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John B. Pinto
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ISBN: 978-1-63091-959-7
© 2022 SLACK Incorporated with the kind per-
mission of the author, John B. Pinto. All rights
reserved.
John B. Pinto is an ophthalmology practice management consultant in his firm, J. Pinto & Associates, Inc.
Dr. Richard L. Lindstrom has not disclosed any relevant financial relationships. Dr. Craig N. Piso has no
financial or proprietary interest in the materials presented herein.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in
any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without writ-
ten permission from the publisher, except for brief quotations embodied in critical articles and reviews.
The procedures and practices described in this publication should be implemented in a manner con-
sistent with the professional standards set for the circumstances that apply in each specific situation.
Every effort has been made to confirm the accuracy of the information presented and to correctly relate
generally accepted practices. The authors, editors, and publisher cannot accept responsibility for errors
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and Administration or FDA. Each professional should determine the FDA status of any drug or device
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Dedication
This book is dedicated with affection to the world’s roughly
50,000 ophthalmic practices … and their respective 200,000
ophthalmologists, million-plus support staff, and seven billion
potential patients.
My deepest gratitude for allowing me the opportunity, over
the last 40 years and all the years remaining, to simultaneously
be a student and a teacher within this elegant, confounding,
evolving, and marvelously deep profession.
Contents
Dedication............................................................................................................................. v
Acknowledgments.................................................................................................................ix
About the Author.................................................................................................................xi
Foreword by Richard L. Lindstrom, MD.........................................................................xiii
Introduction......................................................................................................................... xv
Chapter 1 Testing Your Practice on Twenty-Five Simple Things................................ 1
Chapter 2 The Big Picture................................................................................................. 5
Of the Five Domains of Practice and Life
Of Paying Attention
Of Career Management
Of the Intentional Practice
Of Practice Culture
Of Vanquishing Chicken Little
Chapter 3 Leadership...................................................................................................... 25
Of Simple Leadership
Of Decisiveness
Of Prioritizing and Implementing
Of Teamwork
Of Abandoning Failed Projects
Of Strategic Business Planning
Chapter 4 Adaptability.................................................................................................... 43
Of Ophthalmology Then and Now
Of Sustainability
Of Disaster Planning
Of Entrepreneurism
Of Adaptability
Chapter 5 Metrics............................................................................................................. 65
Of Numeracy ... Mastering Math as a Second Language
Of Measuring Efficiency
Of Growth, Stasis, and Shrinkage
Of the Three Buckets of Money
Of Objectifying That Which Is Subjective
Of Benchmarking
Of Financial Sufficiency
Of Staff Cost Containment
Of Frugality
viii Contents
Chapter 6 Administration and General Management.............................................. 101
Of Developmental Hallmarks
Of Practice “Birth Defects”
Of Administrative Success and Failure
Of Patient Satisfaction
Of Coaching Points From Managers to Physicians
Of Provider Performance Reviews
Of Marketing and Selling
Of Office Facilities
Chapter 7 Compatibility and Collaboration With Others........................................ 129
Of Adding Value to Patient Relationships
Of Working With Family Members in Your Practice
Of Optometrist Associates
Of Meetings
Of Conflicts
Of Physician Bullying
Of Collaboration
Of Mergers and Acquisitions
Chapter 8 Partnering..................................................................................................... 153
Of Partnership
Of Adding a New Doctor
Of Happy Partners in a Group Practice
Of the Associate Doctor Becoming a Partner
Of Acting Like a Partner
Of Fixing Broken Practice Boards
Chapter 9 The Inner Game........................................................................................... 169
Of Measuring Success
Of Excess Attachment to One’s Career
Of Provider Burnout
Of Career Satisfaction
Of Security
Of Retirement
Afterword: A Psychologist’s Perspective on the Inner Game........................................... 185
of Ophthalmology by Craig N. Piso, PhD
Last Word: Pinto’s Ten Commandments.......................................................................... 189
Acknowledgments
To My Teachers
Mom and Dad and Sister Laura
Miss Short
A Four-Inch Rainbow Trout
Mr. Hassan
Camp Fox and the Midnight Cot Caper
Grant Neely
Boyd Smith
Osiris
Julie R.
Sierra Nevada
Hemingway
Mescalito
Paul Saltman
Bob Holly
Henry David Thoreau
The First Third of El Capitan
Gibran
Big Al Kildow
Jonas Salk
Francis Crick
Paris
Madame Atger and Jean-Philippe
S/V Chrysalis
Sir Francis Bacon
The Pacific Ocean
E. F. Schumacher
Samantha
Jim Rohn
Doug Simay
David Schneider … and belatedly, golf
John “Ain’t Done Crashin’ Yet” Corboy
Whitney and Graham
Lucy Santiago
Michel Arowns, Martine Cartier et Familles
Dick Lindstrom’s Generous Mind and Cellar
The Crane Meadow Lodge Follies
Rioja in Boston
Craig Piso’s Healthy Power
The Black Beast
The Zafu
The Ukulele
And Mom … again
About the Author
“Life Is Only Teaching and Learning.”
John B. Pinto is the most-published author in America
on ophthalmology practice management topics. He founded
J. Pinto & Associates, Inc, an ophthalmic practice manage-
ment consulting firm, in 1979. Since then he has provided
strategic planning, operations, and marketing advice to
pharmaceutical companies, basic science centers, hospitals,
multispecialty clinics, and single-specialty facilities.
For over 40 years, a majority of the firm’s service has
been to ophthalmic practices ranging from small solo prac-
tices to high-volume market leaders, teaching centers, and
ophthalmic product companies. He has been active as a
practice consultant in North America and Europe, and has
worked and lectured in South America and the Far East.
Pinto is best known as a strategic planning and economic advisor to practices large
and small. In addition to covering most dimensions of modern practice operations
management, he is a career advisor—providing individual coaching and contract ne-
gotiation services to new graduates and midcareer ophthalmologists. His professional
life today is rounded out with succession planning, practice valuations, partner dispute
mediation, merger/acquisition counsel, and leadership development for administra-
tors and physicians.
A prolific writer, Pinto is the author of several books beyond the text you now
hold:
• John Pinto’s Little Green Book of Ophthalmology
• Turnaround: Twenty-One Weeks to Ophthalmic Practice Survival and Permanent
Improvement
• Ten Eyecare Practices: Benchmarks for Success
• Cash Flow: The Practical Art of Earning More From Your Ophthalmology Practice,
written with Anne Rose
• The Efficient Ophthalmologist
• Legal Issues in Ophthalmology: A Review for Surgeons and Administrators, written
with Alan Reider and Allison Shuren
• The Women of Ophthalmology, written with Elizabeth Davis, MD
• Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and
Teams
• Marketing Your Ophthalmic Practice
Many of these titles are now published by SLACK Incorporated and can be or-
dered by going to www.slackbooks.com.
xii About the Author
John is a member of the editorial board of Ocular Surgery News and a regular
contributor to other eye care publications. He is available for individual physician and
practice consulting services to supplement this book. Please contact him at:
J. Pinto & Associates, Inc.
2926 Kellogg Street Suite B18
San Diego, CA 92106
619-223-2233
[email protected]
www.pintoinc.com
Foreword
Choose the life that is most useful,
and habit will make it the most agreeable.
—Sir Francis Bacon
As ophthalmologists, we are experts at complexity. We excel at minutia. We parse
and re-parse the smallest details.
That’s great for our patients, and terrific intellectually, but sometimes it’s not so
great for our medical practices—where seeing the big picture and keeping things sim-
ple is the key to business success.
For most of 4 decades, John Pinto, our profession’s “ophthalmologist-ologist” and
leading advisor, has studied our strengths and our weaknesses and helped an interna-
tional community of surgeons deal with our ever-growing business and organizational
challenges.
This new book, Simple, is exactly that. Whether you are in the first or the last
5 years of your career as an ophthalmologist, the maxims and truths in this book will
help you be more successful.
John has distilled some 50,000 hours of on-site consulting work throughout
America and the world into those factors and professional habits which—once mas-
tered—will decrease the frustrations and uncertainties felt by all of us as practice own-
ers and leaders.
—Richard L. Lindstrom, MD
Minnesota Eye Consultants
Minneapolis, Minnesota
