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

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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.


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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!

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.


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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

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 8/25/17

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: How Does Clutter Affect Employee Productivity shared by Productive Physician

My Take

In today’s Position Paper, Productive Physician shares an article outlining the many influences clutter has in our workspace. I think we have all walked into a physician work room or office with papers scattered everywhere. If you’re like me, it gives you a mini panic attack!

The article mentions some interesting statistics that are especially relevant for physicians. One cited study states the average employee spends up to 4.3 hours per week looking for papers. Physicians, I shouldn’t need to remind you of the administrative drain already placed on your day. If you’re like me, then you routinely traipse around the office looking for those home health orders or lab results.



There are several common sense tips mentioned including keeping an organized filing system and keeping workplaces clean. Personally, I speak with my physicians a lot about keeping our workspaces organized. Though this article may talk about the real economic cost, there is also the clinical cost to our patients we have to consider. Losing lab results or patient messages has real consequences for our patients.

An area the article does not delve into, which I think is especially relevant for doctors, is electronic clutter. Many electronic medical record (EMR) companies would have you believe that you can fire up your computer and only open your EMR each day. That is simply not true.

How many times a day do you realize that you have numerous things open on your computer including your EMR, email, reference materials, internet, and the list goes on? All of these extra “things” that stay open distract you from your primary job, patient care.

You don’t need to see what the next email is the second it comes in. You need to take care of the patient in front of you and check the email later. Decluttering your electronic workspace is key to accomplishing this.

Now go and clutter no more!

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 8/23/17

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: The Golden Handcuffs For Doctors-Loan Forgiveness by InvestingDoc

My Take

In today’s Position Paper, InvestingDoc talks about loan forgiveness and the many factors you must consider if you are going to accept an employment contract with loan forgiveness. First, loan forgiveness comes in many flavors. Here are just a few examples:

I have been offered loan forgiveness via employment contract, and InvestingDoc correctly points out that these are often structured as loans. Either the full balance will be due if you don’t stay for the length of the service agreement, or a portion of it will be due depending on how long you stay. There is often interest attached to the balance you must repay.


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I recommend actively negotiating that the balance be repaid if needed based on the portion of the service agreement you complete, avoiding interest altogether, or negotiating the lowest interest rate possible on the loan if interest must be included.

InvestingDoc also discusses PSLF, which can be great if you work for a federal agency or 501c(3) non-profit. He correctly states that you need to be prepared to fulfill the full 10 year commitment if you want the tax-free loan forgiveness at the end.

He also discussed the recent paranoia surrounding ending PSLF for physicians. Though it is definitely a possibility that physician access to the program could be limited, I highly doubt the government will end the program for physicians already out of training.

The government’s modus operandi for cost reduction is to limit anyone new from entering a program, not cutting off people already in it. As someone with federal employee experience, I can tell you this is always what happens. Not only is it the most fair thing to do, but it is also the most politically popular thing to do.

Remember docs, if you want that PSLF to stay, vote early and vote often!

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!