Louis Costa

I wanted to share this from Katherine King.

“I had some mentoring in fellowship , but after and even now really poor mentoring mostly time used for the mentor to talk about themselves or knock me down. The result is I learned to fight back with “courageous conversations” to say stop . But I am overall trying to hard to ” be nice ” most of the tim…[Read more]

Great point Clement ” If so, there are many cpt with 0 rvu.  So for me, it does not help much or give any additional info.”  Collecting data on work metrics that are meaningful is key.  Why waste your time collecting meaningless data points.  This financial statement is a mess, but it represents a company revenues of close to $2.5 million.  Figure that!

I have a friend who I have visited on his farm in Kansas for more than 20 years.  He has had knee pain for several years and over time I had gradually noticed him doing less and less walking.  This last year it seems much worse.  At one point we were walking in a field and he caught his foot on a milo stalk, kind of like stubbing your toe, and he…[Read more]

Great comment Katelin from someone in the front line.  I wanted to respond to hospital employment shielding a provider from any of the business end of their practice, especially finance.  Financial decisions are being made daily that affect that providers ability to care for the next patient that comes through the door.  Allocation of resources st…[Read more]

Katelin, that is the first thing that jumped out at me as well.  Accounting is supposed to help you make actionable decision based on financial information.  How can you have confidence in the accounting that tells you the smallest payment showed up in one of the highest harge months.  There may be more than one reason for this but sorting th…[Read more]

Joe, I was actually looking forward to your comment on this one.  True the charges are out of control, and they tag their A/R to the charge value.  A/R should reflect a realistic collectible so that when you do an aging or the A/R you are talking about real money.  Imagine going to a bank and asking for financing based on your A/R or selling of…[Read more]

Thanks for the insightful comment.  Unfortunately this is the rule in most organizations.  First, according to the rules of meetings, 100 people at a meeting is only good for announcements or information distribution.  In the age of email you see less of these, having one every month seems wasteful.  Counting the time lost for the meeting its…[Read more]

Dan, another great comment, you are red hot.  This is the bane of the physicians who see patients.  The admin, who holds the power of resource allocation which is where the power lies in any organization, says they want a “Quality leadership” culture but in practice are authoritarian.  They talk a good game but their actions don’t match up.  It…[Read more]

Great great comment Dan.  You bring up real life issues that we confront every day.  I alway feel it comes down to education.  When someone is disruptive it is usually the result of an insecurity.  Insecurity can often be addressed through education.  Was I ever disruptive in my clinical practice?  Probably yes.  A couple of things really influe…[Read more]

This si from a student in our Delaware cohort and I thought it worth posting here as well.

“Daniel J Meara, MD, DMD wrote: I have been in an organization that embraced Deming’s idea of Quality Leadership.  Attempts were made to improve processes and involve all staff so as to enhance engagement and performance.  However, the organizational s…[Read more]

Me too Clement.  When I thought about myself, comparing a financial reward (extrinsic) with an intrinsic motivator, there really was no comparison.  The financial award comes and goes quickly.  When your performance is recognized by other organizations members it has major lasting power.  It also allows you to be creative and inclusive when det…[Read more]

Randi

I am interested in hearing about how conflicted leadership styles have had an adverse affect on your practice.  Both you and Betty seem to be on the right track.  When you hire someone who is going to be empowered to make decisions, how are they incorporated into the practice leadership culture?  A formal mentoring process is one way, un…[Read more]

Stephen

Thanks so much for this comment, it helps us all to see what is going on with other organizations so that we can compare and improve.  I had physicians at Hopkins where the department was being reimbursed using RVUs and yet they were setting performance goals using # cases taken to the OR.  If you were under quota in # cases you were p…[Read more]

Great comment Rob.  It really comes down to actions and not words or feelings.  I am a good listener, and then I do exactly what I want.  That is not leadership.  Creating a meeting environment that uses equality driven technique for idea generation and then establishing a fair and transparent decision making process up front will go farther to…[Read more]

Just to make it a little more relevant to you.  You are doing work for your department at AAMC.  That work is entered into the revenue cycle and a payment comes back associated with you.   Granted it all gets mushed together as a department income statement and them all the departments come together in a hospital wide income statement, but you…[Read more]