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Cover Focus | Sept/Oct '19

Notes From a Physician CEO

In 2016, I started my own ophthalmology practice, which, upon opening, consisted of me and one other employee. Fast forward to today, and Loh Ophthalmology Associates has grown into a team of seven individuals, including me. In this time, I have learned a substantial amount about working as both an ophthalmologist and a business leader. This article details seven important notes I have accumulated over the past 3 years. They may be useful for those starting their own practices, those assuming the role of physician CEO, and even those working as an employee in an ophthalmology practice.

1.Human resource management is crucial. I did not fully appreciate the importance of human resources (HR) prior to starting my own practice. But, as I have come to learn, a practice is truly all about its people—not only patients, but staff members as well. HR management is the hardest part of my job; however, it is also the most rewarding. Every day, I feel fortunate to walk into our office and join individuals with whom I want to work, and I try to ensure that all our employees experience this too.

As ophthalmologists, our staff members represent us, and they have an impact on our patients and our practices. About a year ago, Loh Ophthalmology Associates received a 5-star online review that I found particularly interesting and important. In this review, the patient did not mention me once. Instead, the patient wrote, “Her entire staff was professional, caring, and listened to my concerns.” This is just one of many reviews focused on my staff. It is crucial to have good staff members representing you because your patients likely spend more time with these individuals than with you.

2. Observe local and federal HR rules and regulations. There is a laundry list of HR rules and regulations that must be followed. Given that this is not an area covered in medical school, it is incredibly helpful to have access to an experienced HR coordinator who can offer advice. I am in constant communication with our HR coordinator, asking her what is legal and what is not, how to make things right with an employee, how to effectively train a new staff member, etc. These are daily, sometimes mundane tasks that can become onerous over time, but they are important when you are the leader of the ship.

3. Be a leader 24/7. Act like the leader you want to be or like the leader you would want to follow. Remember that your staff and your patients are always looking to you. Your staff looks to you on how to treat each patient and how to treat their coworkers. If you belittle patients or speak negatively about them, your staff members will likely do the same. I have learned that I am constantly being observed, and it is therefore best to always stay positive. No matter what a staff member says about a patient, I always respond positively. Additionally, I do whatever it takes to prevent an us against them mentality. This mindset often creeps up in settings where staff members feels like they are pitted against the patients. It is essential to prevent this because it harbors ill will, and a healthy practice culture is the most important element to success.

4. Learn to delegate. As physicians, most of us are naturally self-sufficient and controlling overachievers. However, I have learned that just because I can do something doesn’t mean I should. It is not an efficient use of our time to do everything.

It is also important to note that being a physician CEO is different from being a practice manager. Once your practice has gotten off the ground, find a practice manager who can help with the more routine daily tasks. Don’t get burned out or frustrated by tasks that you don’t love doing. For example, I hate dealing with attendance, tardiness, and paid time off—all tasks I had to deal with in the early days of my practice. Now, I am able to delegate these tasks to a practice manager, which has relieved me of some added responsibilities and stress.

5. Learn to use QuickBooks. As a physician CEO, you must learn about financial statements. For those new to QuickBooks, YouTube offers helpful tutorial videos on its use. If you aren’t familiar with the program, it can be overwhelming at first, but it’s actually quite user-friendly and a great way to learn about financial statements. Also be sure to understand cash flow, equity, profit and loss statements, and balance sheets—these are terms you need to know in order to properly assess your practice. Savak Teymoorian, MD, MBA, authored a great book called Business Fundamentals for the Eye Care Professional that covers many of these basic principles.

6. Always have a vision. Determine which type of practice you want and craft a mission statement based on that vision. To do this, consider the following questions: Are you a family-friendly community ophthalmologist, or do you prefer to be more academic? Are you only refractive? Are you comprehensive? Are you high-tech? Do you fall more on the efficiency side of things? Are you strongly skilled in patient care? Identifying your strengths can help you to create the type of practice you want. Also, have specific goals. Look at the key performance measurements that can be tracked over time—for example, how long it takes for your technicians to work up a patient or how long it takes for you to see a patient. Access to this information can help you to evaluate and grow your practice.

7. Know when to phone a friend. Finding a mentor is crucial. I call my friends and family members often to bounce ideas off of them, even if they are not specific to ophthalmology or medicine. Remember, no one has all of the answers, but we can learn so much from the knowledgeable and insightful people around us.

author
Jennifer Loh, MD
  • Founder and Physician CEO, Loh Ophthalmology Associates, Miami, Florida
  • jenniferlohmd@gmail.com
  • Financial disclosure: None
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