By the Numbers

Finding your authentic self is at the core of practice success

Knowing who you really are will help you set your life goals, which ultimately drive professional goals.

“Authenticity means erasing the gap between what you firmly believe inside and what you reveal to the outside world.”
– Adam Grant

“Don’t worry about what’s cool and what’s not cool. Authenticity is what’s cool.”
– Zac Posen

“Authenticity can’t be replicated or faked. You’re either real or you’re not.”
– Bibi Bourelly

After more than 30 years of writing for Ocular Surgery News and 40 years advising surgeons, I am still learning how this grand profession ticks. Most insights come while on the road, traveling to client practices and seeing how surgeons strive not just for clinical mastery and commercial survival, but more importantly for self-mastery, or at least self-understanding.

Many years ago, I developed and wrote in these pages about a “bull’s-eye” model to help surgeons determine the best path forward as they make decisions about their life and their practice.

Planning process graphic

The center of this bull’s-eye diagram is your bucket list: What do you want to see, have, do, be, experience and ultimately give away in however many sentient, physically active years you have before you no longer exist? This bucket list includes the common goals (pay for your daughter’s grad school education, pay off the mortgage, take nice vacations and drive a hot car) and extends to exceptional goals (fund mission surgery travel, establish a local foundation for disadvantaged youth and the like).

The first ring out from the bull’s-eye is your personal financial plan. What do you need to earn annually to pay for your bucket list? Which is to say, your pre-retirement and post-retirement lifestyle. For the best-advised surgeons, this is determined by working with the aid of a fee-only financial planner or CPA who can model your budget before and after retirement, and provide a source of external discipline to assure that you hit your “number.”

The next ring out is the strategic plan for your practice. This is less exotic than it sounds and is driven by your personal financial obligations. Over the next 5 to 10 years, what will be your service area? Mix of services? Provider mix? How fast do you intend to grow the practice? Will you collaborate with other practices or health systems in your community or stand alone? If practice owners are older, what will be the succession plan?

The last ring out is the tactical plan. What near-term actions do you, your colleagues and your management staff need to take to bring forth your strategic goals? For example, if you want to grow revenue and patient visits at 8% per year (about twice the rate at which the demand for eye care services is growing), what tactics are you going to employ? Outreach to referring optometric practices? Direct-to-consumer advertising? The acquisition of nearby practices?

Authentic self

This four-level planning process I have just described is in the past. I understand now that I was wrong, or at least incomplete. Inside the central bull’s-eye should be a smaller, critical bull’s-eye called “one’s authentic self” because it is impossible for any of us to define our bucket list of life goals without getting clear about who we really are.

Complete planning process

After many hours of binge-watching TED Talks on the topic of how to become who you authentically are — and there are hundreds of clips to choose from — here are five that may change your life:

The distillate to finding and living an authentic life includes this:

  • Like many highly educated people, you are probably more “outer directed” than “inner directed.” You have been conditioned by parents, teachers, professors and chief residents to perform in a certain way. Their way.
  • Your authentic self is probably not far off from the dreams you had as a kid, before adults imposed their will on you. What would your 12-year-old self say about your 42-year-old self today?
  • What percentage of your waking hours are you doing things you truly enjoy? Do you grit your teeth seeing clinic patients for the rewards of surgery, or do you enjoy the full scope of a clinical/surgical practice?
  • Try to be less obedient to the opinion of others and listen more to your inner voice.
  • Observe the seemingly trivial signs that you may be captive to the expectations of others: the way you dress, the hours you keep, the conventions you obey.
  • You may not have a singular authentic self, but many competing alternatives. In this case, it is important to become aware of (and try to integrate) the conflicts you have about the ultimate meaning of your life.
  • Finding your authentic self is hard work. Do not struggle going it alone; seek help if you get stuck.

Know who you are

Practicing ophthalmology and living a successful, optimally abundant life is straightforward, if rare. Know who you are, really, and strive to be that person. Set life goals congruent with who you are. Establish financial goals that align with your desires and do not overshoot your reasonable capability. Strive to assure that your practice’s business plans will ultimately deliver a satisfactory financial result, without overshooting your needs or falling short of your requirements. And finally, pursue only those practice business actions in this coming year that align with your longer-term strategic goals.

“Authenticity means erasing the gap between what you firmly believe inside and what you reveal to the outside world.”
– Adam Grant

“Don’t worry about what’s cool and what’s not cool. Authenticity is what’s cool.”
– Zac Posen

“Authenticity can’t be replicated or faked. You’re either real or you’re not.”
– Bibi Bourelly

After more than 30 years of writing for Ocular Surgery News and 40 years advising surgeons, I am still learning how this grand profession ticks. Most insights come while on the road, traveling to client practices and seeing how surgeons strive not just for clinical mastery and commercial survival, but more importantly for self-mastery, or at least self-understanding.

Many years ago, I developed and wrote in these pages about a “bull’s-eye” model to help surgeons determine the best path forward as they make decisions about their life and their practice.

Planning process graphic

The center of this bull’s-eye diagram is your bucket list: What do you want to see, have, do, be, experience and ultimately give away in however many sentient, physically active years you have before you no longer exist? This bucket list includes the common goals (pay for your daughter’s grad school education, pay off the mortgage, take nice vacations and drive a hot car) and extends to exceptional goals (fund mission surgery travel, establish a local foundation for disadvantaged youth and the like).

The first ring out from the bull’s-eye is your personal financial plan. What do you need to earn annually to pay for your bucket list? Which is to say, your pre-retirement and post-retirement lifestyle. For the best-advised surgeons, this is determined by working with the aid of a fee-only financial planner or CPA who can model your budget before and after retirement, and provide a source of external discipline to assure that you hit your “number.”

The next ring out is the strategic plan for your practice. This is less exotic than it sounds and is driven by your personal financial obligations. Over the next 5 to 10 years, what will be your service area? Mix of services? Provider mix? How fast do you intend to grow the practice? Will you collaborate with other practices or health systems in your community or stand alone? If practice owners are older, what will be the succession plan?

The last ring out is the tactical plan. What near-term actions do you, your colleagues and your management staff need to take to bring forth your strategic goals? For example, if you want to grow revenue and patient visits at 8% per year (about twice the rate at which the demand for eye care services is growing), what tactics are you going to employ? Outreach to referring optometric practices? Direct-to-consumer advertising? The acquisition of nearby practices?

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Authentic self

This four-level planning process I have just described is in the past. I understand now that I was wrong, or at least incomplete. Inside the central bull’s-eye should be a smaller, critical bull’s-eye called “one’s authentic self” because it is impossible for any of us to define our bucket list of life goals without getting clear about who we really are.

Complete planning process

After many hours of binge-watching TED Talks on the topic of how to become who you authentically are — and there are hundreds of clips to choose from — here are five that may change your life:

The distillate to finding and living an authentic life includes this:

  • Like many highly educated people, you are probably more “outer directed” than “inner directed.” You have been conditioned by parents, teachers, professors and chief residents to perform in a certain way. Their way.
  • Your authentic self is probably not far off from the dreams you had as a kid, before adults imposed their will on you. What would your 12-year-old self say about your 42-year-old self today?
  • What percentage of your waking hours are you doing things you truly enjoy? Do you grit your teeth seeing clinic patients for the rewards of surgery, or do you enjoy the full scope of a clinical/surgical practice?
  • Try to be less obedient to the opinion of others and listen more to your inner voice.
  • Observe the seemingly trivial signs that you may be captive to the expectations of others: the way you dress, the hours you keep, the conventions you obey.
  • You may not have a singular authentic self, but many competing alternatives. In this case, it is important to become aware of (and try to integrate) the conflicts you have about the ultimate meaning of your life.
  • Finding your authentic self is hard work. Do not struggle going it alone; seek help if you get stuck.

Know who you are

Practicing ophthalmology and living a successful, optimally abundant life is straightforward, if rare. Know who you are, really, and strive to be that person. Set life goals congruent with who you are. Establish financial goals that align with your desires and do not overshoot your reasonable capability. Strive to assure that your practice’s business plans will ultimately deliver a satisfactory financial result, without overshooting your needs or falling short of your requirements. And finally, pursue only those practice business actions in this coming year that align with your longer-term strategic goals.