Back to basic principles: Every successful practice rests on these five pillars
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“Far and away the best prize that life offers is the chance to work hard at work worth doing.”
– Theodore Roosevelt
“Quality means doing it right when no one is looking.”
– Henry Ford
Source: Adobe Stock
A lot of articles about living a better life or raising a smarter kid or running a better business enumerate a short list of surefire principles that are critical for success. Every guru’s lecture starts with a line like, “Tonight I will tell you seven steps to enlightenment that will change your life forever.”
This is satisfying to the audience because it promises quick results from a digestible checklist. And it is a great crutch for the guru’s ghostwriter who cannot think of an eighth step to add to the list.
So this month, let’s take that simple approach and pronounce:
“Every successful eye surgeon rests on five critical organizational pillars.”
Here we go.
One: A long-term strategic plan
This plan spells out your objectives as a business owner. Not more than one private ophthalmology practice in 10 has even a rudimentary version of a written long-range business plan. I no longer puzzle over this. Most eye surgeons are, in equal measure, exhausted, content and highly successful. That makes it difficult to rally the energy and motivation to write down your plans for the future. All the same, I can report after 45 years in the field that thriving practices do a better job than others in planning the future. This plan need not be exhaustive to be effective. Simply write down:
- Your planning time horizon — this will typically be from 5 to 10 years. A small or fragile practice may only plan a couple of years ahead and then make revisions. A large multigenerational practice should plan 20 years out.
- Your service area — the natural north, south, east and west boundaries of your practice. Count the number of people living there. Count the number of ophthalmologists working there. Divide the first number by the second number to get the number of customers available to the average ophthalmologist. If the number is more than 30,000, it will be hard for your practice to fail. If the number is less than 15,000, it will be harder, but certainly not impossible, to succeed.
- Your service mix — the patient care services you provide now, want to add or perhaps want to eliminate. The choices you make here may be driven by professional interests, career stage, competitive factors or raw economics.
- Your provider mix — this usually boils down to the number of MDs vs. the number of ODs, but it might be extended to a count of physician assistants, nurse practitioners or even non-eye care providers.
- Your growth rate — the overall business of ophthalmology in America is growing about 5% annually. Do you want to match 5% and preserve market share, beat 5% and gain market share, or settle for a slowly declining practice because you are heading toward retirement?
- Your succession plan — in this area, some doors are closing, others opening. We are no longer training enough residents, so it is getting much harder to arrange a traditional handoff to a younger surgeon. On the plus side, partnering with private equity can result in a potential windfall, and an increasing number of large private practices and health systems are in the hunt for practice acquisitions.
Two: A set of short-term tasks
These are often clustered into multipart projects that will help you accomplish your long-term objectives. What tasks need to be accomplished in the next 12 months or so? If you aim for 10% practice growth, you might need to invigorate marketing, hire staff, add exam rooms and boost administrator competency. If you want to add a new patient service, you might have to attend national meetings, gain new skills, purchase equipment, train staff and reach out to referral sources.
Three: A project accountability tracker
This tracker assures that your priority tasks are being completed on time. There are lots of project management options to turn to. Some prefer robust off-the-shelf software such as MeisterTask or Microsoft Project. Others get by just fine with a running list kept in Excel or Word. Whatever approach you choose, it should be a) simple and easy to update; b) clearly understood and navigated by managers and owners alike; and c) updated at a frequency proportional to the needs of the practice, typically biweekly or so.
Four: A strong administrator and their management team
This typically includes your head tech, lead receptionist, billing manager and perhaps a chief optician, marketing manager and internal bookkeeper. If you have an ASC, the team is rounded out with your director of nursing. In the smartest practices, this team meets every couple of weeks with the managing partner (or sole owner) of the practice.
Five: A formal management team development program
This is for your practice’s leaders, who are only going to deliver optimal value if you support their continuous improvement. Unfortunately, most practices underinvest in management training and coaching. My partner Corinne Wohl and I wrote Up: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction as a unit-by-unit, self-help workbook. (Please see below for a discount on Up for Healio/OSN readers.)
Like a professional sports team owner, it is incumbent on you to groom each individual “player” in your lineup. Every individual manager in your practice should have a continuing education budget, a written career development plan and regular performance feedback.
Summary
With the first pillar, every practice owner has agreed on an ideal future vision for the company. With the second pillar, you have spelled out the details of the more granular tasks that need to be checked off month by month. With the third pillar, you have a tool to monitor progress with these tasks. With the fourth pillar, you possess the raw talent that can accomplish these tasks. And with the fifth pillar, you optimize the power, output and effectiveness of your management team.
- 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.
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