The CEO Mindset: Decisions and Risks
While clinical care requires high certainty and a "do no harm" philosophy, business leadership necessitates taking calculated risks. True leadership often involves making pivotal decisions with only 60% to 70% of the available information. While clinicians are trained to be concise and clear with patients, the CEO must be comfortable with the unsure nature of business growth, moving forward even when the path isn't fully lit.
To succeed, practitioners must also embrace the reality that they are in sales the moment they start a practice. Sales is not a bad word; it is the vehicle through which an eyecare practitioner communicates their value and the value of the practice to the patient.
Myopia Management as a Clinical and Business Strategy
Myopia management serves as a prime example of how clinical expertise and business structure intersect. Our practice has adopted a stance where every child receives a comprehensive vision plan exam that includes topography, auto-refraction, and axial length measurements.
The transition from measuring diopters to tracking axial length is a shift in clinical belief that mirrors the shift from clinician to CEO. Eyecare practitioners can use tools to offer parents a crystal ball view of their child’s ocular future, making the intervention a logical and necessary decision rather than a difficult sale.
Creating "The Show"
Successful clinical practice is one where every encounter matters. Patients can feel the difference when a practitioner is genuinely curious and engaged. Our motto is "every patient, every time, every encounter." This emotional intelligence builds a modern reputation, serving as a modern business card through Google reviews and word-of-mouth.
Whether a patient calls with a question about myopia management or walks in with an outside script, the entire team—from the front desk to the optical trainers—is knowledgeable and ready to facilitate a 5-minute conversation that could lead to life-changing myopia treatment.
Here are my specific philosophies and leadership strategies that directly apply to orthokeratology (ortho-k) and myopia management in a clinical practice.
The first hurdle is internal: Providers must stop viewing myopia as a simple refractive error and start seeing it as a medical condition that requires intervention. Transition your brain from treating diopters to tracking axial length.
Standardized Clinical Protocols
"Simple scales, complex fails" is a guiding principle for implementing myopia management. Every patient in the practice should receive a standardized suite of tests to include topography, auto-refraction, and axial length measurements.
Communication and Parental Trust
The clinical encounter is a "show" where the eyecare practitioner’s primary role is to be a clear decision-maker. By using axial length and oculometric calculators, you provide parents with a visual endpoint of where their child could be at the age of 18 if no action is taken.
Never prejudge a parent's interest or financial status. For any treatment plan, whether it is low-dose atropine, ortho-k, soft lens, or myopia spectacles, ensure all decision-making caregivers are present or fully informed to ensure the treatment is approved and they are ready to move forward and be involved with treatment.
Building an All-In Team
Myopia management is not just a task for the eyecare practitioner—it requires a fully knowledgeable staff.
Train specific staff members who love the category to be the dedicated ortho-k trainers or myopia coordinators. Ensure everyone knows how to identify a candidate. For example, if an 8-year-old walks in with a –2.00 D script, the staff should immediately provide a pamphlet and suggest a consultation.
Think Like a Patient
Successful practices focus on the emotional intelligence of the patient experience. Use the 10 minutes in the exam lane to be genuinely curious about the patient's life. This builds the trust necessary for parents to commit to long-term, specialized myopia treatments like ortho-k. To honor our commitment to our young patients, we take a Polaroid picture of every child to build our "wall of kids," signaling to new parents that the practice is a specialized, child-friendly hub for myopia care.
At the end of the day, remember that it is not up to you to decide if this treatment is important to the patient or the parent. Instead, it is your responsibility to present the options. You have to believe in what you are doing and know you are making a difference. Celebrate every “yes” and look at every “no” as a “not right now.”
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