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Avoiding Burnout in the Age of High Volume and High-Stress Optometry

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THE PACE OF HEALTHCARE has changed. Doctors are tasked with seeing more patients in less time. Additionally, performance is evaluated by productivity goals that often hinge on a more is more model. As insurance reimbursements continue to decrease, we see the proliferation of high-volume optometry where clinicians see double to triple the amount of patients typically seen in traditional private practice settings.

What is burnout? Burnout is a result of chronic stress which manifests in psychological and physiological ways. Common symptoms include emotional and physical exhaustion, cynicism, a feeling of being overwhelmed, a lack of connection to your work, and decreased performance and productivity. Long-term burnout can have more serious consequences including chronic fatigue, anxiety and depression.

Burnout can also negatively affect patient care and professional success. A 2016 study of physicians at the Mayo Clinic found burnout and declining job satisfaction to be directly correlated with decreased professional effort and oftentimes a move to part-time employment. We see this same shift in optometry as burned out clinicians turn over or decrease their number of practicing days thus limiting patients’ access to care.

This type of optometry is here to stay as we deal with a growing population, reimbursement factors beyond our control, and large optometry student loan debt. However, we can be smart about avoiding burnout in a high-volume setting.

Know The Warning Signs

Recognizing early stages of burnout is key. Are you becoming emotionally exhausted? Are you becoming more tense, worried, or irritable with your patients and staff? Do you dread going to work or find yourself becoming cynical? These feelings are early warning signs of burnout. Confront them at the onset by reconnecting with your “why” and what drew you to your setting. Maybe gaining clinical experience is your main objective or the increased pay is helping you tackle financial goals. Shifting to this larger perspective creates an emotional shift and helps stop burnout.

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Discover Your Prime Productivity Hours

It’s imperative to be efficient with your time. We are all uniquely wired and have different hours for peak productivity. Based on your natural rhythm, learn when you function best and look for a job that fits within those. Don’t be afraid to talk to your boss about changing hours to be more beneficial for you and the practice. Burnout is more likely to occur when you’re operating against your natural rhythm.

Optimize Your Energy

In high-volume settings it is common to feel emotionally and physically drained. Offset this by paying attention to your lack of energy, one of the body’s physical symptoms of burnout. Focus on keeping your energy high by eating right, working out regularly, getting enough rest, and investing time in a hobby. High level functioning requires high levels of energy. Burnout depletes your internal battery and it’s your job to recharge daily so you aren’t operating at an energy deficit.

Know Your Limits

If your current mode of practice is causing burnout you can’t shake, perhaps it’s time to consider switching to a more sustainable environment. Not everyone has the stamina to practice in a high volume setting and your health is more important than a paycheck. The beauty of optometry lies in the variety. It’s possible to create the perfect job for yourself where you feel competent, supported and healthy.

Dr. Danielle Richardson practices in Houston with Texas State Optical and runs a holistic wellness company, Fierce Clarity. She is a registered yoga teacher and hosts wellness retreats, yoga classes, and pop-up events for busy, professional women to help manage stress and avoid burnout. Follow her on Instagram at @fierceclarity

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Forget Opinions, Measure the Hard Facts and Data to Improve Your Business

In the end, it is the least expensive and most productive business tool in your arsenal.

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THERE’S A BUSINESS axiom that says if you want to improve something, measure it. The sheer act of quantifying an issue and then determining how to improve its outcome incrementally, will itself create improvement.

W. Edwards Deming, the father of continuous quality improvement, believed that management decisions should be made using facts and data; and that successful managers use that data to best understand customers and their ever-changing expectations of goods and services.

The contrast is making decisions based on opinion. I believe that this is done far too often by optometrists and managers in our industry and these are the reasons why:

It’s easy. What could be more comfortable than offering your opinion about patients’ preferences and behaviors? In some ways, it just makes sense. You spend all day, several days a week observing people in your practice. Naturally, your opinion is enough on which to base your decisions.

It’s popular. Everyone has an opinion. The dilemma is when team members’ views conflict with one another. Whose opinion is correct? Usually, it defaults to the person with the most authority. When this happens, you can diminish the perspective of others.

It’s cheap. Opinions are free. You don’t need to go to the expense of both time and money to gather facts and data. Why go to all of that time, effort and spend money when your opinion will do the job just fine? However, a decision based on belief and not facts can be the most expensive decision you’ve ever made.

Recently, I was working with a young optometrist to open his first practice, and as you can imagine, he was full of enthusiasm and confidence in his opinions. He had classmates that had started new practices. What could be so difficult?

Of course, he had an opinion about his location. He had already determined where he wanted to open his new office. When I pointed out some of the challenges this selection would create, he wouldn’t be dissuaded. It had everything he believed, in his opinion, that was critical to a successful location.

It was close to where he wanted to live. It was half the price of locations in areas with much higher traffic patterns, and there were no other optometrists within a five-mile area. In his opinion, this location was ideal.

I explained to him that selecting the right location is probably the most critical first step in building a successful practice. That he should consider the households in the area, the exposure that a site will provide his new office, and that is all a part of what you pay for in lease payments. Basing this decision on his opinion is an example of how expensive a wrong decision can be.

Another practice data area that is neglected is the retention of patients. We don’t measure the percentage of patients we saw a year ago that return in twelve months. Why would we? We are great at what we do, why wouldn’t they return?

After all, we sent them a postcard telling them it was time to come back for an appointment.

The office most successful at retaining patients that I know measures and reports to the team each week the percentage of recalled patients who booked an appointment. They have learned that success in this area requires a phone call to follow up on those who do not respond to their postcards, emails, and text messages. The OD/owner is proud that 87.3 percent of their recalled patients return for their annual exam and he is still working on improving this percentage.

Managing your business using facts and data is crucial. It takes the emotions, personal perspectives, and biases out of making improvements. In the end, it is the least expensive and most productive business tool in your arsenal.

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Editor's Note

Size Matters … The Bigger the Better

And addressing some other sensitive subjects you might encounter in the workplace.

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AND THE BIGGER the better as far as I’m concerned. I have no problem admitting I am a size queen. I love a BIIIIIG … survey. The more data the happier I am. So, I got a lot of pleasure out of seeing the results of our first Big Survey and wow did it provide some insight. There is a lot to unpack there and you can see everything we found starting on page 34. This is the first of many to come and I’m excited to see how this survey evolves from year to year.

The answers were of course anonymous but there is one more thing I need to say: breastfeeding or having a pregnant employee’s water break at work are not weird things employees have done. Those are natural and unavoidable. If you answered something in this vein to the question “What is the weirdest thing an employee has done at work?” perhaps you need some sensitivity training and to take a very close look at yourself. Ok, rant over.

You know what amused me in this issue? The number of people cutting their nails at work — for the record, that is weird and gross (page 70) — and that so many of you consider your best and worst habit one in the same!

Also, rarely does a Real Deal generate the sort of response this issue’s did – The Case of the Concealed Concern on page 72. I know the gun debate is a hot topic and in a magazine with as broad an audience as INVISION’s there is no way we are all going to come down on the same side of an issue, but except for one slightly over the top (and poorly written) response, all the points of view we received were measured, well-executed and logical. This one really got you thinking, so if you haven’t read it or addressed this issue in your business, I encourage you to review it and discuss.

Best wishes for your business,

Dee Carroll

EDITOR-IN-CHIEF

dee@invisionmag.com

Five Smart Tips From This Issue

1. Start a movement. Resurrect a one-off holiday celebrating opticians. (Calendar, page 20)
2. According to our Pop Quiz, 58% of you are anti-flu shot (page 71). So, be flu ready with an in-office flu kit. (Tip Sheet, page 58)
3. Want to know how to get to the root of a candidate’s strengths and weaknesses in the interview? We’ve got some ideas. (Ask INVISION, page 62)
4. Everyone loves a party… that’s how you “get to show them up” to your in-store events. (Line Time, page 66)
5. The perfect way to harness the power of the modern consumer’s self-absorption to benefit your business. (Benchmarks, page 68)

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Danielle Richardson

A Case for Yoga

Let go of any preconceived notions… yoga is for everyone.

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I KNOW, I KNOW — yoga is not for you… but let me stop you right there. Yoga is truly for everyone! Yoga is finding its place in the mainstream as 1 in 7 American adults reported practicing yoga according to a 2017 survey.

However, as the number or practitioners continues to rise, so too does the number of people who feel alienated by yoga. Social media has warped the perception of this ancient practice into something that more closely resembles gymnastics or acrobatics. This shift distances many would be practitioners because of feelings of not being “flexible” or “fit” enough. I’m here to tell you that’s BS! This article is to make the case for yoga and its inclusion in your wellness routine.

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The true origin of yoga can be disputed, but the most popular types of yoga in the West are derived from a 5000-year old Indian philosophy system and body of knowledge. Yoga takes a holistic view of the human experience and consists of practices to unite the mind, body, and soul. Yoga extends beyond physical movement to combine meditation, self-discipline, and breathing practices to achieve optimal health and wellbeing. Below are a few things to remember about yoga:

Yoga is for everyone. Contrary to popular belief, yoga does not require fancy tights or expensive studio memberships. Additionally, you don’t have to overhaul your life or become a Himalayan monk to practice. The only requirements for yoga are your body and your breath. Yoga is most often practiced on hard wood with a mat or blanket, but carpet is suitable as well. Yoga can also be made accessible to those with disabilities using chairs and props for modifications. There truly is something for everyone.

Beginners are always welcome. There are plenty of resources available for new yogis. You can go the in-person route and sign up for a new student special at a local studio. Local yoga studios often have classes designed for beginners where you can receive in-person guidance and personalized tips to make the practice more comfortable. Additionally, you can use online beginner yoga videos on YouTube via my channel “FierceClarity” or another excellent source like “YogaWithAdrienne.” My recommendation is to begin once per week and gradually increase frequency. There is no right or wrong amount of yoga to do, but the longer you stick with the practice the more benefits you will see.

Yoga has real benefits. According to The National Center for Complementary and Alternative Medicine, an NIH affiliate, research shows yoga may help relieve stress and chronic pain, manage chronic disease symptoms, and even aid in smoking cessation. Other studies have found yoga to successfully decrease inflammation, improve heart health, and improve some symptoms related to anxiety and depression. Additionally, yoga aids in weight loss and can help maintain a healthy weight when practiced regularly.

I started practicing yoga at the end of optometry school when I was burned out and sick from an unhealthy lifestyle. This simple practice has changed my life for the better. I became so passionate about it that I now teach yoga to others. I hope you will let go of any preconceived notions and give yoga a try. It is a rich tradition with several different styles and teachers. Be like Goldilocks and experiment a bit until you find the yoga that is just right for you.

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