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4 secrets to sustaining success in your practice


When success starts coming your way, the last thing you should do is take your foot off the gas. You must push even harder if you want the success to be sustainable.

Putting It In View By Dianna E. Graves, COMT, BS Ed

Take-home message: When success starts coming your way, the last thing you should do is take your foot off the gas. You must push even harder if you want the success to be sustainable.

The longer I work as a manager, the more I realize my position is similar to that of a sports coach. It doesn’t matter what type of team it is-football, baseball, or hockey-the concept is still the same.

So I am sure that you should not find it surprising that I would say there is a great deal of wisdom being imparted every day via the sports talk shows that I listen to faithfully. You just need to listen to the message and relate it to the field of ophthalmology.

For example: I was driving to work early one snowy, January morning. I had my car defroster set to “melt the windshield” heat and the car radio on one of the AM sports stations.

John Gruden was on in his weekly time slot. Gruden was the former Tampa Bay Buccaneer coach that won Super Bowl XXXVII in his first year as a head coach with the Buccaneers. He was the youngest head coach ever to win a Super Bowl at age 39.

One of the sports aficionados was grilling Gruden on the managing style of another coach that had just clinched their football division. That team would now be play-off bound but still had two “mean nothing” games left to the season before the playoffs began.

The question arose: Now that this team has clinched their division and are definitely in the first round of the playoffs, as a coach, do you rest some of your star players during the remainder of the season to ensure they do not get hurt prior to the playoffs?

"I did that once."


Gruden stated emphatically, “No.”

“I did that once. We made it to the playoffs, and we still had some games remaining in the regular season. So I rested my quarterback and a few other guys hoping to give them a chance to heal up and to not get hurt further.

When we got to the first round of the playoffs, we lost the first game and it was a BAD game!” he said. “I learned a valuable lesson that game. When you make the playoffs – run the table.

I thought about that for the rest of the day, playing it over and over in my mind.

Then it became crystal clear as to why this was absolutely sound reasoning.

His football team for a whole season had practiced, and played, as a unit. Learning each other’s moves, style of play, strengths, as well as weaknesses, had been a season long endeavor. By removing key people of his team and inserting newer, weaker, less skilled players, Gruden threw the rhythm of the whole team off. When they finally got into the playoffs, they played flat, made foolish mistakes, and lost badly. Their rhythm, and team style, had been altered. He creatively made changes that threw the rhythm of the whole team off.

Same phenomenon in clinics


Same phenomenon in clinics

This same phenomenon can happen in our clinics and cause the same result. We may not lose a playoff game, but we begin to slip in our clinic performances drastically.

Let’s say that you have a stellar year with the clinic performance and financial earnings. There are smiles all around, money in the bank. No one is worried about some extra bills, or a slight increase in patient complaints, because the year was great.

Creatively, change will begin to slow to a crawl because everyone will get into a groove of “staying the course”. Or is really a rut?! But, whatever happens, the entire team and clinic do it together. The philosophy becomes: Why make changes when things are going so well?

Now, think about this: maybe the situations surrounding your successful year had nothing to do with how you managed and planned your year. They would have occurred with you or without you!

How does that happen? The economy began to get better; people started having expendable cash to start doing fun things again like eating out and traveling more, as well as necessary things, like getting eye exams and updating their glasses. You found that the doctors were in the office more, seeing patients, because they had less illness or family crisis’s and were seeing the patients that were now flooding in. Nothing you had any control over, but it happened all the same.

And… then the following year goes well also. Change becomes something of a distant shadow in the rear view mirror. The pattern of “not rocking the boat” and “ride the success out” begins.

Don't fix it if it's not broken?


“Don’t fix it if it's not broken” almost becomes the battle cry in everyone’s minds as well as actions. But, as sure as the wave of prosperity rode into your clinic, it then came crashing down onto the shore in the form of “slippage”.

Decreased patient exams, increased patient complaints, and frustration/irritation become the daily norm. Trying to ramp the staff back up into play-off mode is extremely difficult because they have slipped into bad habits: long exam times, more puttering between patients, and sloppy work. Nothing new has been happening on the creativity level and mild panic is starting to set in with the doctors because the bottom line has taken a turn for the worse-as have people’s dispositions.

Before you know it, you have ridden the high wave of success and prosperity for four or five years and now the waves are getting smaller and smaller.

What Gruden was saying is that when you had your first year of success – you should have powered the boat full steam ahead and kept the course; “Run the table.”

When the clinic is doing great and riding high is exactly the time that you want to continue pushing forward-not backing the throttle off!

Instead of reveling in the success you are having, you need to continue to work as if it this windfall never happened. Continue to cautiously make tweaks here and there, keep the belt tightened, and prevent bad habits of overspending and bulking up in areas (staff, expenditures) that will eventually start to eat into the bottom line. Can you sustain those changes if the pendulum swings to the other side?

Keeping your players in a “meaningless” game may seem foolhardy. What if my star quarterback gets hurt while we are playing a team that hasn’t won a game all year? Well, your quarterback is going to get hurt whether they are playing the number one team in the division or the last place team. Life happens!

4 secrets you need to know


But you need to remember what got you to those playoffs in the first place:

1. PRACTICE, practice, and then do it again! 

You need to ensure that the staff never lets down their game. Their exam times need to remain efficient and their patient care demeanor remain exemplary. If they slip, they get benched!

2. Know The Game Plan and Stick To It 

Every coach has a game plan for the game. In football, the coach knows the first ten to fifteen plays they will use. Once those plays are over, they will re-assess and set the tone for the next fifteen plays. Set the plan, execute, re-assess, and execute again off those plan changes. You need to always be doing constant re-evaluation.

3. Have Some Trick Plays Up Your Sleeve Just In Case

Every coach has a trick play or two up their sleeves to keep the other team on their toes. If you use them at the right time, they can be devastating to the moral of the opposing team. This takes hours and hours of watching your competition, and planning strategy to capitalize on their weaknesses. By isolating their weaknesses, you can plan your strategy to use their weaknesses against them.

4. Change is Good-But Routine Will Keep The Team Moving Forward

While change is good to keep your team fresh, consistency is what keeps the team working as a finely honed machine. Keeping the same expectations and goals for the team ensures that there are not lapses in communication or performance. 


While winning and achieving success is the goal of every coach (clinic manager), we need to continuously be reminded that it is a hard fight to win at anything. One must remain vigilant, hard driven, and observant to trends as well as warning signs of slippage.  

It would help to remember the words of the highly successful businessman Zig Zeigler:  

“You were born to win, but to be a winner, you must plan to win, prepare to win and expect to win” Now get out there and run the table!



Zeigler, Z. (2014). Born to Win: Find Your Success Code. Washington: Made for Success Publishing


Dianna E. Graves, COMT, BS Ed

E: dgraves@stpauleye.com

Graves is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983.


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