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OPHTHALMOLOGY BUSINESS 136 October 2016 by Corinne Wohl, MHSA, COE, and John B. Pinto Prioritizing your must-do c. Do you review and update your task list at appropriate inter- vals? Obsessively editing your list several times a day is not an effective use of your time—but neither is checking your list weekly. Some of the most effec- tive ophthalmic executives we know make it a habit to exam- ine their to-do list closely twice a day—once at the start of the work day as a reminder of the priorities and once at the end of the day, when the next day's priorities are flagged. d. Are the right time frames covered? Your current to-do list should probably not be bogged down with tasks you won't get to until next quarter. e. Are all of the tasks on your list really yours? Or do you clog up your to-do list with the actions that others are responsible for, simply to assure you haven't forgotten what you delegated? 2. After considering the structure and content of your action list, let's turn to function. The whole reason for having an action list is to stay on task with the priorities of your company. Do you know what these are? Surprisingly, fewer than 5% of practices have a formal, written strategic plan. But even in the absence of a plan, your practice's leadership team should at least have a punch list of longer-term strategic priori- ties, each of which should match up with one or more actions on your to do-list. See Figure 1 for an example. 3. And last comes discipline. Make sure you apply sufficient energy and focus. The best list-making in the world is for naught unless you take action on your action list. Here are a few pearls from the most diligent administrators we know: • As a mechanic pal once said, "When you lift up the hood, do something easy first—it gets your confidence up." You, too, may feel more accomplished if you complete one or two easy things first thing. This may give you confidence and boost momentum. • Alternately, if you are the procrastinating type, you may find it most effective to each "The key is not to prioritize what's on your schedule, but to schedule your priorities." –Stephen Covey S urgeons learn early in their training to triage—address- ing big medical problems first and small ones later. And yet somehow, too little of this lesson is applied when doctors and managers are running their practice businesses. Everything can be flagged as a priority, which is a little like a doctor treating his pa- tient's shattered orbit and toe blister at the same time. Learning how to quickly and effectively prioritize business tasks is at the heart of great practice man- agement. We all pay lip service to prior- itization. The surgeon-owner asks his administrator, "What are you working on now, Susan?" "Plans for the new satellite office," Susan replies. And yet, when she continues down the hall to her office, Susan faces a whiteboard with a list of 26 urgent tasks, none of which is really number one. Practices, managing partners, and administrators who thrive devel- op a system to nominate the most important tasks and communicate these priorities up and down the organization. Applying Covey's advice, it's best to tend to the non-urgent/ important items before turning to urgent (and only seemingly import- ant) ones. But the contemporary demands on practice leaders encourage all of us to either address the "on- fire" issues (which could have been prevented with earlier attention) or worse, to put first efforts every day into those things that are either easy to check off your list or fun to do, but not necessarily a priority. By the end of the day, the truly important tasks can be left untouched—again. Good and bad prioritization habits are part of each practice's culture. We see practices where everyone diligently pursues the most important priorities first—and prac- tices where the opposite is true. What's the culture of your prac- tice? Do you apply major attention to major items? Is procrastination called out or overlooked? Are blown deadlines blown off, or is there an appropriate, adverse consequence for not getting your agreed tasks done on time? Prioritization is so important and fundamental to success, it's some- thing best periodically relaunched formally at the board level and then refreshed once again down the ranks. Doing this creates a culture of shared urgencies. Business prioritization is per- haps more art than science, some- thing that the most fortunate of us stumble upon for ourselves rather than by learning an effective system. But every effective executive even- tually finds what works best for him or her. If you want to speed up the process of learning how to better pri- oritize, what follows is a systematic approach, abstracted from the best habits we see in our travels around the country. 1. First, let's discuss structure. Exam- ine your current list, no matter how ugly. Ask: a. What's the format of your list? Consistency here is as important as what physical tool you use. Some perfectly excellent man- agers manage their to-do list on 3x5 cards, others on a yellow tablet, or like most today, on a Word file or Outlook task list. All of these can work, but work best if used consistently. b. Do you have a system that flags true priorities? This can be "A, B, C," 1 through 5, or even a simple asterisk. To the point: Simple practice tune-ups for complex times

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