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Up Front | Jun 2009

Chief Medical Editor’s Page

Business Acumen Especially Helpful in Recessionary Times

We are all facing recessionary and hard times, with many practices implementing measures to ensure long-term survival. Some obvious tactics include watching every line item and limiting expenses, concentrating on developments that provide value, and increasing revenue streams by offering more services. The correct mix of measures varies from practice to practice and country to country. As ophthalmologists who run our own show, two areas should not be compromised: technology acquisition to improve services and outcomes, and the patient experience. Both issues are addressed in CRST Europe this month, and the contributing authors provide similar advice and rationales.

Talking to my colleagues in Europe, it is clear that thinking like businessmen is alien but acknowledged as a necessary component of a successful practice. It is unfortunate that, during the course of our medical training, leadership and management are learned though experience and not through formal training. Doctors in the past managed quite well because they were in short supply and high demand. Now, in a competitive environment with corporate ophthalmology filling in a vacuum (certainly in the United Kingdom), it is vital that we learn the business tools and understand how to run our organizations effectively, no matter what size.

Learning business tools is useful, and from my own experience it changes the perspective of a practice altogether. So often we immerse ourselves in the details of providing care without considering the fact that we are just one component of the whole organization; all the other cogs are also of tremendous importance and require attention. Understanding finance and the concept of return on investment makes decision-making in terms of new technology much easier.

Often I hear colleagues who make do with mediocre technology and minimal technician and administrative support complain that their practice volume is too low. Practices might grow organically in a straight line, but, in my observation, the reality is that growth takes place in a series of steps following implementation of new technology, hiring additional supporting staff, or perhaps experimenting with a new marketing effort. That is not to say that implementing new developments always results in a return indeed, sometimes it does not. However, the discipline of putting a business plan together for further practice development covers the rationale and measures that should be used to monitor progress. This is not an exercise often conducted by ophthalmologists. It is interesting to see that attempts to fill in this gap are happening, and many ambitious colleagues have enrolled in so-called boot camps to learn the business side of our trade. The European Society of Cataract and Refractive Surgeons (ESCRS), under the leadership of Paul Rosen, has instituted a practice development program that is likely to grow once ophthalmologists see the benefit. More specific programs related to improving surgical outcomes while also developing your practice are also becoming popular, and it is my hope that CRST Europe will develop some of these in Europe for the benefit of the readership. It will be useful for you to let us know if this is of interest, so please e-mail us.

Meanwhile, we hope you enjoy this issue, which addresses some business facets of ophthalmic practice.