Article Date: 12/1/2010

“Uneasy Lies the Head That Wears the Crown”
o.d. to o.d.

“Uneasy Lies the Head That Wears the Crown”

Optometrists toss and turn over any number of anxieties, including those related to competitors, staff and Uncle Sam.

By Walter D. West, O.D., F.A.A.O., Chief Optometric Editor

What keeps an optometrist awake at night? William Shakespeare said it precisely in Henry IV, Part 2: “Uneasy lies the head that wears the crown.” In that play, the king's son plots to replace him, possibly by killing him. Today's optometrist doesn't usually worry about losing his crowned head by assassination. Probably the most common reason an optometrist tosses and turns at night is the worry that an ambitious competitor is anxious to take the old king's place.

The optometrist may also mull over the elusive bottom line, or a barrage of finance-related questions: Is the practice making money? Is the practice growing well? Have capital investments in new equipment paid off? Is the amount of money going out exceeding the money coming in? When the practice booms, when is it time to add to staff? When practice ebbs, when should staff cuts start?

Unanswered staffing questions

In practices at which great responsibilities are delegated to staff, the optometrist can lose sleep worrying about the retention of qualified staff. Are the staff individually or as a group stonewalling on taking on more responsibility? Is the relationship with the optometrist's staff deteriorating to the point at which individuals may begin to leave the practice looking for other career opportunities?

If a problem exists with the relationship between the optometrist and his/her staff, how can it be settled before severe damage is done to the practice's ability to attract new patients and retain existing patients? If key staff members leave the practice, can the optometrist recruit appropriately trained replacement staff, and if so, at what cost?

An unkind public perception

Many times, the general public considers all physicians, including optometrists, as grossly overpaid fat cats who just sit around making “important” phone calls, holding “big-shot” meetings, giving “brilliant” orders and looking very important. As for the overpaid part, an observer merely needs to look at recent attempts at reducing physician reimbursement by Medicare to appreciate the tenuous nature of any physician's salary.

Today, growing public resentment appears regarding what is perceived by the ever-suffering consumers of healthcare services to be an unfair rise in healthcare costs, which are directly related to what they perceive as exorbitant salaries charged by hospitals and physicians. This perception is fueled by the current administration's labeling of those whom they designate as “wealthy.”

Your worst nightmare?

Therefore, despite the fact that many of today's optometrists are making higher incomes than ever before, they probably all spend some sleepless nights on their mattresses (which aren't actually stuffed with money). And, even if they do manage to get some sleep, in their worst nightmares, the government is attempting to fund healthcare reform, and reduce the federal deficit, with the monies taken from their pockets. These pockets belong to those men and women who are the owners of the small businesses (practices) who at the same time, have been identified by the government as the same group who will carry us out of the current recession. OM

Optometric Management, Issue: December 2010