If it feels like too many decisions in your practice run through you, you’re probably right. Most ODs end up as the default go-to for everything because it’s faster in the moment (and because you’re a leader). Over time, though, these small decisions add up and start competing with patient care.
You may not even realize how many small decisions you make until you try to step back — or until you’re out for a few days and questions start piling up.
Delegation can help, but it has to reflect the day-to-day realities of an optometry practice. There are legal expectations around what must stay with the doctor. Patient safety is always part of the equation, too. And on the staff side, you’re working with different levels of experience and different comfort levels with responsibility. All of that influences how smoothly a handoff goes.
How to hand things off successfully
1. Decide what you’re comfortable letting go of. Before moving anything to staff, take some time to evaluate the task.
Ask yourself:
- Does this require clinical judgment?
- Does it fall under a legal or state-specific rule?
- Could a mistake create risk for the patient or the practice?
- Is this predictable enough for staff to handle without guesswork?
2. Most offices have unwritten guidelines floating around. The problem is that people remember them differently, and that can be why questions still end up on your desk. Clarifying the “rules” prevents things from coming back to you out of uncertainty. Example of a rule: Approve a remake when the issue is a scratch, coating defect, or shipping problem, and bring it to me only if the concern involves vision or prescription accuracy.
3. Not every staff member is suited for every responsibility, so choose someone who is trustworthy and handles details well. Once you know who that is, give them context to know when the task belongs to them and when you still want to be involved:
You can answer these messages because they are not clinical questions.
You can finalize this referral paperwork because the clinical review happens when I sign it.
4. Decide in advance how you want to stay in the loop. Otherwise, people may still check in too often (or not often enough). Would you like end-of-day notes? Or just an update when something unusual happens?
5. As things get underway, be sure to do some reflecting:
- Do I feel good about the decisions being made?
- Is this person handling small issues in a way that fits the practice?
- Are the questions I’m getting reasonable, or do they point to something I didn’t explain clearly enough?
- Am I getting involved out of habit rather than necessity?
- Is this handoff giving me the breathing room I expected?
Where you might pare down
This following list is meant to help you assess avenues for delegation. These are the things that can sometimes default to the doctor’s desk but don’t actually require it. Ultimately, what matters most is building a structure that protects patients and frees you to focus on clinical care.
Around the office
- Answering staff questions about policies that already exist.
- Making minor schedule adjustments when the office manager is unavailable.
- Stepping in to calm small service frustrations that staff could resolve.
Optical and billing
- Approving remakes when the issue is mechanical or cosmetic, not prescription-related.
- Processing exchanges or simple adjustments that fall within your normal policy limits.
- Handling insurance or billing questions that match the defined guidelines your team already uses.
- Completing the admin portion of referrals or forms so your only role is the clinical review and signature.
Patient communication
- Processing contact lens reorders when the prescription is current and the chart shows no recent symptom notes.
- Answering messages about pickups, tracking, hours, or other general logistics.
- Resolving small delays, shipping issues, or inventory questions before they reach your desk.
