Louis Costa

Sorry it took me so long to respond.  Better late than never.  Let’s say you have a list of 10 causes.   Your team decides that 4 of those causes are the most likely.  Create an 8 question survey.  Allot 2 questions to address each cause.  Open ended questions are hard to score so stick to strongly disagree to strongly agree, 1 – 5.  Phase your q…[Read more]

“On the hook” that is a phrase well familiar to all physicians in a variety of situations.  I will refer you to an article in the Harvard Business Reviews that was very influential for me.  Like very!!  Go back to the reference section in the first lesson of the “Quality Leadership” course.  It will only take you 5 minutes to read it but for me…[Read more]

Thanks for the comment Ray.

I look at it like this.  As a surgeon there is a best practice process.  Eliminating variation in the process is essential to the best outcomes.  Your team needs to stay on track and follow the process to the letter, and that is your observation.

Good leaders then examine the process in a theory Y manner.  All of the…[Read more]

Thanks, I love this thoughtful comment!

Theory Y was applied in the Toyota experiment in the 60s and 70s that produced the best cars on the road.  The first thing they did was to educate the workers on the techniques of data driven process improvement.  Once they showed competency they we then set forth to improve, and improve they did.

I see y…[Read more]

Someone in own extended family developed diabetes after her pancreas failed to make insulin at the age of 50.  To say she was in total shock was an understatement.  Her first instinct was to blame herself, it must have been something she did to herself.  She had a teenage son and she felt she had let him down.  She felt powerless and dep…[Read more]

It seems that there is a disconnect concerning the financial consequences of MACRA.  My wife is a radiation oncologist with a 40% revenue contribution from Medicare.  Her 9% penalty for bad performance would result in $26,600 in really cash.  Multiple that by three, she has two partners, and you have $64,800.  Now if they perform well and rec…[Read more]