Mastering your fears
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“There is only one corner of the universe you can be certain of improving, and that’s your own self.”
– Aldous Huxley
“The risk of a wrong decision is preferable to the terror of indecision.”
– Maimonides
This month, let’s contemplate the incomprehensible.
The universe is all of space and time, including in ascending order: planets, stars, galaxies, and all other forms of matter and energy. Our life-giving sun is one of a few hundred billion stars in the Milky Way, which in turn is one of a few hundred billion galaxies in the observable universe. According to prevailing theory, the universe was created nearly 14 billion years ago, with the Big Bang.
It is not just old, this universe of ours. While the true size of the entire universe is unknown, they say the observable universe is around 93 billion light-years in diameter. (For those of you who forgot eighth grade science, 1 light-year is about 6 trillion miles.)
All of which, since each one of us is so infinitesimally small and short lived, delivers us to a point I would like to make about life’s risks and human fears, and a lesson I learned recently in Naples, Italy.
Savor the moment
You probably already know the story of the volcano Mount Vesuvius. Maybe you have seen Pompeii in person, which disappeared under ashes when Vesuvius exploded in 79 AD. But you might not know about the current risk from a nearby “super volcano,” as they call it here.
More than 500,000 people living west of Naples are under daily threat from the much larger Campi Flegrei volcano system, which has generated more than 1,100 earthquakes in the last month alone. Italian officials have now devised an elaborate evacuation plan. And yet, most of the Neapolitans we met are pretty relaxed and fatalistic, even though they stand on land being thrust upward 7 inches a year by molten lava.
Our driver, Mario, said it best: “The city says they have a plan to evacuate all of us in a few days. That’s if there is enough notice. The scientists say we might only get a few hours warning from the volcano, like the people of Pompeii. So, what am I going to do? I’ll tell you. When they give the warning, I’m going to pour a glass of wine. Then I’m going to cook some pasta, which only takes 10 minutes. Then I’m going to have a great meal with my wife, Maria. From there? Who knows? Who cares?”
Here is what that has to do with ophthalmologists and the business of eye care.
Most eye surgeons are by nature cautious and risk averse — and made much more so by their professional training. Which is probably good, given the slim difference between excellence and disaster.
Unfortunately, that caution can spill over and diminish the rest of your life.
I am not counseling here that you become as relaxed as Mario. But even if by small degrees, try to face your fears and demons. Be braver.
Don’t worry about money. The average American ophthalmologist makes seven times the median annual income and retires in comfort. With effort, you can make twice that. Add luck, and it is three times. For people with money worries, income is never the problem. The trick is to match your lifestyle to your income. We have clients with personal jets and clients with 25-year-old sedans. Both, on balance, seem to be about equally happy, so long as they can afford the fuel for their vehicle of choice.
Don’t worry about your health. First, it is likely you walk way more than the average American’s 5,000 or so steps daily. Researchers at Vanderbilt University Medical Center found that walking 8,200 steps a day was the threshold at which a person begins to significantly lower their risk for developing a variety of chronic diseases. And it is not just the steps — you are doing squats all day long and tightening your core with indirect eye exams. Plus, if your health and vitality are ever a concern, you have the skills and contacts and cash to refer yourself out for needed care. That just leaves the biggies: an accident, incurable cancer, an attacking heart or armed mayhem, which you really can’t do much about anyway.
Don’t worry about your staff. The average ophthalmologist employs, directly or indirectly, about six lay staff. As soon as you employ people, your worries compound. Do they like it here? Will they stick around long enough to learn their job? If they can’t learn their job, how responsible should I feel if I have to fire them? In truth, most of your staff are doing their best and get better and faster over time if you provide training and encouragement. If they rise to whatever standards you set, you and they will both be happy. That said, the demands on every member of your team are higher than in the average $25 per hour job these days. If they don’t make the grade with you, they will keep trying other jobs with other employers until they find a fit.
Don’t worry about the opinion of others or where you stand in the professional pecking order. Like your employees, you are mostly doing the best you can. No matter how gifted you are, there will always be a better surgeon than you somewhere in the world. Half of all eye surgeons perform below average surgery, but most patients seem to do just fine and wind up with outcomes that would have been called miracles 50 years ago. Run your own race. Or walk it.
Don’t overthink business decisions. In specialty training, you received about 5,000 hours of intensive instruction on how to discover and treat the same 20 or so common ophthalmic maladies. If you were lucky, you maybe had a lecture or two in your residency on the business of medicine, in which there are a few thousand potential things that can go wrong. Not even the greatest business minds understand the nuances of human resource management or financial forecasting as well as you understand glaucoma. The truth about business is that most of the decisions we make are one part objective analysis and nine parts subjective spitballing, predicated on what has seemed to work best in similar settings and then executed without looking back. Everything you need to know about business you learned in medical school. Gather the available facts. Make a diagnosis. Weigh the cost-benefit of treatment vs. patient observation. Then act. If you get stuck, refer the problem out.
Finally, just remember — given the infinite time and space of the universe and our fleeting, microscopic place in it, we are, all of us, living within constant view of our own personal Vesuvius eruption. Like Mario, remember to savor the moment.
- For more information:
- John B. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979. He is the country’s most published author on ophthalmology management topics, 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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