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Back to basics: The core competencies of effective practice owners
Find out if private practice ownership is the right choice for you.
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“In the astronaut business, we have a saying, which is, ‘There is no problem so bad that you can’t make it worse.’”
– Chris Hadfield
“I am the astronaut of boxing. Joe Louis and Dempsey were just jet pilots. I’m in a world of my own.”
– Muhammad Ali
It used to be that if you had the right stuff for medical school, you had the right stuff to launch or join a private, independent medical practice. Be your own man or woman. Call your own shots.
Not so much, anymore.
Senior surgeon-entrepreneurs, increasingly burdened by regulatory and cost-containment strictures, and pounced on for innocent “gotcha” infractions, are jumping ship, retiring early, selling out or simply closing shop.
At the same time, more young surgeons than in the past now contemplate skipping practice ownership altogether for all of the same reasons.
So it is important to ask yourself, “In this problematic environment, do I have the right stuff to not only be an eye surgeon, but also take on the arguably greater contemporary challenge of running a business?”
Here is a modest self-test that might not only get you thinking generally about your global fitness for practice ownership, but also help to shine a light on specific deficits in your skills, behaviors or comfort zone.
Below are 12 attributes and traits of ophthalmologists who I have observed over the last 40 years to be the most adapted to and successful at private practice ownership. Read each, and score each attribute with one of three numbers:
+1: “This describes my thinking and my feelings well. I agree with this.”
0: “I feel kind of neutral about this attribute. It is kind of like me, but not really.”
–1: “This is nothing like me. This does not really match how I feel or think.”
1. ___ “I enjoy the business of ophthalmology as much as or more than I enjoy medicine itself. Although solving business problems is an entirely different discipline, business is rational, generally rules-based, and can be subjected to objective analysis and optimal ‘treatment’ just like medical problems.”
2. ___ “I really enjoy sitting down with managers and fellow doctors, hashing out problems and brainstorming together. I like the give-and-take of being part of a team and realize that I don’t always have the best ideas in the room. Compared with business meetings, it’s kind of lonely working all by yourself in an exam lane.”
3. ___ “I’m generally considered by others to be a workaholic. It doesn’t bother me in the least to have to stay after hours or work a bit on the weekend to catch up with my work.”
4. ___ “I don’t get bent out of shape easily when faced with business challenges such as staff who disappoint me or arbitrary fee cuts. I roll with the punches and see every business setback as an opportunity to learn, grow and improve.”
5. ___ “I relish the feeling of developing those people who work with me. When I make even a small contribution to a young doctor’s understanding or help our administrator dig deep on a tough problem, that’s as much of a rush as nailing a surgical case.”
6. ___ “I don’t really like us to sit still or rest on our laurels. I enjoy finding constant small improvements in how we run our business affairs.”
7. ___ “I like big picture thinking and dreaming about what our practice could become one day. But I’m not just a dreamer. I am very disciplined, and when faced with a long to-do list, I always tackle the tough but important items first.”
8. ___ “I am a very effective and clear communicator, and that helps me be an effective delegator. When giving instructions to staff, they rarely come back and ask for clarification because I take pride in patiently helping our people at the outset, no matter their experience level, do the best job they are capable of at the time.”
9. ___ “I am very tough and set high standards, but combine that with being very fair, even-handed and lavish in my praise. I rarely have to raise my voice. People who work around me feel safe, do their best and hear from me often about the great job they perform.”
10. ___ “I have a high tolerance for insecurity, change, risk and ambiguity.”
11. ___ “Most people take an early liking to me, and me to them. I’ve learned that no matter our background or education, we’re really all the same inside, and that helps me connect quickly not only with patients, but with the people I work with.”
12. ___ “I would rather work for myself or a small group of co-owners and make $200,000 a year than work for somebody else and collect a $300,000 paycheck.”
Now add up your composite score. Out of a maximum potential score of +12 points and a minimum potential score of –12 points, how did you do?
If you are not yet an owner and had an especially high score, this might give you the confidence to seek out a partner-track position, buy a practice or even develop your own practice de novo, which is still feasible in selected markets.
If you are currently an owner and had a low score — even a negative overall score — this might awaken insights that it is time to change your situation. Realize that there are several options short of abandoning ownership that might be feasible:
- Delegate vexing business chores more actively to your management team or outside vendors.
- Merge with another practice in your community. We are certainly in an era in which there is growing strength and security in numbers
- Improve or replace your practice administrator.
- Reduce the complexity of your practice. A two-office practice can be four times more complex than one with a single office.
- Shed services or patients that are no longer time-effective or professionally satisfying.
- Add a more business-loving physician to your practice to share the management load.
- For more information:
- John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John 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, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams and a new book, Simple: The Inner Game of Ophthalmic Practice Success. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.