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Chief Medical Editor's Page | June 2020

Keep Your Chin Up and Your Head Down

Who would have thought that 2020 would be the annus horribilis for ophthalmology? For as long as I can recall, the ophthalmology community looked forward to the Year of the Ophthalmologist. It turns out that 2020 was that, but for all the wrong reasons. We will never forget the tragic loss of our colleague, Li Wenliang, MD, of Wuhan, China, who called attention to the dangers posed by the novel coronavirus. And we cannot ignore that, of all medical specialties, ophthalmology has had the most significant decrease in patient volume during the lockdown.1-3

To complicate matters, many ophthalmic societies advised ophthalmologists to limit patient care only to urgent and emergent cases.4 Flattening the curve was the unequivocal priority, but demoting ophthalmology to a service that does not provide significant health and lifestyle benefits was disappointing.

The year 2020 needs serious turning around. We have a lot to do to get the Queen of Specialties back where she belongs. What can we do now, as many of us return to the clinic and hospital, to enhance our efforts? In times of turbulence and uncertainty, it always helps to have a clear focus.

Focus on your team. Focus on your patients. Focus on strengthening your relationships with both your team and your patients. Tell them what you know, what you do not know, and that you will do your best to find out and inform them of the missing answers. The stronger your leadership now, the better your team will perform.

Looking inward is not enough; we must also look outward. What can we do to meet the new demands and lifestyles that will follow once the pandemic subsides? There will be new habits formed, new problems created, and new solutions sought. We need to ensure that we are well-positioned to provide these solutions to our staff members and patients. Employing a management strategy can help us create a meaningful and lasting impact. See Strategic Management Process for one simple 12-step approach.

Meanwhile, stay safe. Keep your chin up and your head down.

Strategic Management Process*

Step No. 1: Create a Solutions Team
Assign your most effective team members to the solutions team and explain their roles and authority to the other members of your staff.

Step No. 2: Get the Facts
The solutions team must gather facts while simultaneously taking into account the emotional impact of the crisis. Help them find the truth with empathy and compassion.

Step No. 3: Clear the Table
Remove the team members’ other responsibilities and allow them to focus on crisis management.

Step No. 4: Resolve ASAP
It is critical that the solutions team gather information that will allow the leadership team to take the next step in resolving the issue. Fear paralyzes, and rumors destroy confidence.

Step No. 5: Leadership
Be poised and positive. The leader’s reaction to the situation will determine how the team responds. Show courage and remain positive.

Step No. 6: Overcommunicate
Whether it is to your employees, customers, or suppliers—overcommunicate. We are often overconfident about how much people understand what has been said.

Step No. 7: Take Ownership
Great leaders do not point fingers. Every leader must take absolute ownership for what went wrong.

Step No. 8: Be Present
When significant challenges arise, real leaders are born. It is most important for you as a leader to be present.

Step No. 9: Stay Focused
While the solutions team is working in the background, the rest of the team must remain engaged and focused.

Step No. 10: Evaluate the Solutions Team
After the solutions team has identified the new way forward, evaluate how the team managed the crisis and implemented your crisis management strategy. Always appoint the right people for each situation and remove those who are unable to keep with the principles outlined here.

Step No. 11: Real Crisis
Be careful not to create an environment in which everything feels like a crisis and everyone wants to be a firefighter. Organizations must accurately discern when the creation of a solutions team is needed as opposed to relying on existing teams in your organization.

Step No. 12: Refresh Your Goals
After the crisis has resolved, the solutions team members must return to their routine duties. It is important that the expectations for the employees in the solutions team are readjusted and managed well, as they may be behind on their preexisting goals.

*Source: Wright T. The strategic management process. Cascade Strategy. October 30, 2019. www.executestrategy.net/blog/strategic-management-process. Accessed June 5, 2020.

Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin)

Physician CEO, Wellington Eye Clinic, and Consultant Ophthalmologist, Beacon Hospital, Dublin, Ireland

1. Brown T. Ophthalmology practices hit hard by covid-19 closures, changes. Medscape
. May 13, 2020. www.medscape.com/viewarticle/930431#vp_1. Accessed June 5, 2020.

2. Pinto JB. Anticipating coronavirus impacts on private practice: A thought experiment. Healio
. March 3, 2020. www.healio.com/news/ophthalmology/20200303/anticipating-coronavirus-impacts-on-private-practice-a-thought-experiment. Accessed June 5, 2020.

3. Analysis: Ophthalmology lost more patient volume due to covid-19 than any other specialty. Eyewire News
. May 11, 2020. www.eyewire.news/articles/analysis-55-percent-fewer-americans-sought-hospital-care-in-march-april-due-to-covid-19/. Accessed June 5, 2020.

4. Parry NM. AAO urges ophthalmologists to provide emergency care only. Medscape
. March 23, 2020. www.medscape.com/viewarticle/927320. Accessed June 5, 2020.

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