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Mastering five domains of practice life
Young ophthalmologists should be prepared for the business side of their chosen profession.
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“The purpose of human life is to serve, and to show compassion and the will to help others.” – Albert Schweitzer
“The mystery of human existence lies not in just staying alive, but in finding something to live for.” – Fyodor Dostoyevsky
“The purpose of life is a life of purpose.” – Robert Byrne
In a few days I am going to sit down with a group of residents and fellows in the Midwest and talk with them about the business affairs of their chosen profession. As the last of my PowerPoint deck is buttoned up, I can see that I am leaving out a few important details, which we could sum up as “mastering the five domains of practice life.”
What follows is a recap of what clients-turned-mentors have taught me over the last 40 years, which, with luck, I will be passing along shortly to America’s next crop of eye surgeons.
Your life is no longer entirely your own
A search for control is at the heart of ophthalmic science. Control over injury, disease and blindness. And on the surface, control would appear to be at the heart of your practice’s business affairs. But as a provider embedded within a complex commercial machine, your exerting excess control personally gums up the works.
Just as patients under your care trust you and relinquish control, it is important for you, as a member of the practice team, to trust the professionals who are supporting you. The managers, techs, receptionists and others. This assumes, of course, that you have made wise staff choices. If there is anyone on your team — from clerk to administrator — who you would not feel comfortable taking direction from, should they remain in your practice?
Relinquishing control applies even in “your” domain on the clinic floor:
- Asking your senior tech if you are caught up enough to dictate or make a phone call.
- Accepting direction from staff about whether a special test can be squeezed in today or would best be rescheduled at another time.
- Eliciting feedback from scribes on how you could improve patient communication.
Realize that being self-actualized is harder for ophthalmologists
How do we make an ophthalmologist? Start with a smart kid who wants to please his parents. Add pats on the head for every A-plus and frowns for every A-minus. Throw in a couple of decades of preselected curriculum and the approbations of teachers, professors and chief residents. And out the far end will come an ophthalmologist who is more outer-directed than inner-directed.
As a result, most eye surgeons shine with obliged, rote, moment-by-moment clinic duties but have a hard time with long-range planning.
Strive to overcome this with a disciplined approach to seeing the big picture of your life and career and, when appropriate, get outside assistance for the following “future focusing”:
- The bucket list: What do you (and perhaps your partner) want to see, have, do, be, own and give away in the years you have left on this planet?
- Personal financial plan: Are you earning and saving enough to pursue your bucket list before and after retirement?
- Strategic business plan: What kind of practice do you want in the next 10 or more years?
Working smarter is no substitute for working harder
Nobody becomes an ophthalmologist without being very smart and very motivated. But hubris (and 25 years of harsh academics!) leads young surgeons to believe that intelligence can make up for hard work and long hours. As someone who regularly hires physicians, I can report that I would rather employ a hard-working A-minus than someone ranked No. 1 in her class.
In practical terms, this means:
- Arriving earlier and leaving later than is expected of you.
- Collaborating with staff to increase patient volumes, in part by maintaining a more intense pace than your peers.
- Moving purposefully throughout the day and not ditching the clinic pod for less taxing emailing or journal reading.
- Visiting high-achieving fellow surgeons to learn their efficiency and tempo secrets.
Unfailing courtesy is 80% of the game; competency brings up the rear
Patients largely judge their doctor’s competence based on affability. This is especially the case in ophthalmology, in which the relationship is highly personal and most patient care is longitudinal, stretching out over years.
The typical eye surgeon, in the span of his or her career, has roughly half a million professional interactions with patients, referral sources, vendors and staff. Compare that with other professions both in and out of medicine, and it is clear there are more opportunities in ophthalmology to delight or dismay than in other fields.
If Emily Post had traveled in ophthalmic circles, giving out etiquette advice, her short list would have included:
- Be equally kind to superiors, peers and subordinates; don’t take out your insecurities and frustrations on the help.
- Be the person who unfailingly says: “Please.” “Thank you.” “Can I do anything else for you?” “I’m sorry.”
- You are a role model. Harness the admiration that others have for you to demonstrate and impart kindness, patience and respect.
Your legacy is not what you think
Given the baby boom bulge of 60-ish surgeons now approaching retirement, there are a lot of ophthalmologists thinking about their legacy today and wondering, “Will my practice live on after me?” This is not the right question. And the answer is often unsatisfactory — many practices will be simply closing down in the years ahead when their founders retire.
Your legacy is not your office building, the reception desk or the slit lamp in room 3. It is not the fact that you were the first to do a new procedure in your town or your lifetime case counts. Instead, your legacy is every patient you have ever treated or reassured. Your legacy is abuilding every week that you practice.
In the words of my colleague, psychologist Dr. Craig Piso, happiness flows from unselfish, outwardly directed service. The opportunity for this is abundant in eye care. It comes from finding a purpose greater than yourself and a mission that serves that purpose.
- 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.