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thankful few despise and avoid their c olleagues like bickering spouses. Such conflicts must be dampened— or the source of conflict removed— to be able to effectively operate a contemporary ophthalmic practice in these fast-shifting times. Strategic goals "Strategy" and "tactics" are often confused and transposed. Simply said, strategic goals are couched more sweepingly and over longer t ime horizons: • Where will we be in 5 to 10 years? • What will our environment be like? Will we have access to patients and premium dollars? • What will be our geographic span? • What services will we add or subtract? • What will the provider mix look l ike—ODs vs. MDs/DOs? • What will be our growth rate? (If r evenue doesn't grow at least 4% per year, we will be losing market share.) • Will we have firm institutional ties, or remain neutral and "Swiss" in our market? • How will we handle succession? Only after the answers to these larger questions are clear can we a ddress the more granular tactical choices. Ophthalmology Business 96 February 2014 Tactical goals Tactics are actions, planned and performed over shorter time hori- zons, in the service of your practice's strategic goals. In the example of Dr. Smith, who needs to transit nine more patients a week in order to m eet her financial goals, the logical tactics would include: • Inform the staff of your goals and get buy-in • Change the template to accom- modate three more patients per clinic day • Change overtime policies to allow one tech to stay half an hour late P RN • After the new template has been running for a few weeks, pull the staff together and iron out any wrinkles: Is the clinic running be- hind? Are patients complaining of too little face-to-face time with the doctor? Is the billing depart- ment keeping up with a slight in- c rease in workloads? Tactics have to be triaged, just like medical care. You can't do everything this year. Striving is important, but be balanced in your striving. Goals are more about trajectory than target. Few of our greatest goals are fully realized, even by the most talented among us. The value and purpose of great goals, "push goals" as they're often called, is not to achieve them precisely, but to mean- der toward them approximately. Attaching excessively to an out- come—"I will live in a penthouse and drive a Ferrari by the time I'm 50"—may keep you from enjoying the perfectly terrific consolation prize of driving a Lexus up the drive- way of your comfortable suburban home. On your path, cleave to Hemingway's counsel, "It is good to have an end to journey toward; but it is the journey that matters, in the end." EW ABOUT THE AUTHOR Mr. Pinto is president of J. Pinto & Associ- ates, an ophthalmic practice manage- ment consulting firm established in 1979, with offices in San Diego. He can be contacted at 619-223- 2233 or pintoinc@aol.com. The five continued from page 95 A n A S C R S P u b l i c a t i o n O c to b e r 2 0 1 3 w w w. O p h t h a l m o l o g yB u s i n e s s . o r g M A N A G I N G PAT I E N T E X P E C TAT I O N S P. 6 T H E A G E N C Y A D VA N TA G E P. 2 0 F R O M O N L I N E T O C L I N I C P. 2 3 T h e g re a te s t s m a r t m o n e y s e c re t t o f i n a n c i n g o p h t h a l m i c e q u i p m e n t an d o t h e r m a j o r c a p i t a l o u t l a ys P. 1 6 T M March 2014 issue ... coming soon! • Private practice fellowships vs. fellowships in academic settings • Fraud: Every business is at risk • Want to examine your own eyes? There's an app (or website) for that • Physician shortages and ophthalmology digital.ophthalmologybusiness.org 91-97 OB_EW February 2014-DL2_Layout 1 1/30/14 11:51 AM Page 96