o.d. to o.d.

The Secret to Flying High is a Well-Grounded Set of Lists.

Pilots use checklists for everything. This is a good piece of management advice that you can borrow.

BY WALTER D. WEST, O.D., F.A.A.O.
Chief Optometric Editor

From age 16 until 51, I flew my own plane. It started out as a boyhood goal that was initially a pastime that I enjoyed purely for pleasure. Through my years in undergraduate and optometry school, my flying was very limited due to a lack of funds. Once I established my practice, however, I returned to flying and advanced my capabilities with an instrument and multi-engine rating.

Through the years I've owned and flown several planes, the last of which was a Cessna 340A. I flew the 340A, with it's pressurized cabin and weather capabilities, around the country to all my speaking engagements for several years.

In 2001, I began to experience diplopia, which resulted from ocular myasthenia gravis. As a result, my practice and my flying career both came to an abrupt end. In practice, I could no longer use a binocular indirect ophthalmoscope or slit-lamp. As far as flying was concerned; well, it was just a little too sporty to pilot a plane using double vision.

A list for everything

So, as I write this month's column, aboard a Southwest Airlines flight in smooth air at flight level 330 (or for those of you unfamiliar with aviation, 33,000 feet), I'm reminded of lessons learned as a pilot that served me well in managing not only patients but the business of my practice.

One of the primary lessons new pilots learn is to use checklists. Checklists in the pilot world exist for everything. There's a checklist to inspect the aircraft before flight; a checklist to follow prior to starting the engines; a pre-taxi checklist; a takeoff checklist; an after takeoff checklist and cruise checklist. So you get the point — tons of checklists.

While the novice pilot sees a checklist as a way to avoid forgetting anything, the more seasoned pilot recognizes a checklist, first, as a process that defines a sequence of tasks that he must perform in order to achieve the desired result. And, second, a means to avoid overlooking any of the steps that go into the process.

The reason pilots use checklists so religiously is because if they don't accomplish certain tasks or do so in a specific sequence, scary stuff, such as crashing, can happen.

From planes to patients

The same reasoning holds true for managing patients in your practice. A checklist to ensure you've gathered all the appropriate diagnostic information for patients of a specific diagnosis can take the form of a customized recording form, or electronic template — if you're using electronic medical records.

As an example, a customized form or template for glaucoma guides you and your staff through the data gathering process while at the same time providing you with confidence. That is, when following the checklist, you'll be assured that you've gathered all the necessary data and in the correct sequence.

From patients to practice

Also, checklists serve you well in managing your practice. For example, if you and your staff follow a checklist when opening your practice in the morning, you'll be less likely to overlook important tasks, such as disconnecting the answering service or taking the phone system out of "night mode." Missing or delaying patient calls can hurt your practice.

Just as in piloting a plane, when managing a patient or managing an optometric practice without checklists, some scary stuff can happen. OM