Develop your skills at giving and getting advice
Click Here to Manage Email Alerts
“When you pick your advisers, you pick your advice.”
– C. Roland Christensen
“Advice is like snow — the softer it falls, the longer it dwells upon, and the deeper it sinks into the mind.”
– Samuel Taylor Coleridge
Much of your time as an ophthalmologist is spent on just two activities: giving advice and receiving advice.
The giving part was formally learned in medical school and has been well practiced ever since. By the end of every exam, you have told patients and their family members what you have learned today and what should be done next. As a specialist or subspecialist, you also confer with referring colleagues, advancing the interests of your mutual patients and passing your knowledge along to someone who is more generally trained.
But how are you at receiving advice? Chances are, you have had little formal training in this area. Whether it is advice from your housepainter or your business attorney, getting advice is different from giving it. If you are the recipient, the tables are turned. You are not the expert, so you have to apply as much instinct as experience or logic.
The art of giving and getting advice is not limited in your world to patients and doctors and hired professionals. It surrounds you:
- The ASC director who advises a substitute for a product no longer available.
- The pharmaceutical rep detailing you on a new drug.
- Your head tech who advises a corrective action plan for a faltering staffer.
- Your administrator when they confer with you on two job candidates.
- A scribe who signals that you are running late in clinic.
Both sides of this — the getting and the giving — are harder than they appear. In the words of Garvin and Margolis, writing in a 2015 article in Harvard Business Review, “Whether you’re receiving or giving advice, flawed logic and limited information complicate the process. Advice seekers must identify their blind spots, recognize when and how to ask for guidance, draw useful insights from the right people, and overcome an inevitable defensiveness about their own views. Advisers, too, face myriad challenges as they try to interpret messy situations and provide guidance on seemingly intractable problems.”
Let’s unpack this a bit and put it in a surgeon’s context.
Receiving and using advice
1. Building an advisory “board.” Most surgeons collect a hodgepodge of advisers over the years rather than intentionally curating a balanced portfolio of experts they can turn to. Your panel may be quite diverse:
- The usual attorneys, CPAs and consultants, of course.
- A “surgical guru” whose elevated skills you seek to gain for yourself.
- A medical colleague with particularly sharp practice business skills.
- Whoever you turn to in stressful times: a counselor, buddy or cleric.
- Whoever you lean on for personal health and fitness advice.
- A personal financial adviser.
Your relations with these advisers are mostly one on one. It is unlikely you would ever call a group board meeting, per se.
2. Seek diversity. Ophthalmology is an incestuous business; birds of a feather flock together. All the same, do not pick out a new CPA just because they serve other eye docs in your community.
3. Taking advice does not always sound like two pals having a friendly conversation. The best adviser on a given matter may make you somewhat uncomfortable. Do not use this as a pretext for turning the discussion into an argument. Yes, you are the one who is paying for counsel, but you are always better off paying for blunt truth than gentle lies.
4. Depending on the matter, get a second or third opinion. When a patient has a sore throat, visiting a single doctor is generally sufficient. When the same patient gets their first serious cancer diagnosis, a second opinion should be routinely sought. It is the same with the big things outside medicine. When you are approaching retirement, do not just take your financial planner’s report for granted. Send it along to your CPA or a second financial consultant.
5. Be proportionate in gauging your adviser’s counsel. There is a common tendency for ophthalmologists to unduly overvalue or undervalue. This applies to a lot of areas. The new phaco machine is either “perfect” or “scrap metal.” Depending on the day, a tech may be “the smartest person who ever worked here” or “the worst refractionist on the planet.” In most cases, the advice you receive will be neither perfect nor dreadful, but somewhere in between. As a recipient, try to fairly gauge the advice you are receiving, and use it accordingly.
6. If the advice is good, take it. The Kaiser Foundation did a study and learned that 29% of patients do not fill their prescriptions and another 18% cut their dosing to save costs. Do not be like these noncompliant patients. As the proverb goes, “To know and not to do is not to know.” Of course, it is your prerogative entirely to delay implementation or even toss out a recommendation if it does not feel right.
Giving advice
1. Make sure the ground is fertile for the advice you are dispensing. Yes, the patient is in your chair. They took the trouble to make an appointment and drive in. But they may simply be keen for a new pair of glasses today. They freeze up the first time you say “cataracts” or “glaucoma.” Faced with this resistance, wise docs will plant the seed, provide a few gentle basics and maybe a handout, and accelerate the next appointment.
2. Lay out the options. I had a personal physician years ago, “Doug,” who retired and became a buddy. Doug was the best doctor I ever had. Why? After my annual exam, he would talk out loud as he wrote up his chart notes (back in the day when this was done with a pen). If there was something he had found that needed further testing or care, he would clearly spell out the options, along the lines of, “We can watch that birthmark, biopsy it or simply remove it today.” Take the same approach with your patients or referring community. By spelling out the options, you involve and empower them.
3. Get into the patient’s head. To you, the new cataract diagnosis in room three is routine and humdrum. But it can set your patient’s brain on fire. Meet the patient wherever they happen to be. Stoic patients with a long history of medical care may be as bored as you. But many patients need to hold your or your surgical counselor’s hand to get through the visit.
4. Check in — are they getting it? When I talk to front desk checkout staff, they tell me that one of the most common patient complaints (besides waiting) is that they did not understand what the doctor said. Doctors are powerful figures in our society. Few patients will interrupt you to say, “Hold on just a minute there, doc, I lost you a minute ago.” If you are delivering important advice, check in along the way. Ask a time or two midstream if they understood. Send them home with a printout to read or a URL to click on to reinforce your findings and advice.
5. Avoid the potential appearance of self-interest. Warning flags would go up if your CPA were to push you into an investment because she would get a cut of the deal. In the same manner, patients are increasingly on the lookout for doctors who are pushing unnecessary care. So, even when cataract surgery is more than indicated, it helps to say, “Timing for your surgery is always up to you. It appears you would really benefit from surgery — especially in your right eye — and some patients would have insisted on surgery a year ago. But you and your daughter should decide what’s right for you.”
- Reference:
- Garvin DA, et al. The art of giving and receiving advice. https://hbr.org/2015/01/the-art-of-giving-and-receiving-advice. Published January-February 2015. Accessed Dec. 3, 2021.
- For more information:
- John B. Pinto is the author of several books on ophthalmic practice management, including John Pinto’s Little Green Book of Ophthalmology: Strategies, Tips, and Pearls to Help You Grow and Manage a Practice of Distinction, UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction (with Corinne Wohl), Simple: The Inner Game of Ophthalmic Practice Success, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at slackbooks.com. Receive 20% off with promo code PINTO20. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.
Collapse
Read more about
Click Here to Manage Email Alerts