YOUNG OPHTHALMOLOGIST CORNER
STRATEGIES FOR BUILDING THE BEST OPHTHALMOLOGY PRACTICES AND
OVERCOMING CHALLENGES
OVERCOMING CHALLENGES
Dr. Vidushi
Sharma, MD (AIIMS, New Delhi), FRCS (UK)
Sharma, MD (AIIMS, New Delhi), FRCS (UK)
Author: Meri Kitab Meri Dost: A Motivational Book for Youth
Director, SuVi Eye
Institute & Lasik Laser Center,
Institute & Lasik Laser Center,
C 13 Talwandi, SuVi Eye
Hospital Road, Kota, Rajasthan, India
Hospital Road, Kota, Rajasthan, India
Email:suvieye@gmail.com
Dr. Suresh K Pandey, MS
(PGIMER, Chandigarh), ASF (USA)
(PGIMER, Chandigarh), ASF (USA)
Director, SuVi Eye
Institute & Lasik Laser Center,
Institute & Lasik Laser Center,
C 13 Talwandi, SuVi Eye
Hospital Road, Kota, Rajasthan, India
Hospital Road, Kota, Rajasthan, India
Email:suresh.pandey@gmail.com
Affiliation: Visiting Surgeon- Intraocular
Implant Unit
Implant Unit
Sydney Eye Hospital, Save Sight Institute
University of Sydney, GPO Box 1614, Sydney, NSW,
Australia
Australia
-Visiting Assistant Professor
John A Moran Eye Center, Department of
Ophthalmology & Visual Sciences
Ophthalmology & Visual Sciences
University of Utah, 50 North Medical Drive, Salt
Lake City, Utah-84132, USA
Lake City, Utah-84132, USA
Corresponding Author:
Dr. Vidushi
Sharma, MD (AIIMS, New Delhi), FRCS (UK)
Sharma, MD (AIIMS, New Delhi), FRCS (UK)
Director, SuVi Eye
Institute & Lasik Laser Center,
Institute & Lasik Laser Center,
C 13 Talwandi, SuVi Eye
Hospital Road, Kota, Rajasthan, India
Hospital Road, Kota, Rajasthan, India
Email:suvieye@gmail.com
Phone 9351412449
Ophthalmology Practice is unlike practicing in
other branches of Medicine with its own unique advantages and disadvantages.
The current practice of ophthalmology faces many opportunities and challenges
going forward. There are many forms of Ophthalmic Practice today, including
Solo Practice, Group Practice, Corporate Practice, Institutional Practice and
newer forms of Practice Consolidations and Mergers. There are also newer
challenges (generic drugs, possible price cap on IOLs, Goods and Services Tax,
etc), which have an impact on the way we practice ophthalmology, and it is in
our best interests to stay ahead of the challenges posed by these policy
changes. With decreasing reimbursements, increasing cost of equipments and a
changing economy, it may become increasingly difficult to stay afloat and
flourish. In this write-up, the authors offer valuable pearls for the
young ophthalmologist to overcome these challanges—from personal enrichment to
building a practice and dealing with increasing patient loads and the eventual
difficult patient.
other branches of Medicine with its own unique advantages and disadvantages.
The current practice of ophthalmology faces many opportunities and challenges
going forward. There are many forms of Ophthalmic Practice today, including
Solo Practice, Group Practice, Corporate Practice, Institutional Practice and
newer forms of Practice Consolidations and Mergers. There are also newer
challenges (generic drugs, possible price cap on IOLs, Goods and Services Tax,
etc), which have an impact on the way we practice ophthalmology, and it is in
our best interests to stay ahead of the challenges posed by these policy
changes. With decreasing reimbursements, increasing cost of equipments and a
changing economy, it may become increasingly difficult to stay afloat and
flourish. In this write-up, the authors offer valuable pearls for the
young ophthalmologist to overcome these challanges—from personal enrichment to
building a practice and dealing with increasing patient loads and the eventual
difficult patient.
1.
The
successful young ophthalmologist:
The
successful young ophthalmologist:
A good
doctor needs to be a people’s person at heart. Someone who enjoys interacting
with all sorts of people. He/ she needs to be truly skilled in fine ophthalmic surgery,
as ocular surgery has really evolved to a very high level of precision over the
last few years, and therefore the patient expectations have also risen
dramatically. However, in this competitive and demanding world, both the
science and technique as well as the art are important. And therefore, while it
is quite enough to be a good surgeon and give good results, to excel, one has
to learn good communication skills, strive constantly to give the best surgical
results, as well as the best overall experience to the patients. Last but not
the least, punctuality and keeping up announced
timings in the clinic remain important to spread the message among your
patients that you are available for your patient to deliver the best possible
care.
doctor needs to be a people’s person at heart. Someone who enjoys interacting
with all sorts of people. He/ she needs to be truly skilled in fine ophthalmic surgery,
as ocular surgery has really evolved to a very high level of precision over the
last few years, and therefore the patient expectations have also risen
dramatically. However, in this competitive and demanding world, both the
science and technique as well as the art are important. And therefore, while it
is quite enough to be a good surgeon and give good results, to excel, one has
to learn good communication skills, strive constantly to give the best surgical
results, as well as the best overall experience to the patients. Last but not
the least, punctuality and keeping up announced
timings in the clinic remain important to spread the message among your
patients that you are available for your patient to deliver the best possible
care.
2.
Learn and
Imbibe these qualities Early on
Learn and
Imbibe these qualities Early on
Young ophthalmologists first and foremost need to
learn and fine tune their surgical skills as best as they can, and the earlier,
the better. At a young age, without the additional responsibilities of family
and children, it is possible to travel to different cities and countries, and
get the best possible training. Good surgical training is the bedrock, that no
one can do without in today’s age. Along with this, young ophthalmologists
should also make it a habit to observe their seniors interacting with patients,
particularly difficult and demanding patients. If you have plans of having your
own practice, then you need to know the basics of financial planning and
administration. Observe the facilities that are provided in good practices, and
the small things that can make a significant difference to the overall patient
satisfaction.
learn and fine tune their surgical skills as best as they can, and the earlier,
the better. At a young age, without the additional responsibilities of family
and children, it is possible to travel to different cities and countries, and
get the best possible training. Good surgical training is the bedrock, that no
one can do without in today’s age. Along with this, young ophthalmologists
should also make it a habit to observe their seniors interacting with patients,
particularly difficult and demanding patients. If you have plans of having your
own practice, then you need to know the basics of financial planning and
administration. Observe the facilities that are provided in good practices, and
the small things that can make a significant difference to the overall patient
satisfaction.
3. Overcoming Challenges for Starting and running a new
ophthalmic practice
ophthalmic practice
By default, even today most young ophthalmologists end
up starting their own practice, though the practice patterns are now changing
rapidly, with more emphasis on group practices, shared facilities etc. When one
starts a new practice, often they realize that the residency training has not
prepared them for this at all. When managing a new ophthalmic practice, the
ophthalmologist needs to go beyond clinical and surgical ophthalmology to truly
satisfy and manage a patient, and beyond patient management to run an
efficient, financially viable growing ophthalmic practice. Someone said that “The
education of the doctor which goes on after he has his degree is the most
important part of his education”. At this stage, we need to keenly and quickly
learn the basics of practice management, in terms of staffing, administration,
providing the right ambience, marketing, communication and patient handling
skills etc. in short, while we need to hone our surgical skills during
training, we must also focus on our soft skills if we want to run a successful
practice.
up starting their own practice, though the practice patterns are now changing
rapidly, with more emphasis on group practices, shared facilities etc. When one
starts a new practice, often they realize that the residency training has not
prepared them for this at all. When managing a new ophthalmic practice, the
ophthalmologist needs to go beyond clinical and surgical ophthalmology to truly
satisfy and manage a patient, and beyond patient management to run an
efficient, financially viable growing ophthalmic practice. Someone said that “The
education of the doctor which goes on after he has his degree is the most
important part of his education”. At this stage, we need to keenly and quickly
learn the basics of practice management, in terms of staffing, administration,
providing the right ambience, marketing, communication and patient handling
skills etc. in short, while we need to hone our surgical skills during
training, we must also focus on our soft skills if we want to run a successful
practice.
4.
Art of
managing high volume patient workload in ophthalmic practice
Art of
managing high volume patient workload in ophthalmic practice
If you are fortunate enough to have a high volume
patient workload in your practice, it often becomes a challenge to give enough
time to each patient and fully satisfy them. Here effective communication
skills become very important, where you can give all the necessary and relevant
information in a short time, and utilize your chair time with the patient most
efficiently. However, despite all this, there will be patients and attendants
who need repetitive explanations and guidance, and here the role of
well-trained staff, and particularly counsellors becomes very important. We
must utilize the services of well-trained and groomed
staff and counsellors who can take over the work of explanations and can give
the patients more time, thereby reassuring them and satisfying all their
queries. Depending on the workload and the practice setting, we can delegate
many other tasks to the staff e.g. optometrists who can do more than half the
work, or trained technicians who can perform investigations etc. However, it is
important to keep motivating the staff regularly to provide their best services
to the patients. At the same time,
have printed brochures for all common diseases and facilities available in your
clinic, that give detailed information to the patients and attendants.
Electronic Medical Record (EMR) Systems can also help in managing high volume
practices, when used efficiently.
patient workload in your practice, it often becomes a challenge to give enough
time to each patient and fully satisfy them. Here effective communication
skills become very important, where you can give all the necessary and relevant
information in a short time, and utilize your chair time with the patient most
efficiently. However, despite all this, there will be patients and attendants
who need repetitive explanations and guidance, and here the role of
well-trained staff, and particularly counsellors becomes very important. We
must utilize the services of well-trained and groomed
staff and counsellors who can take over the work of explanations and can give
the patients more time, thereby reassuring them and satisfying all their
queries. Depending on the workload and the practice setting, we can delegate
many other tasks to the staff e.g. optometrists who can do more than half the
work, or trained technicians who can perform investigations etc. However, it is
important to keep motivating the staff regularly to provide their best services
to the patients. At the same time,
have printed brochures for all common diseases and facilities available in your
clinic, that give detailed information to the patients and attendants.
Electronic Medical Record (EMR) Systems can also help in managing high volume
practices, when used efficiently.
5.
Handling
unsatisfied patients
Handling
unsatisfied patients
This is becoming an increasingly difficult but
necessary art to master. We must take part of the blame for raising the patient
expectations so high, that they have become very difficult to satisfy. A lot of
aggressive advertising, tall claims and high surgical costs have convinced the
patients that eye surgery is a five minute wonder, where nothing can go wrong,
and the patient will get “super-vision”. In this scenario, the first thing is
to have good counselling for all surgical patients. Adequate chair time needs
to be given so that the patient expectations are realistic, and there is no
mismatch between their expectations and what can be delivered. Despite these efforts, if a patient ends up
dissatisfied with the results, the first thing is to give a patient hearing.
Many irate patients often cool down enough with a felling of having been heard
and understood. Never try to brush aside their complaint, even if they seem
insignificant to you. Patients will seldom create much trouble if the doctor is
respectful and sensitive and hears them out, but with become increasingly
aggressive of they get the impression that the doctor makes them feel inferior
or is too rushed to listen to them. Also,
it goes without saying that we must do the best that we can to solve the cause
of their dissatisfaction, and be financially considerate while doing so.
necessary art to master. We must take part of the blame for raising the patient
expectations so high, that they have become very difficult to satisfy. A lot of
aggressive advertising, tall claims and high surgical costs have convinced the
patients that eye surgery is a five minute wonder, where nothing can go wrong,
and the patient will get “super-vision”. In this scenario, the first thing is
to have good counselling for all surgical patients. Adequate chair time needs
to be given so that the patient expectations are realistic, and there is no
mismatch between their expectations and what can be delivered. Despite these efforts, if a patient ends up
dissatisfied with the results, the first thing is to give a patient hearing.
Many irate patients often cool down enough with a felling of having been heard
and understood. Never try to brush aside their complaint, even if they seem
insignificant to you. Patients will seldom create much trouble if the doctor is
respectful and sensitive and hears them out, but with become increasingly
aggressive of they get the impression that the doctor makes them feel inferior
or is too rushed to listen to them. Also,
it goes without saying that we must do the best that we can to solve the cause
of their dissatisfaction, and be financially considerate while doing so.
6.
Image
Buliding
Image
Buliding
Marketing and image building is an
essential part of practices today, and is no longer considered a dirty word in
medicine. However, marketing in medicine bears a greater responsibility to be
ethical and appropriate. We owe it to the dignity of our profession to ensure
that our marketing is not in poor taste. Marketing is not synonymous with
advertising, and aggressive advertising is still controversial among medical
circles. Subtle marketing on the other hand is less expensive, often more
effective and also acceptable. But with the increasing presence of corporate
sector in the medical profession, advertising is here to stay. Marketing in the
medical field can initially be cold call type like newspaper advertisements,
billboards etc., where we make unsolicited contact with a wide audience. For a
new practitioner, this is necessary as he needs to inform the widest possible audience
in his area of practice about his services and expertise. Later, one can
progress to inbound marketing using the internet and social media for potential
customers, giving them a platform to ask queries and know you and your services
before they choose you and in-house advertising, where the services available
ain your practice are prominently displayed in your own premises with clear
information and staff is willing and capable to answer any queries related to
these services. For a young practitioner, it is important to control the
finances in marketing, and after the initial few cold calls, turn to more
focussed marketing and do not try to “outdo” competitors in advertising. It is
also a good idea to organize educational awareness activities and camps at
sites of public gatherings, which is a cheap and effective way to market
yourself. Finally, you must aim for a scenario, where your satisfied patients
become your best marketing tools, because this word of mouth publicity is the
strongest and most convincing to potential customers.
essential part of practices today, and is no longer considered a dirty word in
medicine. However, marketing in medicine bears a greater responsibility to be
ethical and appropriate. We owe it to the dignity of our profession to ensure
that our marketing is not in poor taste. Marketing is not synonymous with
advertising, and aggressive advertising is still controversial among medical
circles. Subtle marketing on the other hand is less expensive, often more
effective and also acceptable. But with the increasing presence of corporate
sector in the medical profession, advertising is here to stay. Marketing in the
medical field can initially be cold call type like newspaper advertisements,
billboards etc., where we make unsolicited contact with a wide audience. For a
new practitioner, this is necessary as he needs to inform the widest possible audience
in his area of practice about his services and expertise. Later, one can
progress to inbound marketing using the internet and social media for potential
customers, giving them a platform to ask queries and know you and your services
before they choose you and in-house advertising, where the services available
ain your practice are prominently displayed in your own premises with clear
information and staff is willing and capable to answer any queries related to
these services. For a young practitioner, it is important to control the
finances in marketing, and after the initial few cold calls, turn to more
focussed marketing and do not try to “outdo” competitors in advertising. It is
also a good idea to organize educational awareness activities and camps at
sites of public gatherings, which is a cheap and effective way to market
yourself. Finally, you must aim for a scenario, where your satisfied patients
become your best marketing tools, because this word of mouth publicity is the
strongest and most convincing to potential customers.
7.
Leadership
in Medical Society
Leadership
in Medical Society
To grow professionally among peers, one needs to have
good oratorical as well as public relation (PR)/communication skills. Start by
attending the meetings of the medial societies in your area and offer to
organize one or two activities at special occasions, where you can display your
organizational as well as presentation skills. Societies always need young,
dynamic people willing to take on responsibilities, without displaying any ego.
Remember not to get involved in factional politics, and be respectful to all
seniors.
good oratorical as well as public relation (PR)/communication skills. Start by
attending the meetings of the medial societies in your area and offer to
organize one or two activities at special occasions, where you can display your
organizational as well as presentation skills. Societies always need young,
dynamic people willing to take on responsibilities, without displaying any ego.
Remember not to get involved in factional politics, and be respectful to all
seniors.
8.
Secret of
Growing Your Practice
Secret of
Growing Your Practice
If you can provide good services, the work is bound to
grow. You need to ensure that you deliver not only good surgical results, but
also ensure an overall good experience for your patient. This would mean that
you focus on all services provided in your practice right from the ease of
paring near your practice to the reception, waiting time, comfort in the
waiting hall, adequate facilities for drinking water, toilets, refreshments, if
needed, reading material to keep them busy while waiting, professional
reasonable quick service, cheerful and cooperative staff and an adequate
explanation of fall their queries and concerns. Of course, the satisfaction
provided by the doctor would be the main driver, and you need to develop your
own soft skills and communication skills so that the patients feel reassured on
meeting you, and you can inspire confidence in them. Learn to connect with your
patients and empathize with their concerns. As you grow, try to provide more
services like Retina etc. depending on the financial viability.
grow. You need to ensure that you deliver not only good surgical results, but
also ensure an overall good experience for your patient. This would mean that
you focus on all services provided in your practice right from the ease of
paring near your practice to the reception, waiting time, comfort in the
waiting hall, adequate facilities for drinking water, toilets, refreshments, if
needed, reading material to keep them busy while waiting, professional
reasonable quick service, cheerful and cooperative staff and an adequate
explanation of fall their queries and concerns. Of course, the satisfaction
provided by the doctor would be the main driver, and you need to develop your
own soft skills and communication skills so that the patients feel reassured on
meeting you, and you can inspire confidence in them. Learn to connect with your
patients and empathize with their concerns. As you grow, try to provide more
services like Retina etc. depending on the financial viability.
9.
Buliding
and Managing the Team
Buliding
and Managing the Team
If you have other ophthalmologists
and optometrists working for you, it is crucial and often difficult to keep
them satisfied and motivated. One crucial factor is opportunities for financial
and/ or professional growth. Also, be accessible to listen to genuine problems
of your staff and give them a patient hearing. Just like your patients, the
staff also wants to feel heard and understood. Do small activities, to foster
the team spirit among all the members, and make them feel valued. At the same
time, also let it be known that you observe everything, and any misdemeanours
will be strictly acted upon.
and optometrists working for you, it is crucial and often difficult to keep
them satisfied and motivated. One crucial factor is opportunities for financial
and/ or professional growth. Also, be accessible to listen to genuine problems
of your staff and give them a patient hearing. Just like your patients, the
staff also wants to feel heard and understood. Do small activities, to foster
the team spirit among all the members, and make them feel valued. At the same
time, also let it be known that you observe everything, and any misdemeanours
will be strictly acted upon.
10. Work Life Balance
In a busy practice, efficiency is important to ensure
that the patients are seen quickly, and your working time also doesn’t
overstretch. Learn to delegate all except the core work. Develop a good team
and employ good quality staff that can take off some of your burden. Have
enough staff to guide the patients and answer their queries and develop
effective communication skills yourself, so that you can give a quick yet
comprehensive explanation to the patient about his/ her condition.
that the patients are seen quickly, and your working time also doesn’t
overstretch. Learn to delegate all except the core work. Develop a good team
and employ good quality staff that can take off some of your burden. Have
enough staff to guide the patients and answer their queries and develop
effective communication skills yourself, so that you can give a quick yet
comprehensive explanation to the patient about his/ her condition.
If your practice is managed efficiently, this will
leave you time for your family. However, the most important factor for
achieving a good work life balance is to firstly recognize its need and
importance. Remember that your work is just one aspect of your life, which cannot
replace the equally or often more important aspects like health and family.
Ambition is an endless race, and therefore work to satisfy yourself and not get
ahead of others.
leave you time for your family. However, the most important factor for
achieving a good work life balance is to firstly recognize its need and
importance. Remember that your work is just one aspect of your life, which cannot
replace the equally or often more important aspects like health and family.
Ambition is an endless race, and therefore work to satisfy yourself and not get
ahead of others.
11. Take Home message for Young Ophthalmologist
For young ophthalmologists, we would say that running
your own practice is a huge work and responsibility. Think well before you
choose what exactly you want to do,. If you feel you are not cut out to handle
all the responsibility (including clinical, financial, administrative etc.),
choose another option like working in hospital or a shared facility. If you do
choose to have your own practice, the initial few years are very crucial and
remember to focus only on patient satisfaction at this time. Also, remember to
be strong even if there are minor setbacks. Keep the big picture in mind, and
do not fret over small things. In the end, remember that the ultimate aim of
life is to be happy and professional success is just one means of achieving
that along with many other things.
your own practice is a huge work and responsibility. Think well before you
choose what exactly you want to do,. If you feel you are not cut out to handle
all the responsibility (including clinical, financial, administrative etc.),
choose another option like working in hospital or a shared facility. If you do
choose to have your own practice, the initial few years are very crucial and
remember to focus only on patient satisfaction at this time. Also, remember to
be strong even if there are minor setbacks. Keep the big picture in mind, and
do not fret over small things. In the end, remember that the ultimate aim of
life is to be happy and professional success is just one means of achieving
that along with many other things.
Further Reading: The readers can also view
the video on following link: https://www.youtube.com/watch?v=Rg0yAwQHxH0
the video on following link: https://www.youtube.com/watch?v=Rg0yAwQHxH0
