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Take your practice from the Temple of Doom to the Holy Grail


Arnold S. Prywes, MD, said he believes that achieving the "Holy Grail" of a high-performance practice culture requires finding a great administrator; developing a wonderful staff; having doctors who are great; finding a wonderful setting; being willing to do new things and to change as necessary; having communication between doctors, staff, and patients; involving yourself with information technology, because that's the future; and having a good time.

Key Points

New York, NY-Years ago, ophthalmology practices were simple. Staffs were small, accounts receivable was not part of the business, and health insurance was nonexistent. Physicians only needed to concentrate on their true passion: treating patients.

Today, achieving the "Holy Grail" of a high-performance practice culture depends on making the right choices, according to Arnold S. Prywes, MD, assistant clinical professor, Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Yeshiva University, New York City.

"The first thing everyone in the practice needs to decide is who gives the orders. Settle on who's in charge and who's in charge of what," said Dr. Prywes, who also is chief of glaucoma, Department of Ophthalmology, North Shore University/Long Island Jewish Medical Center, New York City, and co-director of ophthalmology, New Island Hospital, Bethpage, NY. "You really need to clear a path of communication with doctors, staff, and administrators."

Enter the administrator. A good administrator is the quarterback of the practice, determining what happens in the practice and how it happens, Dr. Prywes said. The administrator is key to holding regular staff meetings, identifying clear goals, and delegating responsibilities. A good administrator can provide a single voice for the practice by making staff aware of policies and procedures, putting those policies and procedures into writing, and developing staff training that creates consensus and uniformity.

The Golden Rule

In 1902, James Cash Penney opened the Golden Rule Store, predecessor of the J.C. Penney Co. Inc. The original store name represented Penney's personal beliefs in customer service. "The Golden Rule is an interesting metaphor for what I think should happen in doctors' practices," Dr. Prywes said. The rules, he added:

Dr. Prywes' customer service tips include placing people with positive attitudes at the front desk to greet patients, conducting surveys to gauge customer satisfaction, providing patients with a variety of information resources, maintaining a Web site, writing thank-you notes for referrals, and reminding patients of upcoming appointments.

"Find out what patients like," he said. "Think of your office as a place where your patients expect to be treated well." Surveys, Dr. Prywes explained, can alert the staff to patient concerns such as dirty bathrooms, out-of-date magazines, uncomfortable furniture, and dreary office settings.

Providing patients with information can help put them at ease. Programs, brochures, and leaflets can refresh patients' minds about their diagnoses, remind them how to use those eye drops, or explain insurance policies. Think about having a model of the eye in each exam room, along with scratch pads so doctors have the ability to draw diagrams to explain a point.

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