Healthcare Management Problems

Go Far Beyond Technology Tangles

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

Doctors and Staffs find themselves having to be caught up with 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 (like, for example, the current fad for dedicated insistence on “lean” healthcare) enslaves the other.

Relentless interruptions of non medically-trained government and insurance regulators who seek to satisfy their self-importance at the expense of doctor, staff, and patient stress levels, have the same effect as throwing gasoline on a fire.

Whether rulings require doctors to spend just 12 minutes per patient (likely headed toward 8 minutes!), or to conduct patient gun ownership surveys, the result is negative stress.

Negative stress feeds medical errors. It 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 best guess: Most Practice Managers end up absorbing 3/4 of all the stress generated by the madness of keeping Herculean time schedules, by catering to the administrative needs of the doctors they serve, by managing the daily barrage of staff, task and insurance management issues, and by having to deliver “customer service psychotherapy” to patients and families.

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

WANT TO BE MORE OF A LEADER?

TALK AND WRITE LIKE A LEADER.

Over 30 years of writing and training business, industry,

healthcare, and academic leadership have taught me

some important words I now share with you . . .

People who regularly incorporate the use of the following kinds of words in their daily conversations and written messages stand tall among the most successful of worldclass leaders.

This magic pack of words is just for openers. You need to be willing to raise your own consciousness about whether the words you use every day are helping you perform to the best of your own leadership ability. This list can, in other words,  get you started. But only you can decide what works best for you and your personal leadership comfort zone.

The point is: Take a couple of minutes to review this list, think about it and assess yourself. If you can change some words you may presently be emphasizing that are not helping you perform, change them! It’s your choice.

Opportunity. Becoming. Challenge. Team. Can. Forward. Focus. Here and Now. Let’s. How? What will it take? Go! Do I understand you correctly to mean . . .? Us. We. Our. Fun. Enjoy! Together. For example. Passion. Try. Enthusiasm. Empathy. Customer. Diagram.  Innovation. Client. Partner. Listening. Self-esteem. Service. Needs. Desires. Learning. Facts. Exciting. God. Illuminating. Choice. Value. Timing.  Self-confidence. Trust. Authenticity. Genuineness. Objectives. Goals. Strategies. Tactics. Specific.  Flexible. Realistic. Ignite. Timeline. Activate. Boost. Stimulate. Care. Compassion. Spark. Consistency. Measure. Hustle. Effort. Reward. Share. Accurate. Recognition. Implement. Respond. Energy. Responsive. Responsible. Behavior. Spirit. Assist. Invigorate. Results. Invest. Humility. Grace. Please. Thank you. Respect.  Grow. Patient. Happiness. Family.

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When Followers Lead Leaders

You think only a weak leader would step aside when followers close rank and try to take over? Maybe you’ve seen too many wild-eyed-pirate-and-rats-desertion-of-sinking-ship themed movies. You may want to revisit your thinking because in a lot more than some cases, stepping aside is an indication of truly superior and truly successful leadership!

There are probably as many avenues to leadership roles as there are leaders, yet none of them reflects the inherent strength-of-leadership qualities of authenticity and transparency as –like raising world-class children— being able to move confidently out of the way when followers (or your kids) take up the flag and charge forward with it.

No one ever said that being a parent or playing a parental role in business and professional practice development would be easy. In fact, parenting of any kind may well be among the hardest of life challenges. On the heels of committing to the ongoing practice of nurturing and investing in self-responsibility, personal and career parenting is certainly job one.

Why would self-development come first? Because if you cannot be true to yourself, you cannot be true to others. If you don’t know and aren’t continually searching out what makes you tick, you can’t possibly be in a position or mindset to lead others. If you don’t value your self and appreciate your own strengths and weaknesses, how can you measure and guide others?

When followers lead leaders, it may be because the leaders have faltered or it may be because the leaders have thrived on showing the way, on lighting the path, on motivating others to see that light AND the path, and on stepping out and onto it.

Weak leaders work at keeping followers following.

Truly great leaders

inspire followers to become leaders.

Which are you? Which are you becoming? Where are you aiming? What’s your target? Your goal? Your objective? How will you get there? The more you help others to grow as leaders, the more you grow as a leader. And since all of this swirls around what you think and how you behave, it’s worth remembering that thoughts and behaviors are a choice.

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Yada, Yada, Yada,

 Blah, Blah, Blah…

Odds are that your best leadership response to other people’s yackity-yack is probably NOT:  yeah, yeah, yeah!

When someone who follows your lead is being busy saying nothing (hmmm, sound familiar?), try taking the person off to the side — or into a private setting — and explain that you want to share the value of some of what you’ve learned from successful sales leaders.

Start by noting that virtually EVERY exchange we have with others EVERY day –both on the job and off– constitutes an attempt to sell SOME thing.

Yes, “EVERY” and yes, “SOME.”

Think about it before jumping down my throat with some condemnation for using “ALL OR NOTHING” language. Before you throw exceptions at me, take a minute to dissect them. Odds are you’ll discover that at least one individual in every interaction has a mission to sell her or his self, or ideas, or products or services, or brands, or affections, or . . .

Here’s what the world’s most successful salespeople know and practice: LISTEN 80% of the time and TALK 20% of the time. Maybe not easy, but it IS simple. And it works! This behavior breeds success in all walks of life with all kinds of circumstances where we seek to make a sale or an impression or gain trust or show understanding.

By disciplining ourselves to listen more carefully to those we are charged with the responsibility to lead, and by being more selective and economical with what we have to say to others, we are also becoming more productive with time and energy spent.

When we can save time and energy by communicating more accurately and productively, we are getting a better handle on what others want and need and suggest, and we are saving on wasted time and energy costs and lost opportunities.

But don’t stop there!

Talking less and listening more does NOT mean talking less and HEARING more. Active listening is an acquired skill that involves open body language (no arms, legs, ankles, wrists, hands, fingers crossed and no peering over the top of your glasses), paraphrasing and asking for examples and diagrams, and nonverbal (e.g., head nodding) as well as verbal acknowledgements.

It means paying attention, staying focused, not allowing distractions. Easy stuff? No. Hardly ever is it easy. Active-listening communication is more work and it takes longer. Ah, but you simply can’t compare the success-level results you’ll get with the productivity (or lack of) that accompanies the typical 80% talking communications that surround our daily lives.

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 WHEN “LEAN” IS FAT!

The buzz word in today’s management circles is “LEAN” — not as against a lamppost, but as trimmed back to basics and making the most of computerized technology to produce a measure of quality efficiency. This is a fantastic concept that works in manufacturing (such as with Swiss Screw precision parts, and with automated equipment operations).

Unquestionably, implementing LEAN can make a difference. The problem is that –as with MBWA and Quality Circles and Theory X and Theory Y and JIT and scores of other management and leadership approaches– too many leaders desperate to make a name for themselves by shaking up their organizations tend to latch on to the latest fad, and expect nirvana.

With LEAN, too many advocates of quality leadership in management are attempting to put this square LEAN peg in a round ultimate consumer hole. The result for many of these forced marriages — especially in healthcare (doctors, hospitals, and facilities of every description)– is that they can end up victimizing themselves by a rush to “leanness.”

It’s not unlike cutting back food consumption to lose weight, then ending up dizzy and disoriented. In other words, too much reliance on streamlining the process can easily overshadow the basic thrust of an organization’s purpose.

Consider for example, what the last few letters (hint: Not “EHR” or “EMR”) in healthcare, are all about. All the cost efficiencies and lightning record retrieval systems in the world cannot come close to the only thing that –in the end– really matters:  care.

Of course a LEAN approach in healthcare can mean more accurate, more efficient, more rapidly delivered patient care. But buying into LEAN as if it were the end-all, be-all, ultimate solution to healthcare is like saying that the process of flying the plane is more important than the pilot. And that may well be the case some day but, for now, reality dictates that computer technology apps are simply tools to afford providers the opportunities to provide better quality patient care.

Use LEAN. But give careful budget and strategic planning consideration to the kinds of staff training and practice development avenues that far override the values of LEAN, such as:

1) Staff, patient and patient family communication. [A world-leading hospital I am intimately familiar with has robots delivering meds to patient rooms, but staff physicians who file endless numbers of computer reports don’t read one another’s reports, or communicate with each other. Few even have direct contact with the nurses dispensing the drugs!]   

2) Staff, patient, and patient family stress management [Did you know that the more relaxed a patient is, the more accurate the diagnosis can be and the better the response will generally be to treatment? The better the odds for reimbursement too, not incidentally! Patients and their families seek trust and  reassurance. LEAN may set that table, but only physicians, nurses and professional staffs can deliver the meal.] 

Target your budget and your process emphasis behind the kinds of communication skills and stress management training that providers and provider support staffs most need and least often get if you really want LEAN to work. Diets are great if you stick to them, and success often reduces itself to maintaining an ongoing dialogue about it with someone who supports your pursuits.

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HOW LONG

CAN YOU HOLD ON?

Maybe a year? Y’think? Six months? Hmmm? Three or four weeks? Whew! Hours perhaps? Ack! First of all, if your answer is “forever” or “a lifetime” or “long enough,” you may want to revisit your brain because if you’re not living IN it, you’re dangerously close to fantasyland.

One thing I’ve learned in this blessed long life I continue to have is that NOTHING on Planet Earth is permanent. Nothing! That may be no surprise to scholars who know that circa 2600 years ago, the Greek philosopher Heraclitus said “Nothing is permanent except change!” (Pretty heady stuff for a guy that old, eh?)

Q. 

What are we talking about here?

Businesses? Families? Friendships?

Entrepreneurial ventures?

Professional practices? Our minds?  

A. 

All of the above!

We “hold on” in five different (yet mostly intertwined) ways:  financially, emotionally, intellectually, physically, and spiritually. And most of the reasons we hold on are anchored in shifting sands. We have numbed ourselves with fear of failure. We have built artificial (and, admittedly, often flimsy) protective walls around our endeavors, pursuits, and ourselves.

So what am I saying? We should all run out and be more carefree? Take bigger risks? Throw away everything we’ve worked hard to earn? Change horses in mid-stream? Stop paying taxes? Buckle under to competitive pressures? Cut off shaky relationships instead of working them through? I’m saying it may be time to reassess what we’re holding onto, and why.

What’s the worst thing can happen by taking a couple of minutes out tonight and thinking through what is and isn’t worth it in your life —  your business or practice, your family, your relationships, your finances, your emotional stability, your intellectual pursuits and development, your body, your sense of spirituality and religious commitments.

Give yourself the benefit of doubt. Just dabble in this arena of yours for a few minutes. Think hard about what it’s all worth, and what you can and are free to choose to do right this minute by making a decision to change things for yourself for the better . . . and then choose it, and do it. It’s really not so hard –and can be fun– once you put yourself on the path.

Letting go may seem –and even feel– hard, but it’s a piece of cake compared with the stress and strain of hanging on to a piece of fantasyland. In the end, for all humans everywhere, reality wins. So why not grab it now and ride it to the finish line? — Your business. Your relationships. Your self. Old song lyrics:

“We may never pass this way again.”

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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

 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