Resolve to Resolve Conflict

Resolve to Resolve Conflict

Top Ten Keys to Effective Interpersonal Conflict Resolution

By Ron Blue

James Autry, in his book, Love and Profit: The Art of Caring Leadership, writes that “conflict is not bad and it is not destructive…conflict is not good and not constructive.  Conflict becomes good or bad to the extent that it either becomes growth and learning or hostility and failure.  You, as manager, determine which it will be.”

So many morale issues found in our practices can be traced to ineffective interpersonal communication and, more specifically, the inability to resolve interpersonal conflict.  Listed are some ways to transform conflict into growth and learning.

  1. Resolve conflicts quickly.  Don’t assume if you ignore it, it will go away.  The longer you wait to talk to someone, the harder it becomes.
  2. Only take your concern or problem to the person who can directly influence a solution to that concern (i.e., go to the source, not the grapevine).  If someone comes to you with gossip, let them know you are not interested in hearsay and/or encourage the perpetrator to directly resolve the issue.
  3. Defend those not in your presence (i.e., don’t let others come to you with gossip about someone else).  Also, remember, people who gossip about others in your presence are most likely gossiping about you in your absence.
  4. When you do approach someone directly about a personal gripe, difference in opinion, personality issue, etc., enter the conversation with a win-win attitude and presumption of goodwill.  Make it “carefrontational” instead of confrontational.  For example, “I would like to talk to you about an issue we don’t seem to agree on.  It’s important that we come to an understanding that we both feel good about.  The issue I’m concerned about relates to…”  And, remember, it’s okay to agree to disagree agreeably.
  5. Conflicts generally are based on principal (substantive) or “turf” (non-substantive).  You must rise above the “turf” and work hard to resolve the conflicts based on principal by striving to find a compromise.
  6. If you are on the receiving end of someone attempting to bring a conflict to your attention, don’t take it personally.  See it as an opportunity to improve.
  7. When approaching someone in an effort to resolve a conflict…always separate the person from the behavior.  Personal attacks are never effective or appropriate.
  8. If you can’t resolve an interpersonal conflict, involve your coordinator or the Administrator.  And, remember, the longer you wait, the more difficult it will be.
  9. To prevent conflict, value the differences.  It’s not the way some are that matters nearly as much as what they do.  Diversity is necessary to build strong teams.  A basketball team with all seven-footers stands a poor chance of winning many games.  Without differences, there can be no synergy.
  10. To further prevent conflict, focus on the good in people.  “You can’t mine for gold without running into some dirt.”  No one is perfect, we all have weaknesses and shortcomings.  So, stay focused on the gold, not the dirt.


Think Like a Practice CEO

Think Like a Practice CEO

These six steps will start you on your way.

He, and increasingly she, is a familiar figure in corporate America – the workaholic middle manager.  He is a dedicated soldier in the corporate army, obsessed with his work.  He can be found at his desk late most evenings, slogging through endless mounds of reports and e-mails.  No problem or issue is too small to command his attention.

Our tireless corporate servant immerses himself in the minutest details within his sphere of responsibility and is convinced that no one else in the organization is capable of managing his turf.  He will jump in and prepare the report that someone else failed to deliver on time or will spend hours tracking down and resolving a customer complaint, even if outside his area of responsibility.

The heroic recoveries from snafus and the loyal service he provides are invaluable but seldom noticed by his supervisors.  Overworked, underappreciated and usually anonymous, he gets stalled in the scramble to the top of the corporate ladder and financial freedom.  Bosses label him as unpromotable – lost in detail and task, focused on today and not tomorrow, unable to delegate, unable to inspire colleagues.  He does not think or act like a chief executive officer.

Does the shoe fit?

What does the profile of a familiar corporate type have to do with you?  All too often practice owner/optometrists find themselves trapped in the role of overworked chief employees.  While they dream about escaping the daily grind and increasing their personal income, they can see no way out of their predicament.  They believe that stepping off the treadmill means reducing their income.  From our consultations with practices throughout the United States, we know that is simply not the case.

To maximize financial success and gain control of your personal schedule, you must begin to think like a CEO.  This does not mean abandoning our primary role as a care provider.  It does mean performing both the duties of patient care and small business executive management well.

Learn the balancing act

We find that there is a universal trait among practice owners who achieve both high-gross revenue and a high-net income: They have discovered the optimal balance between their duties as practice CEO and as patient care provider.  Achieving a high net income is never an accident.  It requires planning, goal setting, delegation, leadership and constant oversight, all of which are the key skills of any CEO.

The Management and Business Academy’s (MBA) surveys of large optometric practices in the United States (MBA median gross practice revenue = $1.4 million, median number of employees = 10.5) revealed that large practice owner/optometrists spent 85% of their working hours on patient care and less than 10% of their time on planning and leadership activities.   We think this allocation of time dooms many owners to the fate of our passed-over, workaholic corporate hero.  While this group has been highly successful, the owner must step off the treadmill and begin to act like a practice CEO to achieve the full potential of the practice asset.  We advocate that owners of large practices spend no less than 20-25% of their time on management duties.

The six-step plan

It’s easy to agree in principle to become a practice CEO, but quite another matter to take the first step to change the practice routine and make it a reality, it will not occur overnight, but here are six steps that will help you become a practice CEO.

Step One.  Get out the appointment book and mark off the hours that you will devote to planning and leadership duties. You cannot have it both ways – a full schedule of exams and sufficient time to manage. Don’t be too busy to make more money.

After you reduce the time you spend in patient care, you will discover that the time spent managing the practice yields a far higher return per hour than seeing patients.  Your CEO hours will become your most productive at increasing net income. Many doctors discover that these are also the most enjoyable hours they spend in the office, because they stimulate the imagination and involve creativity.

Step Two.  Create a practice budget.  MBA surveys revealed that less than 20% of large optometric practices have a formal practice budget.  No business, large or small, can be run effectively without on-going measurement of income and expenses.  What is good enough in managing family finances is to adequate for a well-managed practice.  Without basic financial information, planning and control is impossible.

You do not need to be trained in accounting to budget and it is not time-consuming. Establishing a budget is quite simple with the basic spreadsheet tools that most practice software systems incorporate.  The budgeting process starts with an accounting of the proper year’s income and expenses and monitoring progress toward defined performance goals throughout the year.

The financial performance of practices that establish a budget always begins to improve immediately. The mere process of measurement sensitizes the practice to control income and expenses, and to adjust spending to achieve financial goals.

Step Three.  Establish a vision of the practice and concrete financial goals. Nearly every optometrist wants to make more money without spending a lot more time to do so.  Yet many feel trapped in their daily routine and would love to have more free time to enjoy life.  Those facing imminent retirement hope to improve their practice net to make their asset more valuable.  Many also need to reduce the practice’s dependency on their own personal relationships with patients. All of these goals are achievable when you put on your CEO hat and set measurable financial goals.

Establish goals for gross revenue and net income as well as for the major expense categories.  Beyond the near-term financial goals, articulate your longer term aspirations for the practice in measurable terms.   How large an enterprise do you wish to create? How much time do you want to spend in the practice each year?  What are your personal goals? How much would you like the practice to be worth at retirement? What is your exit strategy?

Step Four.  Conduct weekly staff meetings. Staff looks to you for executive leadership, not just for your medical expertise. Only you can set practice goals, define staff roles and responsibilities and establish operational guidelines for the practice.  Your role as team coach and cheerleader is often vital.  But most optometrists are so preoccupied with seeing patients that they interact little with the staff.  Most practices spend far too little time in staff management. In our research, we found that only 35% of the larger optometric practices hold weekly staff meetings.  Yet MBA program participants cite staff management as the most vexing problem they face.

Your first few weeks of staff meetings should be devoted to reviewing the practice budget and goals, and brainstorming with the staff about how to accomplish those goals.  Your staff will have many ideas about how to control those expenses that involve their work as well as how to increase patient revenue and probability per patient.

Topics for subsequent staff meetings can include:

  • Staff roles and responsibilities
  • Resolving patient complaints
  • Improving patient loyalty and satisfaction
  • Product training and case presentation skill
  • Team appearance
  • Patient – handling standards

You will never run out of topics. What’s more, staff meetings will become the basis for continuing improvement of the office process.

Step Five.  Manage by walking around. Don’t get so trapped on the exam treadmill that you overlook inefficiencies and patient-displeasing aspects of your practice.  Is the upholstery up-to-date in the reception area?  Are the bathrooms well maintained? Are patients treated personably at the front desk or is there an over-emphasis on fees and immediate payment? The only way you will become sensitive to these issues is to get out of the exam room and observe your office through the eyes of the patient.  During the weekly staff meeting you can get the staff to help fix the problems you observe.

Step Six.  Delegate. The only way most doctors can free up time to perform their executive role, without reducing the patient load, is to delegate more duties to the staff.  Start by ridding yourself of all routine administrative tasks, such as meeting all sales reps, ordering products like contact lenses and frames, actually doing all the steps in paying the bills instead of just overseeing the process.

Next, examine how much time you spend with each patient during the exam.  In many well managed practices the doctor spend no more than 15 minutes with each patient while completely satisfying the patient’s need for personalized care and attention. If you are spending more time per patient, consider taking steps to delegate testing tasks to the staff and streamline the entire process.

Change from the inside out

To become a practice CEO requires a change in mindset. While your role as eye doctor is primary, your role as business owner, asset manager, and merchant and team leader deserve a substantial portion of your time. Start with the steps outlined here and you will find yourself well along the journey to practice success. OM

About the authors: The authors are the faculty of the Management & Business Academy (MBA), a professional education service co-sponsored by Essilor of America and CIBA Vision.  To help optometrists realize the full business potential of their practices, the MBA conducts management seminars and publishes materials that provide real-world advice on practice improvement.

From Optometric Management, Nov 2005.

Authors: Neil Gailmard O.D., Gary Gerber O.D., Jerry Hayes O.D., and Peter Shaw-Mcminn, O.D.


Insurance Contract Checklist

Insurance Contract Checklist

  • Plan name_______________________________________________
  • All attachments, addenda, and documents referenced are attached.
  • All verbal representations made to you are referenced in writing.
  • The contract adequately identifies the entities responsible for payment and provides all contact information needed. You have confirmed the information by actual contact.
  • You have spoken with other doctors of administrators experienced with the plan and asked about ease of communications, prompt payment, and hassle factors.
  • You have requested and obtained a financial statement or other support information verifying the plan’s solvency and financial strength.
  • You have obtained verification that the plan has stop-loss coverage and liability insurance.
  • The contract indicates that your fees will be paid within a certain number of days, and it contains an incentive for the payer to comply, such as interest or penalties.
  • The contract specifies the reimbursement rate in dollars for at least some procedures, or the capitation rate per member per month.
  • The contract allows a reasonable time to submit claims and has a provision for extension of that time because of unforeseen circumstances (for example, employee termination or fraud, severe weather, computer malfunction).
  • The contract has a claims appeal process and you have checked references to find out how well it works.
  • The contract does not require you to hold the plan harmless or indemnify it for any actions other than your own.
  • The contract does not require you to pay the plan’s legal fees in a patient action, dispute, or for any other reason.
  • The contract says you will be compensated for any extra activities required (such as quality assurance or utilization review) and you will receive adequate insurance for those activities.
  • The contract adequately describes quality assurance, utilization reviews, dispute resolution, or other oversight functions.  Those functions appear to be fair, and physicians other than those administratively employed by the plan have input.
  • The contract does not hold you to a standard higher than “a reasonable physician acting under the same or similar situation.”
  • The contract does not require you to obtain an unreasonable amount of professional liability insurance or other coverage.  It also does not require that your policy cover the insurer.
  • The contract does not prohibit you from participating in other plans.
  • The contract does not allow your name to be used in marketing activities without your consent.
  • There is a confidentiality clause prohibiting the plan from making disclosures about you that aren’t indicated in the contract.
  • The contract does not require you to significantly change your billing practices or use of staff, alter your hours, or otherwise make major changes in the way you practice.
  • The contract provides an adequate panel of specialists and ancillary services.
  • The contract allows you to stop taking new patients without penalty.
  • The contract allows you to bill patients your normal fee for non-covered services and medically unnecessary services demanded by patients, and for charges the plan is unable to pay or fails to pay.
  • The contract provides explicit instructions on verification of patients’ eligibility.
  • The contract provides reimbursement when the insurer mistakenly indicates a patient is eligible under its plan.
  • Adequate patients or lives will be available to you from the plan.
  • If capitated, you will receive fee-for-service until an appropriate number of lives are provided.
  • If capitated, you are (ideally) capitated differently for each demographic group you’ll treat.
  • If capitated, the services included are clearly defined.
  • The contract allows you an “easy out” in case of dispute, inadequate patient volume, or any other reason, without penalty and within a reasonable period of time.

Source: Medical Economics/June 4, 2004


CPT CHANGES FOR 2012 – Impact on Contact Lens Fitting

CPT CHANGES FOR 2012 – Impact on Contact Lens Fitting

There are a few changes in the CPT coding manual affecting ophthalmology in 2012.  Those changes include:

  • The new and established patient definitions have been revised to include a reference to specialties and subspecialties.  The definition now states that a new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
  • The Integumentary System subsection has been expanded to include new guidelines to clarify reporting of wound care management and skin substitutes.  A new heading was created for Skin Substitutes Graft.
  • A parenthetical phrase was added below code 65775, Corneal wedge resection, to indicate that fitting of contact lens for treatment of disease, should be reported with codes 92071, 92072.
  • Code 92070, Fitting of contact lens for treatment of disease, including supply of lens, has been deleted.
  • Code 92071, Fitting of contact lens for treatment of ocular surface disease.
  • Code 92072, Fitting of contact lens for management of keratoconus, initial fitting.
  • These two new codes were created to replace code 92070.  Report supply of lens separately with code 99070 or appropriate supply code.  As a reminder, Medicare does not pay separately for the lens.
  • Serial Tonometry, code 92100, now includes a parenthetical phrase indicating that ocular blood flow measurements are reported with code 0198T and that single tonometry is a component of an office visit.
  • Codes 92120 and 92130, Tonography, have been deleted due to extreme low use of these services.
  • Code +0289T – Corneal incisions in the donor cornea created using a laser, in preparation for penetrating or lamellar keratoplasty.
  • Code +0290T – Corneal incisions in the recipient cornea created using a laser, in preparation for penetrating or lamellar keratoplasty.
  • The two codes are to be used in conjunction with 65710, 65730, 65750, and 65755.


Top Ten Things that Turn Patients Off

Top Ten Things that Turn Patients Off

1. Ignoring Them

The office should be anticipating each arrival.  When people walk in the door they should be greeted by name.

If the patient has to wait beyond what is considered reasonable, offer to reschedule them.  Offer to call for their ride, if appropriate.

Ask the patient who has had to wait if they would like a beverage or if they wish to use the telephone or the restroom.

2. Acknowledging Them as if They Have No Business Being There: Do you have an appointment? 

The staff should assume the patient belongs there, some people will stop by to make their appointment in person so the staff should greet people with a friendly “Hello, how may I help you?” or “Hello Mrs. Smith. Thank you for coming to see us”.

Remember the patient is the guest in the practice.

3. Making Them Feel “Helpless”

Patients are already anxious about the fact they need medical care. This is stressful and they often don’t understand what is happening.

Make patients familiar with the office if it’s a first appointment.  Give them a tour – show where restroom facilities are, etc. This helps make them feel more I control of their situation.

Also, explain the examination and results as well as eye anatomy to ease that helpless feeling.

4. The Clipboard and Chain Greeting

What is the profile of the average patient seen in the practice? (Age, Sex, mobility, dexterity, hearing, memory, bladder control, vision, etc.)

This profile can make stuff more aware of patients needs.

Older patients often have problems with forms – have someone sit down and fill it out with the patient.

Another option is to mail it out ahead of time with a map to office.

5. Calling Patients Out of Turn

Get each person into the process in order of their appointment time.  IF the doctor must see someone out of turn, it won’t be as critical if the other patients are already in progress.  However, if it is necessary to see someone out of turn and this is apparent to others waiting, be sure to go to them and explain that a special test is necessary which will require that patient to be seen earlier.

6. The Question: “Have you been into the office before?”

This is insulting and the staff should know the answer to that question.

Again, anticipate appointments and if you’re caught off guard, it is better to say, “I know you’ve been in the office before, but I can’t put the name with the face.”

7. Laughing Too Much or Too Loud

Avoid at all costs – make the patient feel they are being laughed at.

Save it for the break room.

8. Being too busy to find out how long it will be before the patient will be seen or how much it will cost, etc.

This usually becomes an issue after the patient is ignored or on the way out after the examination.

Response should be to ask the patient to take a seat and you’ll find out right away and get back to them as soon as possible.  Or, you’ll find out and let them know while they are having their examination. Or, tell them you’ll ask the doctor when they will be seen and get right back with an answer.

9. “The Doctor is With a Patient Now”

This statement has been used as an excuse many times and the patient has heard it over and over. It also is in conflict with the guidance the patient has received from the doctor to call if there is a question.

It is better to say that the doctor is currently in the middle of an examination and ask if you can pass their questions to the doctor.

10. Please Pass the Patient

Often the patient is seen by a number of technicians as well as the doctor.  When they are passed to a number of different people, they don’t know their name or what is going on.

One way to avoid this is to have a patient coordinator walk the patient to each new area.

Another is to explain the process and introduce the different people on the tour.

Have each person introduce the patient to the technician and the next phase to the exam at the traditional point in the process.


The Importance of Patient Service

The Importance of Patient Service

THE PATIENT…

Is the most important person in any eye care practice.

THE PATIENT…

Is not dependent on us…we are dependent on her/him.

THE PATIENT…

Does us a favor when she/he calls…we are not doing her/him a favor by serving her/him.

THE PATIENT…

Is part of our practice…not an outsider.

THE PATIENT…

Is not a statistic…she/he has feelings and emotions like our own.

THE PATIENT…

Is not someone to argue or match wits with.

THE PATIENT…

Is a person who brings in their wants and needs…it is our job to fulfill them.

THE PATIENT…

Is deserving of the most courteous and attentive treatment we can provide.

THE PATIENT…

Is the life-blood of every eye care practice.


Get Ready for the Boom

Get Ready for the Boom

Eye care professionals: Get ready for the boom!

The age range of today’s baby boomers is associated with two main visual events: onset of presbyopia and the development of cataracts.  The implications for eye care providers are tremendous; the rapid increase in the number of people turning 60 each year will create a parallel increase in demand for all forms of eye surgery and care associated with aging.  The eye care professionals will need to respond.  Manufacturers are already doing their part by developing new products and procedures to help restore vision and minimize or eliminate presbyopia and cataracts.  Tremendous resources are being channeled toward finding solutions for glaucoma, age-related macular degeneration, and dry eye conditions.

Providers have a lot of work to do in preparation for this influx of patients that will occur during the next 5 to 15 years.  In a nutshell, eye care practices need to:

  • DO MORE WITH LESS (Become more efficient)
  • DO RIGHT THINGS RIGHT (Become more effective)
  • DO THINGS BETTER (Continuous improvement)
  • DO THINGS AS A TEAM (Hire right, cross train, empower people)

 (Adapted from Ka-BOOM, Here They Come: by Shareef Mahdavi; Cataract and Refractive Surgeon Today, Feb. 2005)


Understanding Mission Statements

Understanding Mission Statements

By Ron Blue

  • Mission statement sets an overall purpose for the organization.
  • A mission statement answers questions like:
    • What are the core values, principles, and beliefs (i.e., what is really important?)
    • What are the organization’s strengths? Unique strategic advantages?
    • What is to be accomplished?
    • What are the interests and desires relating to constituencies:
      • organization
      • patients
      • employees – stakeholders
      • vendors
      • community
  • A mission statement provides general guidance.
  • A mission statement cannot be measured.
  • A mission statement is brief, concise, but comprehensive.  Align goals around the mission.
  • Clarifying the mission is an ongoing process.
  • When put on the wall, a mission statement will inspire the devotion of your employees and the commitment of your patients (customers).
  • A mission statement is compelling and pulls people toward them.
  • Success requires the capacity to relate a compelling image of a desired state of affairs – a kind of image that induces enthusiasm and commitments in others.
  • Vision through mission focuses attention on your critical strategic advantages.
  • A mission statement adds value to others.
  • A mission statement focuses attention on lofty aims with which everyone can identify.
  • A mission statement becomes a deep abiding belief, a rallying point that touches deeply the hearts and souls of everyone.
  • A mission statement incorporates components that both adds value to others and focuses on strategic advantages.
  • A mission statement creates energy by instilling purpose into others.
  • A mission statement provides meaning and purpose.
  • A mission statement allows you to recognize when off course so you can correct it.
  • There is more to a mission statement than just economics.  You must address higher needs like self-esteem, offering autonomy and responsibility at work.
  • A mission statement is bound by no preconceived limitations.  It inspires people to reach for what could be and rise above their fears and preoccupation with what is.
  • A mission statement starts with determining what you really care about and want to accomplish and committing yourself to it.  You can always develop expertise.  First, discover your preference.
  • The most productive team is the one in which every individual is important and in which every individual, at the same time, is committed to the common mission of the team.
  • Mission – an image of a desired state of affairs that inspires actions, determines behavior, and fuels motivation.
  • From values and beliefs comes missions.  From missions come the tasks that call for the most creative, productive efforts.
  • Alignment occurs when individuals perceive that contributing to an organization produces direct contributions to their personal mission…

The more opportunity an organization gives its people to align their missions with its own the more likely it is to succeed and survive.


Roots Before Fruits

Roots Before Fruits

(This is a cover letter for a report I wrote for a client after a consulting engagement.)

STRATEGY TO IMPROVE ORGANIZATIONAL EFFECTIVENESS

By Ronald A. Blue, Consultant

During my recent consulting engagement, my interviews with the administrator and clinical manager revealed a strong perception that there was a lack of focus in the practice, that doctors were “spread too thin”, and thus, didn’t have time to meet (i.e., not enough communication).

Specifically, I heard statements like “I don’t understand what they want”, and ‘We seem to have separate agendas”, and “He has his hands in too many things”, and “It takes forever to get a decision made”… I sensed a feeling of frustration and paralysis…that they were helpless to change anything or to stop the wheels from spinning in place.

In my experience, I believe this situation represents the rule and not the exception. What can be done to help resolve the pressing concerns and improve effectiveness going forward?

Well, the old cliché “It starts at the top” rings true.

PHYSICIAN/ CEO AS LEADER

Regardless of titles or desire not to have them, I feel the physician-owner must adopt the mindset of a chief executive officer. As “CEO”, he is the leader of the organization. He must communicate to everyone his professional goals and his vision for the type of practice he thinks he needs to have and what it takes to be successful. The “CEO” must keep the organization focused by constantly reinforcing his vision through ongoing communication.

More specifically, the “CEO” determines the right thing to do and thus defines what is appropriate. This includes providing direction in the areas of policy, budget, capital expenditure, planning, staffing requirements, and strategic development, As “CEO”, his emphasis should be on results and not methods.  He is the key decision maker regarding “macro” issues confronting the practice.

In effect, the management function must be delegated to the administrator by the “CEO”. Many physicians believe delegating is a bad thing…that it means loss of control.

Actually, the opposite is true.

Delegation expands control and liberates the physician from time-consuming, low priority activity that robs him of valuable time that could be spent on high leverage activity that only the physician can do, for example: learning new surgical techniques, seeing more patients, and more important, spending more quality time at home with loved ones.

Change and improvement begin with the leader.

ADMINISTRATOR AS MANAGER

The administrator must function as the manager. The administrator must be fully empowered with the effective authority to perform in congruence with the responsibility placed upon her to produce results.  The administrator’s responsibility is to develop the “micro” portion of the CEO’s “macro” design, develop the methodology to get results (doing things right), hold people accountable, measure results, and solicit appropriate feedback from those involved.

The administrator must be able to make decisions impacting daily operations and the CEO must refrain from intervening.

The administrator, too, must learn to delegate any task that someone else can perform equally as well or better, and concentrate on activity only the administrator can perform (e.g., managing and expanding the data processing function).

Also, it is incumbent upon the administrator to keep the CEO fully informed of key issues and concerns.  Thus, regularly held meetings are crucial and should be considered a priority.

LEADERSHIP/MANAGEMENT IS THE “ROOT”

Leadership and management must be in balance. The physician/CEO and administrator must, through mutual trust and understanding, come together as one… forming a synergistic bond.

I suggest this leadership/management paradigm I am describing, is the only viable way overall organizational effectiveness can be achieved. You cannot expect to bear “fruit” without first establishing the “root” and synergistic leadership/management is the “root”.

The prospect of successfully implementing the recommendations made in this report and realizing  the resulting “fruits”… is directly related to the depth of the root…and the depth is determined by the credibility of the commitment.

Credibility diminishes in direct proportion to the number of received mixed signals interpreted along the way, therefore, the physician/CEO must continually “walk his talk”.

Unless the physician/CEO is willing to wholeheartedly embrace this concept, unless he is genuinely committed to the process, unless he understands that delegation expands control rather than decreases it, and unless he is willing to empower the administrator to “carry the ball” after he has handed it off, the chance of achieving long-term, lasting change is not favorable.


Dr. Swale Talks About Visian ICL

Dr. Swale Talks About Visian ICL

Dr. Swale discusses the intricacies of the Visian ICL

Visian ICL is an innovative long-term implantable collamer lens that corrects nearsightedness.