Unwinding an ophthalmic career involves active planning

A smooth and incremental transition out of an oversubscribed professional career can have an enormous positive impact on your life.

Ophthalmologists who are entering the last decade of their practice careers have a lot to think about. The clock is ticking, and there are fewer healthy years remaining. Practitioners who started out 20+ years ago were often willing to work unlimited hours in order to succeed. But this “success” often translated into an enormous workload and ongoing demands for their time. These demands are often greater now than when these ophthalmologists first started in practice. Many have recognized this issue, but few have considered how to manage it. Unwinding an ophthalmic career can be more complicated than building one.

The easiest path is to do nothing and stick with the status quo. However, making no decision is a decision in and of itself. Staying the course means facing an increasing workload with ever decreasing physical and mental stamina. The life equation is changing, and one needs to respond appropriately.

I am offering some ideas to help ophthalmologists begin to make a gradual transition out of an oversubscribed professional career. A smooth and incremental transition can have an enormous positive impact on your life. Take a lesson from younger colleagues, who seem to have no difficulty with the concept of working less and enjoying life more. In the end, few will ever regret that they did not spend more days working in the clinic.

1. Redefine your personal goals

Take some time to contemplate what you would do if you suddenly could have 5 or 10 more hours of free time per week, a week more per month or a month more per year. These hours could be allocated toward things as basic as more exercise and a better diet. In other words, if you could do anything you really wanted, what would you do?

2. Pay yourself first

Look at your schedule for 2 to 6 months in the future or further out if necessary. Block off a day per week, a week per month, or whatever increment of time you decide you want to take in order to free up your schedule. Stop working 1 day a week. Take 3 weeks off in your slow season. Inform everyone in your practice that you are making this significant change. This will leave you and your associates with lots of new issues. The more complex those issues, the more lead time you will need before you can block off that time. Work the problem backward. Pay yourself first by making sure that you have created the time to do what you truly want.

3. Take a pay cut

Make no mistake, this is going to cost you. You must come to the realization that the newfound time will come at a price. But given the relative affluence of our profession, the marginal loss of income should not have a major impact on your lifestyle. What you stand to gain, however, could be life-altering.

4. Hire a consultant

It is remarkable how much value there is in finding the right answers to a few important questions. Having a sounding board will expedite your progress. A good consultant can provide excellent feedback and help with forward momentum. He or she can analyze the operational and financial impact of each contemplated change.

5. Rebalance your professional goals

Start making cuts in your professional activities and see where the chips fall. Stop working Fridays or Mondays. Consolidate your surgery or teaching schedule. Nothing should be off the table. Resistance from your staff and colleagues will be inevitable. Be prepared to do whatever it takes to make it work. You should not be a victim of your own success.

6. Learn to manage from afar

It is remarkable how much office work one can do without physically being in the office. Get rid of time-consuming meetings in favor of targeted phone calls. Embrace technology (email, cell phone, fax and Skype). Have your staff contact patients by phone instead of bringing them back in the office for low-level follow-up visits. Carry a briefcase full of work that used to be done in your office and do that work on a plane, at home or on a beach.

7. Nurture and explore your hobbies and interests

Redefining my personal goals led me to stop working Fridays for the past 11 years. This gave me a whole day a week to spend with my wife and young children. Two years ago, I wanted to take an extra month or two off from the cold Michigan winter, when the office was slow anyway. However, this was impossible because I had three school-age children (then 8, 11 and 13). I knew I would be locked into their school schedules for at least the next 10 years. This led me to extensive consultation with John Pinto, who helped me formulate a plan to move to Palo Alto, Calif., in 2009. I now enjoy many more hours of exercise, particularly hiking in beautiful places. I had taught cataract surgery extensively in national teaching courses before my children were born, and I had a desire to return to teaching. I recently joined the faculty of Stanford as an adjunct clinical assistant professor and will volunteer my time in the residency program. I plan to take art and music courses at the university. I do this while still maintaining an active interest in my original private practice in Michigan.

• Alan W. Solway, MD, can be reached at asolway@comcast.net.