Howard Savage M.D.

My leadership style throughout my professional career was relatively authoritarian,  especially when I was in the OR.  I truly believed if everyone did exactly as I wanted, the patient would have the best outcome.  Granted, occasionally mistakes did happen but they were well within the realm of common occurrences.  The thing is, when I look bac…[Read more]

Great point Rob

When I first started doing this, as a physician I was uncomfortable with projections.  I like data driven, peer reviewed, solid facts.  In business, when looking at strategy, and a capital purchase is the implementation of a strategy, moving from qualitative ( we need this thing because it will help our patients) to quantitative (…[Read more]

Rob, this is a great insight that will truly help those behind you.  Organizations of all shapes and sizes have relied on the “Take is as is” or “That is a small point, don’t worry about it” as a negotiating tool.  Both of these are illustrated in the presentation.  The practice was charging back malpractice insurance even though the co…[Read more]

Those, Aug and Sept,  are actually very good months to look at.  Let’s look at adjustments.  Those are the discounts from the charged amount that are calculated based on fee schedules for different payers.  The August charges is lower than Sept, but the adjustment amount is higher.  Usually payer mix is relatively consistent, why the much high…[Read more]

Another example of old style medicine screwing up a current medical practice.  I know a radiation oncologists in a 3 person group within a 13 person radiology group.   When the radiologists were making more money that the radiation oncologists the radiologists insisted on making them a separate cost center, segregate the revenue cycle, live off wh…[Read more]

Sabir, this is one of the best posts in the entire program.  It is pretty amazing what we do to each other.  Why?  I think the overwhelming response is that we do not know any other way.  Another may be too much attention on short term goals.  The hire is the key, not how long they last or how they feel about their job a year later.  As physi…[Read more]

Hi Stephen, thanks for the contribution.  I find that practice improvement and strategy get mixed up all the time.  Improvement technique does not work so well when you are dealing with a strategy issue.  Improvement takes an inefficient process and changes it to fulfill the original goal of that process.  Strategy looks at a problem and dev…[Read more]

So true Ralph

So much of how we organize our work in medicine is continuation of practices from long ago.  The “Rounds” as a team/meeting dynamic is something that should be unlearned.  The goal is to learn but also to provide care for a patient.  I know my rounds were often pressure cookers for the junior residents and not much learning was ac…[Read more]

I wanted to comment on the mentoring aspect of your contribution.  Mentoring has to be a formalized process.  The selection of a mentor is individualized but everything else is by the book.  You meet every 3 months in the first year, set a specific meeting time (no longer than 1 hour), have it be in the office of the mentor.  The mentor should can…[Read more]

Thanks Omar

It really is amazing at the lack of decision making technique we use in some of the most important decisions in our career.  Simple strategy planning techniques can help on both ends of the hiring equation.  For the employer, what is the state of our practice (SWOT)?  What is our mission, vision?  Who do we need to hire to move for…[Read more]

Be careful here.  You have already jumped to the solution before you understand the problem.  You may be expending resources determining that you have a perfectly functional phone system.  First assess the Problem itself, how big a problem is it.  Often time perception and reality do not match up.  Maybe that should be most of the time.  You don’t…[Read more]

I get your point Joe.  You are trying to do idea generation and then ranking all in one session.  It will seem a bit rushed to all.  It might be better to subdivide the meeting.  Part a is idea generation.  Part B is consideration of project logistics.  Part C is something else.  Next meeting Part A is idea ranking and decisions on which idea(s) to pursue.

I think that is a great idea Katie.

When the team is first formed, at the top of the initial agenda should be a description of team operations.  Included is this process for idea generation, you get an email, you return the email in 72 hours, no excuses, everyone participates.  You complete a whiteboard with all of the ideas before the meeting, s…[Read more]

I was just reviewing the discussion boards and found this incredibly insight.  I always love the character I introduced to you, Edwards Deming.  Every employee wants to do a great job when they have the opportunity to do so.  The key to our role as the leader is to provide them the opportunity and then the recognition when they perform.  If you…[Read more]