Omar Zalatimo

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]

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]