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OPHTHALMOLOGY BUSINESS 110 February 2018 by Corinne Wohl, MHSA, COE, and John B. Pinto team. They can assist you with writing the specific tactics that will emanate from your overall strategy. 3. Benchmarks and key perfor- mance indicators Tracking your practice's key perfor- mance indicators provides an early heads-up for trends that may be more difficult to notice promptly if you are limited to reviewing tradi- tional financial statements and dry columns of figures. a. It's important to primarily use external peer-practice bench- marks; these are analogous to the clinical benchmarks you use to assess patient health. You proba- bly don't diverge much from your colleagues in what you consider to be healthy IOP. b. In addition, you should be bench- marking internally (i.e., against your own statistics, month over month) for traits unique to your practice, such as the productivity of a nurse practitioner you use as an extender. c. By limiting yourself to gross profit and loss statements you will only see what has changed; there will be little indication of why things changed. For example, if revenue is rising and patient visits are rising, you might assume that all is well in the customer service area. But if you were tracking and benchmarking both new and established patients, rather than total patient visits, you could un- cover that your new patient ratio has risen, while your established patient visits have fallen—and that could indicate the practice has gaps in the recall process. 4. With growth, more formality is obligatory a. Written communication, rather than just oral communication • Departmental policy and procedure manuals • Employee handbooks • Meeting agendas and minutes b. Formal (and more) meetings • Administrator and managing partner: weekly • Management committee: weekly or bi-weekly have a formal, written strategic plan. Yet it makes perfect sense that a written plan functions as a clear guide and can help commu- nicate the mission and goals of the practice. What can you do to push past the barriers and inertia that prevent many from writing the plan? a. Rather than imagining a 25-page, meticulously detailed written plan, focus on the nuts and bolts of planning. You can accomplish this in two to five written pages. b. Overlook the fear of commitment or of not hitting your targets. This document is a guide, not a test. c. Every practice has more oppor- tunities than it can undertake; a written plan will allow you to sieve through this list and pursue the priorities. d. Base your goals and assumptions on what you know right now. Plan to review your strategic plan annually and revise as needed. e. The administrator and owners are best prepared to write the first draft. Once the main goals are agreed on, share the draft doc- ument with your management tation as both guidance and a risk management tool is crucial and includes: a. An employee handbook that is regularly updated and approved by legal counsel. b. Operations manuals that are up to date and detailed enough to be used as a training manual when onboarding new employees, as well as a resource for all depart- mental employees. c. Written communication, in gen- eral, to keep employees informed and oriented to the practice goals. d. Management team meeting min- utes that specifically reflect the directions and instructions pro- vided to mid-level managers. (You might be surprised at how many different interpretations there are from a meeting you held. Without review and set deadlines, your management meeting can be deceptively unproductive.) 2. Strategic planning Strategic planning is prominently missing from most practices. Fewer than 10% of the ophthalmic prac- tices in the U.S. we first come across "Sometimes the hurdles aren't really hurdles at all. They are welcome challenges, tests." —Paul Walker "I learned two basic lessons on Everest. First, just because something has worked in the past does not mean it will work today. Second, different chal- lenges require different mindsets." —Lewis Gordon Pugh D espite reimbursement differences, ophthalmol- ogists from around the world have similar chal- lenges. While presenting a practice management master class at the XXXV Congress of the ESCRS in Lisbon, Portugal, many of the same questions and concerns we hear in the U.S. arose from the audience. Here are common challenges that ophthalmology practices face. 1. Human resources management Hiring smart, firing promptly, and how to effectively manage the prac- tice so your employees are retained and productive definitely tops this list. The use of formal documen- Similar challenges for ophthalmologists around the world To the point: Simple practice tune-ups for complex times

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