• David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 7 months ago

    First, it is cheaper to use intrinsic motivators.  Just need some good imagination and a goal for why you are implementing the motivator.  A little engagement with customers saved SW 10 or 15 minutes per takeoff.  That may have great value for the airline.

    Here is what I think about your bonus.  The money is coming directly from the ACO qua…[Read more]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    First, this is a great story of achievement by applying business skills in the small practice setting.  You have maximized revenue and reduced expenses by improving efficiency, I would say by creating an inclusive team driven work environment.  Did you get hit by lightning and somehow obtain the skills it takes to accomplish this?  Bottom line, yo…[Read more]

  • @jweidner Everyone should check out Joe’s profile page. Try to figure out his background image.

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    I think you outline the biggest problem with the trend toward physician employment.  When I was in a small single specialty group, we participate in decision making on the process of patient care.  Granted, our decision making process wasn’t very good, we didn’t know any better, but we were in touch with our patients needs because we talked to t…[Read more]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

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    Tell us about your most frustrating, time consuming, keep me up at night problem in your practice.  What metrics would you chose to measure that characterize the problem?

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • First, do you have access to departmental financial statements or your personal profit/loss statements.  If so, what effect have they had on you and if not, why have you not accessed them?  Where is the financial decision making done and how empowered are you to participate?
    Second, this charges and collections statement, from one of the largest b…[Read more]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 8 months ago

    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]

  • Describe the leadership style in an organization in which you were a member.  How would you characterize the leadership style?  Did it work?

  • 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]

  • David Joyce MD, MBA replied to the topic in the forum Sabir Taj, MD 6 years, 9 months ago

    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]

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