Louis Costa

Hi Katie.  Thanks for joining us in class.  The class is a distillation of the best parts of my MBA.  We have had over 150 students here and in Delaware and their experience will be added to what you see here.  We have a pretty diverse group so far, but you will see many of the same issues pop up as you look through the discussions.  It does…[Read more]

Hi Karin, did you know that Sabir went to Rush as well.  We haven’t had anyone from GBMC for awhile.  I am so pleased that you could join us.  I will be interested to see how effective we are using this LMS as a basis for the course.

I am also looking forward to following you progress and seeing your discussion board contributions.  This sys…[Read more]

Hi Steve, great to have you in class.  I shall be very interested to see what you think about our virtual classroom here.  This program constitutes the best parts of my MBA that are directed at issues that arise for you all who see patients every day.  Everything here is real, no fake cases or numbers.  It all has happened, the good and the bad…[Read more]

Welcome to the program Sabir.  I am quite familiar with the “Must exercise” program that you are on.  Myine is ice hockey, used to be basketball, but skating is a little easier on the body than BBall.  You are the second student in this class who went to Rush.  Do you know Katie O’Connell?  This program is a distillation of my MBA from Johns Hopk…[Read more]

Hi Omar, welcome to the class.   You may be the first neurosurgeon we have had in this program.  Interesting that you trained at Penn State Hershey.  You will find a familiar name in the second course on the section on reimbursement, Robert Harbough.  I use a quote of his.  I will leave it at that for now.  We aspire to share this program at the…[Read more]

These are great comment Piyush.  My point was to question Saturday hours as a strategy.  What are you adding/fixing that requires Saturday hours?  Pay attention to that and form strategy in a team setting including representatives of the practice that are affected by the original problem.  Saturday hours may be one of the strategies that come out…[Read more]

“but again did not ask whether they wanted to do it or not, because we were afraid they would say no”

This is one of the biggest problems for a leader.  This issue was about sharing call.  Sharing call is a solution to a problem.  It is identification of that problem that is important to leadership.  Once you have a problem, it is the team, and…[Read more]

This from Randi

“Thanks for the constructive feedback Dave. Interestingly, Betty had the right idea to roll this idea out them as a possibility, but I sensed that out of our 15 providers, the majority would “vote it down “ so I suggested we tell them this was happening and they could choose to participate or not. Now I see what a big mistake tha…[Read more]

My response to Randi;

I think we also cover this issue in “Leading Improvement”. How do you get buy in from those who end up doing the work when you want to implement new strategy or create improvement. The answer is to incorporate them from the beginning in the process and then make sure the process is transparent. In this case, are the Sat…[Read more]

Imagine a data system that delayed decisions for a year in the care your were planning for a patient.  You would almost think you were in England.  Thing is, there is no care unless informed actionable decisions can be made on the financial side of your practice.  We would never put up with it on the clinical side, why put up with it on the fi…[Read more]

How much are you paying to outsource your billing?  It is the same with most practices, we treat our billing vendor like they are doing us a favor for the service they provide.  Granted they hold the lifeblood of the practice in their hands and you don’t want to make them angry.  But why do they deliver reports to you using an accounting system th…[Read more]

The big horror story was the purchase of a multimillion dollars therapeutic machine at the same medical center.  The purchase was the idea of a senior physician who had a great deal of pull with decision makers.  The machine was cutting edge, but had a very specific use.  Two years after the purchase that physician left to work for the co…[Read more]

Rob, well done.  When those who do the work and produce the revenue begin to engage in the financial results, financial statements, of that same work it puts pressure on the administrators, none of who produce revenue for the hospital, to become more transparent.  I would like to take the credit  for awakening the attention it took for you to cr…[Read more]

Great comment Rob.  The way financial information in handled in your organization is very typical of the way most hospitals do things.  Just think about it in a business sense.  You are employed by the hospital.  You produce revenue for the hospital both through fees collected for your work and downstream revenue based on care given.  You are an e…[Read more]

This from Joel Chodos

“Valuable teaching points of broad applicability. Impt to know what other side really needs and wants. Prepare an argument for their side and your–like a lawyer would in preparing a case so you can be prepared to counter arguments persuasively but politely. I need to walk in their shoes to effectively negotiate your p…[Read more]

This from Rubeen Israni

“I did not have any formal mentoring but looking back I had to 2 senior physicians during my office hours- I used to bounce cases off them and then I started asking them business questions as well. I still fondly remember those interactions and only now realize how important they were in my development. 10 yrs into my pvt…[Read more]

This from Janet Pedro

“I absolutely agree 100% on mentoring. I think this is something the military did right for me and in my current job, there is no mentoring structure. I have found myself in an interesting situation. I’m medical director hiring new staff and am creating a mentoring process for my new hires, but have no real mentors myself (…[Read more]

Bad mentoring is worse than any mentoring. Probably both agree on that. This entire program is all about developing the same systematic approach to delivering care as we have in obtaining and processing our clinical knowledge. An effective mentoring program should have a set process, set deliverables and set goals. Mentoring is not a time for…[Read more]