32 AE Fall 2010

desk person, a billing person, and anadministrative assistant. TheUniversity of Minnesota Departmentof Ophthalmology allowed me toinvite my former patients to transferto another doctor at the Universityor see me in my new office.Fortunately, I was busy clinicallyfrom day one, and with supportfrom the Phillips Eye Institute I wasable to create a research laboratoryand continue with my educationalgoal of surgical skills transfer teach-ing for practicing ophthalmologists.

I was able to manage the prac-tice myself with help from my very

In October 1989, after a decadeon the full-time faculty at theUniversity of MinnesotaDepartment ofOphthalmology, I decided to

open my own private practice. I bor-rowed $400,000 against my home,leased 1,500 square feet of space,equipped four lanes, and acquiredthe necessary diagnostic equipmentto support my consultative practicein cornea, external disease, complexcataract surgery, and glaucoma. Ihired six employees: two very experi-enced COMTs, a nurse who hadworked with me for years, a front

A Superior Practice AdministratorFacilitated Our Success

Running the Practice MD Perspective

Richard L. Lindstrom, MD

experienced team of employees. Ialso engaged Bruce Maller and histeam from BSM Consulting from thestart to serve as an advisor, and thishas proven invaluable for more than20 years. While I did not know it atthe time, those first two years in soloprivate practice were destined to bethe simplest and most carefree of mycareer.

True to my basic personality (orperhaps I should say pathology), Isat down with Maller and developeda business plan that focused on cre-ating the largest anterior segmentconsultative practice in the 50-milecircle surrounding Minneapolis andSt. Paul. I hired three additional cli-nicians, and we all worked hard, pro-viding quality care, teaching our col-leagues, and working in our own lab-oratory and with industry develop-ing the next generation of drugs anddevices. We became Lindstrom,Samuelson, Hardten, and Associatesand continued to grow in patientvolume, teaching commitment, andindustry collaboration.

To strengthen our offerings weadded our first comprehensiveoptometrist to the practice, anotherdecision that has proven to be ofgreat value, and with 12 optometristsand 12 ophthalmologists we are nowa leading example of a practiceapproach that I call theOphthalmologist Lead IntegratedEyecare Delivery Model. With thehelp of my loyal and hard-workingadministrative assistant, Brenda Boff,and the advice of Maller and hisassociates, I continued to managethe practice, but signs of stress werebeginning to appear. It was becom-ing obvious to me that I was over-

Recruit the best of the best, empower them tosucceed, treat them well so they stay, and rewardthem so they are personally highly motivated. If youdo so, you and your practice will be richly rewarded.

AE Fall 2010 33

committed, and there were just notenough hours in the day to meet allthe demands on my time. It wastime to look for an administratorwho could help us pursue and actu-alize our vision.

I had always been associatedwith ASCRS as a member from theinception of the organization, so itwas natural for me to turn to ASOAfor guidance in selecting an adminis-trator. I learned that a former presi-dent of ASOA, Candice (Candy)Simerson, worked for another prac-tice in our area. Her credentials, tal-ent, work ethic, and experiencemade her the ideal person to recruit.We met and discussed the opportuni-ty. I remember promising Candy thatshe would never be bored and thatshe would be rewarded proportionalto her contribution.

Following her addition to thepractice, we decided to rename our-selves Minnesota Eye Consultants,held an extensive planning retreatagain moderated by Maller, andrededicated ourselves to our originalvision. We have now grown fromone surgeon, one office, and sixemployees 20 years ago to seven sur-geons, five medical ophthalmolo-gists, 12 optometrists, two fellows(one MD and one OD), 12 offices,and nearly 180 employees. We owntwo ambulatory surgery centers (inMinneapolis and St. Paul), and oper-ate eight optical shops and one hear-ing center. With Simerson andMaller at our side, we have been intoand out of a Physician PracticeManagement Company. Five yearsago, after 15 years as managing part-ner and CEO of Minnesota EyeConsultants, I elected to step downfrom this position, and my associ-ates, in turn, have assumed the man-tle of managing partner and CEO.

In a practice like ours, this posi-tion is truly a growth experience foranyone who assumes the responsibil-ity, and it is both rewarding andgratifying for me to see my associates

rise to the challenge and grow fromthe experience of managing a largeand complex business. The availabili-ty of a superior practice administra-tor who now operates as presidentand chief operating officer of ourpractice has continued to facilitateour success. My personal experiencein selecting a practice administratormirrors my experience in selectingan ophthalmologist partner: Recruitthe best of the best, empower them

to succeed, treat them well so theystay, and reward them so they arepersonally highly motivated. If youdo so, you and your practice will berichly rewarded. AE

T he business aspects of manag-

ing an ophthalmology practice

have become increasingly com-

plex over the past several decades.

The onslaught of new government

regulations has become the norm,

while the increasing penetration of

managed care has created unique

challenges in trying to enhance pro-

ductivity and efficiency. The simple

fact is that most ophthalmologists do

not have the time, energy, or expert-

ise to successfully navigate these

waters.

During my career as a consultant

I have observed that the most suc-

cessful practices employ a high-quali-

ty practice administrator. This individ-

ual generally has a strong back-

ground in managing people and proj-

ects. S/he understands the impor-

tance of business planning and team

development while being able to

effectively “manage up” with the

physician owners.

While the search for the right

candidate can start either inside or

outside the four walls of the practice,

finding the right person for a practice

requires a clear sense of the position

requirements and associated skills

necessary for the job. A working

knowledge of accounting and finance,

the ability to assess the economic

Hiring a Quality AdministratorBruce Maller

impact of practice-related issues, and

the ability to communicate these

issues clearly and concisely, thereby

enabling the physician owners to

make better decisions, are essential

to success in the role. Other key suc-

cess factors in the role include one’s

level of emotional maturity, the ability

to exercise good judgment, a commit-

ment to training and development,

and sufficient experience in medical

practice administration. The Certified

Ophthalmic Executive (COE) designa-

tion provides an excellent opportunity

for skills development; however, there

is no substitute for on-the-job training.

Because a capable administrator

can play an important role in the prac-

tice’s success, an upfront investment

in finding the right candidate can pay

big dividends for many years to

come. In addition, providing the right

environment with a functional gover-

nance structure and an open and

honest relationship between the

physicians and practice administrator

will enable the practice to achieve its

long-term vision.

Bruce Maller (800-832-0609; bmaller@bsmcon-sulting.com) is presidentof BSM Consulting inIncline Village, Nev.

Richard Lindstrom, MD (rllind-strom@mneye.com), isfounder of Minnesota EyeConsultants in Minneapolis,Minn.