Viewpoint FROM THE CHIEF MEDICAL EDITOR

Diminishing Returns

Larry E. Patterson, M.D.

Lately, we can't avoid hearing constant pronouncements from economists, politicians, and the media about the sorry state of our economy, both here and abroad. Many of us have noticed the effects in our practices. LASIK numbers are down. Premium IOLs are a tough sell. I even noticed a drop in optical sales in my practice for the first time in 20 years.

You may recall that last month I discussed how cataract surgery has evolved over the years. Every time there's a breakthrough, we promptly ask more of ourselves. Early on, just replacing an opacified lens was enough to make patients happy. Nowadays, we have to perform small-incision sutureless extracapsular surgery that achieves emmetropia, avoids astigmatism, restores accommodation and minimizes patient discomfort. It's great to raise the bar on our aspirations. But don't forget that we're still achieving something amazing every time we replace a cloudy lens with an IOL. There are diminishing returns after that.

Everything has diminishing returns, even income. Especially income.

Maybe your income is going to go down a bit this year. Will that be so bad? A few years ago I was amused at one of our national meetings when I attended a lecture entitled "Getting by on $150,000 a year," or something like that. They were pointing out that you can make less money, and still be happy. Is that really true? Well, in a nutshell, yes.

Several studies have been published under the general theme, "Can money buy happiness?" The answer is that it does — but only to a point. These studies showed that if income increased from $20,000 to $50,000 per year, people were happier. Makes sense: suddenly an unexpected plumbing bill doesn't throw you into a financial crisis. But somewhere between there and $90,000, it leveled off. Once you earn enough to cover your basic needs, being much richer doesn't make you much happier. Since very few of us (except "refractive only" docs) are in jeopardy of falling to that level, here are some things to keep in mind.

For most families, two cars are enough. The Infinity will do just as well as the Ferrari. (And, yes, the Nissan will do just as well as the Infinity, but give me some latitude here.) How many houses do you have? Stop and consider if all of that extra "stuff " really makes you happier. I mentioned in an earlier column how much happier I was when I sold my cruiser boat. I enjoyed having it, but after a while the headaches outweighed the fun. Diminishing returns once again.

If things do slow down for you in the coming months, do all you can to prosper. Invest in your practice, not the markets. Take a sales course. Get better at coding — PQRI and E-prescribing give a 4% bonus that really adds up. Open that optical dispensary — it's more profitable than LASIK, just not as sexy. But don't sweat the small stuff you may have to give up. A $200 bottle of wine may be better than a $20 bottle, but it's not 10 times better. The economy, and your income, will rebound eventually. In the meantime, enjoy your practice, and enjoy your life. And the next time you go out to eat, get the cheap wine and give your waitress a double tip. Spending money on yourself often does little for your spirits, but spending it on others should always make you happier.