reflections - THE HUMAN SIDE OF OPTOMETRY
Far and Away
Shannon's West African adventure, Part I of II.
J. SHANNON, O.D., SCOTTSDALE, ARIZ.
Click here to view Part II
had been invited to Ho, Ghana, West Africa, to work with the Miracle Life Clinic
on management issues. The manager of the facility was also the chief medical officer.
Educated in England, Dr. Archibald Lesta, MPH (Masters of Public Health), had a
vision to provide modern health care delivery and excellent patient care in his
city near a rain forest. Like so many health care providers, Archie had received
an outstanding education in his field, but very little education in business. I
suspect he had some unspoken concern that an optometrist from the United States
could be of much value to a clinic in Africa . . .
Cut to the chase
"How are you doing financially," I asked on the
morning we met for the first time. "Great!" was his smiling reply. "Great!" echoed
his office manager.
Proudly the doctor showed me his very
expensive state-of-the art-equipment.
"How often do you use the Blood Analyzer?"
I asked the technician. "About twice a month," was the reply. "And how often do
you use the Ultra Sound?" "Maybe a little more often," he answered.
Neither Dr. Archie nor his accountant
had a basic understanding of expense issues that even though paid for, the
equipment had a continuing financial impact on the practice: depreciation, useful
life of the equipment, return on investment.
We discussed the basic business formula:
Profit equals Revenue minus Expenses. They knew their daily revenue, but only assumed
revenue was greater than expenses. I gave the accountant a list of typical business
expenses and assigned him to determine all expenses of the clinic. He looked quizzically
at Dr. Archie, who nodded.
Then I went to the office manager.
"How often do you do staff training?" I asked. "We tried it once, but it didn't
work," she replied.
The patients received prompt, quality
health care, much better than in most of Africa, but when the accountant completed
his expense calculations, it became obvious the financial health of the clinic soon
would be terminal.
Bring in the staff
I spent the first days learning the practice,
working with Dr. Archie and his staff. They were quick to grasp the issues and even
quicker to implement solutions. Anything we discussed on Tuesday was put in practice
The clinic included a pharmacy for
frequently used medications. Everything was stocked in bulk, and I noted that when
a new supply of pills arrived, they were poured in on top of what was already in
the big bottle.
"How old are the pills left in the
bottom of the bottle?" I asked. I explained the concept shelf-life and FIFO (first
in, first out). A look of understanding crossed the nurse's face. "I will take care
of it." And she did.
I stressed to Dr. Archie the need to
communicate with the staff, to make them part of the decision-making process. From
my private discussions with them, it was obvious that the staff knew how to improve
things, but had no opportunity to do so.
Next month, doctor and staff begin
to communicate and the prognosis is excellent.
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Optometric Management, Issue: August 2005