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

You will NEVER

have enough money

to start a business!

“Yeah, yeah, I’ve heard this before,” your stubborn venturesome self may say by way of dismissing the ugly truth, but dismissing reality doesn’t make it go away. Your offhandedness will inevitably come back to nip you in the tush. UNLESS! Unless you can get yourself to accept reality unconditionally and plan (that nasty entrepreneur word again) accordingly.

Ah, and one other very important asset you need to bring to your business startup table: PLUCK! [No, not as in fingering a banjo!] Pluck as in backbone, bravery, courage, daring, fortitude, gameness, grit, guts, mettle, moxie, nerve, zest, spunk. This is not to suggest recklessness in talking money. It is rather to suggest being realistically bold and fearless.

“Realistically”?

If you grow your business idea to the point where a major infusion of someone else’s cash or equipment is needed in order to survive and/or continue to grow, you’d better be prepared to give up total control in exchange. This translates to the need for you to be prepared to hedge your bet, and possibly diversify your interests (if your investors allow you to!).

Starting a business is not a task for the meek. It is not a retirement or corporate escape. It is not a hobby. It is not simply taking advantage of a spur-of-the-moment opportunity. It is not a one-night stand. When you start a business, you marry your idea! Without some grand inheritance, how many marriages start out with enough money?

No matter how carefully you budget and think through where your idea is headed, no matter how much arm-in-arm support stands with and around you, no matter how many promises you get from vendors, suppliers, ancillary services, and government agencies, you can be sure of only one thing: You’ll never have enough money to start a business.

So? So assess yourself first. Don’t dwell on it, but do be honest. Determine exactly how much pluck is inside you, and how realistic your attitude is. See where and who and how to plug the openings. If you don’t, your startup efforts are destined to fall apart and your financial exposure will be crippling.

You need to substitute for being under-capitalized by rallying your strengths and surrounding yourself with the reliable strengths of others whose skills and experience can fill in your gaps! It CAN be done. Many have succeeded. But many more have failed. The difference is pluck and a realistic attitude. How much of each have you?

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Hal@BUSINESSWORKS.US

National Award-Winning Author & Brand Marketer – Record Client Sales

Open Minds Open Doors

LEADERSHIP STARTS

WITHOUT FOLLOWERS

Now what exactly do I mean by such an apparent contradiction? Answer: That leadership begins (and thrives) with attitude. “Yeah, Hal, right! Sounds great, but what kind of attitude and HOW does someone get it? Like it falls from the sky, or what?” Good questions. No it doesn’t “fall from the sky,” but it does begin at the beginning.

Leadership begins at the beginning, without a following, without an entourage, without an expedition, without a master plan, without a goal line, and without intentions of superiority or competitiveness. Effective leadership starts simply, with a mindset that exudes integrity at every turn in the road.

Leadership starts with an attitude that explodes in words and actions which set examples. Exemplary words and actions– by their very nature, by their very implementation– attract the attentions and admiration of others. True leadership attitudes ignite, engage, motivate, and sustain without ever having to ask others to roll up their sleeves and dig in to work alongside you. When people step it up and rise to the occasion, others rise as well to follow.

A TRUE LEADER DOESN’T START OUT

WITH A GOAL TO BECOME A LEADER.

A true leader simply demonstrates the qualities of behavior that set her or him apart from the pack, but this is accomplished by taking action, not by talking about taking action, or by aiming to play a leadership role.

Neither do great presentation or oratory skills make a great leader. Walk the walk beats talk the talk. Track-records speak louder than words. Show me what you’ve done and show me how to do it are far more important follower requests than tell me how great you are.

Effective leaders are great activists who consistently strive to teach and motivate by quietly doing. He or she is a great innovator, and a great solutions creator who takes entrepreneurial pursuits to completion, who doesn’t stop short with an idea, and who thrives on the sense of accomplishment that accompanies each step of bringing an idea to fruition.

Leaders move constantly forward. They turn over every stone and readily adjust themselves, their approaches, and the processes they use along the way, unafraid of taking action without having all the information.

Focusing on the finish line is not leadership. Focusing on each step, as the fortune cookie might say, prevents one from falling on one’s face, and almost always wins the race. 

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Hal@TheWriterWorks.com     Open Minds Open Doors

BUSINESS & POLITICS DON’T MIX!

Best Advice: Speak out in private, but hold your tongue in public! Customers and others you do business with may or may not agree with your politics, but the odds appear overwhelming that they do not want to hear your political views as part of any business transaction.

Treat every opportunity to speak out in accusation of your political opponents or in defense of your political favorites as you might instinctively deal with dysfunctional elements of your own family at the Thanksgiving dinner table.

In other words, exercise greater caution, discretion and respect than you would normally be inclined to, for the welfare of the rest of your family, and for the betterment of your own well-being and stress level. Save confrontations for when you become a professional boxer or hockey star.

“But it’s my right, my privilege, and my responsibility to speak up!” Well, okay, you may think you’re entitled, even required, to express your personal political preferences. And you are certainly entitled to your opinions, but if you own or manage a business, there’s simply no room for political opinion!

Every time you open your political mouth, you risk losing a minimum of 100 customers because anyone who disapproves will tell ten others,who will each tell ten others. Can you afford this kind of loss?

How do I know all this? Because I’ve had a big political opinion mouth in one of my past lives and it cost me substantial business. “Who cares?” you might say. Well, it may be costing you too!

The problem is that while you may not care about someone who’s critical of you offering editorials– critical of your criticism, so to speak– you maybe need to care a great deal about someone who’s related to, or controlled by that individual, and there’s just no way to ever know when some big mouth comment will come back to haunt you.

Taking the low road is not always a bad thing. Low road activity is often read in a positive light by others. Non confrontative attitudes typically produce positive reputation assessments of virtue: “humble;” “reserved;” “rational;” “objective;” non judgemental;” and “thoughtful” come to mind. It’s the sign of someone who walks the talk!

So, now, even if I’m only half right, wouldn’t you prefer those kinds of reputation attributes to “opinionated;” and “loudmouthed;” and “narrow-minded;” and “confrontative;” and “pushy”?

Bottom Line:

Work for your favorite candidates,

but don’t bring your favorite candidates to work!  

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HAL ALPIAR Writer/Consultant 302.933.0911 TheWriterWorks.com, LLC

National Award-Winning Author & Brand Marketer – Record Client Sales

Open Minds Open Doors

FAULT AND BLAME

 DON’T MAKE SALES!

Here we sit, small business owners, managers, and entrepreneurs, on the day of the first 2012 Presidential Debate. We are seething with anger, frustration, disappointment, and stress over what has and hasn’t happened since the last 2008 Presidential Debate. We blame it all on the political candidate we least agree with. And the harder we blame, the more we lose.

We have seen our businesses and personal finances go every direction except up.

We have become more outspoken about that, especially as we’ve seen respect for America’s military and America’s job and housing markets collapse . . . and food and gas and transportation prices explode through the roof! Normally free-spending customers have become suddenly frugal and stoic. All of that must, after all, be somebody’s fault.

But let’s be honest with ourselves here. How much real fault sits on our own shoulders for not planning properly, for not adjusting our business and professional practice development strategies appropriately, for not having solid contingency plans in place? It’s true that some circumstances prevent proactive business management. But many do not.

The way I see it, we have indeed had pathetic government leadership, but aren’t we just as much to blame as anyone for not keeping our own businesses fluid as they slid sideways across the top of shifting sands. After all, we chose to stand there in the first place. With that commitment, comes the responsibility to be flexible and stay forever on the alert. Am I alone here?

I’m not suggesting that going with the flow is easy. But, with a small business, it’s essential.

And that means staying tuned in to government screw-ups and broken promises because they will–in the end–affect where, when, and if you grow… or even if you survive! Easy to “Tuesday morning quarterback,” yes, but we’re looking at a lot more shifting sand before we see solid ground no matter who gets or doesn’t get elected.

It took us time to get here; it will take time to get out of here. So, there’s no time like the present to reassess your branding efforts, to initiate an overhaul of priorities and to inject time and expertise (necessary business growth ingredients that no doubt feel unaffordable) into monthly, weekly, and daily schedules.

That investment alone can make the difference for you no matter what happens on November 6th. And hopefully something will happen. The bottom line:

SALES MAKE BUSINESSES GROW.

FAULT AND BLAME AND PROMISES DON’T MAKE SALES!

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HAL ALPIAR Writer/Consultant 302.933.0911 TheWriterWorks.com, LLC

National Award-Winning Author & Brand Marketer – Record Client Sales

Open Minds Open Doors

When is a pat on the back

actually a kick in the butt?

A client tells you your service is great, then complains about it later to others. Assuming nothing changed along the way to erode the value of your praiseworthy performance, your sense of anguish may simply be the result of of a mixed message. Mixed messages find their way into everyday business exchanges with increasing regularity.

“Pretty good job . . . for a woman!” is a typical example. “You’re doing this the right way, but you need to slow down and think it through better!” is another. Have you ever heard something like: “We need to move forward with plans to collaborate, but not at the expense of our own department (division, team, group)?”

Mixed messages are nonproductive. Mixed messages often couch hidden agendas. Unlike much problem solving that requires “two to tango” and cannot be realistically addressed by a single entity alone, mixed message situations can be resolved by one person taking preventive measures. These include paraphrasing, note taking, feedback, diagramming, and offering/ requesting examples. 

1)  PARAPHRASING. Instead of simply taking statements at face value and then squirming with them later, ask: “Do I understand you correctly to mean . . . (and repeat back what you think you heard, using your own words)?”

2)  NOTE TAKING. The biggest problem with note taking is that most people do not take notes. And even when they do, they fail to directly request the speaker to allow for it. “Would you mind please slowing down on (or repeating) that point for me  so I can make note of it because I don’t want to forget what you said.” is not just called for; it’s flattering to the speaker. But write it!!

3)  FEEDBACK. Speakers need to pause periodically and take inventory: “How are we doing here so far? Do you have any questions? Is all of this information clear?” Listeners need to politely interrupt periodically and take inventory: “Excuse me. Can we take a ‘Time Out’ minute here to summarize this last bit of information? I want to make sure I understand what you mean.” Write it!!

4)  DIAGRAMS. When speaker or listener is not 100% sure that communications are clear, ask for a diagram of the information; arranging keywords and ideas visually helps ensure accuracy, and can often illuminate a new perspective.

5)  EXAMPLES. Ask for them. Very few exchanges of information fail to become transparently clear when examples are offered and discussed.

Getting tangled up in miscommunication can be frustrating and annoying, and stressful. One person who is determined to “get it right” the first time, and who is willing to accept that it may take longer and be more work, will ultimately experience greater accuracy in dealing with others, and accuracy spells success.                               

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HAL ALPIAR Writer/Consultant  302.933.0911 TheWriterWorks.com, LLC

 National Award-Winning Author & Brand Marketer – Record Client Sales

Consider the worst,

 but assume the best!

There’s no longer any excuse for being surprised in business (or life) when you’re able to discipline yourself to practice the thinking: “What’s the worst that could happen?” in every major decision . . . and then proceed to believe that only the best outcome will actually occur to reward your efforts!

Mind over matter? Perhaps. But, more than that, each worst case scenario situation you consider will better prepare you for the reality of what’s possible while it protects your belief in making happen what’s probable.

In other words, you will move forward most effectively when you’ve weighed the risks involved realistically.

Every leader worth her or his salt will attest to this thinking. The difference between it and a proverbial doomsday attitudes is simply that considering bad outcomes need only be a momentary departure from the positive thrust of making something positive happen.

Dwelling on negativity produces negativity.

Well, you say, making negative thoughts be fleeting ones is easy to SAY, you say. Ah, but it’s also easy to DO. Doesn’t it all come down to a matter of choice, after all? We do, by the way, choose our behaviors, yes?

So can we not simply choose to make  negative thoughts be benchmarks with a caution flag?

Who’s to say that considering the worst possible outcome has to be a long, drawn-out, analytical affair? It’s as quick as saying, “If I take this deal, I could lose the farm” and then realize the risk is not a reasonable one. (Contrary to popular opinion, by the way, Entrepreneurs take only reasonable risks.)

If you have trouble stopping your own runaway train when decisions come to the surface, force yourself to close your mouth and take a deep breath through your nose. Get more oxygen into your brain and more blood-flow into your muscles. Then exhale the stress slowly through your mouth.

Every choice you make is a better choice when you have better control of yourself. More deep breathing more often will put you in better control of your self. Is that a no-brainer, or what? All from making the choice to consider the worst that could happen before moving forward? Whew! Look at what you just taught yourself. The lesson is worth repeating:

Make the choice to consider the worst

that could happen before moving forward.

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HAL ALPIAR Writer/Consultant 302.933.0911 TheWriterWorks.com, LLC

National Award-Winning Author & Brand Marketer – Record Client Sales