Physicians Make Mistakes, Correct Them The Right Way

“If they will hand me the instruments when I need them, then they won’t get yelled at. This is my OR and my rules.”

“Well, I’ve always prescribed Cipro for strep throat. In my experience, it always works. No one can tell me how to practice medicine.”

We’ve all heard stuff like that before. Try to offer a correction or suggestion to a colleague and the walls go up immediately. It can be very uncomfortable, especially for non-physician staff, when a physician shuts down a conversation. Physicians often implicitly hold the most power in conversations or interactions that they have with staff and patients. If they refuse to discuss something further, then there is little recourse, but the long-lasting impact on relationships can be irreparable.

So how do we deal with this? As a supervisor, how do I hold staff accountable? As a colleague, how do you approach someone and speak up when you see a problem? It will always be uncomfortable to criticize someone, but if structured correctly, criticism can lead to growth.

If structured incorrectly, then these conversations can lead to worsening distrust within healthcare organizations. If administrators thought their job was hard now, try to lead a cadre of physicians that refuse any attempts you make at change or improvement. It can get ugly fast.

Peer To Peer Conversations

Physicians correct other physicians. That is the practice in my organization, and it is essential. Due to the extensive amount of training that the average physician undergoes, it is very difficult for non-physicians to grasp the knowledge base and unique experience that most physicians have.

This is similar to many other highly specialized fields. I wouldn’t dream of micromanaging the daily tasks of a nuclear physicist. I have no clue what he does on a daily basis. In the same way, physicians are much more apt to listen to a fellow colleague than a non-physician.

My first thought when an MBA tells me I’m not seeing enough patients? Who does this bean-counter think he is (no offense!)?

My first thought when a fellow internist tells me I’m not seeing enough patients? Holy crap, am I not pulling my weight?

Establish the Standards

If you’re going to hold someone accountable, then you need to define what the standards are. Decide the standards up front and include physicians in the decisions regarding this. As I always say, the mission is the answer, and you have to very clearly delineate what you expect your staff to accomplish when they show up at work.

These standards can get as specific or as broad as you like. I personally prefer to keep them broad so we hold each other to the spirit of the law rather than the letter of the law.

I may receive hate mail for this as well, but I think you should define what the standards are not only when it comes to behavior, but also clinical practice. Civility and respect should be a common expectation in all interactions, and most will not have a problem with this. ZdoggMD has an excellent video below demonstrating how to appropriately talk to patients:

OK, maybe not, but I think you get what I’m going for here.

There are numerous benefits to establishing clinical practice standards as well. If all physicians practice in a similar way, then it is much easier for staff to effectively do their jobs. We use published clinical practice guidelines as our starting point and have established methods for deviating from them if there is a compelling clinical reason that the physician staff can agree on.

If a situation is outside of established guidelines, then physicians need a formal venue for peer assistance. This can be through interdisciplinary rounds, tumor boards, etc. The purpose of clinical practice standards is not to cram every patient into the same box. The purpose is to practice in an evidence based manner where evidence is clear, and allow for reasonable judgement when the evidence is not clear.

Public Praise, Private Correction

Do you enjoy being called out in public? Didn’t think so. Then don’t do it to other people! Physicians are no different. Nobody responds well when called out in a meeting of their peers. A justified critique will easily be interpreted as a personal attack because of the venue.

Despite what some may think, adding the extra humiliation of public critique doesn’t “add emphasis” to what you say or “make them remember.” It just builds resentment. The average physician is a driven, hard working individual that will have no trouble remembering any criticism they receive.

In contrast, everyone wants their accolades to be publicly broadcasted. Even folks that shy away from the limelight enjoy being congratulated in front of their peers, whether they admit it or not.

Again, physicians, on average, amplify this even more. Physicians pride themselves on the quality of their work and enjoy seeing that work recognized. Remember you are talking to a group of people that earned a lot of A’s during their school years! Feed the ego a bit and let everyone know when someone performs well.

Professional Courtesy

I hear this phrase thrown around a lot in break rooms. Several physicians have told me before they should be “given the benefit of the doubt” or shown a little “professional courtesy.” Unfortunately, they don’t seem to know what that really means when they say it.

I think our professional athlete colleagues can assist us with an example. Here is Peyton Manning and Jeff Saturday, formerly of the Indianopolis Colts, giving a wonderful example of professional courtesy (note there is some language in the video courtesy of Youtube):

See, professional courtesy means you just sweep problems under the rug, right? Ha! Professional courtesy means I do you the courtesy of coming to you, peer to peer, to ask about what happened rather than simply acting on the information I receive (or calling a press conference in Peyton’s case), under the assumption that we are both on the same page regarding our common mission and goals.

There are many vocations where someone reporting your misdeeds leads directly to termination or other bad consequences. Try working at McDonald’s and have one of your co-workers report that you stole something. Your manager will have a conversation with you, but it will be very brief and will likely end with you handing in your name tag.

Professional courtesy means if someone reports a potential problem to me about a physician, then I do not pass judgement during that initial conversation. I will promise to investigate, but I will not promise to punish or even agree. This can be frustrating for other staff at times, but to me, innocent until proven guilty is an essential part of professional courtesy.

Second, I will review the facts surrounding the case myself and come to you, physician to physician, to discuss the matter (hopefully with fewer bleeps than Peyton). I will not pass judgement before talking to you, and I am open to hearing your reasoning for your actions. This may or may not change my mind, but I will speak directly to you and not to anyone else.

As I said before, professional courtesy never means that I will ignore problems. Our standards are our standards and everyone must be accountable to them. However, I will absolutely promise to come to you, and no one else, to discuss the issue. That is professional courtesy.

Address Problems Now

If there is any final piece of advice I can give, it is to address problems immediately. Don’t ignore them. Don’t say you’ll “address it next time.” Address it now. Show your colleagues that you really think accountability and performance standards matter. Demonstrate urgency with your actions.

The single greatest problem I see amongst physicians and physician supervisors is lack of urgency when it comes to accountability. We get caught in this every man is an island mode of thinking where we simply throw up our hands and say “he’s responsible for his own actions.”

We have to acknowledge that our fates as physicians are tied together and act accordingly. It is always better for physicians to collectively improve. Always. No improvement happens without accountability.

Remember that, at the end of the day, we are going to be accountable to someone. We can either be accountable to ourselves or to someone else. We’ve tried the someone else route in medicine. Time to do something different, wouldn’t you say?

Have you ever tried to correct a colleague or bring up a problem? Did it blow up in your face and turn out well? Tell me about your experience in the comments!

Extended Hours 9/9/17

Welcome to this week’s edition of Extended Hours! While the term “Extended Hours” may be an undesirable phrase in the lives of physicians, this series on the TheBossMD should prove to be a much better experience!

Extended Hours is the weekly roundup post published every Saturday here on TheBossMD. As with all of my content, the purpose of this series is to help physicians manage their positions, whether it be personalfinancial, or professional.

These posts are light on my thoughts and heavy on the best content I can find during my travels through social media and the internet. We might even have some fun along the way!

And The Winner Is…

As many of you may know, we have been running a contest to give away a 50 dollar Amazon gift card to one of my email subscribers. I appreciate everyone that participated and shared the contest! With that said, I have notified the lucky winner. Stay tuned to see if they will announce themselves! Please continue to share TheBossMD with your friends and sign up for my email list for more free stuff coming in the future.



Personal Position

Zero Day Finance had an excellent article about how Everyone Must Prepare For Emergencies. There are a lot of very practical tips included, all the way to lists of specific items you should make sure you have on hand. Personally, I have the most experience with hurricanes, and we keep a hurricane box ready with supplies along with several larger items (like our generator). Figure out what you should be ready for and get prepared now!

This next one is for my younger colleagues either in training or just out of training. I travelled a fair amount in my younger days, and it was one of my better decisions. Miss Millennia Magazine hosted a great article Why You Should Travel When You’re Young that contains some good tidbits for the younger crowd looking to see the world on the budget. You’re only young once. Go see the world!

Many travel blogs have numerous articles about the Caribbean, Alaska or any number of other popular destinations. Some of my favorite travel, though, is to smaller locales where I can really experience the local flavor. We plan to hit Europe, and specifically Germany, at some point as Mrs. BossMD does have some German family. 5 Must-Visit Fairy Tale Towns in Germany over at Travel Alphas will definitely help us out on our trek. The pictures of the available food and drink should be enough to get you to check it out.



Financial Position

Let’s face it. Those little munchkins you have are expensive. Given that you’re going to be financially responsible for them for eighteen to thirty three years (if they go into neurosurgery), you should look into ways to save some money. Derek at Life and My Finances gives some nice tips in How To Raise Your Kid For Half The Cost. My favorite tip? Definitely his suggestion to use cloth diapers. Sorry man, I just ain’t doing it!

The good doctors over at Physician Couple gave an update on their methods for dramatically increasing their net worth in How We Improved Our Net Worth By $730,000 In Less Than Three Years. Nothing complicated here. Just some good old fashioned thriftiness and saving. I am jealous that at least one of them still gets to wear scrubs on a daily basis. One of the main things I still miss about residency to this day.

Listen up government employed physicians. Dr. Dahle over at The White Coat Investor has an update for you on how to manage your Thrift Savings Plan (TSP) account in What You Need to Know About The Thrift Savings Plan. Like Dr. Dahle, I also have experience with the TSP. It is one of the best 401k plans around and everyone with access to it should be contributing. Follow Dr. Dahle’s advice and you can maximize your gains.


Want to track your money for free? I use Personal Capital. Check it out!


Professional Position

After talking about The Curbsiders podcast last week, I decided to see what kind of podcasts other physicians were listening to. Fortunately, the fine folks at Doximity shared an article from Physician’s Practice entitled Listen up! Podcasts for Physicians. There are some great picks in there ranging from personal finance to clinical medicine. Coincidentally, this site has a similarly broad range, so I felt right at home!

My disdain for poorly run meetings is well documented, so I was thrilled to see an article about how much money meetings can waste from SuccesIsWhat. Many people don’t think about how much money a meeting can waste, but everyone should think about this, especially when you have high income employees like physicians. My monthly staff meeting I run costs $852, and the bigger meetings I participate in cost much more. Download the calculator and see what yours cost!

I keep things simple in my life, and I enjoyed Lolly’s Daskal’s article that asks a very simple question. Are you adding value or subtracting value? Many physicians simply assume we add value by showing up to our clinics each day. While treating our patients certainly adds a lot of value, I think we miss opportunities as leaders to do much more in our daily workflow. Think about this simple question as you go throughout your work day. What actions add value and which ones detract value? Should be eye-opening.

Just For Fun

While you’re reading this, there are one of two things going on. Either I am in Disney World having a blast, or I am at home preparing for Hurricane Irma. Neither scenario involves me checking in here multiple times throughout the day, but I sincerely hope that I am taking pictures with Mickey rather than hitting all the stores to find as many D batteries as possible. For you hurricane rookies out there, D batteries are worth their weight in gold one to two days prior to a hurricane.

Hurricane Harvey has obviously raised awareness recently about the devastation a hurricane can cause and with good reason. Speaking from experience, hurricane clean ups can take months and even years. If you’re looking for a monetary way to help, then I recommend giving to the American Red Cross.

I live in a part of the US that sees hurricanes a lot, so I have been through quite a few hurricanes myself. Most importantly, I’ve watched enough forecasts of hurricane tracks to know that things can change very quickly. We generally have pretty good data about how strong a storm is, but predicting exactly where that storm is going to go is a whole different ballgame.

My general rule is that I will stay home for a Category 1 or 2 storm. I am fortunate to be on high ground, so flooding is not an issue for me. Category 3 and up is usually where I am looking for hotel rooms or friends further inland so I can get out of dodge. Hopefully I won’t have to do this.

On a brighter note, my Clemson Tigers started their season last week with the fierce Golden Flashes of Kent State. No disrespect to these fine folks, but I think everyone knew what the outcome would be. There has been much discussion regarding if we could find a quarterback to replace Deshaun Watson, who was arguably the best to ever play at Clemson.

I may be biased, but I think our new starter Kelly Bryant answered the bell, and both of the guys behind him also proved they could get the job done. Many analysts have expressed doubt that we could repeat as champions this year, but let me give a warning to all. This team has more talent and depth than last year’s team. Just ask this guy from Kent State how it feels to play the Tigers:

With that said, bring on the Auburn Tigers today and let’s see who the better team is. There’s nothing like college football! Make sure to drop me a comment and tell me how your team fared. Maybe you even think your team has what it takes to knock off my Tigers. Bring it on!

Have a great weekend!

TheBossMD

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The Position Paper 9/8/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Professional Position

Featured Article: None

My Take

No featured article today, as I thought I’d give my brief thoughts about physician accountability. As many of you know, I am a physician that supervises other physicians. As such, I am the guardian of our organization’s mission and values within our clinic.

I take this job very seriously, as I view this as just another way to ensure that our patients receive first class medical care. My role sometimes requires me to have tough, direct conversations with colleagues, and I don’t shy away from it.

I have marveled, however, that some others in similar positions refuse to speak up when noticing their employees delivering substandard work or behaving in an an unacceptable way. Often, they will tell me something along the lines of “I’m not going to tell another doctor how to practice medicine” or “They are responsible for their own actions.”

On the surface, I agree with these sentiments. I don’t go to work every day and tell my physicians how to practice medicine, and they most certainly are responsible for their actions on a daily basis, just like anyone else. However, professional courtesy requires that you act like a professional.

I am not going to sit by and watch one of my physicians treat a patient with disrespect. I’m also not going to watch any of them give out narcotics to every patient with back pain that walks in the door. There are standards of behavior and quality that we all must adhere to. Enforcing these standards does not diminish our profession; it enhances it.

As I tell my employees, we can either police ourselves or someone else will come and do it for us. As a physician, myself, I think I am the best positioned to fairly and accurately judge my staff’s performance and behavior. As long as I hold everyone accountable to a standard of excellence, then no one else will bother us.

If I fail to hold others accountable, then other people will likely start to bother us. I think we all can agree that medicine needs less outside people shaping our direction, not more. Accountability is the only way to ensure physicians remain the leaders of the healthcare system; we should embrace it.

Have a great day!

 

TheBossMD

Do you like The Position Paper format? Is this someone I should keep doing or trash it? Leave me a comment and let me know!

The Position Paper 9/6/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Financial Position

Featured Article: Here’s The Key To Getting A Good Raise At Time Money

My Take

So, you want a raise, huh? Think you deserve to have your paycheck padded? Think you deserve a bonus for your efforts? Well, let me give you a really complex tip to get paid more at your job. Be good at your job.


Want to track your money for free? I use Personal Capital. Check it out!


 

While not the most earth shattering advice, this tip is timeless. It doesn’t matter what compensation structure is en vogue at the time. It is always financially better in the long run to be a star performer.

Our article today from Time Money not only talks about the monetary value of achievement at work, it also talks about trends within the workforce today. Many workers have come to expect the periodic “raise” purely from just showing up.

For those that really do “only show up,” that is the only raise they will ever see. Rather than giving larger raises to great workers, however, the current trend is to make better use of bonus programs.

Clinical medicine is no stranger to this trend, as many hospital systems are instituting clinical quality bonus systems in line with payers’ increasing focus on quality. Interestingly, this shift in focus has led to a slightly different definition of a “star performer” within the employed physician ranks, but that is a different discussion.

I would highly encourage you to know all the details of any bonus program you participate in so you can maximize your chances of getting every dollar, and don’t forget the different tax treatment of your bonus versus a pay raise so you can plan ahead for your taxes. It’s all about what you keep when it’s all said and done. If you’ve gone through the trouble to be the best, then you might as well get the most you can!

Have a great day!

TheBossMD

Do you like The Position Paper format? Is this someone I should keep doing or trash it? Leave me a comment and let me know!

The Position Paper 9/4/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Personal Position

Featured Article: Modern Day “Needs,” Which Really Aren’t by Money Propeller

My Take

The recent tragedy with Hurricane Harvey has really gotten me thinking about what matters in life. Many folks lost all of their material possessions in the hurricane and subsequent flooding. I think it’s only natural to think about how I would react if that happened to me as I watch all the news coverage.



Today’s article from Money Propeller doesn’t quite have this kind of focus, but it does provide some perspective about modern day things that we, sometimes falsely, consider to be “essential.”

There are several items mentioned, but I was glad to see electronics like phones and computers put on there. I have been “unplugged” a few times in my life on purpose, and honestly, I really enjoyed it. This realization has greatly changed many of my daily habits for the better as I do not consider it essential to have many electronic notifications in my life.

I don’t need to receive every email that comes in exactly when it hits my inbox. I don’t even need to receive every text message or phone call exactly when it occurs. There are plenty of things happening my real life that require my full presence, free from outside distractions. So, I really can’t call a phone “essential” to my life.

In healthcare, I think we often overstate the importance of computers. I secretly love when our computer system goes down, and I am free to just see patients with no computer. I may pay the price when they come back up, and I have to chart everything. But, there is something truly sweet about seeing patients with nothing else around.

So think about the things you consider “essential.” Are they really that necessary for your life? I bet you’ll find that your list of truly essential things is really small. Our lives would probably be a lot better if we spent more of our time there than with computers or phones. Give it a try!

Have a great day!

TheBossMD

Do you like The Position Paper format? Is this someone I should keep doing or trash it? Leave me a comment and let me know!

Extended Hours 9/2/17

Welcome to this week’s edition of Extended Hours! While the term “Extended Hours” may be an undesirable phrase in the lives of physicians, this series on the TheBossMD should prove to be a much better experience!

Extended Hours is the weekly roundup post published every Saturday here on TheBossMD. As with all of my content, the purpose of this series is to help physicians manage their positions, whether it be personalfinancial, or professional.

These posts are light on my thoughts and heavy on the best content I can find during my travels through social media and the internet. We might even have some fun along the way!

One Week Left To Win $50!

Before we get to this week’s picks, don’t miss your chance to win a $50 Amazon gift card. I am going to pick one of my email subscribers to be the lucky winner, and it will be announced on the Extended Hours for next week! Please sign up below and share this on Facebook, Twitter, Google+, Linkedin, Pinterest or wherever else you may go.



Personal Position

Wealthy Doc wrote a guest post at Physician on Fire that should be required reading for all medical residents. Doctors are terrible at taking care of themselves, and Wealthy Doc eloquently talks about the value of taking break in his post succinctly titled You Need Rest, Doctor! I preach this to my doctors, and put bluntly, many of you need to read and apply these principles. Book your vacation now!

Apparently Future Proof M.D. is a boxing fan and caught the recent Mayweather-McGregor match. He has learned a little more from what watching the match other than make sure you always demand $100 million to fight someone! In 3 Lessons from Mayweather vs. McGregor, he talks about what you can learn from the match and how it applies to live. I especially like how his second point is to take calculated risks. I’d certainly call getting in the ring with Floyd Mayweather a risk!

How much sleep did you get last night? Don’t lie to me now! Most physicians are sleep deprived and run on empty too much. So I think the article Why You Probably Need More Sleep published earlier this year by Mustard Seed Money is especially applicable. You’d think that physicians shouldn’t have to be told the value of sleep, but I know it’s just not true! Put your computer and go take a nap (well, you can finish reading this first).



Financial Position

I really appreciate Passive Income M.D‘s honesty in his article How to Become Financially Independent Spending More Than $200K Per Year. I feel like many articles on the internet talk about living on bare minimums, and the reality is that many people are not going to go that extreme. Sometimes those expenses are necessary, i.e paying off loans. Just make sure you’re doing it on purpose.

If you want to manage your own money or just better understand investing, then you need to learn from mistakes, not just successes. Wall Street Physician talks about one of the more spectacular Wall Street hedge fund failures in The Dream Team Loses Big: The Fall of Long-Term Capital Management. Watch yourself before considering actively managed funds in the future, so this doesn’t happen to you!

Are you looking to get into real estate investing but have no idea how to decide when to pull the trigger on a property? Well Chad Carson over at Coach Carson has put together a great article to make real estate investment decisions in How to Confidently Buy An Investment Property-My Go, No-Go System. This is a great primer to pricing and financing rental properties, and if you follow the links in the article, you’ll find many more articles that are excellent review of real estate basics.


Want to track your money for free? I use Personal Capital. Check it out!


Professional Position

Productive Physician has really outdone himself this time with his new post entitled Inbox Zero: The Ultimate Guide To Managing Your Email. This epic post goes through every possible nuance of email management. Like all things, you need to make email work for you, not the other way around. I know I have trouble staying on top of it myself sometimes. Thanks Productive Physician for your insight!

I usually listen to several podcasts while driving or charting, and I am constantly looking for new stuff. I just discovered The Curbsiders, and I can’t recommend it enough. This a clinical podcast from internal medicine physicians covering clinical topics. I just listened the heart failure episode this past week and gleaned several good pearls from it. Hopefully, I can start getting CME credit for this soon!

Dr. Schloss over at Left To My Own Devices did a great medical charting article entitled Why Healthcare Documentation Is So Bad. He gives a great summary of the history of EHR’s and the many different forces that led our notes to become the gibberish that many of them are now. Definitely recommend you check out the comments for good discussion.

Just For Fun

It’s been a fun week in the BossMD household. I am now down three pounds! Yeah! My body isn’t completely revolting anymore due to my decreased calorie intake, and my exercise is going a little bit better. My son can still show me up, but I think I look a little more decent this week. Here’s some video below that I think looks pretty close:

We have also hit a really big milestone with my second son. We are sleeping through the night! There is no fatigue like the middle of the night feeding fatigue. I tell medical residents that you might be able to stay awake all night in the ICU, but the sound of a baby crying at 4AM will make you flat out depressed when it happens for the tenth week in a row.

As this is our second child, I am predictably more relaxed with this one. I used to wake up at night spontaneously to check on my first child. Definitely not happening this time. My wife and I woke up once the first night my second slept all the way through. It went something like this.

My wife: “Hey, is the baby OK?”

Me (without moving a muscle): “Of course he is.”

My wife (without moving a muscle): “Awesome.”

Yeah, a lot of concern going on here.

I’ve also derived great joy from tricking my oldest into feeding his brother. He was happy to help at first, but the appeal is definitely waning. There are only so many “emergencies” I can fake and ask him to hold the bottle to feed his brother.

I know I must be pushing my limits because I asked him to help me out this week, and he flat out refused. I tried to put on my stern “dad” face and tell him to help me or else. Wouldn’t you know that little sucker stared at me and said,”You’re really lazy, Dad.”

Well son, you’re right….now get over here and hold this bottle. I may be lazy but, at least in this house, I’m still the boss!

Have a great weekend!

TheBossMD

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The Position Paper 9/1/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Professional Position

Featured Article: Improving Physician Satisfaction By Eliminating Unnecessary Practice Burdens hosted by KevinMD

My Take

 

Dr. Yul Ejnes of the American College of Physicians (ACP) penned a home run with this guest post on KevinMD. Doctors everywhere have long lamented the mounting non-clinical activities that take up our day. We are finally starting to see some real movement to rein in all of this workload so doctors can focus more on patient care.

The ACP has a broader initiative, Patients Before Paperwork, which serves as its national campaign to support this topic. In this article, Dr. Ejnes discusses the growing burden of physician signature requirement and the absurdity associated with it. Any doctor that has checked their inbox can see the vast numbers of signatures required for items ranging from wheelchairs to diapers.

Dr. Ejnes eloquently discusses the intended role that insurance companies want doctors to play (medical fraud detectives) compared with the reality of completing all these forms while still providing high quality patient care. Physicians do not want or need to spend their time policing the contract between patients and insurance companies.

Up to this point, physicians have tolerated this exercise in the name of patient care. No doctor wants to see their incontinent patient go without diapers or their patient with history of stroke go without their wheelchair. We are here to help our patients, so that is what we have done.

The sheer volume of incoming fire, though, has triggered a tipping point where the time required to complete these tasks threatens our day to day ability to actually care for patients. We are willing to bend to provide our patients what they need. We are not willing to compromise the patient care we provide.

I am very hopeful that these type of national initiatives will spark real change in the insurance industry and, in turn, physicians’ day to day lives. Physician organizations will likely have to lead the way, as they are the only groups with the size necessary to interface directly with insurance companies.

Throughout our dialogue, we need to keep the patient at the forefront of our discussion. A signature may seem like a simple thing, but continued erosion of physicians’ time to focus on patient care will never have my endorsement.

TheBossMD

Do you like The Position Paper format? Is this someone I should keep doing or trash it? Leave me a comment and let me know!

The Position Paper 8/30/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Financial Position

Featured Article: Rules For Riches by Wealthy Doc

My Take

I am a simple man, and I prefer to keep my life simple. Wealthy Doc does a great job in Rules for Riches espousing some simple tips that can lead to great results. The unfortunate reality is that many people don’t do the simple things to get the results they say they want. Do you want to win every free throw contest you enter? Practice them. Every day. Shoot hundreds per day. You’ll get really good at it. Guaranteed.


Want to track your money for free? I use Personal Capital. Check it out!


The same simplicity exists in the financial world, despite how hard we try to make it. You want to accumulate a lot of money? Save it. Don’t blow it. Live a simple life. Don’t do dumb stuff. If everyone could pull that off, then we’d have a lot more wealthy people, physicians included.

In his article, Wealthy Doc outlines some of these simple items that can lead to great results. Educate yourself in an affordable, practical way so you can provide as much value as possible. Make career contingency plans so you always have options. Manage your personal life well by avoiding divorce, raising your kids in an economical way, and maintaining a simply lifestyle.

He, of course, also advises to save early and save often. Only then will you be able to execute a well defined plan of how to grow that money. Perfect asset allocation with five dollars is not going to be very impressive. Perfect asset allocation with five hundred thousand dollars will garner much better results.

The one observation I will add here is that his advice assumes a somewhat traditional career path involving employment. Entrepreneurship is the alternative, which comes with more inherent risk but also potential for higher reward. Last I checked, many of the really wealthy people I know own things, so I would add “Be The Boss” to his list (I had to say it).

Once you grasp these simple items, then you can progress to the higher level stuff. As momma always said,”You gotta walk before you can crawl.” Or something like that…

Have a great day!

TheBossMD

Do you like The Position Paper format? Is this someone I should keep doing or trash it? Leave me a comment and let me know!

The Position Paper 8/28/17

Welcome to The Position Paper! The Position Paper is my series featuring my quick take on a particular topic to help you manage your position. I will often feature one outside article as well that will allow you to dig in deeper if you desire. Read this while you drink your coffee in the morning and start your day off right!

Today’s Position: Personal Position

Featured Article: Take Back Your Sanity By Switching From Push To Pull by Keep Thrifty

My Take

Chris over at Keep Thrifty wrote a home run with this article. He published it some time ago on his blog, but many people should probably save it to read periodically. If you’re anything like me, there’s an infinite number of “things” competing for your time. These things often distract me from what really matters in life, and I’m not OK with that.



Chris talks about switching, as much as you can, from a push to a pull method for incoming information. This method applies especially in the context of electronics but can be used in many realms of life. In short, others should not decide what you hear about first or what you react to first; you should.

Do you want your email to stop interrupting your day? Then turn off email alerts on your phone. How about social media? Phone calls? Text messages? Your mother in law? You decide if these things automatically interrupt you (the push method) or if you decide when you view these items (the pull method).

Chris makes a great case that our society often advocates for constantly being in push mode, however there is likely a better way to approach this. He references the great Dwight D. Eisenhower and his Eisenhower method for determining exactly how tasks should be reviewed and accomplished through the day.

By using this method to classify tasks based on urgency and importance, you can set up your day to focus more on tasks that really matter to you, and eliminate or delegate the rest. I especially like how Chris has applied this concept in his life to be more present with his family when he spends time with them. His phone no longer dings with each incoming email or Twitter post. That stuff can wait. Watching his kids grow up can’t.

I encourage you to check out the article over at Keep Thrifty and give this a shot in your daily life. I personally apply this concept a lot, and it has paid large dividends for me. Remember, I am out to help doctors control their lives before someone else does. We need more pull and less push to do that.

Have a great day!

TheBossMD

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Extended Hours 8/26/17

Welcome to this week’s edition of Extended Hours! While the term “Extended Hours” may be an undesirable phrase in the lives of physicians, this series on the TheBossMD should prove to be a much better experience!

Extended Hours is the weekly roundup post published every Saturday here on TheBossMD. As with all of my content, the purpose of this series is to help physicians manage their positions, whether it be personalfinancial, or professional.

These posts are light on my thoughts and heavy on the best content I can find during my travels through social media and the internet. We might even have some fun along the way!

Win $50!

Before we get to this week’s picks, don’t miss your chance to win a $50 Amazon gift card. We will be having a contest here at TheBossMD for the next month. I am going to pick one of my email subscribers to be the lucky winner, and it will be announced on the Extended Hours for September 9th. Please sign up below and share this on Facebook, Twitter, Google+, Linkedin, Pinterest or wherever else you may go.



Personal Position

Physician on Fire up and bought himself a lake front estate in Our Latest Real Estate Investment: 7 Acres of Lakefront. This may sound like a financial piece to you, but I think even he would agree this purchase was more personal than anything. He has some great plans to spruce up the place and build a new home for his family. Good luck PoF as you work on your new digs. Move it about 600 miles south, and I would have considered outbidding you!

The BossMD family is big on Disney World, so I’d like to present another Disney piece this week, Four Secrets of Fastpass+ At Walt Disney World, from The Disney Blog. The Fastpass is the single greatest invention in amusement park history, and this piece gives some great tips for managing that sweet ability to skip to the front of the line. I’ve previously read that up to ninety percent of Disney visitors don’t use the Fastpass system. Insanity! Check this article out and skip to the front of the line while the other suckers wait.

Mr. 1500 and I are kindred spirits when it comes to love of food. It looks like we’re both trying to lose weight as well (see the Just For Fun section below), and he describes his current progress in Ask the Readers:Machiavellian Motivation? If the pictures are any indication, I would love to go on vacation with him. Head over to check them out and support him in his weight loss bet with Mr. Wow from Waffles on Wednesdays.


Financial Position

If you’re brave enough to have kids in residency, then Wall Street Physician has an article to help you get a tax break for those deductions munchkins. The Child Tax Credit for Medical Residents describes the criteria you need to meet for the credit and just how much you can save. For many doctors, residency is the only time you will qualify for this, so listen up and cash in!

Some of you can’t be trusted with your own paychecks, and that’s OK, WealthyDoc has a plan for you. In Direct Deposit-A Key To Your Wealth, he describes how you should use your direct deposited paycheck to automatically fund your financial priorities. Determine where your money should go and set up a system so it goes there. No chance it magically disappears. Right, Building Income?

White Coat Investor revisits an oldie but a goodie in his hosted guest post by Jon Sycamore entitled Layering Term Insurance Can Save You Thousands. Jon talks about the benefits of term life insurance and how layering multiple policies can save you thousands in premiums while still providing the protection you need at each phase of life. Thanks Jon!


Want to track your money for free? I use Personal Capital. Check it out!


Professional Position

Passive Income M.D. has a solid post about time management up this week, How Do You Find the Time? I know a lot of busy people that have trouble finding time to do things. Passive Income M.D.‘s answer is simple, he just does it. No excuses. It really is that simple when you think about it. If something is important to you, then you’ll make time for it.

My love for the Clemson Tigers is well documented, so I’m always conflicted over the growing connection between football and Chronic Traumatic Encephalopathy. Dr. Patricia Salber over at The Doctor Weighs In did a nice recap of some recent evidence in 202 Footballers Donated Their Brains To Science-Here’s What We Learned. Have to say the evidence is mounting that we need more safety in multiple sports, including football. I just want my Tigers to keep running down the Hill!

I am still waiting for the first time I have to respond to a serious medical issue in an airplane, but I have always doubted there would be much I could do when the situation arose. In MacGyver the friendly skies: Whats in a commercial airline medical kit, Sightsee MD gives details about what tools you have to work with when the time comes and what kind of issues tend to happen. I have to say the supply list isn’t too bad, all things considered, though I have no idea what lidocaine is included. Does some need some numbing meds for their IM Benadryl?

Just For Fun

Those that know me know that I am not a big New Year’s resolution guy. If you’re going to put your mind to something, then do it. No need to wait for January 1st, in my opinion. In that spirit, Mrs. BossMD and I recently decided to crank up the diet and exercise and get in shape.

Over the past year, I had gained about twenty pounds from a mixture of pure laziness and sloppy eating habits. When I started to snore at night, my wife gave me the ole’ elbow and said enough is enough.

So I’ve traded in my Doritos for cucumbers and apples. We eat solely at home except on weekends, which has been nice for our budget. We also decided to exercise every day together after work so we could hold each other accountable.

For any of you that have laid off the push ups for awhile and started back, I don’t have to tell you how sore I was at the beginning. It didn’t help that my four year old would exercise next to me and pound out the exercises like it was nothing. I, in turn, looked a little closer to this:

Despite my temptation to make his cookies mysteriously vanish, I really enjoyed getting to spend some time with the whole family getting in better shape. I feel a lot better throughout the day and I’m definitely sharper. A win all the way around!

For those that want to know my exercise regimen, I turned my wife loose on Amazon to pick up some exercise DVD’s. She is a huge Biggest Loser fan, so naturally I found myself exercising to Jillian Michaels – 30 Day Shred.

Not even joking

I can almost hear many of you laughing uproariously at this point, but I will say, the workouts aren’t bad! I definitely break a sweat every time we do one and the results speak for themselves.

My goal is to lose the next ten pounds to get where I started and then go for another ten to fifteen more. I’ll keep you updated on my progress and feel free to send me Jillian Michaels memes on Twitter periodically for inspiration.

Have a great weekend!

TheBossMD

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