Guest Editorial

Achieving efficiency takes a long-term plan

It should include tech upgrades, sound business insights and time.

Ophthalmology Management is an idea factory. Each issue provides insights to support you, the physician, in serving your patients. Sharing ideas and best practices makes us better physicians and allows us to generate the profits we need to fulfill the mission of patient care. Medical practices must run as successful businesses or they will not survive.

The opportunity to serve as guest editor is an occasion to change perspectives and to give voice to some of the best thinkers in our field. As an ophthalmologist and consultant — and as chairman of the PHYSICIAN CEO program at the Kellogg School of Management at Northwestern University — I visit many practices. I witness firsthand how they succeed and where they falter. The topics selected for this issue highlight opportunities for improvement found across practices.

We have assembled a group of authors, all with very successful practices, to discuss economics and technology — two critical elements of success.

  • Practice ownership models: Conflicts over equity distributions can stress practices beyond the breaking point. Private equity intrusions into ophthalmology are exacerbating the problem. This article describes how and why practices fail and alternative structures for solutions.
  • Embezzlement: 80% of practices experience some form of embezzlement over a five-year period. Aaron Waite, MD, PCEO, and Jenifer Martin present a solid defense strategy to protect your practice from that one destructive employee.
  • Physician stress: Physician burnout reduces productivity and can lead to disaster for any practice. Guillermo Rocha, MD, FRCSC, FACS, PCEO, president of the Canadian Ophthalmology Association, provides sage advice to managing time, creating a high-performance practice and fostering a calm culture.
  • Pricing: While price is fundamental to every business, pricing models are often misunderstood. Anna Fakadej, MD, PCEO, of the Carolina Eye Institute, describes her approach to pricing in an active cataract and refractive surgery practice.
  • Process engineering: This is fundamental to practice management. Dan Chambers, MBA, executive director, Key-Whitman Eye Center in Dallas, explains how Six Sigma process engineering using software technologies can improve efficiencies and profits.
  • Workflow management: Contrary to popular belief, EHR systems can improve productivity, provided there are design-incorporated workflow concepts and structured data. Matthias Maus, MD, founder of the Sehkraft centers in Europe, explains how well-designed enterprise-level communications platforms can further drive efficiency.
  • Accessing current technology: Lease or buy? New or used/refurbished? The acquisition process can be challenging but, as explained by Jason Brinton, MD, and Richard Norden, MD, PCEO, the practice can control negotiations.

It is no coincidence that a few of these authors are physician CEOs, having completed the program at Kellogg. Their articles reflect their expertise.

The well-run practice relies on a strong financial foundation and must stay current with evolving procedures and technology. I hope this issue of Ophthalmology Management leads to practice growth for every reader. OM