The way most offices are laid out, with little rooms spread about, ensuring a comfortable temperature everywhere is like trying to get pachymetry on a four-year-old or a wild boar (no difference), which is roughly equal to getting a 50-year-old to understand why he needs reading glasses after LASIK. This room is blazing; that one is freezing. The staff is miserable, and the thermostat is a war zone. 

I always told my kids that you can solve almost any problem if you throw enough money at it, but that’s not true for HVAC problems. After practicing in all kinds of weather since 1979, here’s some advice:

 1. If you get the chance to design your office (not just inherit the space that destroyed the previous owner’s spirit), accept that you will freeze or burn up, no matter what you do. 

2. Dress in layers. Start with Speedos and end with polar bear fur, no matter the season. Use plenty of Velcro for more efficient changes in the hallway. 

3. When the staff complains about the temperature, pretend you care. 

4. Avoid the rooms that are always too hot or too cold. The best way to do this is to stay on vacation. 

5. If your hands are freezing, take advantage of it by making piecrusts. 

6. If your hands are sweating, refer foreign body removals to a cooler colleague or duct tape the spud to your fingers. Otherwise, just remember that two corneal abrasions should heal the same as one. 

7. Attach a fan to your indirect. 

8. In summer, wear scrubs and keep a fresh set in the freezer. In winter, wear a woolen Santa hat. Patients think that’s cute. 

9. Save money on shredding by burning old records in a HIPAA-compliant fireplace. 

10. Keep a cooler full of water bottles (vodka in winter) nearby. 

11. Get a machine that blows snow around the office. Don’t tell anyone it’s not fake.  

12. Tell patients your HVAC system is permanently being serviced. 

13. Make something up about saving the environment for your grandchildren. 

14. Open windows. Nevermind, I forgot eye docs don’t have windows.  

15. Tell patients you give a 10% discount to those who don’t gripe about being too hot or too cold. 

16. If a patient starts sweating, say you are diagnosing them with swine flu and they need a second pair of glasses. 

17. If a patient is chilly, talk about something they are passionate about, like their kids or their kid’s most recent arrest. 

18. Before calling the HVAC guys, remember they charge $600 an hour. That’s more than you make. That’s more than they made as ODs, too. 

19. If a patient can’t see through his new glasses, scrape the frost off. 

20. Put a can of compressed electronic cleaner in your pocket and give yourself a spritz now and then. 

21. Change the air filter at least once every career. 

22. Install a large refrigerator in your reception area and stick a couple of chairs in there. 

23. Allow patients to sit outside where it’s a more comfortable 90°.

24. Have your mother sit in reception to chatter about the good ol’ days before air conditioning. 

25. When patients complain about their comfort, complain back about their vision plan. 

You can overcome these heating and cooling challenges. Don’t let them distract you from your primary mission: retiring.