March 4, 2021
5 min read
“The most insignificant score is the score at half-time.”
– Gresham Barrett
“Cross-country: no half-time, no time-outs, no substitutions. It must be the only real sport. “
– Chuck Norris
In football, they have ‘halftime’, an opportunity for players to take a break and for fans on the losing side to forget their troubles with some precision while walking and pop rocking.
John B. Pinto
In baseball, they have the “seventh inning streak,” between the top and bottom halves of the seventh inning. (Baseball fans need to be more patient, delaying relief until 72% of the game is over.)
Of course, the biggest national and global “game” right now is the contest to fend off COVID-19. Given the human, financial and emotional weariness of the past year – and with a prayer that at least half of this terrible game is behind us – we could all take a break.
Let’s take this break to reflect on what has been learned and what it will take for practices, owners and managers to be winners in the coming quarters before the pandemic recedes and we can all come home winners. .
I have been fortunate to see the winning second half of a pandemic through my past work with ophthalmic clients in Singapore who have had to deal with the many predecessors of this coronavirus for years. This experience, combined with running a national “emergency room” for practices hit by COVID over the past year, reveals the following truths.
1. Leadership tops the list of pandemic game winners. The best restored practices today are those with physicians and lay managers who mobilized early and carried the flag for the rest of their organization. And they did it together. The most impressive practices we have seen are those in which there was a pre-existing and strong bond between the administrator and the managing partner. Together, they secured all other resources to accelerate the return to safe high patient volumes, and nurtured the spirit needed to rally staff to embrace new initiatives. If you and your admin are traveling in different orbits, it’s time to line up.
2. Right behind leadership is money. Almost every practice has suffered a financial blow in 2020, and hopefully a smaller blow in 2021, even under the best vaccination and treatment scenarios. Practices and owners with good access to capital have not lost much sleep over the past year. Even a hectic year, with frank business losses, anchored in a bountiful 30-year career is an irritation, not an existential threat. Check now to make sure you have easy access to at least three times your monthly operating costs.
3. We have to assume that the game is far from over. The most infectious COVID-19 variants now coming out of Brazil, South Africa and Britain at the time of this column’s going to press are in a race with the deployment and masking of vaccines. And this is not the end of virulence. It looks like we’ll be rolling up our sleeves on booster shots and flu adjuvants for the rest of our lives. Investments in public health are billions of dollars and decades behind what they ideally would be in eradicating each new bug that will continue to surface with depressing regularity. Think of it this way: you must have become your own public health worker.
4. Now is the time for abundant empathy. For the direct victims of health care, of course. But also for staff, whose extended family members are probably struggling to find work or pay rent. For imperfect local and national officials on both sides of the political divide, who are doing their best with something they have never seen before. For undereducated patients who struggle with their COVID fears to the point of spraying volatile disinfectants inside their masks before wearing them (true story). For those who still think the pandemic is a hoax. From your position as an educated professional, continuing humbly and compassionately to care for others.
5. Calamity changes everything. The Great Depression and World War II reset life expectations for more than a generation. My mother, a girl at that time, worked two jobs in her 80s and saved every penny. It is not only today’s young people who will be affected. The more thoughtful mid-career eye surgeons will be more careful in their business dealings in the future. Some will speed up their retirement, while others will end up working longer than they imagined to restore depleted savings during the pandemic. And who doesn’t plan their fantastic vacation after COVID? Have your own professional and personal projects changed? Write them down. Discuss it with your family.
6. COVID-19 has brought out the value of emergency planning in both large and small ways. Newly hired doctors and surplus staff were laid off to preserve cash. The satellites have been shut down. The parking lot has become the waiting room. Meetings with patients have become virtual. No one I knew had a pre-game plan for the pandemic. But in the future, consider your playbook for any calamities that have much higher chances: a personal handicap, the loss of a key staff member, a fire or a tornado. Let the pandemic remind you to always try to think a few steps forward.
7. COVID has also been a reminder that you have to go against your perfectionist sense every now and then. Surgeons seeking personal and patient safety suddenly gave up their practice in March, and some still haven’t returned. Perfect sanitary measures are unrealistic. Those who rebounded safely aimed for a reasonable balance between community needs, economic survival, and risk reduction – not perfection.
8. Don’t disband your COVID-19 task force. Rename it. Like many practices, when the pandemic took hold, you may have assembled a group of senior managers to coordinate a response to the emergency. This same group should continue as an “operations management committee”, meeting as often as necessary to stay abreast of the day’s emergencies, even if there are no other emergencies.
9. Think for yourself. National societies render a great service to the profession and are indispensable on several levels. But they are not regulatory agencies. Their best dictates represent thoughtful and sincere guidelines. But at the onset of COVID-19, and with great caution, their guidelines were read by many vendors as a bright red stop sign. As a result, for much of March and April, most ophthalmologists stopped in their tracks, while dermatologists – another high-volume profession and in close contact with arguably fewer urgent patients – moved on. until May and beyond. Take all the data, then let your own professional training drive your patient care efforts.
10. Balance daring and preparation. The more aggressive you were about the number of patients you started seeing after the first COVID alarm, the more aggressive you had to be to enforce scrupulous safety standards for staff and patients. But this is nothing new. The cataract surgeon who goes through four or five cases an hour instead of two or three needs to be more meticulous – and have a more meticulous team. As pilots learn, boldly piloting acrobatic tricks requires more caution, experience and preparation.
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- John B. Pinto is President of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm founded in 1979. He is the author of several books on ophthalmic practice management, including JJohn Pinto’s Little Green Book of Ophthalmology: Strategies, Tips and Beads to Help You Develop and Manage a Distinguishing Practice, UP: Taking Ophthalmic Administrators and Their Leadership Teams to the Next Level of Competence, Performance and job satisfaction (with Corinne Wohl), Simple: the inner game of the success of ophthalmic practice, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at healio.com/books. Receive 20% discount with promo code PINTO20. He can be reached at 619-223-2233; email: [email protected]; website: www.pintoinc.com.
