All physicians desire to establish a thriving and rewarding medical practice. Achieving this goal means setting financial targets, treating a particular mix of patients, and meeting specific clinical/surgical volumes. Over the past 10 years, I have used my experience as a glaucoma and cataract consultant to build a practice that fits my personality and approach to clinical care. This article discusses some basic principles for enhancing the treatment of glaucoma and how practitioners can use these guidelines to improve their patients' lives.
PRINCIPLE NO. 1. STRIVE FOR SELF-AWARENESS
Find a Mentor
On the surface, advising physicians to know themselves seems obvious. I have observed, however, that some physicians do not truly understand their individual strengths and weaknesses. Too often, they are swept downstream in the current of life without any real idea of where they are going or where they wish to go. One way to avoid this pitfall is to find a mentor.
The value of a good mentor cannot be underestimated. Early in my medical career, I sought the advice of more established colleagues to help guide my future. They not only identified my gifts but, just as importantly, the areas in which I needed to improve. Without question, my decision to pursue a glaucoma fellowship was strongly influenced by my relationship with my mentors. I believe that their investment in my career forever changed my life for the better. My mentors have also become lifelong friends.
I am now on the other end of the mentoring relationship. As an academic ophthalmologist, I have found that advising medical students and residents has enhanced my personal and professional lives. I enjoy helping them to succeed and find their path.
Seek Educational Opportunities
In some cases, doctors fail to achieve their full potential because they have only limited exposure to educational opportunities. Participation in ophthalmic residency and fellowship programs can boost the careers of ophthalmologists in training by providing access to a wide variety of medical and surgical techniques. In addition, when doctors supplement formal educational opportunities with visits to different clinical settings, they can develop habits of lifelong learning, self-improvement, and self-understanding that will contribute to success in every aspect of their lives.
Develop a Clinical Philosophy
Tailoring clinical and surgical schedules to reflect core interests is key to building a satisfying medical practice. A flexible clinical philosophy can be beneficial, but it also may prevent physicians from focusing on their true passions.
Introverted doctors, for example, may struggle to establish relationships with their patients. These physicians may enhance their professional duties by focusing on research, extending the time they spend in surgery, or taking on additional administrative duties. Conversely, doctors who are energized by personal interactions may concentrate on developing long-term relationships with their patients. Finally, some physicians prefer to focus predominantly on glaucoma while others may prefer a practice more oriented toward general ophthalmology.
PRINCIPLE NO. 2. FISH WHERE THE FISH ARE
Identify the Need for Services
In any profession, people can very quickly become disillusioned with a new job that does not meet their expectations. Physicians are not immune to this problem and have been known to change jobs, especially if they feel their practice is growing too slowly.
Before committing to a new position, physicians must accurately determine the true need for their services. Fortunately, they can use readily available benchmarks such as those provided by the the American Academy of Ophthalmology (www.aao.org) to assess the need for their services in different areas. Further study of currently available ophthalmic services and demographic trends (eg, population growth) in a particular area may also help physicians identify favorable practice opportunities.
For example, a doctor who wants to devote his clinical practice to glaucoma may find a higher demand for his services in areas where the population has a higher risk of developing this disease.
Avoid Other Sources of Dissatisfaction
For physicians, finding a community in which their services are needed is just the first step in deciding to join a new practice. They must also consider (1) the practice's financial health and governance structure, (2) the dynamics between co-practitioners, (3) the rate of turnover among employees and physicians, (4) the state of the facilities, and (5) the availability of opportunities for personal growth and leadership. Physicians can lower the risk of dissatisfaction with a new job by carefully considering the needs of their families and choosing a geographic location that meets their personal and professional criteria.
PRINCIPLE NO. 3. BE PROACTIVE AND ACCESSIBLE
Invest in the Community
Physicians often expect their clinical schedules to fill up automatically as soon as they open their practice. To achieve success, however, doctors must become involved in their community. Many organizations—including churches, rotary clubs, senior centers, and nursing facilities—welcome the participation of local physicians in their programs. Multilingual doctors will also find that their language skills are a valuable asset for reaching patients who do not speak English. Reaching out not only helps incoming doctors build their practice but also gives the community an opportunity to embrace them.
Develop Relationships With Colleagues
Doctors should make an effort to reach out to local physicians who may refer patients to their practice. Putting a name with a face is just the first step in forming these vital relationships. I have found that regularly meeting colleagues for breakfast or lunch is an excellent way to maintain communication and develop friendships. Presenting educational lectures to peers and other potential referral sources is another tool that physicians can use to enhance their credibility in the community and to lay the foundation for relationships based on trust. Throughout my career, I have used these techniques to obtain new referral sources. I have found that lectures focusing on new diagnostic and surgical technologies are particularly well received by colleagues and are thus beneficial to building my practice.
Ensure Prompt Access to Care
I believe it is important for physicians to accommodate referrals whenever possible, because doctors who have difficulty scheduling their patients in a colleague's office may decide not to send patients to him in the future. Whenever a patient or referring doctor calls to make an appointment at my clinic, I try to be accessible, even when the arrangement is not particularly convenient for me. If I am unavailable, my staff offers the patient an appointment with another doctor at the clinic or with a physician from another practice.
Offer Additional Assistance
Most, if not all, physicians would agree that being on call is not their favorite part of their job. I recently learned, however, of a doctor who purveyed this task into an opportunity to grow his practice. When the doctor arrived in town, he offered to cover all of the other local ophthalmologists' emergency calls. Although the doctors thought the young physician was crazy, they gladly passed this duty along to him. Despite being on call for almost every day for the next few years, the doctor was fortunately rarely required to visit patients in the hospital. Because he was willing to help his colleagues, however, patients and physicians realized that he was always available when they needed him. Several years after the doctor arrived in the community, his practice had grown quickly and was larger than those of all the established practitioners in the area. Although physicians with young families may not be best served by this kind of arrangement, an attitude of always "going the extra mile" for others certainly is advantageous in building new practices.
PRINCIPLE NO. 4. PERFORM ORDINARY TASKS WELL
Remember the Basics
A successful physician need not be the smartest or most charismatic person in the world. I follow a philosophy espoused by Tony Dungy, the head coach of the Indianapolis Colts. After his team won the Super Bowl in 2006, Coach Dungy stated, "I believe the best way to achieve success is by attention to detail and a commitment to the fundamentals—doing the ordinary things better than anyone else."1 For physicians, this means being kind and courteous to patients, providing quality medical care, and creating a pleasant clinical experience.
Focus on Internal Marketing First
I suspect that many physicians would be amazed by the positive impact they could have on their practices if they refocused their energy from external advertising to equipping and supporting their employees. Providing staff members with well-defined job descriptions and encouraging them to be accountable for their actions will help to create a caring environment that patients will appreciate. In our practice, my colleagues and I invest heavily in our employees and strive to provide a positive working environment. By offering training opportunities to our employees and implementing performance-based bonuses, we have seen significant improvements in our staff's performance and morale. We strongly believe that making our employees feel valued enhances our patients' clinical experiences.
SUMMARY
All physicians face challenges in building their practices. Fortunately, many of them can achieve their goals by understanding themselves, maintaining a positive attitude, working hard, and paying attention to details. Although the basic principles presented in this article are not new, too many physicians fail to heed them and therefore never achieve their full potential. As with most things in life, the success of a medical practice is largely determined by the kind of effort one puts into building it.
Steven D. Vold, MD, is Chief Executive Officer and Glaucoma and Cataract Surgery Consultant at Boozman-Hof Regional Eye Clinic, PA, Rogers, Arkansas. Dr. Vold may be reached at (479) 246-1700; svold@cox.net.
