Berning & Affiliates

Losing Sight of What Made Practice and The Doctor CEO Great

I often work with very large and complex practice settings. The doctors that have built these practices are generally driven to have the growth oriented practice. In some cases the growth has happened just by virtue of the practice and doctor being in the right place. As growth occurs, as more staff, larger premises and additional doctors are added trouble can brew. In one practice this month the brew reached boiling. In short, the current doctor CEO has lost sight of what had made the practice prized by patients and made staff want to work at the practice. Size, it came to be seen, was not the end all and be all. All of this was determined after surveying doctors, staff and selected patients. Doctor CEO's, take this lesson to heart: in health care the core attributes that are sought after for a given practice must be carefully maintained throughout the growth and development of the practice or it will be crippled. Patients and staff can and will flee a practice they deem, in the words of one patient, "just an impersonal machine".

Move Staff Forward With Urgency

I saw a great example of a doctor motivating her staff recently. She laid out her objective to focus for three months on improving staff communication with patients, answering the telephone, preparing web updates, at the reception desk and chairside. She indicated that she was aware that some patients felt that the only person who listened to them was the doctor! This had to change she stated and she wanted "empathetic listeners and communicators who cared about the impression of the patients" in this area. She created a sense of urgency that she was being hurt in a way and would not stand for it. The results have been wonderful so far. In talking about the area we both agreed that urgent calls to action have to be selective and have a built in measurement of achieving or not the goal.

The Doctor CEO & Taxes

Every once in a while a short to the point statement really sinks in. The following is from an Opinion article by Ari Fleischer, a former White House press secretary and president of his own communications firm. This excerpt is from the Monday, April 16, 2007 Wall Street Journal. Doctor CEO's, often amoung the highest income earners, should participate fully in the national and state tax policy debates.

The Taxpaying Minority

By ARI FLEISCHER

April 16, 2007 Page A15

If the tax forms you're filing this year show Uncle Sam entitled to any income tax, you increasingly stand alone. The income tax system is so bad, and increasingly reliant on a shrinking number of Americans to pay the nation's bills, that 40% of the country's households -- more than 44 million adults -- pay no income taxes at all. Not a penny. Think of it this way. After dropping off your tax forms at the Post Office, you find 100 people standing on the sidewalk. Forty of them will be excused from paying income taxes thanks to Congress. Twenty of them, the middle class, will pay barely a thing. The 40 people who remain, the upper middle class and the wealthy, will pay nearly all of the income taxes. Look at that crowd again and find the richest person there. That individual will pay 37% of all the income taxes owed by those 100 people. The 10 richest people in the crowd will pay 71% of the income-tax bill. The 40 most successful people will pay 99% of everyone's income taxes. Yet for some lawmakers in Washington, these taxpayers aren't paying enough. ....

"I'm Sorry."

You may have read recent articles indicating that a well intentioned apology is a powerful conflict resolution approach. Some of the discussion has focused on the potential for any form of apology to raise the risk of the words being interpreted as an admission of guilt. This is an important discussion and one that I am sure you will hear more about from professional liability experts and trial attorneys. Long before any need to apologize is applying good risk management. Today there is no excuse for any doctor CEO not be conversant with preventive risk management. You can improve your awareness by checking out Dr. Graskemper's Special Reports on our web store. Risk Management - The Series: By: Joseph P. Graskemper, DDS, JD All four Risk Management Special Reports are now grouped together.
Risk Management 101: Basic Doctrines & Definitions
Risk Management 102: A Primer on What to do to Prevent a Lawsuit
Risk Management 103: Informed Consent How to Do It Right
Risk Management 104: The Standard of Care - What Does it Really Mean

The Greatest Thing About A Vacation

Just returned from a two week trip to cities my son wanted to visit in Germany, Italy and Prague in the Czech Republic. Yes, it was great to travel and absorb different aspects of various cultures and for my wife and I to see again the remains of history and art in Florence, Rome and Venice. But the real benefit to me was to gain perspective. For all CEO's time away, really away, can provide that much needed benefit. By perspective I mean the press of little day-to-day problems falls away. The larger picture regarding what is needed to move a business forward becomes evident. Convictions harden. For me, and I suspect many others, the great reward for a time away from the day-to-day press of a professional practice is the perspective gained on the big picture.

Forging Ahead With Growth Or Not?

Routinely I discuss with doctor CEO's the variety of initiatives they are interested in and various options. One of the most intriguing aspects of these discussions is the CEO that knows they have unattended practice, personnel, systems and transition issues while they continue their emphasis on practice growth. Of course, push as hard as they might, the unattended items don't go away. If anything they grow in intensity. Staff is usually 'ringing the alarm bell' asking for attention to one or more. What is the root of this insistence on growth in the face of a poorly laid foundation? My view is that at a certain point, growth can be easy. That's right, the CEOs know how to grow certain patient areas. However, filling in the blanks and attending to structure and policies is work! My observation is that sooner or later forging ahead with growth demands attention to structure and policies or the growth will slip. Best approach, move forward on the important growth attendant issues now, as the organization grows.