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

ENTREPRENEURIAL

LEADERSHIP MEANS…

Being passionate about your ideas and making them work with the help of others. This means, of course, being emotionally committed to what you’re doing 24/7. By doing that, odds are you’ll never have to solicit and recruit others to your crusade. They will see a place for themselves and gravitate there on their own.

When that happens, others’ commitments will be more solid and grounded than if you had gone out hunting for them and then had to talk them into joining forces. It’s a fact: When people make their own decisions about what they want to do, they are happier and more dedicated to achieving results!

Often acting first and planning second. This does NOT mean rashly jumping from the frying pan into the fire. It instead suggests that over-indulgence in evaluating, assessing, diagnosing, and long-term planning (I call it “analysis paralysis”) wastes time, money, energy, and opportunities.

Entrepreneurial leaders take action, make adjustments, act again, make adjustments, and act again. Except for formal loan and investor-required formal business plans, they limit their planning to the short term — hour, day, week, month. And even those plans are temporary and flexible. Watching the finish line causes stumbling and falls.

Always responding instead of reacting. A key ingredient in the success of this pursuit is stress management. Bottom line: If you always respond instead of react, you can never over-react. If you never over-react, you will be faithfully followed. Built snugly into this thinking is this important awareness:

HOW you respond to someone who

or something that is out of control

. . . IS WITHIN YOUR CONTROL.

And we know this because? Because every behavior — yours, your employees’, your customers and prospects — is a CHOICE. It’s just as easy to choose to make a situation easy as it is to choose to make it hard. It may require some conscious stress management effort but, in the end, leadership is measured by ability to gain results through control and responsiveness!

Learning as much as you can about yourself –your SELF– may be the single most important determinant of entrepreneurial leadership because it is the foundation, the cornerstone, of each of the above criteria, and of any others you might add to the list. Without knowing what makes you tick, you cannot pretend to understand others enough to be a true leader. TALK TO YOUR SELF. Oh, and remember to listen!

Hands-on specifics? Keep a journal. Date every entry every day. Separate facing pages into “What Happened” on the left and “How I felt” on the right. This discipline helps sharpen your skills to separate fact and observation from opinion and feelings. Write, draw, diagram, paste photos, spit, whatever floats your boat. It’s YOUR journal.

Attend group and individual “personal and professional growth and development”-type discussion and counseling sessions. Take advantage of local adult education programs that focus on self-expression — from giving speeches and stand-up presentations to writing or painting or photography or music or handicraft courses. DISCOVER YOUR SELF!

 # # #

 SUCCESS IS THE JOURNEY

. . . NOT THE DESTINATION. 

 It’s entrepreneurial leadership, not the goal!

Losers lack it. Winners exude it. Ask the successful people you know. They will tell you that the most sensible route to organizational success is one that engages and focuses on the passionate pursuit of “here and now” present-moment thinking, instead of dwelling on the past or worrying about the future. VOILA! “Entrepreneurial Leadership.”

Do you sometimes wonder what Barnes & Noble is thinking on it’s way to the Borders graveyard by insisting on following an archaic business model that is completely out of touch with today’s technology and marketplace? Do you wonder why the Post Office’s solution to high expenses is to close on Saturdays, lay off employees and pull in pick-up boxes off the sidewalks?

And why does a nonprofit charity mail out fundraiser letters with “2013 Supporter” car magnets that literally fade to invisibility after a day in the sun? What makes the rampant “GOTCHA” greed of so many cable TV, insurance and telephone service providers completely override the wishes and best interests of the customers they serve?

The answer to these –and any other examples you may be prompted to think about– is the same. It is wrapped around societal acceptance of the need to pursue “the end result” at all costs. It is mired deep in the thinking that popularizes “analysis paralysis” as a characterization. It is the antithesis of innovation, and of entrepreneurial thinking and leadership.

“But winning is the American way!,” you may say. Indeed it is. But just because it’s the most desirable mantra for sports and military performances, doesn’t mean it’s the right way for business or life. If anything, it’s probably as far off base as any guideline could be. No business or life flourishes when it is completely devoted to reaching the goal line. None.

Think about it. When you’re running a race and concentrating on the finish line, you stop paying attention to what’s happening at the present moment right in front of you, right under your feet, and -SMASH!- you trip and fall on your face.  Competitors of course will hop over and around you. Winners pay attention to each step AS they take each step.

Entrepreneurial leaders nurture and thrive on the present moment. Something doesn’t work? They don’t analyze the malfunction to death. They simply adjust it and keep moving forward, and adjust it again and again in the process of constantly moving forward (vs. analyzing instant and slow motion replays again and again and going nowhere)!

Entrepreneurial leaders don’t worry about goals. They have goals, but they simply pursue them by staying tuned in to where they are, each step of the way. Like any malfunction, if the goal isn’t being reached as planned or hoped for, they adjust it. Inflexible or unrealistic, or nonspecific goals are as totally meaningless as wishes.

It’s HOW you do what you do each day that determines success. HOW do you handle staying on top of the process and the interactions? Isn’t that hard? Of course it is. The challenge is to be forever on the alert to opportunities, and that’s impossible for those who are thinking or worrying too much about where they’re headed, and for those lost in the clouds of constantly re-hashing where things have been.

Successful entrepreneurial leaders are also HAPPY leaders because they function as much of the time as possible in the present, here-and-now moment. And, like success, happiness is also “The Journey”! Do you make an effort to function each day in the here-and-now present moment as much as possible? Try it. You’ll like it.

# # #

Innovators: KEEP OUT!!!

I’ve been called an entrepreneurship evangelist. I’ve worked with thousands of doctors, business owners/operators and managers, market innovators and entrepreneurial thinkers. Like most, I’ve spent a lifetime taking (reasonable) risks, rejecting authority, breaking rules, and regularly working long into the night,

And I developed a nothing-is-taboo attitude. [So don’t tell me what to stay away from!]

But — what’s the old saying?– “The truth will (win) out!” And my experience says that the truth is if we are to make a success of  business, professional practice, career, and life pursuits, we need to set success goals that include what to avoid, as leaders, as people.

My top 7 suggestions of what to avoid and why:

KEEP OUT of jail. Let’s face it. There’s not much of anything positive or worthwhile to be had, or add to your resume, by being in jail. Yes, a handful of inmates out of millions might learn a life lesson or two, but jail is hardly a breeding ground for success at any level. So, stay away from it. Question your motives before you act or speak.

KEEP OUT of courtrooms (unless you’re a lawyer). Courtrooms can be just a stress notch away from jail. The attached anxieties alone are enough to topple years of hard work and good intentions. You may think that courtroom appearances are not always your choice, but if you don’t choose to initiate a legal event, you do choose to set yourself up or put yourself in position that could lead you there. No it’s not always avoidable, but much of it is. Bottom line: Can your business afford for you to put business time, energy, and funds into a pursuit that’s not your business?

KEEP OUT of doctors’ and lawyers’ offices (unless you’re a doctor or lawyer). If you are constantly and consciously choosing to live a healthy lifestyle, you can often avoid doctors and minimize  situations beyond routine healthcare.

Remember that once a doctor sends you to another specialist, you are IN THE SYSTEM, and the most tenacious efforts to escape it’s time and money-consuming clutches rarely succeed. For the same high stress reasons to avoid jail and courtrooms, choose to minimize lawyer visits and limit them to essential  occurrences and preventive maintenance.

KEEP OUT of hospitals (unless you work for one). Contrary to the onslaught of misguided hospital marketing that blankets this country, hospitals do NOT spawn good health. They treat those who no longer have good health, and –in many documented cases– actually contribute to the exacerbation of ill health. This is not to question professional dedication or skills. It is simply a reminder to strive for life directions that have the best odds of helping you avoid hospitals.

KEEP OUT of hiding places (unless you’re playing hide-and-go-seek with the kids) when it’s time for family and church and community. These are the times that define you and what you’re all about as a human being.

KEEP OUT of fights (unless you’re a boxer). Disagreements can be healthy, but disagreements require self-vigilance to prevent them from accelerating to the point of getting out of control. Anger, mean-spiritedness and grudges can ONLY work against you and quickly become the undoing of all you’ve worked so hard at to put together.

KEEP OUT of nonproductive relationships (unless you’re a shrink or a cop and your career calls for engagement). In other words, stay around positive-minded people as much as possible and pursue opportunities to surround yourself with others who consistently demonstrate positive, upbeat attitudes. This: will come back to help you!

# # #

So, you think you know

who you are, huh? Really?

Entrepreneurial Leaders are responsive (instead of reactive). They take reasonable risks (which means they don’t bet the farm, or even buy lottery tickets!). They are goal-driven, but focus more on the steps to reach the goal. When something doesn’t work, they make adjustments and try again (vs. corporate/government thinking that produces analysis paralysis!)

Guess what the number one ingredient is in entrepreneurial leadership — any kind, any level (from running a company to running a work crew or department, to running a family or sports team)? It’s knowing yourself. Your SELF. Because unless you know what makes YOU tick, you can never know what makes others tick.

When you don’t know what makes others tick, you’ll never be able to communicate clearly with them . . . because they do NOT think like you think even if you think they do. They don’t. You are unique. No one else has your brain. No one else can reach inside your brain and control it because every one of your behaviors is your choice!

So, are you still with me? If that little bit of awareness is true for you, it is equally true for each person who follows you. To be truly effective as an entrepreneurial leader (as opposed to a robotic leader!), doesn’t mean you have to be a shrink. It means you have to accept that everyone does not think like you, and you need to do your best to figure out what makes them tick.

Just because you may think you’ve “been around the block a few times,” that you’ve “been there, done that and got the t-shirt” doesn’t mean you can dismiss the need to keep learning about yourself and others because these are different times. What worked for you before is not likely to work again for you without some kind of adjustment.

The place to start adjusting, then, is with how, when, and where you absorb new information. Just as you and your life are constantly changing (even, and usually, when you least expect it or are aware of it), so too are the lives of those who look to you for guidance. I’m not suggesting you become a Google-aholic psych student. Just keep yourself alert. Observe. Listen.

Keeping up with all of that is challenging. But isn’t that why you took the job or accepted the responsibility in the first place?

# # #

Fired? Laid Off? Graduating?

It’s All The Same Thing:

CONGRATULATIONS!

“Huh? How can being fired compare to graduating?”

Both set the stage for life change.

“But one is negative and one is positive.”

Yup! Congratulations!

“You can’t be serious.”

Why not? Both situations put great opportunities in your hands. You are finally in complete control of your own destiny. And whatever you decide is 100% your choice!

If you’ve ever dreamed of making your mark on this planet, these are the kinds of circumstances (being fired, being laid off, graduating) that can open the door for you. None of them is problematic unless you choose for it to be.

Some of the world’s greatest success stories have come from those who are in, or returning from, the depths of trauma. Great riches historically land on the shoulders of those who decide in favor of moving forward with themselves instead of choosing to dwell on or wallow in the circumstances that led them into darkness.

Strength of character comes from inside you. And it has more to do with what you decide to do with your life than from outside influences telling you what’s best. No one else can ever know more about you than you know about you. So don’t rely on the judgments of others to make up your mind about what’s best for your present and future.

In sports, when someone screws up, teammates yell: “Shake it off!” because the game continues. And standing around feeling miserable about letting down your team accomplishes nothing except perhaps serves to prompt another screw-up and compound the first incident even further. It’s no different in careers or business or life.

Aaaah, and there is also of course a divine presence that deserves mention here as well because –if you believe in a supreme being– surely every major shift in life status represents the chance to re-examine and re-explore whether the ways you are moving are indeed forward, sideways or backwards . . . and this relates to attitude, not career status.

Do the steps you take today serve the best purposes of your own ambitions? Do they serve or lead you to better serve others? Are you taking steps? Any steps? What’s the roadblock? Have you convinced yourself that any steps are too difficult right now? When will that change? Can you simply choose to change it now? Are you choosing to be resistant?

More often than not, forward progress gets stalled when we get ourselves caught up in our own self-sorrow. The world keeps turning. The clock keeps ticking. Your heart keeps beating. Don’t choose to waste your precious time on earth feeling sorry for yourself. A friend of mine once admonished: “There’s plenty of time to sleep when you’re dead!”

# # #

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.”

# # #

Are You Expired

Or Inspired?

When did you last check your expiration date? What did it say? What does it say now? What happens if you go past that date? You rot? You crumble? You turn green? You become poisonous? You get taken off the shelf? People pass you up and reach way in the back behind you to bring up some fresh dude who doesn’t expire until 2015?

If this describes you, or you worry about it, or you think it’s inevitable, you’ve got a problem, brother (sister), and it’s time to take a few steps on your own behalf. First off, do a few chin lifts and take some deep breaths.

Don’t run to look in the mirror. Just imagine yourself looking driven and productive and successful as you once were, or perhaps you presently are but feel like you’re on the wrong side of the hill.

Contrary to popular belief, life is not all about discovery. It’s about making the most of what you’ve got to get yourself and others to where you and they want and need to be. It’s about energy and drawing on strengths, acknowledging but by-passing –not struggling to overcome– weaknesses. It’s like knowing what you can and are willing to spend before you go shopping.

Yes, you’re right! That’s called leadership! Genuine leadership has no expiration date. It may shift gears at certain ages or after certain accumulated experiences, but true leadership –like true grit, true integrity, true honesty, true passion– doesn’t fade or need to reinvent itself. It simply is.

How to get it? How to keep it? How to have it take you far beyond someone else’s (or your own) imagined idea of your expiration date reduces itself to being forever on the alert to what INspires you rather than to what EXpires you. So it’s a matter of attitude? Hmmm! That’s over-simplified! Hmmm? There’s more to leadership than attitude! Hmmm?

Well then, if leadership is all about attitude, what does anyone need to read a blog post for, since attitude is a matter of choice, and we can just choose it? Do you trust yourself to just choose it, and stay with that? So maybe the difference between expiration and inspiration is self-trust? Hmmm.

# # #

 CUTTING EXPENSES

DOESN’T MAKE SALES!

To paraphrase an old presidential quote, “It’s the government, stupid!” America’s entrepreneurial leaders are grasping for a lifeline to avoid being swept out to sea by the daily onslaught of misdirected government speak and arrogant government attitude — a trickle-down mindset — harbingers of total economic collapse. And it could be just around the corner.

Forget all that stuff your grandparents used to preach about turning out lights and closing doors to save money. You might save electricity and keep out drafts, but in small business, that kind of save money mentality has been the ruin of many startup ventures. In reality this government-style thinking process accomplishes nothing on the road to survival and growth.

NO ONE EVER MADE MONEY FOR

A BUSINESS BY SAVING MONEY!

Biting into economical practices does not make sales. Only sales make money! “Ouch!” you proclaim, “but I’m not a sales type!” Well, then, become one. Or find one. Or give up your business and go to work for the government. Or show some guts and stick it out. You can make your idea work if you stop taking government advice about how to make it work.

This is not suggesting you do an entrepreneurs gone wild act. A mainstay of our current government, though it may be, this post is not about spending. It’s about what you can do now to turn your business around and stand up to the sleazy, ramrod, phony compassion-soaked policies of the current administration that is desperately trying to control small business.

Just because you have an exciting idea and some startup funding doesn’t mean you can let your enthusiasm run rampant. Business success is about extraordinary customer service and relationship-building. It is about channeling energy and making the most of opportunities that present themselves within your realm of pursuit.

Chase one rainbow at a time! And remember that the best leaders are those who make leaders of their followers.

Running recklessly in too many directions at once will simply produce frustration, exhaustion, and distress — especially in this bare-bones economy. But you CAN run a bare-bones business. After all, small business is based on TRUST. Got some?

# # #

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