EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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123 OPHTHALMOLOGY BUSINESS October 2014 As you need to? Figure 1: In the beginning, Dr. Smith is working a lot fewer days than are possible, something he corrects in the years that follow. Figure 2: Dr. Smith's efficien y increase in percentile terms Source (all): John Pinto In a world of adverse changes, you still have a lot more control over your take-home pay than you think by working just slightly longer hours, just slightly more intensively, or both. The anterior segment surgeon seeing fewer than 45 visits in a clinic day (and the subspecialist seeing fewer than 35 visits in a day) has a clear-cut opportunity to be more prosperous. Launch an efficiency task force in your practice with your administrator and chief tech. Exam- ine time studies. Be as specific and objective as you can about goals. Your goal should not be "more," but a finite patient count or financia target that you nominate, with a firm deadline and regular progress checks. Visit higher-volume colleagues whose clinical judgment and out- comes you respect. You don't have to invent a brand new way to see a high-volume clinic. Learn from surgeons who are faster and more productive than you are today. Then repeat the process many times throughout your career. If you are now maxing out at 50 visits, observe a peer who sees 65 visits per day and copy what he or she does. Start shifting as much non- MD work as you are comfortable delegating to tech and optometrist extenders. The average ophthalmol- ogist is spending a third of his day doing non-ophthalmologist-level tasks. If you combine delegation with education and monitoring, your staff will become more valuable up to 2 extra hours of patient care a week, which, as you can see from the example of Dr. Smith, results in a hefty pay raise. Add a half-day to your week. Come back to the clinic after sur- gery. The once-sacred post-surgical afternoon of golfing is now a thing of the past for most surgeons. Work through lunch, if you don't already. An increasing num- ber of surgeons graze on the fly and just keep rolling through the noon hour. Taking a full banker's lunch every day (unless you use the time profitably for outreach and referral development) is costing you about $100,000 in lost production each year. To increase your accountabil- ity to yourself and your practice's financial health in this sphere, it's helpful to track the percent of the total potential time that you actually work. In Figure 1 you can see that Dr. Smith in the beginning is working a lot fewer days than are possible, something he corrects in the years that follow. You can see his efficiency increase in pe centile terms in Figure 2. Creating similar, longitudinal graphs (which can include derivatives like patient visits per clinic session or doctor hour) will help you and your team moni- tor and enhance performance. Of course, as an alternative or supplement to working longer hours, you can work more intensely and intelligently—the proverbial "working smarter, not harder." and their careers (and yours!) will be more fulfilling. Finally, there is a large role here for personal fitness and lifestyle choices to enhance your vigor and output. For more than 35 years I've been an attentive observer of Amer- ica's most productive eye surgeons. They have many traits in common: • They are leaner than their slow-paced colleagues. • They are regular exercisers; this doesn't mean ultra-marathoning, just a 30-minute workout in your home gym works wonders. • They eat healthy foods and limit alcohol consumption. • They pursue good sleep hygiene, getting 7+ hours of rest each night. • They manage their lives to contain the least amount of drama, freeing their minds to concentrate on each patient's needs. EW Mr. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979, with offices in San Diego He can be contacted at 619-223- 2233 or pintoinc@aol.com. About the author