Increasing levels of stress and burnout are aggravating disturbing physician behaviors. Some have changed jobs, others have started new careers, and many have chosen early retirement. For those who remain, stress and burnout have taken their toll on the physician’s physical and emotional health. In some cases, the growing frustration, dissatisfaction, and anger have precipitated unprofessional disruptive behaviors. Although it is difficult to document a cause-and-effect relationship between stress and burnout and disruptive behaviors, the implications are there. In addition to policies and procedures designed to address disruptive behavior, organizations must make a special effort to reduce the triggers that may precipitate these events. Addressing and managing key underlying factors and focusing on enhancing physician well-being is a key part of the solution.
The COVID-19 pandemic disrupted the world of leadership. Every healthcare professional—front-line staff and leaders alike—adapted their work to confront this virus. The contributions of clinical leaders during the COVID-19 pandemic are unique and important. Experiences of clinical leadership reinforce the critical nature of leadership strategy, quality improvement principles, and commitment to integrated, whole-system quality. Clinical leaders, possessing the dual responsibility of front-line care and system-level leadership, hold critical insights regarding change in healthcare organizations as a whole. In their pandemic response, clinical leaders demonstrated key leadership characteristics that required individual growth and facilitated team cohesion: communicating with consistency and humanity; being the first to try; attending to burnout and moral injury; and building bridges to strengthen the overall response. John Kotter’s landmark book, Leading Change, provides an anchoring framework for examining the experiences and strategies of clinical leaders during the COVID-19 pandemic.
While a physician’s priority is always patient care, it is just as important to keep your finger on the pulse of the practice’s financial activities. There are benchmarks and key performance indicators to monitor and paying attention to the reports from the practice management system, will provide tools to assess the practice’s current and future success. Vulnerability results from too much trust. This article discusses the use of emotional intelligence for physicians and the administrative staff to help mitigate financial risk in the healthcare practice.
Information technology has already transformed healthcare, as it has changed every other industry. To begin with, healthcare providers have become computerized. Most hospitals and physicians have moved from paper to electronic health records (EHRs)—a transition that took place primarily during the past decade. More and more consumers are using smartphone apps, coupled with add-on devices and wearables, to track their efforts to improve their health and manage chronic conditions. Home-based remote monitoring systems are making it increasingly possible for patients to be discharged from hospital to home. And a growing number of consumers are participating in video telehealth visits with healthcare providers using their mobile phones, tablets, and home computers.
The time to begin planning is now. Retiring, selling the practice, or relocating can overtake you rapidly. If you haven’t preplanned your exit and succession strategies, you will find yourself short on time.
Healthcare represents 19.7% of the gross national product, making it one of the largest expenses for all U.S. companies. It crowds out investment for growth and is generally considered unsustainable. And the biggest cost is hospitals. Every manager has a vested interest in lowering the cost of care and increasing the viability of hospitals in their community. More than 10% of U.S. hospitals are at immediate risk of closing because of financial losses and lack of financial reserves. Over 70% of 900 hospitals surveyed reported a decrease in operating revenue over the last year. The COVID-19 pandemic provided momentum toward developing alternative deliveries of care, including virtual health, home, and outpatient care. This has created a rapid, massive shift away from hospital-based care. Perhaps the greatest risk is the largest opportunity—to find solutions to this financial crisis in the rapidly changing revenue dynamic of subspecialties, with musculoskeletal care being the prime example. Alternative sites of care and innovative care delivery are being financed by capital market investment. One solution to this crisis is for hospitals to collaborate with capital market-backed companies creating a novel business model.
Being a positive role model for your employees is a lot harder than it sounds. This article describes the values, attitudes, and behaviors that are worth modeling for healthcare employees. It explores four popular misconceptions about being a role model that can interfere with a leader’s ability to model excellence. It then describes five of the biggest role modeling challenges that healthcare executives will face and how to overcome them. These are the challenges of striking out with employees, having only reverse or negative role models, making a mistake that has big consequences, coming across as too perfect, and feeling that a leader is under almost constant scrutiny. This article also offers healthcare executives five practical strategies they can use when they can’t find leadership role models who look like them.
Coaching provides education, motivation, skill development, and insight when helping to facilitate an individual’s competency in and mastery of a particular discipline. Physician coaching has been identified as critical to physicians in the practice of medicine, administration, and leadership. Physician coaching impacts a broad swath of physician activities, including work–life balance coaching, executive coaching, leadership coaching, medical practice business coaching, career coaching, financial coaching, billing and coding coaching, HIPAA coaching, federal law and regulation coaching, prevention and treatment of burnout, and, ultimately, transition to retirement coaching. Physician coaching should be implemented across all physician practices.
After a turbulent year in 2022, provider groups will enter 2023 with significant headwinds via external economic factors and industry-specific reimbursement challenges. Optimizing revenue through core services and managing tighter expense budgets will be critical as our industry weathers this recessionary environment. These factors may further accelerate the consolidation we have seen in previous years as health systems grow and merge and as private equity expands its reach into the provider space.
The traditional in-person, strategic retreat is coming back after having been relegated to virtual gatherings for more than two years. The format is simple—key practice leadership, such as the managing partner or practice manager, hosts a dedicated strategic planning meeting, typically off-site and often over the weekend, for the physicians. The goal is for the team to return with a clear vision for the future and a renewed sense of teamwork with their fellow physicians. This article discusses the importance of practice retreat and offers suggestions for conducting a meaningful and productive retreat.
Rob Lamberts, MD, is an innovator in the world of direct primary care (DPC). Opening his DPC practice in 2013, he continues to believe that the model of care he uses has the real potential to change healthcare. DPC (where patients pay a flat fee for their care) combined with the smart use of technology empowers patients, creates the true “medical home,” and redefines the way doctors think about patient care.
The shift from fee-for-service to value-based reimbursement models represents one of the biggest billing transitions and greatest financial opportunities for physician practices. On the heels of ICD-10 adoption and against the backdrop of new digital infrastructure and workflows, practices face a new journey toward the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Quality Payment Program. Knowledge of how to traverse the path, navigate the intersections, and optimize the opportunities of healthcare payment reform is essential. This article offers an overview of the new Medicare reimbursement landscape and specific steps that practices can take to protect revenue streams today and ensure they thrive tomorrow.
Value in healthcare must focus on accessibility, quality, and affordability. This article describes how a healthcare team provides value by meeting the needs of a rare disease patient and underscores the importance of a chronic multiorgan rare disease home. A nurse practitioner can ensure that barriers to evaluation are removed and communication is prioritized in order to provide accessible and affordable care to a patient with rare disease without jeopardizing quality of care.
Many practices find themselves struggling with their patient schedules. Physicians need to see a certain number of patients per week from a financial perspective, yet want to have enough time to spend with each patient. No-shows often have a significant impact on the daily patient flow, from both a scheduling and a financial perspective. Monitoring schedules and creating a work flow that works for your practice can help decrease no-shows.
In the course of your career in medical practice management, you will almost certainly encounter at least one employee who dislikes you. In some instances, an employee's dislike may be justified. But in many, you will have done nothing wrong. This article suggests what you can do to clarify how an employee actually feels about you, to be sure that what you're observing and sensing is dislike. It then suggests 20 strategies to help you manage, change, or cope with an employee who dislikes you. This article also suggests 14 signs that your employees hate you in secret. It offers 10 reasons that employees commonly hate their managers, five reasons that employees dislike managers who micromanage them, and seven reasons employees may dislike you that you can't prevent. Finally, this article suggests an effective first-aid strategy for bad employee-manager relationships and explores the potential upside of being disliked.
Patient portals can bring many benefits to both practices and patients, but achieving those benefits requires a thoughtful and well-designed launch plan. This article provides four critical steps to a successful patient portal launch along with some tips from one practice manager who has implemented a portal successfully. Learn how to train your staff, communicate about your new portal effectively to patients, use your portal to improve revenue, and increase patient satisfaction.
The seven deadly sins, also known as the capital vices or cardinal sins, is a list of vices of Christian origin. They are hubris, greed, lust, malicious envy, gluttony, anger, and sloth. Likewise, there are deadly sins (mistakes) that have a negative impact on the medical practice. This article discusses the deadly sins of a medical practice and what each physician and each practice manager can do to combat those sins or mistakes.
With the 2016 election now in the past, everyone is wondering and predicting what will happen next. I have heard everything from fearful Democrats saying the new President will abolish Obamacare and throw 20 million people out in the cold and return them to the ranks of the uninsured to optimistic Republicans making statements that President Trump is going to fix everything in the first 100 days and healthcare will be affordable again. To be honest, both are probably equally wrong. Although we do not know what the new administration will do, we can be assured of this: healthcare is a complex problem that will not be solved easily or overnight.
Patient compliance is no laughing matter, but when administrators and doctors are asked if employees follow their directions, the question often is met with nervous laughter. In order to provide high levels of patient care and safety, leaders in the healthcare industry must be able to motivate employee compliance, adherence to policies and preference, and, at a minimum, the following of directions. Each can be achieved, resulting in far higher levels of performance in a hospital or even,small practice, but that requires leadership in each of the following five areas: giving explicit directions; imposing reasonable consequences; monitoring progress; employing empathy; and following through consistently. Without these leadership actions, a lack of employee compliance will have a far more damaging impact than any struggle with patients about following treatment directions.
This article addresses the importance of relationships between physicians and the administrative leader. The article points out that the administrative leader has been hired to manage or run a family business; these organizations are owned by physicians, and they are not only their businesses, but also their life. It discusses the meaning of good concise communications, with a strict no surprises policy, as well as how being willing to adapt rather than adopting solutions will better ensure success. The board of directors should never be seen as people you dread being around. If you do view them in such a manner, it will only be a matter of time until they begin to act in accordance with your worst fears. The goal should be to develop a relationship based on trust, competence, and mutual respect.
