By Debra Wiggs, FACMPE, V2V Founder

Face it, the only place most people want change is from a vending machine. It’s in our nature. A part of our brains, called the amygdala, perceives change as a threat. In response, it sets out to protect us by releasing flight or fight hormones. While this is invaluable in life and death situations, it has no place in the business of your practice. Fortunately, there are steps you can take right now to calm the perceived threat of change.

Changing the culture of ‘supposed to do’
First, it’s important to realize so much of what we do every single day is born in culture and not necessarily in need or fact. The old adage of “we’ve always done it that way” simply isn’t true. If you think about it, our normal was someone else’s change. For me to do the things I do today, someone else had to change the process. I think that’s something we have to be aware of. But people in an organization often cling to the culture of “supposed to do.” They don’t recognize that today’s “supposed to” really isn’t.

A fascinating representation of this was depicted in—of all things—a recent episode of the television program, New Amsterdam. In the episode, the administrator walked around the hospital and found many employees who weren’t “working.” That is, their work didn’t add anything to the organization. Or they were wasting time waiting for someone’s direction.

Thinking beyond your perceptions
Identifying these inefficiencies may be easy. The challenge is how to make others recognize these fallacies and embrace the need for change. The problem is we actually become committed to our tasks. Tasks become part of our identities. And as leaders we often erroneously reinforce the belief that tasks define success. During a time of transformation, we as practice leaders have an opportunity to encourage people to think beyond their program. People do better with this when they feel they have permission to contribute to the change, rather than having change imposed on them.

Promoting a culture of inquiry
Which brings us back to culture. Culture can make or break a transformation. To assess your culture, ask yourself this: Does your organization promote a culture of inquiry, and a climate of trust and validation? This implies that you as a leader are not keeping yourself behind a closed door. It involves you giving people the opportunity to ask questions.

A culture of inquiry begins with you simply allowing your team to ask questions, while you actively listen. The next step, of course, is to follow up with meaningful answers. Welcoming employee concerns will benefit you as well. Because they have different perspectives, their questions may shine a light on where new opportunities lie. These opportunities could include something you hadn’t realized, something that may help define and even improve tomorrow’s normal, today.

By Debra Wiggs, FACMPE, V2V Founder

A client of mine recently did the right thing and freed her future. Prior to that, the practice she oversaw had been operating at a frantic pace. Everything was reactive. Nothing was done as a result of deliberate behavior or within a structure. And so her staff could never settle into effectiveness. Instead, they would change at the direction of one individual with no premise. What this approach ended up doing is imposing change without meaning, which was not only worthless but at times detrimental.

Why STAT management?
It is unfortunate how many practices I work with that have been operating using what I call STAT management. The origin of this approach isn’t too difficult to discern. After all, the practice of medicine is replete with STAT situations that demand urgent action. But the same cannot be said about the business of care.

When it comes to the business of care, the only situations that warrant a STAT type of fast reaction is when something’s metaphorically “on fire, illegal or someone’s going to die”. Those situations represent a very small percentage of the scope of the business of care. The rest of the time, you can and should be deliberate in your processes. That doesn’t mean being slow, pedantic or procrastinating. Instead, a methodical approach ensures our response is focused and productive.

Permission to pause
Shifting your practice in this direction may seem overwhelming. But it can be done. It begins by giving yourself permission to pause. There is real power in that pause. It’s where our most effective decisions and actions are born. Neurologist-psychiatrist-holocaust survivor Victor Frankel alluded to this dynamic when he stated: “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

I challenge each of you to nurture that space, so you can begin to unlock the growth and freedom your practice deserves.

Bending without Breaking:  It’s always a choice

By Debra Wiggs, FACMPE, V2V Founder

In the first part of this series, Blessed are the Flexible, I addressed the truism in effective, resilient leadership.  It is found through bending without breaking.  Philosophically, there is an inherent value in being nimble and adaptive, and in part 1 of this two-part blog, we covered what it looks and feels like for leaders to bend but not break.  The first necessary part of resilient leadership is to take action and for that action to be pro-active, not reactive.

I described the dire situation of a medical clinic I supported that was leaking both money and rainwater through roof, with an out-of-control budget, equipment leases on broken equipment, out-of-control locum tenens expenses, and an actual roof that was primarily tar paper and plywood.

So, what did we do?  After pausing and taking stock of our situation, we were faced with a choice. The typical responses could have been to either increase fees or closed the doors.  However, we chose to change our minds and do things differently.

The force of pressure transforms effective, resilient leaders, it does not break them:  There are a lot of materials throughout nature that transform from heat and pressure and become something new.  The best leaders adapt and evolve instead of breaking.  In fact, they are spurred to betterment by heat or pressure.  Payers and the public have changed their expectations surrounding patient engagement and outcomes.

As a leader, the willingness to consider how-to adapt your organization to meet these expectations will inevitably result in you becoming ADEPT^SM at something new to support your health care business.  Sometimes, it takes heat from the scrutiny of your governing bodies, or pressure from the public.  And, just like fire removes the impurities from gold, the process of bending will help you hone your organizational purpose.

So, back at the medical clinic, to say we were under pressure was an understatement.  With the rain coming down, the office equipment leaking our cash flow, and the locums floating out the door with what would have been our profit margin, this practice needed transformation, quick.  We didn’t sugar coat the situation, just presented the facts.  The team had been frozen, unable to think their way through the problem, until we laid out the very real threat to the organization’s very existence and suggested that they had the power to come up with the solution.

Effective, resilient leaders identify the need for change:  Remember, the antecedent to resilience is resistance.  If you chose to resist against change, or fight it, you will break and that hurts, ouch!  This is where the very real difference between your transactional vs transformational leadership skills are highlighted.

For example, a transactional form of leadership finds you stacking your proverbial boxes, from soup to nuts, in a logical order.  As a transformational leader, you recognize that you should abandon boxes, altogether.  During your work, you identify the need for transformation, and help others understand why and how the box needs to evolve into a sphere.

As I mentioned, earlier, the biggest culprit to this medical clinic’s losses came from paying locums to serve on-call.  However, first I invested time into building trust and rapport with the team by addressing their immediate pain points, including the leaky roof and the office equipment.  As those issues and others throughout the practice were addressed, it was time to turn our attention to that huge propane tank near the fire, the money drain due to the locums on-call situation.

Discussing this issue became transformational to the organization. As we considered our options, one of the physicians simply asked, “Why don’t we rotate call, and accept a pay differential each time we take our turn?”  The physicians earned a little more money and a lot more gratitude from the patients they served.  Almost immediately, the huge annual loss evaporated.  The organization began a cultural and financial turnaround.  All because a leader thought beyond what had always been done and considered what could happen to transform the organization.

When you do that you will need to call upon all that you have gained in what we call your “street creds”—the trust among your colleagues—to use that voice.  To be able to say “change from a box, to a squircle(a square circle),” also means you’ve spent time amid the boxes, you’ve spent time in that environment, so that people trust you and will believe you and take action when you identify the need for change within your organization.

Effective, resilient leaders look for a fresh perspective:  As a transformational leader, you also have the insight to call another important, very personal question:  Am I stuck in my transactional leadership skills when I need to be using my transformational leadership skills?  (See my blog on Transformational vs Transactional Leadership.) How frequently do we, all, jump to a delusion-or-conclusion, instead of starting a conversation about a certain situation with someone?  When you’re fighting something difficult, do you put on your blinders, rather than binoculars, to see a situation more closely?  How often, when you reflect on a frustrating conversation, do you replay the conversation in your head?  The next time you do so, listen for what the other might be hearing from you, rather than what you’re saying.  That subtle shift demonstrates transformational leadership and abilities.

Effectiveness is about resilience and transformation.  My colleagues at V2V often talk about the fact that health care is a very complex business, today.  We must not make our complex world, complicated.  As a transformational leader, call-the-question on statements like “we’ve always done it this way” for some process that’s serving as an anchor around the neck of your organization.  Have the courage to ask “Why?” and follow up with “this is not okay,” or “this is not working for our organization and I’m going to change it.”

You can be malleable without melting.  You can bend without breaking.  In fact, I recommend it, highly.  The benefits to you and your organization will be far worth the investment of time and energy.  Are you ready?  We can help inspire your people, bringing you a fresh perspective that transforms your organization.

Blessed are the flexible, for they shall never be bent out of shape

By Debra Wiggs, FACMPE, V2V Founder

Whether you are a follower of author Robert Ludlum or you more identify with the verse from Acts 16:1-24, there is a truism in effective, resilient leadership.  It is found through bending without breaking.  Philosophically, there is an inherent value in being nimble and adaptive, but what does it look and feel like for leaders to bend but not break?

Effective, resilient leaders take action:  Leaders cannot just sit, idly, by. If they bend, it represents movement, achievement, forward momentum, and progress. My colleague, Dan Diamond, MD, would advocate that resilience comes as a complement to the ability to take effective action.  If something’s on fire, make sure you take in the whole scene, not just the flame in front of you.  In his book, Beyond Resilience, Dr. Diamond explains that resilient leaders look beyond the obvious because the specific pain point your organization is experiencing may not be the source of the problem.  The threat from fire may be secondary to the risk posed by a propane tank sitting dangerously close to the flame. The point is to discover, in a thoughtful, intentional manner, how to save yourself and others.  This also rings true in today’s health care environment.

Whether your organization is suffering from specific pain points or simply struggling with the changes in our industry, it suggests a larger issue that needs to be addressed and solved.  Everything is changing, from regulatory requirements to payer authorizations and billing.  You and your team will make mistakes as part of a transformation process, think of it as failing forward, you are moving forward, nonetheless.

While some organizational leaders may not feel their organizational platform is on fire, they recognize that they are not moving forward, either.  Just maintaining the status quo, with no change or adaptation, will prevent your organization from surviving and thriving at the new business of healthcare.

Effective, resilient leaders are responsive, not reactive.  Understanding the power of being thoughtful allows you the ability to keep energy reserves.  Holding that energy assures others that you, collectively, have the power to act. One of my favorite quotes on this truth is from Viktor Frankl, Austrian psychiatrist and holocaust survivor.

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

You can respond to the changes in our industry, not merely react after-the-fact.  You can make a transformative, positive difference in the daily work of your organization.  The way you bend without breaking is to have a willingness to be in that place of pausing, that allows you to reset to determine “How do I respond?”  And, with a calmness that helps establish whether there is a reason to truly fear, or if this is False Evidence Appearing Real.  How often do you take at face value someone’s observations and their response before considering your own first?  A colleague just put this choice into action a few minutes ago. She wondered if she should be frustrated by a situation that she was encountering; I asked her what she was reacting to–the email dialogue or to the facts of the situation?  I encouraged her to make a clarifying phone call before she decided how to feel about the situation.  In that time, she walked away from the choice of frustration (growth) with a sense of direction (freedom).

Among my experiences included supporting a medical clinic located in a remote community, with an out-of-control budget, equipment leases on broken equipment (a fax machine that only sent one sheet of paper at a time without redialing), locum tenens expenses through the roof and an actual roof that was primarily tar paper and plywood. The clinic roof leaked so much that in the rainy climate of the Pacific Northwest, I wondered whether the whole thing would cave in during the next seven-day soaker.

We needed to take action.  Immediately.  So, what was the first thing I did?

Following the guidance of Viktor Frankl, I paused and took a deep breath.

So, did we make it through the winter without money running out or the roof caving in?  Yes we did.  We were flexible and chose to think differently.   In the second part of this blog, I will address how to use your transformational leadership skills when faced with the challenges of making a choice.

Identifying and fixing the unintentional-and very real-threats to your brand

By Debra Wiggs, FACMPE V2V Founder & Transformationist

The lament is real. Here you are, wondering, WHY! You’ve spent years-requiring not just a small amount of intestinal fortitude-to earn your degree, train through your residency, strengthen your credentials by staying abreast of the latest developments in your specialty, and to later found and build your health care business. After all of these investments, why are you seeing comments on social media or patient feedback surveys that question the quality of your care?

Some of you, after seeing these results, are prone to throwing your hands up in the air. Others of you will adamantly say you don’t care a bit about these survey results or public comments. Either response fails to seriously consider the valuable feedback gained through lackluster patient grades.

Everyone has some perception of what a makes up a quality experience. In contrast, most people just don’t understand what is required to earn the right to display your diplomas on the wall. They just can’t truly comprehend or qualify the competency of your care because most people have few reference points for what it took or means to have those diplomas. Each of us can only measure competence by our own common frame of reference, not by the framed certificate on the wall.

Think back to your earliest memories of being told to clean-your-room and tidy up your space. What did clean and tidy represent, back then? Fast forward to today. You may, in fact, have the cleanest office in the building, but is the paint is peeling? Do your tools, like the blood pressure cuff, stay in place? Are there rips in chairs or the exam tables? If so, then your patients will draw on their own experiences and probably feel that other aspects of your care is lacking. When was the last time you walked through the clinic or your facility with the patient’s point of view in mind? Do you have a plan to refresh your clinic or facility, every five to seven years, because of wear and tear? The materials in your surroundings must reflect a specific level of cleanliness & safety. These directly impact your patient’s perception of the quality of your care, regardless of your reputation.

See your clinic from a new perspective: The Banker’s Box Exercise
So, what do you do about it? What you measure is what you move. So, armed with this philosophy, my drill has been that twice-a-year, you go through the office and clear out the place. Do you check your magazine dates on a monthly basis? Do you clean out the corners, where walls meet, at least once-a-quarter? Do you ensure that art on the walls have been wiped, arranged, and fresh? If not, this should become part of the routine of your practice.

Twice a year, invest into a “spring” cleaning, though it doesn’t matter the season. To do that, you have everyone pack up their personal effects at their desk into a banker’s box that no one can touch. Then you become work-station agnostic, rotating to sit at a new workstation, armed with a checklist of things to look for: This includes outdated materials, broken equipment and excess supplies.

Frequently, as part of this process, you find things that have been tucked away and then promptly forgotten. At one critical access hospital, for example, this exercise resulted in discovery of a “supplies” closet filled with items with items whose expiration dates were dangerously close and, more importantly, would have triggered a serious violation had it been discovered by DOH, or The Joint Commission.

Beyond perception, there is a monetary value to this exercise. The savings can be calculated in real dollars, in terms of inventory management, preventive maintenance, and the cost of new patient acquisition when current patients leave your practice. Be your own best advocate, and take time to check for the dust bunnies under the exam tables.

V2V Founder, Debra Wiggs talks with Sheila Bixler & Heidi Johnson of Healthcare Recruitment Link

By Debra Wiggs, FACMPE, Founder

One of the building blocks of the organization is strategic planning. Deeply rooted within strategic planning is the sustainability that is generated through retention. And, retention starts with the right fit.
Inevitably, this line of reasoning begs the question, which comes first, the chicken or the egg? Meaning, do you get your strategic plan in place and hire good people or do you first embrace a philosophy that encourages the growth and longevity of your employees?

Well, the answer is, actually, both. You can (and should) do both, simultaneously.

Today, so many organizations are at a crossroads. Along with the transformation of our health care industry due to health care reform, so many tenured staff are leaving because the bell curve of the baby boom generation is poised at retirement age. After years of working with health care clients, our V2V team of advisors has learned that there are key outcomes of strategic planning and one of those is to ensure strategic succession planning and expansion. I always refer to this as having the right people in the right place, doing the right work at the right time. As part of that effort, many organizations discover that to implement the strategic vision, they need to address their recruitment needs.

Recently, we’ve been collaborating with Heidi Johnson and Sheila Bixler, of Healthcare Recruitment Link, a health care recruitment firm that specializes in physician, advanced practice provider and executive search work. So I asked them their thoughts about retention, recruitment, and strategic planning.

Deb Wiggs: What is the connection between recruitment, retention, and strategic planning?

Heidi Johnson: Retention is at the core of building a culture and ensuring that an organization thrives. It is the fuel that feeds the culture and it reflects a basic commitment to the sustainability of one’s organization.

Deb: Where does successful employee retention begin?

Sheila Bixler: From our perspective, at Healthcare Recruitment Link, it starts at recruitment. However, from a holistic perspective, it really starts during strategic planning. We’ve learned, in experiences with V2V and beyond, successful placements happen because an organization has a clearly defined job description and parameters for their “ideal” candidate for the position… For example, not only are they clear on needing a position filled, but also, what will the specific and additional responsibilities include and what type of person and skill set will work best. Beyond specific scope of work, these responsibilities and the person performing these job functions must complement organizational culture.

Deb: Absolutely. In my experience, I’ve found it’s vital to be crystal clear regarding not just what the person in this position will be doing, but how he or she will perform the work. That’s an important question to answer. And, when you begin working with an organization on recruitment, how do you discover culture? How do you identify it’s congruence with strategic plan?

Heidi. During the information-gathering stage, our team focuses, first, on the characteristics of people who are successful at the organization. And, we’ve found that those organizations with a positive, well-articulated strategic plan and vision are far more successful at recruitment and retention. It’s far easier to recognize a good fit for each position. Those organizations with tremendous disconnect between strategic plan and culture are also seeing a costly employee revolving door. It’s truly about an organization being in alignment with both its written and unwritten vision and values.

Deb: So, I’ve had the opportunity to work with you on several projects where we were able to successfully place physicians with an organization. From your perspective, what is the role you play with an organization who knows what they want? What is the mantle you assume as you search for the ideal candidate?

Heidi: Oh, that’s easy. We are matchmaking mavens! And we follow a thoughtful tried and true process. First, we ask about job skills, medical education, training, and work experience. When the organization is crystal clear on the role to be filled, this aspect of the screening process is much more straightforward. After that, it is about finding out what it will take for the candidate to thrive within the organizational culture. Again, when strategic plan and corporate culture are aligned, this second set of questions is also far more easily answered.

Sheila: We must have a solid understanding of the community culture. At this point, we want to get to know the candidate’s lifestyle and community preferences. Frequently, candidates have a significant other or spouse and family who will be involved in the decision. Is this a place where the family, along with the candidate, will thrive? As matchmakers, we want to know what is important for the family. Our goal is to ensure the community offers everything the candidate and his family will need to thrive and call the community “home.” And, when there is a solid strategic plan and vision at the organization, we are able to address other elements of successful placement and retention, such as community fit for the candidate and family.

Deb: Thanks to you, both, for joining me in this exploration of how strategic planning fuels retention-focused recruitment. Strategic planning is a core commitment to the sustainability of an organization. It’s not just about a job description, that’s just one aspect of retention-focused recruitment. It’s really about expediting the right fit for the right reason. And, a successfully-placed candidate creates another building block to fulfilling strategic vision and fostering organizational sustainability.

Heidi Johnson and Sheila Bixler founded Healthcare Recruitment Link, a boutique-style healthcare recruitment firm, with the philosophy of being intimately involved with each search and focusing on client needs and budget.

Recognizing the value of leaders who go beyond just doing what they’re told

By Debra Wiggs, FACMPE, Founder

When considering the difference between transactional vs. transformational leaders, the Rolling Stones had it (almost) right.  Unlike the song lyrics, you can get what you want.  With transactional leaders, if you tell them to do something, they will check the box and it will be done.  However, there are times when real value is in the leader who helps you not only get what you want, but also get what you need.

There is no question we operate in a complex industry and in a complex world.  The challenge in health care is in not making the complex complicated.  That’s where transactional leaders are all about checking off the boxes.  They are told to do something, they know how to do the work and will do it, as prescribed.  Box checked.

On the other hand, transformational leaders empower others, creating boxes for others to check off that they didn’t even realize were needed, at first, but relish the tangible results.  These leaders inspire the work through attributes that are not tangible, but if you focus on them, these attributes inform transactional leadership and help it from becoming more complicated.

Let’s say that the readmit rates at Mid-Size Rural Hospital “A” were far exceeding targets.  Patients and their families were frustrated with these poorer outcomes.  A transactional leader is told to reduce readmits by extending stay to ensure the patient is healthier at discharge, because hospital administration is just sure that the patients are leaving too soon.  Patient stays are mandated to extend an extra 24 hours and the entire hospital cadre focuses a tremendous amount of effort on entreating CMS to authorize the investment.  Averaging an extra night’s stay to achieve healthier outcomes is a small price to pay, right?  This situation underscores that transactional leaders struggle with the gap between thinking-its-done and actually getting-it-done.

In contrast, the transformational leader knows that releasing the patient too soon is just one aspect of the breakdown in Hospital A’s discharge process.  Other issues are also important, such as engaging the patient in managing disease conditions, along with warm transfers by talking directly to providers in the next care setting.  All of these solutions work together, creating a more successful outcome, along with producing more engaged patients and families.  And, of course, re-admit rates plummet.  See?  With transformational leaders, you get what you want and you get what you need.

Some health care administrators are looking for a miracle, but they also like things just the way they are, thank you very much. Many are struggling with the sea change in how health care is managed. Unfortunately, “just the way they’ve always done it” is frequently cumbersome and adds another box to check, just making it more complicated.

Rather than looking at the task with the mindset of “somebody’s making me do this,” question or reflect on the “why” of it, not just the functional roles of leadership. If you’re doing a retrospective annual review of your employees, for example, you can surely fill out the current forms and call the job “done”.  However, that is just a transactional function.  It’s yes-or-no.  End-of-story.  Then you address the next task which is the next box to check.

Instead of asking “how do I critique something that was just completed?” the transformational leader asks “how do I move something forward?”  So, in the situation of the annual review, the transformational leader looks at it as a prospective opportunity to ensure that in the year ahead, his or her staff understands how their work impacts the future success of the organization and how to accomplish complex work without making it complicated.  The transformational leader approaches any activity a future focus.

The work we do in health care is complex and messy.  There are a lot of people who view solutions or esteem success in neat, tidy rows.  They just line up blocks without thinking about their correlations.  They create silos but they are just sure that they’ve got it all figured out.  And, it makes things more complicated, not just complex.  To get to the heart of transformational change, you need identify core challenges and implement solutions that improve the functionality of the medical practice.

Next time the problem you yearn to solve rears its ugly head, fill the gap between think-it-done vs. get-it-done.  See the transactional issues before you as a symptom of this transformational divide.  And, yes, you can get what you want, by solving the problem, and also get what you need, by fostering sustainable success at the new business of health care.  What’s holding you back?  You can do this.

We can help.

Joy, you say? What about the stacks of charts? Those patient records won’t update themselves!

True, amid all that we have to do on any given day as health professionals, during this season of thanks+giving, how-in-the-EHRs do you have time for spreading goodwill+joy around the clinic?

Not only do you have time during the holidays, but as ADEPT ^℠ leaders, you will gain a considerable advantage from the consistent practice of cultivating joy. The rewards, found with increased productivity, engagement, and ultimately, a happier workplace, will reap benefits that are measurable and consistent in terms of clinical quality and patient satisfaction.

So, to plant the seeds of high morale, where do you begin? While advising and leading teams during specific periods of growth and change, I’ve found three key areas to focus on. They communicate to your team that you regard the people in front of you and it affirms their role with your organization.

1. Courtesy: We learned in kindergarten to say “please” and “thank you” but does that extend to the clinic setting? Of course it does! Whether patient or staff member, there is specific joy found when being regarded with polite behavior. For some, courtesy comes second nature. For others, it takes a specific commitment. Courtesy recognizes that each person has a soul. People come to work because they know they have work to do and they know not to foul it up. Our job is to encourage each other while doing that work.
2. A sense of humor: On any given day, we deal with very serious circumstances. Are you injecting a premise and way for your people to find humor? Having a sense of comedy, even laughter, helps lift one another up rather than get bogged down by the dire odds that often face us and the patients we serve.
3. Discipline: Now, I’m not talking about the yardstick kind of discipline. This is not about creating rules and delivering punishment for breaking them. Do you know what matters and understand everyone’s role within your practice? Do you commit, daily, to focusing on those activities? That kind of discipline creates confidence in one’s actions and that makes room for joy.

Since the time of the druids, winter has been regarded as the season of renewal. While it’s dark and cold outside, we are regenerating, like seeds underground. After a time, we will be ready for the next season, to come, of growth and spring. Encourage your staff members. If they need a break, give them the grace to take a walk and breathe deep. Help them laugh. Give them the gift of predictability in an often-unpredictable setting. Wrap up some professional development so they, too, can recharge their batteries and be inspired and ready for the next season, to come. Help your team learn and become ADEPT ^℠ at courtesy, good humor and the discipline of knowing what to do and when to do it. The rewards for your investment of time will be more than worth the effort.

When I was little, it was sometimes difficult for me to pay attention to the sermon during church.

My dad asked me to find just one thing that I didn’t know, and could learn from what I heard. That strategy gave me a challenge. As a student, I adapted that concept when I needed to pay full attention in class, yet my mind frequently wanted to wander elsewhere.

As an adult attending professional conferences, I know it is important to network and that helpful pearls of wisdom can be found in each seminar, break-out or plenary session. So, I go back to my childhood strategy and make a short list of things that I search for during every conference I attend.

Nowadays, cell phones and email make it so easy to wander back, mentally, to what is happening at the office or in the hospital. Yet, this investment of time at a conference or seminar is important, and validates the expense. So, for the cost of travel, registration fees and the outlay of time, when I dive into each conference session, I have committed to return-to-the-surface after experiencing three separate “aha!” moments. These insights represent three important pearls to strengthen my professional arsenal.

Affirmation: I call it the pat-on-the-back moment. It’s important to toot your own horn on the things that you know you’re doing right in your daily work. For example, you could attend a session in which the speaker confirms that your strategy on Quality Payment Program implementation is spot-on. You could return to your staff with this message: “Hey, at this conference it confirmed we’re doing an amazing job on this. They validated that for me.” Look for those things that affirm what you are doing well. It will go a long way to sustain you.

Inspiration: Sometimes at a conference, I want you to experience a lightbulb moment. It is energizing to discover access to people and/or resources to realize an effective solution to a problem or broken process. This would be reflected when you say, “I can see the value proposition at my organization, or “I have access to those who can help me find the monies, other resources to make this happen. I’m excited to go do this.” Or, “Wow, I did not know that — I can go back to the office, implement this strategy and my team will be heroes.”

Conviction: I call it the kick-in-the-butt moment. There is always an issue back at the office that everyone has been tip-toeing around or a project or activity that all avoid with dread. At each conference, look for an opportunity to say, “Dang, I’ve got this very issue at my organization. I know it needs to get done.” It’s that conviction that something has not been dealt with and that now is the time to return with the tools and know-how to get it done. I want you to have the feeling of gratitude for having been shown the way, knowing that a chronic issue or task will be addressed immediately.

In each of these three areas, one of the best ways to make this strategy successful is to connect with people who will hold you accountable through information, affirmation or with a solution. That is what the peer group is for in the session you’re attending. Take advantage of the opportunity in a safe environment to ask questions and be vulnerable.

In turn, realize that you are also able to be part of that solution for other conference attendees. In the area of affirmation, where you know you and your team are doing something right, be a leader for others who are seeking inspiration and conviction. Be a part of the solution and pay it forward for someone, as has been done for you.

Adopting this strategy often pays for the cost of conference attendance. The things you learn will save or earn your organization real dollars. Your takeaways can prevent you from incurring wasteful costs or even help you discover a new revenue stream.

Everyone knows there is a six-foot-tall pile of papers or an inbox of hundreds of unread emails after a conference. If you dive into your next conference searching for these pearls of wisdom, you may very well return with a set of valuable takeaways to make the investment of time worth it, paying dividends for you and your organization.

Part II: Saying “Stop It” to the sacred cow

Intuitively, we all know what a sacred cow is. In practice or by definition when was the last time you asked, “Why do we do this, this way?” What was the trigger that created that practice or process? Is it work you just don’t like to do?

There are lots of things you can’t stop in this world: Records retention, charting, notifying patients, prescribed billing requirements. However, are you doing them as efficiently as possible? Is your EMR customized to your practice specialty? All of them can be. Are there interfaces and efficiencies that need to be built to optimize your systems? They may that look expensive on the front end but the current workarounds are costing you hours and hours of wasted time on the back end.

Sometimes you have to STOP whatever it is you are actually doing to reflect. Do you take time, regularly, of looking and reflecting on your current practices, processes? Do you ask the question: “Why are we doing this?” Particularly when you’re hearing the same comments at the same pain point over-and-over again. So, call the question: “Is this REALLY the way it should be done?” My experience is that 80% of the time, there is an opportunity to find a new solution. There are times (about 20%) when you need to build a bridge and get over it. Some things cannot change.

However, the vast majority of practices and processes could use the “Stop It” button. The next time you reflect on your current-state, ask yourself three questions:

1. What didn’t work? This is NOT asking yourself why. It is just identifying what isn’t working. It’s important to understand that stopping something doesn’t necessarily imply failure. Sometimes, it just didn’t work.
2. What would stopping do? Quantify the benefit of stopping. While doing so, also inventory what gaps would be created and so, what needs to be filled.
3. What are the barriers? It helps to identify what is preventing you and your practice from stopping something.

When I consult a practice and witness staff members scrolling through lists of items that are not their focus in software or online interfaces, before reaching their area of focus or assignment I feel their discouragement. For example; the only ICD-10 codes that should come up on the screen should be those relevant to your specialty. Build in the filters that make it easier for people to do their work. It takes time on the front end, but the cost-benefit ratio is high.

In the case of the physician who stopped seeing pharma reps in the course of her day, she identified the barriers to stopping something and then identified a staff member who could capture samples and log them appropriately. (which also mitigated a liability risk). As soon as she hit the “Stop It” button, she transferred 45 minutes of her day to about 15 minutes of someone else’s day. She also successfully shifted it to a person who wasn’t seeing patients and gave herself the opportunity to see more patients and positively impact revenue.

To begin the process of looking for things to “stop” doing, just look around your office for things that aren’t getting done in a timely fashion. Are they things that need to be stopped or are there other activities that are preventing you from getting them done. If there are things piling up, you have to ask yourself: “What needs to be stopped?” Is this process contributing to patient care or the bottom line? Or is it busy work because our team does not trust each other?

If you are way behind in your charting, for example, that cannot stop. However, there are probably several things that are being done right now that should stop to afford the time to do the things that are legally required and essential for practice operations and success. Soon enough, your practice will be ADEPT^SM at the new business of health care. If you need a bit of insight on the specifics, we can help.