Economic 'storms' can aid ophthalmologic practices in the future

Key Points

Complacency: A feeling of contentment or self-satisfaction, especially when coupled with an unawareness of danger, trouble, or controversy.

"If we had no winter, the spring would not be so pleasant: if we did not sometimes taste of adversity, prosperity would not be so welcome."-Anne Bradstreet

Winter driving can be like running a clinic. In the "non-winter" months, we drive without a care in the world, radio on, zipping along the highway at 65 mph, top down, and loving life. We don't anticipate any issues, such as a slippery road, so we don't plan ahead. We go about our day and are happy-until we find a big pothole in the road we didn't expect that dents our rim. But it is too late then.

It's like that in our clinics. You have a full staff and good workers who obviously enjoy being in your practice because they stay with your group. Revenue is coming in from exams, so the doctors and administrator are relaxed and satisfied as well. We don't worry about the little expenses: buying fun t-shirts for all 50 employees, taking the employees and friends to a ball game and footing the bill, or even a little overtime here and there. We become complacent and self-satisfied that all is well in our world. Most of us could say it more simply: we become oblivious to the hard fact that even though it is summer, winter is not far away.

Right now, we are all in a deep-winter freeze. The economy has created an extremely icy road that none of us is driving very well. You might be asking yourself, "What could we have done as a practice to prevent the financial situation we are in right now?" Maybe we could have all taken defensive driving lessons to give us a clue as to how to survive the panic and economic dread we all have.

People just don't work that way. As a group, we tend to put off the unimaginable. Thinking about the bad things that might come is scary, or worse yet, a potential jinx. We don't tend to plan well for the future when we are enjoying the benefits of the present, and we always are shocked when the bottom drops out. When it happens to us, we spend a great deal of time wondering why this happened to us. Well, it didn't just happen to you; it has happened to all of us. Planning wouldn't have kept this away. It may have prolonged the potential agony, but sooner or later it would have come knocking on your door and could not have been avoided.

To be sure-and I have to believe this, spring will come, as it always does, and this slump will fade. We will gratefully push the memories away and go about our business, not having learned a thing to prepare for the next cold snap.

Managing 42 technicians and being part of the administrative team, I am no better. When we are at full staff, I let my guard down, as do my technicians. I don't push the staff as hard to stay current in their schooling. I am more patient with minor goofs and am willing to look the other way a little more when there are staff flare-ups. After all, they occur in a group our size. We tend to slow down on continuing education in the summer months because there are so few of them. And at times, clinics tend to be cancelled a little more frequently than in the winter months. We become complacent. We become "fat and happy."

This is the time when we need to take this experience (most would call it a depression) and focus on the lessons we are being taught. Look at your practices and yourself with a critical eye, and try to identify how to weather the coming winters better. As a start, answer these three questions:

1 Are you overstaffed? If the answer is no, then is the staff performing at a high level of competency, or have you let down your expectations? If you have let down your expectations, I guarantee that your staff members also have let down theirs. What training do you need to do to get them back to a point where you can practice "lean" and not have to compensate with additional staff for average performances? Get back to everyone performing at a high level.

2 Are there organizational practices that have become costly-and perhaps unnecessary? Do you really need to have four new pieces of uniform a year, or can you get by with two? Do you need to have two staff outings a year, or is one enough?

3 Are you advising the doctors of the amount of days out of clinic they take and the effect this has on revenue, especially short-notice cancellations of clinics? Physicians often are unaware of the financial impact that occurs when three or four doctors are out of a practice for a week at a time. If you have a large practice, they may not be aware that four of them are out at the same time because each is just watching his or her own schedule. Staff members still need to be present to answer phones, generate claims in the billing office (even if revenue is not coming in), and sit in an empty office in case a patient walks in and needs to have his or her glasses adjusted.

Planning ahead for winter is something that has been born into me. It's always in the back of my brain: get the hay and harvests in before the first bad frost, store up the pantry in case we get a big snow fall and are homebound for a day or two, and tune up the furnace to make sure it makes it through a prolonged cold snap.

We will come out of this winter, but as sure as spring and sunny days are ahead, another winter is right around the corner again. This is the time, in the off-season, to tune up your "furnace" and get your practice ready for the next ice age.

Dianna Graves, COMT, BS Ed, is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983. She can be reached at dgraves@stpauleye.com
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