s.   Leaders are always looking for someone doing something right, or effectively, and will point out the specific thing the person did or said.  The more specific the feedback, the better.  “Praise in public, correct in private” is a good guide.  If someone goofs up (and they will), the conversation takes place in private, and is usually best handled by letting the employee work out what they did that didn’t work, and what they will do instead the next time.  When staff creates solutions, they are more likely to use them. 

5)  Invest in staff training and development.  This is no place to cut corners.  Effective training and development demands a third element, education.  Training is HOW you do something, education is WHY you do it.  Development is distinct, and sometimes seems to have little connection to the practice.  For example, sending your marketing assistant to a seminar on getting the most from email, or social media marketing, can increase the effectiveness of your external marketing program.  Personal development can help an introvert become more open and communicative.  Another of our clients has a weekly case review meeting with therapists, and soon learned to keep quiet and let the therapists run the meeting.  His input only comes when participants get off track or suggest actions that aren’t appropriate for the patient.  This is how you develop a clinically competent Chief Therapist, someone who can handle typical daily patient situations with minimum doctor input. 

6)  How best to make sure your great system is working as planned?  Have those in charge of each aspect of the staff-run practice report significant information (including statistics), on a weekly basis.  These are regularly scheduled, brief meetings with individuals in which they report the specific actions they’ve taken.  How many call-ins, how many booked, how many had evaluations, how many went on through the next enrollment steps.  How many signed up, how many graduated; no shows?  The status of marketing efforts, emails out.  Signups for the email list.  Talks booked, number of workshop attendees who booked evaluations, new talk dates in the hopper.  We use forms in our system to guide staff through each major step, and the forms also make it easy to report without generating additional paperwork.  The platitude “What gets watched, gets done” applies, but don’t hover like a hawk waiting for a mouse to pop up its head.  Schedule these meetings no later than midweek so you have time to apply a fix if needed.

7)  Place the wellbeing of the patient before all other considerations.  VT practices often attract exceptional people who are dedicated to helping others.  Very few will be interested in YOUR financial reward.  If you constantly talk about money or other statistics, they will be put off and doubt your sincerity. 

In our training, we constantly speak to how a procedure or method is going to help the patient.  We are not interested in efficiency, we focus instead on effectiveness.  The paradox is that if you focus on the patient’s concerns, (not the doctor’s,) the money takes care of itself.  All the patients’ financial issues are handled during the execution of the system and are always resolved in the best interest of the patient. 

The system is all about making sure that every person you see takes action to make sure they get the vision therapy they need. 

We are scheduling an Essentials For Vision Therapy Success course soon, which presents many of the details of the system mentioned here.  It also provides a flow chart, or map, of the steps so you can visualize exactly how the systems elements fit together and reinforce each other.  We recommend the doctor, Vision Therapy Administrator and in some cases, the spouse come along.  Other staff can attend, of course, yet we often discuss financial an personnel issues during this course, so if there are issues in your practice, this is an opportunity to work through them without staff being upset.  We plan to offer this wintertime course in a warm climate.  Watch for it.

Give Amee a call at 760-686-4648 for more details on the items in this article, or to discuss getting help ramping up your practice.  As former client Julie Ryan, O.D., FCOVD said, “You don’t have to do this alone.”


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Lecoq Practice Development
Apple Valley, CA 92307

CONTACT US BY PHONE:     760-686-4648
To Reach Thomas Lecoq:  idealvt@verizon.net
To Reach Amee Lecoq: idealvt1@verizon.net 
For Therapist Training, Lyna Dyson:  visionhlp@juno.com
FAX  760-262-3172

For Information: idealvt@verizon.net
For NETwork questions: idealvt1@verizon.net 

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Last modified: 04/21/20
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