By the Numbers

Ten keys to being a leader in an ophthalmic setting

Bridging the gap between managing and leading can be hard to accomplish.

Our chief want is someone who will inspire us to be what we know we could be.

– Ralph Waldo Emerson

One does not “manage” people. The task is to lead people. And the goal is to make productive the specific strengths and knowledge of every individual.

– Peter Drucker

Imagine a small, green visitor from Alpha Centauri, our closest solar neighbor, lands on your practice parking lot next week. He shuffles along the sidewalk, opens your front door with effort, finds his way to your receptionist, Molly, and using the familiar interplanetary lingo, says, “Take me to your leader.”

Does Molly know where to escort him?

If you are the surgeon-owner or the practice administrator, and things are going according to plan, Molly should be heading directly to your office. You are the leader, of course. But are you?

Perhaps not.

If you hire and fire and sign the paychecks, this is sufficient to be someone’s “boss,” but not their leader. And you are not a leader if you merely look over workers’ shoulders or chastise them for errors or give them a new task to accomplish. You may be supervising or overseeing or managing, but you are not leading.

Mere “management” is not necessarily leadership. Leadership takes management to the next level. All effective leaders are excellent managers. Only a few managers are excellent leaders.

Bridging the gap between managing and leading is a rare thing for managing partners and administrative managers to accomplish. Becoming a leader is less an accident of birth, as many assume, and more a matter of study and emulation of great leadership by others, combined with personal trial and error.

“Natural” leadership is a myth. Being a great leader is most often an unnatural act, obliging that you reach beyond your narrow personal interests. To sacrifice, when it is natural to take. To be workaholic, when it is natural to be lazy. To be self-deprecating, when it is natural to puff yourself up.

Here is a basic list of the 10 hallmarks of leadership in an ophthalmic context. I did not invent these concepts; I merely wrote them down after 33 years of observing the best leaders I have met in the business.

Ten hallmarks of leadership

  1. Being an effective MD-leader takes raw time, at least 8 additional hours per week on top of your core job as an ophthalmologist — time for communication and meetings along with self-education and reflection about what works and what does not in your hands and in your unique setting. Effective administrators must be equally workaholic; 45 to 60 hours a week is not uncommon. As Dr. John Corboy is fond of saying, “If you’re not smarter than them other guys, you had better work harder and longer than they do if you want to get ahead.”
  2. If you want to be both a great manager and a great leader, you do not have to think like General Patton or President Lincoln. Instead, think like a doctor. Gather information about a problem, make a decision, act on your decision and revise tactics as indicated by how well the problem resolves.
  3. Ophthalmic microsurgery is the domain of slow, cautious, 100% perfection. Ophthalmic leadership is the domain of well-intended, timely approximations of 80% perfection. Or less. Nobody dies or goes blind in the world of business. Be bolder and faster than is natively comfortable for you. Get on with it.
  4. Tough plus fair wins the day. People respond best to and do their best work for leaders (parents, teachers, bosses, politicians, etc.) who are inordinately tough but simultaneously fair. Think back to your own favorite leader; chances are, they were not loose and easy in setting standards for you. You may have hated your parent or teacher at the time, but in hindsight you can see they were right and acting ultimately in your best interest.
  5. As an ophthalmologist providing patient care, you are in a popularity contest and want 100% of patients and referral sources to love you. As an ophthalmic business leader, you are decidedly not in a popularity contest. And this is not a democracy, except among equal partners in a boardroom setting. Leading the practice is doing the right thing for the company, even if it makes you a bit unpopular.
  6. Practice staff members, like kids (although we do not want to overstretch the analogy), do best with binary leadership. A highly engaged MD-leader and an equally engaged administrator, like unified, collaborating parents, are a force to be reckoned with. This is true at all practice scales, from modest solo practices, with one doctor and one beleaguered office manager, on up to the largest private clinics in America, with one medical director or managing partner and one senior-level CEO director.
  7. The typical ophthalmology practice, unlike larger corporate environments where you would come up the ranks and serve under many mentors, does not provide a very effective setting in which to learn leadership. Backfill this gap by studying other industries. Read widely, especially the biographies of leaders in other spheres.
  8. Effective leadership is at least as much about one’s desire to lead as it is about one’s innate skill set. Do not elevate a junior staff member to a supervisory position or a board member to managing partner unless he or she really wants the job. You have probably run into this problem already. Most practices have at least one mid-level manager, most commonly a head tech or head of billing, who is technically excellent but does a terrible job leading other people.
  9. Take your fiduciary responsibility to the practice seriously. Think “practice first.” Make decisions based on what is best for the practice and the patients, not what is best for you personally. If it is best for you to open up extra clinic or OR days to accommodate patient demand, do so, even though your personal preference may be to enjoy the time off. If it is best for your partner to get her way this year with a new piece of testing equipment instead of you, because that is what is best for the practice, do not be a grump about it.
  10. In the present environment, with ever-lower fees and much-higher taxes on the horizon, it takes a highly disciplined leader to not mutter out loud throughout the day about how the sky is falling. Robert Louis Stevenson said, “Keep your fears to yourself, but share your courage with others.” While it is perfectly appropriate to discuss your fears with your partners and administrator, your mid-level managers and especially your in-the-trenches staff should be spared the doom and gloom. Find your courage, even in the present situation, and share it.
  • John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology and a new book, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams. He can be reached at 619-223-2233; emailed: pintoinc@aol.com; website: www.pintoinc.com.

Our chief want is someone who will inspire us to be what we know we could be.

– Ralph Waldo Emerson

One does not “manage” people. The task is to lead people. And the goal is to make productive the specific strengths and knowledge of every individual.

– Peter Drucker

Imagine a small, green visitor from Alpha Centauri, our closest solar neighbor, lands on your practice parking lot next week. He shuffles along the sidewalk, opens your front door with effort, finds his way to your receptionist, Molly, and using the familiar interplanetary lingo, says, “Take me to your leader.”

Does Molly know where to escort him?

If you are the surgeon-owner or the practice administrator, and things are going according to plan, Molly should be heading directly to your office. You are the leader, of course. But are you?

Perhaps not.

If you hire and fire and sign the paychecks, this is sufficient to be someone’s “boss,” but not their leader. And you are not a leader if you merely look over workers’ shoulders or chastise them for errors or give them a new task to accomplish. You may be supervising or overseeing or managing, but you are not leading.

Mere “management” is not necessarily leadership. Leadership takes management to the next level. All effective leaders are excellent managers. Only a few managers are excellent leaders.

Bridging the gap between managing and leading is a rare thing for managing partners and administrative managers to accomplish. Becoming a leader is less an accident of birth, as many assume, and more a matter of study and emulation of great leadership by others, combined with personal trial and error.

“Natural” leadership is a myth. Being a great leader is most often an unnatural act, obliging that you reach beyond your narrow personal interests. To sacrifice, when it is natural to take. To be workaholic, when it is natural to be lazy. To be self-deprecating, when it is natural to puff yourself up.

Here is a basic list of the 10 hallmarks of leadership in an ophthalmic context. I did not invent these concepts; I merely wrote them down after 33 years of observing the best leaders I have met in the business.

Ten hallmarks of leadership

  1. Being an effective MD-leader takes raw time, at least 8 additional hours per week on top of your core job as an ophthalmologist — time for communication and meetings along with self-education and reflection about what works and what does not in your hands and in your unique setting. Effective administrators must be equally workaholic; 45 to 60 hours a week is not uncommon. As Dr. John Corboy is fond of saying, “If you’re not smarter than them other guys, you had better work harder and longer than they do if you want to get ahead.”
  2. If you want to be both a great manager and a great leader, you do not have to think like General Patton or President Lincoln. Instead, think like a doctor. Gather information about a problem, make a decision, act on your decision and revise tactics as indicated by how well the problem resolves.
  3. Ophthalmic microsurgery is the domain of slow, cautious, 100% perfection. Ophthalmic leadership is the domain of well-intended, timely approximations of 80% perfection. Or less. Nobody dies or goes blind in the world of business. Be bolder and faster than is natively comfortable for you. Get on with it.
  4. Tough plus fair wins the day. People respond best to and do their best work for leaders (parents, teachers, bosses, politicians, etc.) who are inordinately tough but simultaneously fair. Think back to your own favorite leader; chances are, they were not loose and easy in setting standards for you. You may have hated your parent or teacher at the time, but in hindsight you can see they were right and acting ultimately in your best interest.
  5. As an ophthalmologist providing patient care, you are in a popularity contest and want 100% of patients and referral sources to love you. As an ophthalmic business leader, you are decidedly not in a popularity contest. And this is not a democracy, except among equal partners in a boardroom setting. Leading the practice is doing the right thing for the company, even if it makes you a bit unpopular.
  6. Practice staff members, like kids (although we do not want to overstretch the analogy), do best with binary leadership. A highly engaged MD-leader and an equally engaged administrator, like unified, collaborating parents, are a force to be reckoned with. This is true at all practice scales, from modest solo practices, with one doctor and one beleaguered office manager, on up to the largest private clinics in America, with one medical director or managing partner and one senior-level CEO director.
  7. The typical ophthalmology practice, unlike larger corporate environments where you would come up the ranks and serve under many mentors, does not provide a very effective setting in which to learn leadership. Backfill this gap by studying other industries. Read widely, especially the biographies of leaders in other spheres.
  8. Effective leadership is at least as much about one’s desire to lead as it is about one’s innate skill set. Do not elevate a junior staff member to a supervisory position or a board member to managing partner unless he or she really wants the job. You have probably run into this problem already. Most practices have at least one mid-level manager, most commonly a head tech or head of billing, who is technically excellent but does a terrible job leading other people.
  9. Take your fiduciary responsibility to the practice seriously. Think “practice first.” Make decisions based on what is best for the practice and the patients, not what is best for you personally. If it is best for you to open up extra clinic or OR days to accommodate patient demand, do so, even though your personal preference may be to enjoy the time off. If it is best for your partner to get her way this year with a new piece of testing equipment instead of you, because that is what is best for the practice, do not be a grump about it.
  10. In the present environment, with ever-lower fees and much-higher taxes on the horizon, it takes a highly disciplined leader to not mutter out loud throughout the day about how the sky is falling. Robert Louis Stevenson said, “Keep your fears to yourself, but share your courage with others.” While it is perfectly appropriate to discuss your fears with your partners and administrator, your mid-level managers and especially your in-the-trenches staff should be spared the doom and gloom. Find your courage, even in the present situation, and share it.
  • John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology and a new book, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams. He can be reached at 619-223-2233; emailed: pintoinc@aol.com; website: www.pintoinc.com.