Just What Americans Need:

Less Healthcare. More Politics.

Shame on you, AARP, and tsk-tsk to Marsha Mercer, “freelance journalist who lives in the Washington, DC area.” Neither of you appear to offer much in the way of common sense, or even the hint of a realistic viewpoint, when it comes to your manipulative and politically-charged-below-the-surface feature story that appears in the AARP March Bulletin.

Your front page hype,”Fixing The Doctor Shortage – Big Changes For Patients” (and guts of the story) deceptively suggests that the evolving physician shortage is one that’s the product of an aging doctor marketplace and by private insurers undercutting Medicare reimbursement rates. Simply not true.

Relentlessly increasing

government control is the culprit.

MEMO TO AARP: Put the premise that your article spotlights in the drawer, and start making phone calls. Ask a few hundred doctors. I have. They will tell you in so many words that relentlessly increasing government control is the culprit.

The article’s lead source, Dr. Steven Berk, is certainly a distinguished one, yet the context of his quote appears to have been quietly tucked away. Surely, Dr. Berk had more to say about the subject than thirty-six words? Could it be that the rest of his comments failed to support the sensationalist undercurrent of your story?

And how about adding the link for 2012 Physicians Foundation survey that you cited so people can check it out for themselves? Check it out here. Certainly the survey IS worth noting. Skewed, though it may be to represent the best interests of its sponsoring organizations, it seems credible enough.

So what is worth noting you ask? How about the glossed-over fact that all the alarming findings referred to have taken place since (and are compared only with) the survey of 2008? Does that strike you as worth noting?

Hmmmm! And what else happened in 2008? An increase-government-control advocate was elected president. So, are we to conclude that most of the problem we face today regarding doctor shortages and the systematic transitions in healthcare that have forced the issue are attributable to physician aging and private insurers, as the article purports? Not likely.

To Find Doctors we should be looking — instead of to state medical associations — to family, friends, neighbors, other doctors, and other healthcare professionals. After all, isn’t it TRUST we seek? Surely, it’s not more government in our lives, or politically-motivated state medical associations trying to justify their membership fees.

Let’s remember that –far and away– the single greatest reason that the vast majority of Americans seek any (even including ER) medical care is to get reassurance. Reality, even for seniors, isn’t a TV hospital show. It’s seeking reassurance.

Oh, and please: FORGET about .gov websites. They are not invested in helping you. They are invested in controlling you! Go instead to private practice websites. Go to The American Academy of Family Physicians and other non-governmental professional physician credentialing organizations. And stop believing what you read in AARP propaganda.

Unless you prefer some politician to give you a diagnostic workup, prognosis, and treatment program?

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Hal@Businessworks.US     302.933.0911

Doctors know where they’ve been

but they don’t know

where they’re going!

Today’s medical professionals are strapped to a rudderless ship at sea that’s being sucked into a raging storm.

Some politicos would have us believe that the scandalous fifteen-thousand-page Obamacare program (and when, by the way, was the last time anyone you know read 15,000 pages of anything?!) need not be such a shocking insult to healthcare consumers because after all, it helps “less fortunate” people to get medical care.

Steamrollered through an inept Congress, Obamacare appears to have little if anything to do with the realities of healthcare. Instead, Obamacare hints at having everything to do with the crippling economic and personal freedom limitations brought on by the relentless White House pursuit of dictating increased government controls on American lives.

The end result? We will definitely end up with fewer competent physicians.

And those who remain will clearly not be providing adequate care –regardless of competency–  because of the restrictions Obamacare piles on top of the restrictions already imposed on them that limit their ability to deliver meaningful health services.

But computerization is what tightens the noose around healthcare necks, some say. Not so. The mismanagement and misappropriation of administrative computerization advances by interfering and uninformed government misfits and ignorant insurance providers is what is at the root of today’s healthcare delivery shortcomings.

The de-humanizing of humanizing services is the characterization that uninformed and manipulative individuals, agencies, and organizations have wrought as they’ve twisted administrative computerization advances into shortcut invasions of patient and physician privacy. Have we lost even having thoughts of human dignity?

When “DOCTOR’S ORDERS” becomes “DOCTORS ORDERS” (as in orders issued to doctors by the White House) to conduct patient gun ownership surveys to build a bigger “Big-Brother-Watching” database universe designed to gain yet more government control, do you think this might possibly get just a bit in the way of doctors performing healthcare services?

Of course EMR (electronic medical records) and EHR (electronic health records) have succeeded at putting patient care over paper care. But are these important advances enough to be really helping doctors to know where they’re going?

And the Internet has fully armed healthcare consumers to be better prepared to understand and manage their own healthcare issues, to be more informed about diagnostics and treatments, and to work more productively with their doctors. But are these advances enough to be able to really help doctors to know where they’re going?

The whole lean organization, lean management fad (where did Quality Circles go?) may be a solution, but is not THE solution. It is simply a band-aid acknowledgement that things have gotten so bad, we can no longer afford for the physician to spare a minute or two extra with each patient and patient family to help heal, and help ensure and reassure a sense of well-being.

More dollars are saved. Care is more efficient. But –at the ultimate point of care– doctors don’t get to spend more time with their patients, so is this increased efficiency really enough to help doctors know where they’re going?

Being preoccupied with efficiency necessitates lower levels of individual healthcare delivery. And last time I looked, healthcare was a profession dedicated to individual care. Perhaps it’s time to redefine the word “care”? The bottom line is that doctors are literally trapped.

Adherence to rules and regulations designed to increase control over their skills and abilities to earn livings commensurate with their training and societal value is squashing the very lifeblood out of healthcare. And Obamacare will surface as the culprit when it’s too late to matter — unless enough small business owners and practice administrators and doctors start to make waves

. . . NOW.

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Hal@Businessworks.US   302.933.0911

Healthcare Management Problems

Go Far Beyond Technology Tangles

Thanks to what many doctors regard as excessive and medically-uninformed government intervention, and excessive and medically-uninformed insurance company intrusion, America’s private and hospital-based medical practices are suffering from excessive and medically-unacknowledged stress.

They find themselves having to be caught up in blood-curdling power play control battles instead of with innovating and nurturing methodologies for improved case management and patient care. This is not a condemnation of medical technology advances by any means. It is in fact an endorsement for more tech exploration while simultaneously getting back to basics.

Positive stress enables healthcare managers to answer the wake-up call for effective practice management to realistically occur on two fronts at the same time. EMR and EHR systems and skills represent focal point one. Case management, patient care, and patient family care, focal point two. But negative stress (or “dis-stress”) surfaces when one of these enslaves the other.

Relentless interruptions of non medically-trained government and insurance regulators seeking to satisfy their self-importance at the expense of doctor, staff, and patient stress levels, has the same effect as throwing gas on a fire. Whether rulings require doctors to spend just 12 minutes per patient, or to conduct patient gun ownership surveys, the result is negative stress.

Negative stress feeds medical errors, and takes its toll on the lives of trained professionals and their families. Often, patients and patient families suffer needlessly because of mixed or contradictory signals lost in busy day-to-day clouds of smoke.

Even monster teaching hospitals, including the highest-rated in the country, fail miserably at basic communication skill levels. Doctors don’t talk with one another. They are too pressured to take the time to advocate on behalf of the very patients they serve.  And –worst of all– they fail to communicate with their patients and patient families meaningfully and consistently.

Practice managers get the short end of the stick. My guess is that most end up absorbing 3/4 of all the stress generated by the mad rush for maintaining Herculean time schedules, by catering to the administrative needs of the doctors they serve, and by managing the daily barrage of staff, task and insurance management issues, plus catering to patient and family requests.

There are solutions, but they are not one-dimensional. Healthcare can never have universal value unless those charged as providers can have the freedom they need to function without constant government interference and insurance company strangleholds.

The first step to fixing a leak is to stop the leak. This means making extraordinary efforts to channel stress productively and to commit to implementing improved personal communications.  CHECK OUT  Medical Practice Managers

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Hal@Businessworks.US    302.933.0911

“Whaddayadonfermelately?”

In today’s instant gratification world, many professional healthcare practices, B to B firms, and customer service business owners hear some version of this question with increasing regularity. Not a bad thing to be asked. Huh? Well. because there’s always room for an answer when you know what the question is.

In fact, NOT hearing some version of “Whaddayadonfermelately?” is far worse than being asked because the unasked question itself portends a “not much” answer.

Savvy proactive service business owners and managers never allow any form of this question to surface in the first place. Their secret? Regular, ongoing “How Goes It?” inventory exchanges. Meetings and discussions (note NOT text messages or emails, which are too superficial) that chunk up and evaluate workflow, deliverables, and performance.

These usually daily or weekly assessments (which generally best occur on Monday mornings to set up the week ahead) are typically followed by a call to action — adjustments in the timing, speed, quality, quantity, agility, relevance, attitude, goals, roles, responsibilities . . . whatever steps will help ensure productive forward motion from point to point.

And when you were a kid (no doubt possessing prototypical entrepreneurial characteristics such as resentment of authority in school and reluctance to follow rules), you might have thought report cards were nonsense — or perhaps unpleasant harbingers of parental lectures?

But “report card” dynamics in service businesses –especially when they’re self-imposed– have saved many client accounts and relationships from collapse. Instead, as  some family elder likely forewarned us as children when we had clearly overstepped or under-achieved, it’s a good thing to “nip it in the bud” when it comes to following a problem direction.

When you, the service provider, take the initiative to nip problems “in the bud,” by requesting regular, ongoing feedback and assessment from your client/customer/patient, you are exercising a form of positive preventive maintenance. And this is not even to mention the other values attached to the client’s impression of your commitment.

Asking for feedback is an admirable posture all by itself but, more importantly, you are opening the communication expressway to allow for more give and take, and a healthier more communicative and more rewarding relationship that operates from a position of strength and confidence, instead of one of cowering and covering your butt.

How do YOU feel about doing business with s0meone who makes assumptions instead of asks? Or someone who disappears when the going gets tough or when you have issues to discuss? Hmmm?

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Hal@Businessworks.US    931.854.0474

 OVERWHELMED?

Make Decisions.

The most overwhelming thing about being overwhelmed is getting your decision making mechanism activated. The holiday season gives rise to getting your personal leadership gears stuck. People to see. Places to go. Events. Gifts. Special meals. Family reunions. And always, there’s business and career. So much to do and so little time.

“Personal Leadership”? Yes, I did mention that. As in leading your SELF  through all the excitement, clamber, congestion, over-indulgence temptations, and disheartening year-end assessments, to a place of reckoning.

That translates to getting UNstuck by getting back in touch with your ability to prioritize and make decisions. There’s really no place else to start except with yourself. If you aren’t healthy and moving forward, how can your business be?

Here’s an old standby method that always works and will help you get UNstuck now. . .

START by listing the 6 critical personal leadership categories at the top of your Word page or Excel grid or piece of paper: spritual, intellectual, physical, emotional, mental, financial. Then itemize random points/parts/ issues that need attention under each heading. Maximum 3 minutes for each column. (If it takes longer to think of, it’s not critical!)

Then, consolidate all items that can be addressed in a bundle fashion or that may represent duplication of effort.

Next– and always with the understanding and expectation that priorities can change in an instant– assign priority number values to each item in each column. Maximum 1 minute per column.

NOW, assign * or ** or *** to each #1 item in each column, then to each #2 item, etc. Take *designated #1 item and attack it. NOW. When it’s done, move on to *designated #2 item, and so on, through **designated #1 items, etc.

Always be prepared to re-prioritize based on what may end up in your face that changes the circumstances. The trick is to use determination and stick-to-it-ive-ness to take each challenge to a point of resolution before moving ahead to the next one.

When you clear the decks of issues that jam up your personal leader-ship skills, go for the rest of the overwhelm. You will be enormously more successful at business, career, and family leadership when you simply start making decisions about how to first deal with you so the rest of what you do is coming from a position of strength, and a true leadership posture.

Oh, and take lots of deep breaths and make it fun whenever you can. Those are choices, you know.

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Hal@Businessworks.US    302.933.0911

 DON’T SURROUND YOURSELF

WITH YOUR SELF!

Besides the number one ailment of entrepreneurs –being under-capitalized– a close second place is awarded to the All-American crushing entrepreneurial ego! This business venture is my idea. I can do it better than anybody. I want people working with me who will ask how high when I say “Jump!” Yup! BTLS (“Born To Lose Syndrome”) it’s called.

Generally speaking, and it’s unfortunate, most people who start, buy or inherit a business or professional practice tend to think the opposite of proven success experience, at least at the outset, and completely blow off the idea of hiring and surrounding themselves with those who are better, smarter, wiser and more experienced than they are. 

Don’t rely on my opinion. Ask any successful business owner or manager you know. You’ll find that those who truly make a difference with the pursuit of their ideas are those who surround themselves with excellence. It’s the mark of a true leader. If you have an ego problem, work at it. If you don’t, it will kill your business or practice.

Accept the fact that someone who has studied and practiced law or accounting or IT or training or marketing or operations, or finance is probably better equipped to make and recommend decisions in their areas of core competence than you are, even though you are great, have great ideas, and are probably a better salesperson than you could ever hire. 

Rule of thumb for successful startups and departmental streamlining: Find and hire the best, smartest people you can in every area of the business that you do not have exceptional command of. Support them. Encourage them. Challenge them. Reward them. And, above all, respect them and listen hard to their recommendations.

DON’T SURROUND YOURSELF

WITH YOUR SELF!

Although it is commonly misunderstood –and many attribute the categorization of being “a jack of all trades” to the word, “entrepreneurship”– entrepreneurship is in fact a really unique form of leadership. It’s unique because it carries the added burden and challenge of being creative while it benefits by the opportunities that creativity produces.

Carry, in other words, entrepreneurial spirit into all that you do while you drop the limitations that entrepreneurial ego fosters. Surround yourself with high quality, high energy people who know more than you and focus –not on competing with them, but–  on being their leader and the spokesperson for your brand. Success will come MUCH quicker.

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Hal@Businessworks.US    931.854.0474

AS ZIG AND ZIGGY SAID . . .

“We should enjoy life while we’re here

’cause there’s no here, there!”

(Worldclass cartoon character Ziggy)

“You can have everything in life you want,

if you will just help other people

get what they want”

(Worldclass motivational sales guru Zig Ziglar who left us this past week,

to hopefully join Ziggy for some fun and enjoyment “there”!)

What’s the point? Entrepreneurs have a way of becoming so driven and preoccupied by the race to achieve their ideas, they rarely take enough time out to enjoy what they already have, like family and friends, and life itself. They can also become so readily entrenched in “doing” for themselves and the growth of their ideas, they can often forget about helping others.

If, like many entrepreneurs, you think you have been put on earth to better mankind by pursuing your great ideas to the exclusion of taking time outs for your self and your family and friends, or to the exclusion of taking time to help others in their moments of need, you might want to revisit your sense of reality and the purpose of your life and business leadership.

My recommendation for how to proceed with this thought for the next minute is to simply take one more step and have a little fun by entering “Ziggy” in the search window to the right, then scan the three blog posts that surface, then enter “Zig Ziglar” in the search window and scan the fifteen or so blog posts that mention or quote him.

I promise –that between the two quick searches– you’ll be amused or prompted to action, if not both. Most assuredly, you will be as I have been by re-skimming these posts, enlightened. I stand humbled by the inspiration I draw from each. You?

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Hal@Businessworks.US    931.854.0474

Help Jumpstart

My Kickstarter

For many businesspeople, asking for help may come easy, but rarely is it easy for an entrepreneur.

For an entrepreneur, such a request can translate into “having to swallow my pride,” “getting someone to do what I can do better,” “having to trust someone else with my baby,” “admitting a weakness,” or “owning up to my own inadequacies.”

So what? Who appointed you as “Perfect”?

When you consider that all of the above suggested excuses (which I have heard often over my years of business and professional practice development consulting . . . and have admittedly tried myself on occasion) reduce themselves to unproductive ego-based thinking and behavior.

Remember your grandfather telling you:

“No man is an island”?

Ego-maniacal thinking and behavior of course tends to dominate early-on entrepreneurship pursuits until experience and reality sink in and struggling entrepreneurs begin to realize that it’s the idea that’s important, and that any (legal) way to achieve success –regardless of others that need to be relied on– is the right way to go.

For entrepreneurs,

results tend to outweigh process.

Interestingly, the opposite tends to be true in government and corporate life where more relience is placed on analysis of available options than on getting the job done (e.g. deciding which committee to study an emerging market becomes folly in the face of an entrepreneurial spirit that simply drives itself into the heart of the market and adjusts along the way.

I have learned a great deal in the first half of my Amazon Kickstarter site effort that literally requires nerves of steel for me to implement in completing the second half of the effort. Stuff I forgot: Ask for the sale. Ask again. And again. Drive as many people as possible to visit or experience your message. Adjust and improvise. Switch gears. Ask for the sale. Ask again.

Why “nerves of steel”? I’m a creator, not Superman, not Zig Ziglar, not (Thank Heaven!) Steve Jobs, not an award-winning super-salesperson or winning candidate. I’m just a small business owner.

I’m me. I don’t like asking. I have to conjure up massive amounts of courage to approach my friends and family, and online contacts (even strangers) to buy into something I created. I know in my heart that what I have to offer is worthy. I know it’s a great dollar-value. And, yes, the Kickstarter race against the clock means it’s “make it or break it” time. It still feels awkward.

But –ahhh— I’ve always taught that behavior is a choice, so it’s time to get over all that and step up to the plate, right? Okay, so here it is —

Will YOU please help me jumpstart my Kickstarter by visiting this site NOW and making a pledge of some kind  —EVEN JUST ONE DOLLAR!??

In the interests of your love for the arts and creative development, will you also please urge your friends and contacts to visit my Kickstarter site NOW?

I will be forever grateful for this very important bit of support.

Thank you!

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Hal@Businessworks.US    302.933.0911

I am thankful for my

 Kickstarter Backers!

Happy Thanksgiving!  I hope it is a time of great rest, relaxation, reassessment and re-energizing for entrepreneurial leaders everywhere. Certainly, it is a time for family, friends, and appreciation . . . a time for prayer and caring and tolerance.  

Thanksgiving is for me personally —and most of all— a time for saying thank you to those who have locked arms with me through the two years of harsh realities and trauma that ended with Kathy’s death this past March.  

It is only because of that allegiance and outpouring of love and support for my personal and business survival that I have indeed survived. It is with full and deep appreciation for all that Kathy meant to me and the joy she brought to my life, that these friendships and offerings of time and help, and support (even food!) have prompted me to do what she urged of me consistently (but that I unwittingly resisted) over her last two years: to move on! 

AMAZON Kickstarter, as many of you know, has enabled me to step forward with the wonderful book manuscript –HIGH TIDE— that occupied thousands of hours of my spare time (and much of Kath’s) over the past twelve years. But Kickstarter is just a platform, a format.  

It took a concerted effort by a small army of close friends and family members to give me the faith and incentive and encouragement to bring that format to life… to move on. As it stands this minute:  it works!         

In the middle of my Kickstarter website, you’ll find a lengthy list of individuals who stayed with me through the long haul and who passed me the torch to light up HIGH TIDE. 

Many others, too many to list here, have eagerly jumped on the bandwagon to help. They know who they are. I will thank each publicly as soon as I can get through the Kickstarter project, regardless of outcome.  

I will simply say here and now that I am deeply grateful to each of you who have taken the time from your own busy lives to reach out and pull me a rung or two up the ladder and for bringing God’s blessings to my doorstep. Thank you. I love you all. And God Bless YOU.  

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I ask also that anyone reading this please be sure to remember all the families still suffering from Hurricane Sandy, and to send God’s blessings to them, as well as to all our young men and women serving in America’s armed forces and emergency services throughout the world. Pray to grant them all continued courage, resourcefulness, patience, forgiveness, and understanding.

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Hal@Businessworks.US    302.933.0911

WRITING   YOUR   BOOK 

It’s just not the same as editing, designing

 formatting and publishing, distributing,

branding, promoting, legalizing, and

marketing your book… or selling it!

READ BEFORE YOU LEAP, YOU 81%!

Why am I telling you this? What makes this relevant to small business? HA! 81% of all Americans think they “have a book in them” according to a New York Times survey report . . . uh, that’s like over 200 million people in the U.S. who want to write a book — more than total viewers of the most-watched-in-history 2012 London Olympic games!

WOW! That sounds like a sizable market right? And an awful lot of new books on the horizon, right? Wrong! How could that be? Well, first off– like the old days when TV first came out, and everyone watched it with the same passion we now relegate to smart phones, all humans thought they could write TV commercials because they watched them!

In other words, if you don’t read, you can’t write. According to industry findings reported at www.SelfPublishingResources.com, the average book buyer reportedly never reads more than the first 18 pages of a book she or he has purchased!!! If you don’t read complete books, you can’t write books worth reading. And if your first 18 pages don’t shake the walls loose . . .

Second: WRITING your book is the easy part!

And even if you DO write a book worth reading, you’d better have a lot of money and/or considerable professional expertise with editing, designing, formatting, publishing, distributing, branding, promoting, marketing, contract law, and sales. Even IF you can manage getting a big-time agent, publishing house, and publicist, the buck still stops with you! Even if.

Discouraging? Absolutely. My best guess is that 80 of the 81% will fall by the wayside trying to effectively manage the tasks noted in the paragraph above. That’s a big pile of dead book efforts! Ah, but now there’s CROWD SOURCING to the rescue!

Go to this site now for an example of how to make your book work once it’s written. Oh, yes, and it’s only a couple of hundred dollars to create! IT’S THE NEW WAY TO SELL BOOKS. IT”S THE WAY ALL FUTURE BOOKS WILL BE SOLD!

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Hal@Businessworks.US