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Accepting change is hard, but with the right guidance it doesn’t have to be


Blogger Donna Suter draws from personal experience and provides four tips on maintaining the needs of your practice in an evolving business climate.

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Donna Suter, president of Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Advanstar

Changes in guidelines and regulations often force eye-care providers to compel with requirements and change how patients are treated. Perhaps 2017 was a year of inevitable, compelled change for you: A key employee unexpectedly quit? The practice upgraded not only to the latest version of an electronic health record platform and practice management software, but also a new system entirely?

It is natural to dislike change that is forced upon us – many times it can stir up angry emotions where you feel out of control. Sometimes, people give up when change demands too much time and resources.

In 2017, I found myself navigating through an adjustment, and it was one I had to accept: neck surgery. I had resisted it -and the extensive recovery -for three years.

I knew that even a successful surgery - one that replaced discs with plates and screw inserts -would be challenging. I underwent surgery in May, and I was determined to grow and learn from the rehabilitation process.

Anyone who has spent even a short stint in an orthopedic physical therapy (PT) rehabilitation facility can relate to the common experience of patients who enter the clinic: weak, temporarily disabled and in need of some significant guidance and direction to get back onto their feet.

Donna in her neck brace.When I reported to PT, it didn’t take long to figure out why some patients cycled through treatment programs without improvements, and with the same complaints year after year.

Why? Because they failed to follow through with the instructions they were given - important instructions related to proper 1) nutrition and exercise, 2) time, 3) discipline, and 4) persistence.




Patients didn’t admit this at first - they cited aging as their problem. I found their fatalistic attitude about growing old overwhelming. Here I was, fresh from a major surgery and decades older than when I first developed this neck problem. Did this mean I was doomed to a schedule filled with PT appointments every fall?

My therapist assured me that I could regain my strength and lifestyle if I followed both my doctor’s and her instructions. She politely pointed out that most PT clients failed to be responsible. They seldom did their home exercises or followed doctor’s orders.

Luckily, I was able to regain mobility and fitness after the procedure. I am forever humbled I was able to heal and restore, and I have a new depth of empathy for those who live with chronic pain.

For anyone who has ever participated in athletics, it is common sense to follow basic principles to enhance physical development. These must be followed, or the athlete will remain deconditioned, weak, and athletically unable to fully participate.

So, how do these same basic physical development principles correlate to practice management and maintaining a healthy net despite shrinking reimbursements? Just how many practices remain in constant need  and rehabilitation due to neglect (or denial)? How many practices remain deconditioned financially, weak in profitable patient flow and futile in their efforts to convince patients to purchase premium spectacle lenses and eyewear from their optical?

Our journeys -mine and those who I have met - allegorically represent your response to practice change. Just like what is happening in your office, most, if not all, presenting symptoms can be resolved with appropriate guidance.


1. Nutrition and exercise

When athletes are malnourished, or spend little time training, they fail to develop. They are not consuming the right fuel or doing what they need to do to be physically competitive.

In your office, patient education and flow is the same. When employees fail to educate the patient (nutrition) and study efficient patient flow and go paperless by using all the features of practice management modules (exercise), they fail to develop the efficiency needed to attract the larger number of profitable patients your office needed to cover fixed costs.

Some employees learn enough to make it through the three-month trial period, and then fail to develop, thus eroding team efficiency. Our physical neglect leads to physical weakness and, in turn, our inability to positively influence those around us.

Employees must excel in all aspects of patient care, rather than meeting the bare minimum. Lack of nourishment (training) and exercise (practice) produces employees who are slow in performing patient-care tasks, or unable fill in for a sick coworker.

When you are hungry or suffer from malnutrition, you become easily distracted due to weakness and lack of sustenance. In the practice, when you do not read and study human nature, your ability to lead the patient calmly and cheerily through the exam process wanes. You become professionally deconditioned and are easily distracted by terminations, high-drama or personal conversations with patients.


2. Time

Successful athletes understand the amount of time and effort it takes to develop the physical requirements needed to effectively compete against an opposing team or individual. You understand that just setting aside five or 10 minutes of your time each day will never allow them to compete at the highest level.

They must put in the appropriate amount of time. Especially for practice managers and owners, the same holds true. If you spend little time benchmarking your practice and comparing performance with that of your successful peers, you will never reach the level of profitability required to be in the top percentile. Slowly, you will lose the ability to hire top talent and upgrade diagnostic instrumentation. You will become a bystander, rather than a participant, due to lack of development.


3. Discipline

Those who exercise routinely throughout the week, month after month, year after year, understand that there are many days when, as that time of day approaches to exercise, you can find one million things you’d rather do. Instead, you discipline yourself to change into your gym clothes and simply "get it done."

You tell yourself, on those lazy days, that if you just do it you will feel much better afterward. You will be thankful that you exercised, which is true. This is just as true with reading trade journals and studying the latest applications of technology in eye care – especially advancements in spectacle lens technology.

There are many days, when, due to a wide variety of reasons, you simply are not in the mood for it. Again, just like exercising, you know that if you discipline yourself to sit down and "get it done," you’re going to feel much better afterward, and you do.

The clarity of your view on what you can recommend to the patient to help him or her see clearly comes into focus after you flip through optical trade journals and spend 30 minutes a month chatting with your optical manager.


4. Persistence

Often, with physical training, a measurable change in our physical function may not become apparent for some time. When this happens, we can lose sight of the big picture as to why our efforts are necessary.

The small daily gains or benefits may not be that noticeable or measurable. Your persistence may wane due to what you feel is an insignificant impact from the effort you may have put into it.

This is true in practice management as well. There are some days when you may feel your patients want no more from you than “just what insurance will cover.”

You may feel there has not been measurable financial growth or development from your efforts. But failure does not have to be in your future.

As with physical exercise, which maintains our strength, the same holds true in your practice. In the absence of what you feel may be a lack of professional development or growth, there will always be a level of maintenance.

The preservation of your core values and goals for each patient  inhibits complete deconditioning.

Due to the growing assault on reimbursement rates and the infinite number of technological distractions, no one on your team can afford to become professionally deconditioned.

With athletics, you are going to be physically challenged, so you prepare yourself to bring your best game to the field. In total patient care, the same holds true. Particularly in the optical, your opticians are going to be challenged daily with all the false assumptions that patients have about eyewear.

Ideologies based on Google searches and discount big-box shopping nurture a mistrust of independent eye-care providers and the value of premium options.

Opticians, front desk, and clinic technicians had better be prepared to bring their best game to the field. You simply cannot show up deconditioned and weak. Consider this your New Year's resolution.


How did my 2017 end? I got over my sense of impending doom, doubled-down on eating healthy, and faithfully did my home exercises. I feel like I have been given a great gift when I wake up feeling rested and pain-free. My strength and mobility are within normal ranges and I am again traveling to client’s offices to conduct trainings and business coaching. I confess, I check my luggage and struggle with cooking vegan without using tons of soy products.

Donna, fully rehabilitated.

My resolutions are never to give up and never to forget the wisdom of planning my day and working on my plan. Change and unplanned challenges in eye care are a given. Be its master, not its slave.


Donna Suter

Donna Suter is president of Suter Consulting Group.

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