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Proactive problem solving can help your practice
‘Responsive realism,’ rather than ‘hopeful idealism,’ sets a great practice apart from an average one.
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John B. Pinto |
Our 12-year-old son Graham discovered one of the most important facts of life last week: If you’re alive, you’re going to have problems. In his world, there are “little” problems such as tonight’s algebra homework sheet, and “big” problems like how to get out of trouble with mom for not cleaning your room. There are low-stakes problems like tying your undone shoelace, and high-stakes problems such as explaining to your parents why you are still up at 1 a.m. on a school night harassing the raccoons in the back yard.
In your grown-up world as an adult eye surgeon (or perhaps as a surgeon’s manager), the problems you have are a lot bigger than a kid’s. But the principle is the same – life is simply chock-full of problems to solve.
Here’s something else Graham has discovered: 100% of the jobs we get paid to do in life involve solving other people’s problems. And the bigger the problems you can learn to solve, the bigger the reward, whether you’re just a kid or a surgeon. In Graham’s case, remembering to take out the trash bins gets an off-handed “Thanks!” Solving the front yard’s dandelion problem is a lot more lucrative… $5 or maybe $10 if you’re extra diligent.
This applies to you, too, obviously. As a surgeon, solving a cataract problem is better rewarded than solving the “itchy-burny eye problem” in room six. So by now you’ve learned that if you want a bigger pay check, you should pack your clinic schedule with lots of big problems to solve, and leave the smaller problems to your associates and support staff.
Along the way you’ve also learned, of course, that problems come in two basic flavors – the gratifying ones that are fascinating and rewarding to solve, and the loathsome ones that make you want to turn the other way. You’ve learned by now that if you’re really, really careful, the world hands you fewer nasty problems to solve and more enjoyable ones. And you’ve also learned that whether a problem is horrid or pleasant depends on whether you are the one with the problem or the person getting paid to solve it. A patient’s complicated eye disease may be a miserable problem for them to have, but as the patient’s surgeon you relish it when you nail a challenging case.
Here are a few problem-solving pearls that you’ve probably grasped intuitively all along, but that are nice to see collected in one place as a refresher for better business and life management.
Identify and respond
Every practice has about the same number of problems. What distinguishes great practices from merely good ones is that they identify and immediately start solving their problems. If your superstar senior technician announces she’ll be retiring in 12 months, don’t wait until the bitter end, hoping she’ll recant. If your marketing efforts are sputtering because of new competition, start now to get one step ahead. Put away the rose-colored glasses. Be a responsive realist, rather than a hopeful idealist. Own your problems and deal with them straight on.
Triage the problems
Learn to triage your practice problems, which can be graded for their severity and potential for adverse impact, just like a trauma case. If your problem-solving resources (time, money or expertise) are limited, you may only be able to attack the priority items. Work with your fellow doctors and managers to develop the skills needed to sift the large problems from the small ones. In my work as a consultant, one of the most common practice failings I see is the misapplication of energy – starving opportunities while squandering resources on distracting, nickel-and-dime problems.
Remember the Rule of Holes
“When you’re down in one, the first thing to do is stop digging.” If you believe that one of your doctors is out of regulatory compliance, stop all activity until you have ascertained he’s in the clear. When a new surgical procedure you’ve learned is not yielding the promised results, stop and back up to the tried-and-true maneuvers until you find out what you’re doing wrong.
Seek experts, resources
You don’t have to go it alone. Rather than worrying if your new building’s architect knows what they’re doing, pull in a detached expert to render a second opinion. When necessary, hire lawyers to fight your unpleasant battles for you. Hire marketers to slay the competition. And let the experts tell you where the line is drawn on compliance.
Seek out resources proportional to the size and sophistication of the problem. This is, of course, analogous to solving problems for your patients. Your techs can handle small problems, you handle the run-of-the-mill cases, and you call your pal at the university if the problem is beyond your scope. Likewise, if you have a low-stakes business puzzler, you might turn to your staff as a sounding board. Bigger problems get your accountant’s or attorney’s attention. Really big business problems may warrant the talents of an interdisciplinary “A-Team.”
Timing
Learn how to compartmentalize your problems. You do this naturally in the clinic, shutting down your thinking about the problem of Mr. Smith in room two as you walk into room three and greet Ms. Jones. In business as in medicine, adopt the discipline to focus on one problem at a time.
Apply the right timing. Most problems, clinical and otherwise, get larger over time and it’s best to not procrastinate. An obviously ineffective member of your staff is unlikely to improve in the next year. On the other hand, sometimes it’s best to procrastinate and push problems off for another time. Indeed, some problems get better or disappear altogether with the tincture of time. Think about this the next time you’re about to jump on your manager for some minor transgression, one you know they’ll find and correct on their own in short order.
Think positive
Try to have a more positive attitude about your problems. Try calling them “opportunities” and see if your approach to their solution changes. A “problem” technician, with poor mechanical skills but great patient interactions and loyalty to the practice, may really be an opportunity in disguise, allowing you to secure a new marketing coordinator.
Share your problems with the important people in your life. Even if certain problems are yours alone to bear, enlist the aide of your partners and administrator, spouse and friends, to help you brainstorm solutions and (perhaps most important) see things in perspective.
Realize that you can handle only so many concurrent business or life problems at a time. Consider the biologic parallel of parasite loads. Your practice may be able to fight off five problems at once, but 50 problems are crippling to the organism. Try not to create situations for yourself where you have to solve lots of extra problems in all the areas of your life at the same time. As one dear client once said, “I try to avoid creating situations where more than one person is mad at me at any one time.”
For Your Information:
- John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. Mr. Pinto 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 and the new book The Efficient Ophthalmologist: How to See More Patients, Provide Better Care and Prosper in an Era of Falling Fees. He can be reached at 619-223-2233; e-mail: pintoinc@aol.com; Web site: www.pintoinc.com.