ASK THE CAREER COACH
Shape Your Future by Understanding the Past
By William B. Rabourn Jr.
Q: Grandma always said “history repeats itself.” Is this old adage applicable to my ophthalmology career?
A: Ophthalmology is an attractive medical specialty in part because it is so dynamic. New and improved ways to treat disease and help patients see better are introduced at a robust pace. This, of course, is good for patients and doctors alike. However, as a number of ophthalmologists have learned from experience, how you manage these dynamics can mean the difference between a consistently satisfying career vs. one that is unsettled by frequent stops and starts. Consider the following scenario that has played out many times in the past.
Dr. X finishes training and spends years building a thriving general ophthalmology/cataract surgery practice. In the mid-1990s, refractive surgery emerges as an opportunity to expand the practice and serve a different patient demographic. Dr. X takes advantage of the opportunity, purchases an excimer laser and watches the new segment of the practice grow.
Unforeseen Circumstances
As refractive surgery volume skyrockets, Dr. X devotes more time and effort to this segment of the practice and less to others. Patients have PRK or LASIK, love the results, and essentially go away. This works well for Dr. X until 2001. The terrorist attacks in September of that year shatter consumer confidence and virtually put an end to discretionary spending. Both eventually rebound, but not to previous levels. Dr. X is forced to downsize staff and office size and is unable to reinvest in newer technologies to help turn the situation around. In addition, revenue from all other types of care has dwindled to nearly zero. The practice stays afloat, only to be sidetracked again by the prolonged recession that begins in 2007.
Voices of Experience
Today, with hindsight being 20/20, “Dr. X” and others who had similar experiences might wish they hadn't transformed their practices so drastically. The issue isn't about refractive surgery per se. Rather, it's about understanding that there will always be something new in ophthalmology that's worthy of being added to your practice, but implementing a dramatic change in the makeup of a practice is a big risk. In any business, big risks can bring big rewards, but they can also bring big losses. If you'd rather not deal with the potential ups and downs of a narrowly focused practice, a more diversified practice will serve you best.
Diversity
Offering a balanced range of services allows you to maintain an even workflow and the steady income that goes along with it. We see this on a basic level every year. Although it varies somewhat by region, refractive surgery volume tends to increase in the first and second quarters, and cataract surgery volume tends to increase in the third and fourth quarters. Furthermore, your career may span 25 years or more, during which time you'll see some ophthalmic subspecialties booming while others are not. Diversification enables you to comfortably ride these inevitable waves.
As you make decisions about how to structure your practice over the years, keep in mind that diversity for diversity's sake can cause as many problems as poorly planned specialization. Any new service you consider adding to your repertoire should be preceded with strategic planning and the collection of as much information about future viability as possible. If you stay focused on your patients' needs and avoid making hasty or dramatic changes in what you offer them, you should experience a lifetime of smooth sailing. nMD
Mr. Rabourn is founder and managing principal of Medical Consulting Group in Springfield, Mo. The Medical Consulting team possesses a wide range of training, development of ambulatory surgery centers, and practice development, management, financial operations, efficiency and marketing/advertising. Contact him at bill@medcgroup.com or 417-889-2040. |