David Joyce MD, MBA

It sounds like you were applying some high level business skills as medical director and department chief.  Most physicians I have met simply fly by the seat of their pants when doing process improvement and take an intuitive approach to management.  Team based improvement like your OR success is usually process driven.  Did you already have th…[Read more]

The biggest fear about joining a committee or even greater, being the leader is having to do all the work .  Quality leadership preaches empowerment.  Often times that concept comes right along with the leader assuming control.  That is when you have the meetings where they ask you to decide but you understand the decision has been made before yo…[Read more]

One more thing.  You can’t just divest decision making and power as a leader because it is part of the modern “Quality Leadership” theory out of MIT.  You have to develop a culture of empowerment.  Most clear understand the chain of command and bureaucratic structure of an organization.  Considering how not to allow those characteristics to han…[Read more]

I always say the perception is the enemy of reality. As a physician, are we comfortable treating our perceived notion of what is wrong with our patients or should we be more directed toward the real cause of the illness. Of course we are looking for the real cause. Yet in our healthcare delivery process it always seems that perception is good…[Read more]

This is very interesting.  Patient centered rounds is a solution to a problem.  It should have been one of a number of alternative solutions to the problem.  What is the problem they were trying to solve and what were the key quality characteristics they chose to measure the problem in the first place.  Who was incorporated into the imp…[Read more]

If anyone of you can give me an idea of this practice’s collection efficiency, I have a special prize for you.  Take a shot at the answer and I will let you know what I think.

Nothing worse than working hard and then letting the revenue slip away because of a combination of bad accounting, poor communication, and lack of oversight.  Remember, rev…[Read more]

The first move to empowerment is to become informed.  The best reason to keep you in the dark is to tell you that you wouldn’t understand the information and as a result would misinterpret it.  If you know how to bread down financial statements and interpret a budget statement that excuse can no longer be used.  It is either admit to a lack of tr…[Read more]

As instructor maybe I should be the first to reply.  In the OR, my leadership style was very authoritarian.  I was very nice and respectful, and all the OR crew liked me a lot.  Still, I had a what may be called, a nice my way or the highway approach.  In a self assessment it was pretty Theory X.  Problem was, I had one case when I was in the Army…[Read more]

I think Theory X is alive and well in healthcare.  I see administrators who just want providers at all levels to show up, work in processes designed and monitored by them, and  keep quiet.  I have had senior people in medical societies tell me hospitals would not support our program because they really do not want an empowered medical staff.  Sha…[Read more]

If it is not written, it never happened.  Where have we all heard that before?  Proper mentoring is a back and forth process over years.  Formalizing the process is key to its success.  Imagine trying to recall a conversation you have 18 months ago to make a point in the present.  Mentoring is used to bring the mentor and mentee to a common path…[Read more]

Kelly

I am very interested.  I would love to see what you have and then consider adding it to a resources/references section for this class.

I agree, negotiation is all about details.  Often time we spend our energy on concepts, and let the details pass.  Yet in a contract negotiation, like the one in this course, it is the small details that ca…[Read more]

From a student of this course

I just wanted to say that I really enjoyed the course.
The financial stuff was intense. I even mentioned some of the things to my
neighbor (who is a retired CPA) and he was impressed and even a little
intimidated of some of the things that we were covering.
Also I was at a non-medical meeting and they were…[Read more]

Ray, you will have the answer to this at the end of the next course where we will talk about mentoring.  I use an example from my local hospital when a new breast surgeon was having difficulty acclimating to the culture of the OR.  She went to her department chief who referred her to the CMO who informed her that  the hospital employs seasoned ph…[Read more]