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President's update: Sept/Oct 2017

Posted By Chet Seward, Sunday, October 15, 2017
What to do with your practice amidst all the turbulence in health care coming from Washington, DC? Many others ask this question, as one-sixth of US economic activity flows through the health care ecosystem. Uncertainty in the fate of the individual insurance markets, and Medicaid cost sharing with the federal government, all create problems closer to home at the state-government level. Furthermore, MACRA and MIPS bonuses and penalties loom on the near horizon for physicians directly.

I invite you to imagine what is possible, and importantly, under our own control, when we shift the focus of health care reform and value-based care from externally imposed to internally driven improvements. By working upon your own practice, you begin to solve the challenges that characterize your practice’s unique combination of strengths and weaknesses. There is plenty to do to improve your practice for intrinsic reasons, but also to survive the transition from fee-for-service to value-based payments. Inefficiencies within your practice are a threat to your practice, like never before.

The foundation for physician-directed practice improvements rests upon three pillars: autonomy, mastery, and purpose. Much has been written lately about these elements relating to “physician engagement with work.” We need to find these three elements in our daily work, and over the course of our professional careers, to ultimately find fulfillment. Activities that do not feature these three principles, especially for high-achieving professionals like ophthalmologists, lead to frustration, and ultimately increase the risk of burnout.

When working hard to create your own solutions to problems, you find pleasure in the exercise of autonomy. As your practice becomes more proficient, the pleasure of mastery is manifest. A higher-performing practice allows the individual and organization to fulfill its purpose. Yes, it is possible to find joy in our work, rooted in these three supports.

What does this look like in practice? The choice of solo versus group practice boils down to how strongly one values autonomy. There are definite trade-offs to either choice. For some, achieving mastery is found by working alone, while for others, mastery is better enabled through the advantages of a group practice. Whether in solo or group practice, a lifetime of feeding one’s curiosity, and an ethos of continual learning and self-improvement eventually leads to mastery. At a minimum, one must continually evolve their clinical and surgical skills, as well as basic business skills – but at some point in one’s career, we grasp the importance of community and advocacy to achieve a higher purpose – service to others.

As president, I highlight that CSEPS is the cement of this foundation. CSEPS provides opportunities to create vital social bonds with like-minded professionals. CSEPS also provides forums to learn from outside experts, such as AAO Past-President Ruth Williams’ cutting-edge talk on private equity last month. Finally, CSEPS is the only purpose-built organization that exists to defend our professional autonomy, supporting our individual and collective efforts to achieve professional mastery, and ultimately fulfill our purpose as healers.

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