Berning & Affiliates

Leverage Your Strengths

Very interesting recent conversation with a doctor CEO who has had the good fortune to discern the areas that he is very good at and then leverage them. How? He related that through some trial and error and discussions with family and staff he had arrived at a list of his core strengths. For him this included his very warm and friendly personality and when talking with anyone an authenticity that with great frequency translated into a trusting relationship. This particularly helped to build his new patient flow. But his practice skills in the areas of financial management, personnel and regulatory compliance were poor. He for some time has focused on being in the community actively, on charitable boards, on local government panels etc. In his office his accountant and key staff coordinate the financial policies and "run the numbers". He has an outside personnel firm help find staff and administer periodic personnel reviews. He is so pleased and confident of the powerful approach being used that I thought it would be beneficial to share this success story with you! By the way, his "numbers" are impressive.

Overconfident Doctor CEOs

Observing and probing the actions of doctor CEO’s can be instructive as it relates to nailing down abilities that help predict success. One of the most interesting came up again this past week in a consultation. A doctor for the past 4-5 years had been focused on practice building. As most of you know, developing a practice to a pre-designated patient level can involve sequentially tackling facility, equipment, staffing and marketing items with, in many cases, considerable overlap. This doctor was very effective and so her confidence grew with each milestone accomplished. Now, staff and partner doctors report that she is crossing from confident to overbearing. It seems to be a case of only she knows what is best, after all, look what has been accomplished in the past few years. A good discussion raised the need for understanding how to develop a buy-in from the now larger group of doctors and staff, tactics for arriving at joint outcomes drawn from many viewpoints and how to reconcile underlying interests. With a new goal, running what has been built, and having the practice team positive and engaged in the practice the Doctor CEO will continue to be confident but not over confident to the point of overbearing and divisive in the practice

Are You Rich?

It depends, is the answer. Apparently, lots of personal and family aspects as well age and lifestyle all get added in when a person answers whether they consider themselves rich. As you know some people consider themselves rich because they have good health, or have the house mortgage paid off. But, a more definitive answer as it related to money was posted as a result of a small survey by Spectrum Group. It was recently reported in the Wall Street Journal as part of their Money Blog. The writer, Robert Frank, notes that "Having a net worth of $1.4 million will put you in the top 5% of Americans, according to the Federal Reserve." Which is true. Of course many doctors know that in certain areas of the country that $1.4 is just what the house costs!

"Do I Need Professional Help?"

In a consultation this week with a doctor evaluating numerous options for a practice transition strategy he wondered about the following: his investments and their performance, his insurance coverage and whether it was adequate, the documents being prepared (for nearly 2 years) for his estate plan and whether the firm preparing them should take into account his potential practice transfer plans, the marketing and management of the office and how it would be best developed when he brought in an associate or partner. There was more than that which gives you an idea of the number of questions and unmet needs being discussed. All of this discussion was prompted by his wife asking "when are you going to have a plan in place to transition the practice?" And his response to her was, "Do I need professional help to develop the plan?" The answer became obvious the more they talked! If you end up in a similar discussion don't wait -- in this case the doctor and his wife had their discussion 3.5 years earlier and he was just getting around to calling yours truly!

The Best Fit

In a discussion recently with a doctor CEO setting his strategy for a complicated practice succession we reviewed each of the current associates. The doctor commented on the attributes of each younger professional and whether they had met or exceeded his written list of performance expectations. Regarding one of the doctors that had held such promise as the heir apparent for the practice the doctors said, "He is a great associate but given his decision making, more than likely a poor partner." This is was a hard observation to make. We all tend to become invested in people and our goals for them and our organization. But this doctor CEO made the hard call. The younger doctor was great at providing care but took issue with every major initiative, could not seem to connect well with several of the staff and felt he was entitled to an equity position. Given those aspects, and others, the doctor CEO was prepared to keep looking.

Your Values Rule

One of the most enjoyable books of recent memory is True North by Bill George. I say enjoyable because it is well written and reflects some of my own experience in a nicely developed format. In particular his discussion of becoming an authentic leader reinforces my long held view that values, especially in the health care context, are preeminent for the doctor CEO. Under the stress of daily or larger business related concerns applying and using your values to make decisions and guide the health care organization is critical. Here is a very small part of an interview by Erin White 12/3/07 for the Wall Street Journal with Mr. George. WSJ: What defines an authentic leader, and how do you become one? Mr. George: They lead with their whole selves—their hearts as well as their heads. They don’t get pulled off course by seductions and pressures. Every leader who has failed, that I have seen, has not failed to lead other people, they’ve failed to lead themselves.

Enthusiasm is Magic!

I was recently visiting a variety of practices from Los Angles to San Francisco, and many places in between. In two of the practices it was apparent that there was a fountain of energy powering everyone from staff to patients. It seemed like magic but it was the doctor CEO in both cases! I was reminded at that point of the Bill Gates quote, "What I do best is share my enthusiasm." In the case of the doctors they made the environment friendly, warm and upbeat. They transferred their good feeling to everyone. Talking about my observation and comparing other practices I had seen, one of the doctors said, "It is all about giving and I get it all back double!" Assess yourself doctor CEO, are you enthusiastic or a drag on the practice? From what I witnessed, its far better to be the former!

Congratulations Dr. Danenberg! Chartered Advisor for Senior Living

We have enjoyed a long and beneficial relationship between Berning & Affiliates and Dr. Alvin Danenberg. Many of you know of his outstanding work with the Danenberg Lifetime Investment Plan, offered on our website. He also has provided numerous CE courses over many years and some of them are also available as slide programs on our website. Now, adding to his background and credentials is a wonderful new professional designation. Al undertook this course of study to better help doctors and their spouses prepare for living as seniors. Here is the news release on his accomplishment.

NEWS RELEASE: CASLÔ DESIGNATION

                                             Alvin H Danenberg, DDS, CFP, CASL

                

ALVIN H DANENBERG EARNS CHARTERED ADVISOR FOR SENIOR LIVINGÒ (CASLÔ) DESIGNATION

CHARLESTON, SC – NOVEMBER 1, 2007 – ALVIN H DANENBERG, DDS, CFP has earned the Chartered Advisor for Senior Living (CASL) professional designation from The American College, Bryn Mawr, PA.

Candidates for the CASL designation must complete a minimum of five courses and 10 hours of supervised examinations. They must also fulfill stringent experience and ethics requirements.

The CASL program is considered the most comprehensive curriculum available that addresses the unique financial needs of seniors. Once the program is completed, a Chartered Advisor for Senior Living can provide expert advice on a broad range of financial topics including health insurance, long-term care financing, pension planning, trusts, Medicare and Medicaid supplemental planning, financial and estate planning, and more. Over 1200 individuals have been awarded the CASL designation since its inception in April of 2004.

Dr. Alvin H. Danenberg is a Certified Financial Planner™ professional, a Chartered Advisor for Senior Living^Ò, and a practicing periodontist in Charleston, SC. He writes a monthly newsletter, Danenberg’s Lifetime Investing Plan, and is an affiliate consultant with Berning & Affiliates, Inc. (a firm with a 27-year history of specializing in practice transition and succession planning for various specialties in the profession of dentistry).

The American College is the nation’s leading non-profit educator of professionals in the insurance and financial services industry. Located in Bryn Mawr, Pennsylvania, The College is a public charity founded in 1927 and accredited by the Middle States Association of Colleges and Schools. The American College offers an array of specialized designation programs, Master of Science degrees in several disciplines, and customized continuing education programs predominantly on a distance education basis for those pursuing a career in financial services. For more information, visit www.theamericancollege.edu

CEO's Reality Check

In an interesting quote a top CEO, Carl Bass of Autodesk, reflected on his experience as he became CEO of the company. "My IQ jumped 10 points and I became much funnier," as quoted in an insightful Wall Street Journal article, A Different Animal Seeks the No. 1 Post by Phred Dvorak, 10/22/07. Mr. Dvorak wrote, "But the greater deference his employees paid to the intelligence and wit of their new CEO had a downside, too. Mr. Bass says he couldn't be as frank and critical as he had been when chief operating officer. He feared employees would overreact. "When you're CEO, what you're saying is so amplified you have to be very careful," says Mr. Bass. This same experience is one I see in countless practices. The doctor CEO is so often told they are right by staff or not given any real feed back that they begin to believe they are very smart. All attempts at humor are met with laughter. Only when some of the doctors runs into operational or valuation or transition issues is the light shown on sloppy procedures, poor financial management or other areas and then nothing is very funny. Doctor CEO's take heed. Have your practice coach provide at least an annual impartial assessment of your performance. Larger practice CEO's should consider implementing six month reviews. You'll find a lot of benefit in clear assessment and a good strengths and weakness analysis. Check out our Doctor CEO services if you want to gain an understanding of the scope of this type of service.

Discipline

Comparing practices on an on-going basis as we do teaches a great deal. What do we find? One of the most telling aspects we find is the consistency or not of delivering growth and meeting patient expectations. We find that without explicit procedures to reinforce how staff and doctor(s) are to interact with each other and accomplish the core care delivery of the practice, operational performance suffers. Further, if there is not a built in mechanism to check performance and then, when it is off track get it back on, difficulties multiply. I often say that our study of practices teaches that delivering consistent results is the result of the doctor CEO's discipline in stating the path of the practice and then fostering growth toward the desired result(s). In short, it is the discipline of the leader that will repeatedly make one practice more successful on multiple levels than another.