This Is The Place Where Physicians Find Prosperity! "How To Use Marketing To Perpetually Increase  Your Medical Practice Income In Any Economy" Curt Graham, MD, FACS, FACOG    www.MarketingAMedicalPractice.com           702-258-0415
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Mentor's Medical Practice Business Views......... "Archives"      March 2012:    February 2012: Topic: "The best Plan B that I've found for private medical practice" (The best offense for doctors fighting government control and restrictions on healthcare) It seems to me......... that Brian Forrest, M.D. from a town in N. Carolina has set a good example for all doctors in private practice to give serious consideration to. It may also be something that physicians and other professional healthcare providers who are not entirely satisfied with their employed status may also find quite appetizing. I figure if there's any way that doctors can beat the government at it's own game, we need to grab the opportunity today. Dr. Forrest, like so many other physicians across the country are feeling the impact of, just got sick and tired of fighting the complexities of the current healthcare system, billing complexities, constant battle with the health insurance carriers over fees and claims, and government restrictions. Dr. Forrest quit accepting any form of healthcare insurance in his practice. He decided to move into a cash only practice. Such a move always involves losing patients who are unwilling to pay cash for medical care or are locked into a healthcare contract they are unable to break for various reasons. To make it possible to retain a good number of patients that he would have otherwise lost, he formulated a system for medical care, which required an annual fee of $399 per year per patient for all office medical care. That happens to be almost exactly what the Concierge practices around the country are charging their patients and doing quite well financially. Concierge practices normally funnel down their practice to around 300 to 400 patients. Doctors are then able to spend much more time with patients and practice better medicine at the same time. It reduces frustration so common among doctors who choose to use patient volume increases to compensate for maintaining a reasonable practice income. Even more profitable is the fact that collection costs go to zero dollars and the office overhead is reduced about 66%. Now, if you multiply 400 patients by $400 you get an annual gross income of $160,000 and get to keep a large portion of that to take home. Add to that the extra cash charges Dr. Forrest imposes on lab work and office supplies used for the patient's care, and the charges made for hospital rounds or hospital consults on a patient--not a bad deal at all! It gets even better if two or three doctors form a group and share overhead expenses. Dr. Forrest along with two other doctors created their own "direct-buy" health plan that businesses can purchase for their employees instead of the traditional health insurance. Amazingly, under the "Obamacare" rules, providing this care method exempts employers both from requirement to provide insurance and the fines/tax for not doing so. It's a win-win. But these doctors aren't done yet. The are now franchising their system out to other interested physicians while making a few more bucks in their side business.  Dr. Chris Tomshack has done the same thing with chiropractic doctors. What's the motivation to do this transition to a cash only practice? The 2,200 page Obamacare Bill passed by congress has 1,700 different directives to existent and new federal agencies, boards, committees, and czars to establish complex rules and regulations that, when done, will require at least 100,000 pages to catalog plus footnotes and references to over 25,000 other documents, rules, and regulations. It seems quite probable that the traditional medical practice will require full time employees just to handle these complexities regarding medical practice, which will increase the overhead costs even more. It's a picture that gives me a headache just thinking about it all. In case you haven't noticed, hospitals and other healthcare provider groups are dramatically increasing their recruiting efforts for doctors and medical practices. I don't know about you, but this sure appeals to me, even as a medical practice retiree.    January 2012: Topic:  "About making doctor's more efficient" "Efficiency can be improved, but not by making doctors work harder." It seems to me..........that the effort by healthcare investors and promoters, such as  Athena, Watermark, Alere, and Itriage and other startups, have been sucked into the "herd effect" belief that any doctor's efficiency problem can be resolved with technological advances as described in an article in Fortune magazine Jan. 16, 2012 titled "The Wired Doctor." Such nomadic wanderings are pumped up by those organizations seeking to grab into the government business handouts of tax payer money. What hasn't been recognized by most are the roots of doctor inefficiency that certainly can be improved long term by starting with business knowledge and systems........not technology. You can give any amount of healthcare technology to doctors to use and these digital elements will only succeed in shortening the time spent on data accumulation, recording, and dispersion. It doesn't improve the basic efficiency of the process of health care delivery in the medical office environment. What will it take to improve a doctor's efficiency at delivering healthcare? I definitely can't criticize the focus on technology as the means to improve efficiency without offering some other reasonable and attainable solutions. Knowing that over the last two decades every provider of healthcare has been struggling to find a way to improve the efficiency of our system that truly makes a difference--and haven't found one. The flaw in the mindset is that a physician's efficiency is attributed to his or her lack of time shortening "toys." It's obvious to me that a doctor's efficiency depends on personal interactions, not technical. If you want to build a house in one month instead of 6 months, you would need to hire employees (experienced carpenters) who have the knowledge of how to build a house, what is constructed first and second and third, and understand the interactions of the whole team to make it happen. Sure, you can add some efficiency to the house building process by providing the most up to date tools. But if the interactions of the team is not coordinated well and certain steps of the building are completed out of sync (and need to be torn out) and rebuilt in the proper sequence, it'll take 6 months to complete the project. If hospitals that buy physician's practices as satellite feeders truly understood that almost all physician(s) running that practice have no sound business and marketing knowledge, a circumstance found all over the profession today, then they have just taken on a business "disabled" employee that adds to their inefficiency instead of improving it. If hospitals would give those doctors good business training, which would make them a huge asset to the hospital, the healthcare system would be greatly improved. And, those doctors and practices that hospitals acquire would not be a business burden, as they seem to be now, anymore. They'd be a highly profitable asset. Improving the efficiency in your private medical office: The above ideas can be used in any doctor's office by following some very reasonable and profitable rules of thumb. 1. Hire only "medical office experienced" employees: If you have to spend the time and effort to train inexperienced employees, you waste time and effort (and income as well)  getting them up to the job position requirements you desire. You will need an understanding about the efficiency of medical office business functions that go much deeper than you may think in order to hire the right person for the job. Try hiring your friend's daughter just out of high school to get cheap labor and you likely will consider self-immolation. You'll have to sacrifice elsewhere in order to afford to pay the salary of an experienced medical office staff member.......no new car for 3 more years, for example. The sacrifices to do this hurt, but in the long run you will be amply rewarded for your persistence. Those who advertise the most make the most money in their business. The same applies to your willingness to pay top salaries, even though you may not believe that now. It's an undisputed fact in business. 2. Replace any office employee immediately, who isn't going beyond the usual office duties: You must pay close attention to what your office and business staff are doing that qualifies them to remain an employee. Some bad signals that you may notice: Repeatedly arriving late to work--even if it's only 10 minutes. Often leave work early for no particular reason except to cheat on the 8 hours work agreed to. Inability to see office work that needs to be done before leaving the office. Procrastinating nature in their work ethic. Get upset with whining patients and show their frustration. Refusal to assist in completing other staff members work before the end of the office day when theirs has been completed early. Hesitant to take over another staff members duties in case of absence for illness. Personality clashes with other staff members, either quietly aggressive or worse. Stealing from office supplies for home use. Conflicts with other doctor's office personnel. Refusal to wear office uniforms for personal reasons. Difficulty in dealing with a hostile patient. The exemplary qualities you should look for: No problem arriving at the office earlier than when office officially opens to do the chores like pulling patient charts that weren't done the day before, or to grab a bite of breakfast before patients arrive. No problem with staying overtime in the office when appointments drift later than usual or are delayed because of emergencies that take the doctor's time to resolve. Happy to help other staff members complete their tasks for the day. Accept the fact that work (beyond the 8 hours they were hired for each day) will somehow be compensated for by extra time or days off for family or medical reasons. Are in the habit of rarely saying anything derogatory about anyone. Spontaneously come up with good office ideas to make things more efficient. Are comfortable working without repeated supervision. Complete jobs that are started.....on time and done thoroughly. Show strong loyalty to the doctor and office reputation. Refer friends, neighbors, or acquaintances to their doctor's care. Demonstrate a "positive" attitude and upbeat personality. Dress appropriately for the job they want to have. 3. Insure and reinforce continued learning and training of office staff: Everyone has an obligation to keep up with the world around them.......especially in the business arena. Do your own teaching, offer to pay for courses your staff might want to take and you see the benefit it will have to your practice, or hire people to teach your staff about efficient business processes. 4. Demonstrate your support of your staff continually and repeatedly: Employees work harder, do a better job, and are much less frustrated when they know their work efforts are appreciated. Go a month in your office without handing out one single compliment or gesture supporting your staff and you'll see slacking work, procrastination, and inattention to their duties. That's your job......do it with tenacity. 5. Efficiency comes with knowing how businesses work and implementing the business principles. If you don't know......learn them. If you don't have time to improve your own knowledge........you will never be able to improve your medical office business. Your office is inefficient because you don't care to make it any better. If you did care about making more money in your profession, you would do what it takes to get there. To do so, will probably mean you will have to skip a few ski vacations, travel abroad, or buying a new fashionable home. Comment: It seems to me that the whole medical profession, especially the medical education institutions, have lost all perspective about the issue of medical professional's survival by ignoring the obvious causes of healthcare inefficiency, hence decreasing business incomes and increasing doctor frustration with their careers. If Mr. Perelman can donate $150,000,000 to the University of Pennsylvania's medical school, why aren't there other millionaires out there willing and able to put "business" education into the medical profession? One of the most irritating examples of business support for college graduates who use college as a stepping stone to becoming a professional athlete, is the STAR MBA program recently created and organized. Several elite university business schools have coordinated their business programs for pro-athletes who after a few years drop out of the pro leagues flat broke. Made millions of dollars and blew it all. It's a damn shame---right? What is more interesting about the STAR MBA program is that it is a home education program, done at one's own learning speed, with a few on site requirements while enabling them to continue with what jobs they might get. It makes me wonder what the four years in college did for them, academic wise, if anything. Now, if these elite business educators had the least bit of intellectual brilliance, they would be able to perceive another group of professionals who need that same help far more than professional athletes............doctors, dentists, and even attorneys. Wouldn't you want to grab on to any offer like this for business education while continuing to practice medicine? Of course, this would only pertain to doctors who would love to earn more and work less while earning a few million dollars during their practice career more than they ever will in their present situation. Ignorance has some fantastic advantages. You would never know what you were losing in terms of practice income. You would never become aware of how the rich get rich. You would continue to think there isn't anything better than what you already have, subject to luck and external circumstances. Stupid can't be fixed, but ignorance can be repaired. "We are all faced with great opportunities brilliantly disguised as impossible situations."      --Charles Swindoll                    December 2011: About-----"Preparing now for what your medical practice and you will                    face in the near and distant future. It seems to me..........all physicians, doctors, dentists, and other professional health care providers need to see the possible future of medicine with fresh eyes. Economic changes and trends in healthcare sway with the breeze. Keeping up with what's happening in the world around you, outside medical care, will give you early clues. The most efficient way to follow the trends in medical care is not to rely on what you read and see published by those in the think tanks of healthcare. In my mind the best way to judge where medicine is going by what patients expect from doctors and the medical profession. Over the past 30 years things have changed in the seller-buyer world from a medical profession that told patients what they should do, to patients being the driving force for what happens in medical care in the future. Politics aside, patients are medically smart enough now to know good treatment from bad, good medical advice from bad, and good providers of medical care from bad. Patients are well aware of their power and dominance while seeking the best healthcare. Because of their influence on the kinds of medical care they prefer, it is urgently wise to do what is possible in medical practice to comply with what patients accept and demand from their doctors. If you don't catch on to that, they go elsewhere. Medical practice competition, especially in urban areas, has become something to contend with. In 2012 patient's want more time with the medical providers. To get that, patients are preferring the midlevel medical providers over the traditional patient-physician interaction. Perhaps you have noticed that is your practice? Patients are demanding more medical information and education than ever before. It's a very good reason to be the one doctor in your community to provide medical information handouts for your patients----the ones you create yourself, not the ones created by medical organizations with slick covers and such watered down information. Patients want to know what you, their doctor, thinks and knows about various medical issues, symptoms, and treatments. They trust you, not something provided by some writer with unknown qualifications. Keep asking your patients what they feel about doctors, want in the medical care. In preparation for the future, you might want to consider these changes: 1. Employing midlevel providers (Nurse Practitioners, Physician Assistants, Certified Nurse Midwives) and using them to spread your medical practice work load out, which results in your have more time to spend on more complicated medical patient issues and problems. There is no doubt that these individuals are a productive and profitable asset for any medical practice if used properly. Many physicians already employ them and understand their value to the practice. Some great positive attributes are: Patients have much less waiting time to be seen---long waits to see the doctor is probably the biggest complaint in medical care today. Midlevel providers commonly spend more time with and give out more educational information to patients that doctors have time to do---a need patients have which is fulfilled. Midlevel providers communicate better with patients because they stay away from lots of technical medical terms. They show more sympathy and empathy than doctors. 2. Prepare for changes in your practice focus: Ever wonder why you are hearing stories about cardiac surgeons who have lost their practices as a result of a massive increase in non-surgical procedures done by invasive cardiologists and radiologists that make bypass surgery unnecessary? With the vast increase in sub-specialization in the USA, even the world, patients now ask for those specialists that are highly focused on a narrow segment of medical care and treatment---even if their fees are much higher and health insurance coverage is nil. It's a logical trend when you consider the vast amount of medical knowledge and information being added to the profession daily makes it nearly impossible for any doctor to keep up with. I predict that my specialty will divide into Obstetrics and Gynecology as separate entities in the near future. I'm reminded of a comment one of my foreign OBG residents said to me the day she quit and headed for Canada--"If there's anything I hate more than Obstetrics, it's gynecology." You may have to stop doing parts of your present medical practice just to remain current in your knowledge of the areas you want to continue with. 3. Move your medical practice: This would be the perfect time, before the national healthcare law (after all the upcoming adjustments are made by late 2013, let's say) become rigid, to move your practice to a much more profitable area of the country, or area of your own city. If you've had a good taste of your practice income flow, patient flow, and future potential for growth where you have been practicing up to now, and find it disappointing, it would be smarter to move your practice to an area you may already be thinking of right now. One of the problems that healthcare faces today is the relatively large numbers of medical doctors who move each year, by AMA surveys. The 15% of doctors that move around creates a gap in medical care and patient access to medical care. I wouldn't be a bit surprised if the healthcare law eventually will prohibit doctors from moving around from place to place---pick a spot and are forced to practice there forever, regardless of the financial and practice problems you have to tolerate. According to the most credible economists, demographic research is showing that the most profitable practice areas in the future will be in the midwest of our country where living costs have always been less than in coastal areas. Studies also show that settling in towns around 100,000 people and that have a college or university there provides for the long term family satisfaction relating to educational and cultural advantages. Comment: Spend more time thinking about these things and others that come to mind. Make some early decisions now that will affect your medical and personal lifestyle later no matter what else happens in this country. "Nobody except a baby in wet diapers really welcomes change"   November 2011: October 2011: "Why Is It That Doctors Fail To See, Understand The Absolute Requirement And Importance Of Business Knowledge/Education, And Do Nothing About It" ---when it makes all the difference in their practice income, profitability, and success in their profession. It seems to me..........the results available from even the slightest efforts made from implementing business and marketing strategies into a medical practice far exceed expectations. You'll never make me believe that physicians have no idea what business strategies and marketing can do for their medical practice. The do know because they are bombarded with various elements of business and marketing daily, on TV, road signs, newspapers, radio, among others. Logically, even the dumbest individuals understand that marketing must produce results because why else would millions of businesses of all sizes spend billions of dollars annually doing marketing and advertising. Obviously, businesses that do no marketing at all don't get many customers, don't make much money, and usually fail within a few years in business. That's the reason 95% of small businesses fail within 5 years after startup--a well documented fact. So......doctors know what any business has to do to stay in business. They know how much that marketing adds to business success. Doctors also understand what happens when their medical practice business is poorly managed and disorganized. Income drops, billing is intermittent, employees are unsure what to do next, scheduling of patients is disrupted, more patients complain, are just a few of the untoward events that occur because of the lack of business systems that keep an office organized. Is there any question that doctors know, by common sense, what should be implemented into their medical practice businesses? The enigma is, why don't they make it a priority? Out of the physician population who are in private solo or group practices in this country, what percent of those consult with business and marketing experts in any degree or format? I don't know the statistics, but I'd wager not more than 5%. What factors might be reasons that doctors avoid learning business strategies and systems, as well as marketing strategies? 1. Lack of discretionary income in their practice? 2. Distrust in those who try to tell them the remarkable advantages of knowing business and marketing top to bottom? 3. Fear of failure in making efforts in business and marketing that fail? 4. Too busy in practice to go back and learn business principles? 5. Stuck in a dimension of inertia and satisfied with what they have going now? 6. Burned out of the need, education, productivity, and income cycles? 7. Just another issue that separates them from family interaction? 8. Do not have the self-confidence that they can make the education work for them? 9. Already tried following business advice and never helped? 10. Just don't believe that any business knowledge or marketing strategies would do any better for their practice growth and income than they already are doing? 11. Medical education clearly implied that business knowledge was not necessary? 12. Too hard to learn all the business stuff I would need to know to create any significant improvements? 13. Just don't give a damn about learning new stuff even if it might help? 14. Have no desire or ambition to reach my highest potential in practice? 15. I know enough to do all that stuff already? 16. I would probably need an MBA from Harvard Business School to do what I'd need to learn and do? 17. Soon all doctors will be forced into employee positions and won't need to do the business and marketing stuff? 18. Even if I do learn all that stuff about business and marketing, constant updating it would create another ongoing job for me in addition to seeing patients? 19. I would be forced to hire a trained medical office manager and pay a big salary? 20. No matter what I do, I can never reach the goals in practice that I originally intended? 21. I'm quitting practice--too frustrating to put up with? 22. I'm changing careers to earn more money than I can make in medical practice? 23. Increasing Government fee restrictions will never stop, so why learn ways to improve my practice when sooner or later I can't financially survive in practice? 24. Malpractice litigation and threats don't make improving my practice a priority, because that will be taken away by a jury award anyway? 25. I'm looking for other alternatives for managing my medical practice? 26. My practice business is different--business and marketing learning wouldn't help? 27. My good loyal employees would never tolerate big changes in the office functions? 28. I'm not the kind of doctor who can fire employees if the new business stuff required it? 29. Just don't believe what the business experts say? 30. I've already accepted the fact that I will never be able to earn enough in medical practice to make any business changes worthwhile? These factors and others don't drum up a strong stimulation for any doctor or other healthcare provider to make learning highly productive business strategies a priority. If these medical warriors would tell me how they feel and what they think about gaining business knowledge and about their biggest medical practice problems, I would be able to create solutions for what they need to circumvent the issues that bother them the most. I am confident there are answers and alternatives for any of these issues, but I have the feeling most doctors don't believe it. If the reason doctors aren't grabbing on to the opportunities rapidly is a mixture of everything above, then no one wins. But, I don't believe that's the case. It seems obvious to me that each medical professional has one specific, maybe two, ongoing practice frustration that is strangling them. If those were resolved, doctors would be much more satisfied with their medical practice. Maybe practice more years before retiring. My profound belief is that business knowledge, once learned and applied, will cure 90% of those frustrations, and that when the income from the practice becomes stable and increasing as a result of that business knowledge medical practice would be enjoyable once more.   Sept. 2011 Topic: "Why Do Medical Schools Refuse To Teach Medical Students Business and Marketing--At Least The Basics and Principles?" It seems to me............that it's time to stand up against the tyranny of the medical education system. What gives them the right to decide that the primary foundation of a medical career (the business of medical practice) doesn't deserve a lick of academic business attention? Is there any doubt in the minds of any physician anywhere in the world who has their own medical practice that the lack of education about running a medical practice business successfully, requires knowledge they have not been taught during their medical education? Just the fact that the medical education system knows that they are now graduating large numbers of qualified medical doctors who will fail in their practices because of having no business education, is not only neglectful, but also a malicious agenda composed of political, money, time, and expense elements. Many will defend that position as being an unaffordable addition to the medical curriculum, when we all know that every medical school receives government money and support for millions of dollars of research they do. My question is, are medical schools created to teach medicine, to do research, or both? Does the research money end up supporting the medical school teaching program, otherwise medical schools would go out of business? My other concern is how the medical school system is able to rationalize pumping out medical doctors who they know full well that many will not do well in their medical practice business because of lack of business education. The unbelievable part of this is that they are at ease doing this at a time when doctors are overwhelmingly frustrated with medical practice and now are quitting in droves. All done at a time when the need for physicians is increasing exponentially. Along this same line, wouldn't you think that it would be much more intelligent to admit medical students who intend to practice full time instead of intermittently? That again brings up the problem of women doctors in medicine. Statistically, 50% of women doctors surveyed practice part time. It may be a blessing to the managed care groups who employ most of them, but not to the smaller communities in need of doctors. Are those doctor attrition rates quoted in medical practice surveys factored into the medical schools production rate of new doctors? If one took the time to look at how each medical doctor after graduation chose to practice, how long they lasted in private practice and what they did next, and look at the real reasons 40% of doctors admit being very frustrated with their profession, I think we would quickly see that the number one cause is lack of practice income enough to stay in practice. And what would be the cause of that? If a doctor can't afford to stay in private practice there must be a reason. Let's not blame it on laziness, inertia, or lack of motivation. Very few doctors fit these categories. It's quite obvious to me that a doctor who has a bang-up medical education and has no business knowledge, will never rise above a mediocre practice level by any standard of measurement. Lack of business knowledge means they lack income. Lack of income means they are forced to quit practice and take on the role of a medical employee. But, what about those who go into another profession, job or business. Yes, it's another form of doctor attrition. When a doctor has the appropriate business knowledge, they also have all the business and marketing tools to make the income they want and need. Others have no idea how to do all that when they get in financial problems with their practices. Yet, any doctor can resolve that by obtaining the business knowledge and using it. Criticizing without offering solutions is something I don't abide by. So here's my ideas about solving the problem of under-trained doctors. I've written about these solutions previously in my ebook and articles, but newer ideas come to mind. With almost certainty we know that there will not be one medical school take on the task of teaching medical students the essential elements of business to insure that doctors leave the school prepared to run a business successfully. But, it's much more than just being able to create a successful medical practice. This specific knowledge prepares doctors to reach their full potential in their career while having the tools to defend themselves successfully from governmental intrusions into healthcare. The economic restrictions that are created against the practice of medicine, the abuse of a legal system, which intentionally avoids enacting malpractice caps on pain and suffering, and the increasing toll on the lives and families of physicians are a few destructive factors all physicians and other healthcare providers face daily in order to serve the public needs for healthcare and all it encompasses. Why are these compromising issues not being addressed by those who have the power, influence, and status to resolve these issues? The same is true for dentists and other professional health care providers. These are my ideas about solutions to this perpetual stigma against the medical profession: 1. Volunteers: Out of all the incredible depth of individuals with the ability and talents to teach business principles and knowledge to medical students, why isn't there, among them, those who volunteer their time, energy, and abilities to serve a greater need? It could be another retired doctor, wealthy entrepreneur, professional business person, or a motivated business school professor near the medical school who recognize the missing link and want to do something about it. An organized group of inspired volunteers could provide a persistent and consistent flow of business education to medical students, even alumni doctors in practice. Perhaps this class of volunteers isn't aware of the business knowledge deficiency among doctors, which would be hard to believe. Maybe it just takes someone to ask them, make them aware of the seriousness of the problem of physician attrition today and the causes, or tell them how they could help with these tasks. It's my impression that people have to know that a problem exists and the consequences of the problem before they think about volunteering for anything. 2. Donors: When it comes to the issue of money and supporting funds necessary to pay for the teaching of business to medical students, this perpetuating need falls to a low priority position for reasons of.......what good would it do? Priorities usually are to build new school buildings, do more clinical research, and keep up with the other schools in competition for government funding. Everyone knows nothing can be done without money. Even single donors, donate millions of dollars to medical schools for all sorts of purposes. It seems that finding donors who recognize the incredible medical career business compromising issues, isn't possible. I propose that informational campaigns could be run to let potential donors know about these circumstances. Retired doctors, who financially are secure, would be the ideal candidate and donor because they have experienced the problems they have had in their practices. It is quite reasonable that donors could be found to financially support a structure for teaching medical students about business and running a medical practice business if donors understood the need and importance of this educational deficiency. It just takes a motivated individual to get the ball rolling. 3. Time availability issue: I'm sick and tired of hearing that there is no time left in the medical school curriculum to teach medical students business strategies, not even the basics. There's always time available for important issues. A 142 medical schools in the United States don't consider business education of medical students important enough, and don't have the funds to pay for such education..........so they claim. We are told, correctly, that medical schools have such an overwhelming amount of medical knowledge to teach medical students today that they can't even find time to teach it all to them......and never will. How does one squeeze into the curriculum an education about small business under these conditions? Good question. Let me respond. First, when all the apples won't fit into the basket, what do you do? You either sort out the bruised apples to make room for the perfect ones or you place the remaining apples in another container.....right? Maybe, medical students are learning far to much medical information, which they will never ever use in their medical practice. Cutting out the "good to know but will never use" stuff, would then allow time to learn about running a medical practice business. This idea brings up several unsettling factors to consider. Most important to my mind is how would all that be accomplished. Need to prepare students to make a definite medical career choice early.   Students would then follow a curriculum specific to that career choice.   Any medical knowledge that was not pertinent to the career choice is removed.   Add another year to the medical schools curriculum of admit them after 3 college years.......maybe. (My choice would be the latter) Second, going to the next alternative for making the time to teach business to students and not disrupting the curriculum profile already established, would be to create a separate curriculum for students to learn about business management and systems. A separate set of lectures would not be difficult to construct. The lectures would be scheduled at times outside the standard curriculum for medical students who were available at the time. Attendance could be made mandatory or voluntary (best if it was voluntary). The series of live business lectures would be continuously recycled so that if a student missed one, he or she could pick it up in the next round. Even better, the live lectures could easily be video recorded on DVDs, and made available to students to view and review on their own time. Live lectures have several advantages such as a Q and A session, additional tips not mentioned on a DVD, and private questions asked of the speaker. Surrounding most of the medical schools are usually business schools in the same complex. Perhaps the advanced business students would volunteer to give business education lectures for extra training, for credits, for personal satisfaction of filling a need. Also, they might create the business lecture series on DVDs as well under the supervision of instructors. As is often the case, students who attend a lecture or course voluntarily that they consider important creates a competitive atmosphere among the other students. Other students believe the students who attend a medical school supported lecture voluntarily leaves them behind, and are then mentally coerced into attending also. These live business lectures could be arranged in early evenings, noon hours, or early mornings before the medical duties are begun......even on weekends. 4. Attendance: Presently, medical schools do not indicate to medical students that any business knowledge about how to run a medical practice is needed, if it's even mentioned at all. It leaves the students with the idea that they will never need knowledge about running a business.......and like a dream, it all will go well in their practice. If you are one who believes that the overwhelming frustration of doctors in practice today is not at all related to their financial (practice income) problems, you haven't been in private medical practice or are financially independent. Therefore, it would be important to let the medical students know how important it is to have the business information and knowledge, since the medical school and instructors do not. A good example of the importance of business education can be made in the case of a graduating medical student with an average of $150,000 educational debt. For young doctors starting private medical practice, paying for the practice expenses as well as the educational debt, may shock them into the awareness and need for a business system. Even then, they can obtain the business knowledge, but not anywhere as simple as it was while in medical school. That's where it should have been grabbed and should be taught. Result........graduating doctors are half educated for their career in medical practice. They don't know what they don't know. It's possible they don't want to know. Any level headed and intelligent physician must understand that they could do lots more in their medical practice career with a foundational business management knowledge. Comment: My belief is, like the issue of "too big to fail", that the medical profession is going through a major transformation as a direct consequence of lack of a strong business education for all doctors. It has been neglected too long and the need for business knowledge has become embedded too deeply into doctors minds that they don't need it, to allow any recovery of the profession back to any resemblance of the way it used to be. It doesn't mean that the medical profession will disappear, only that non-physicians will carry the load of healthcare. I think doctors will drift slowly into social and medical obscurity, but those who remain will still do the hard stuff in medical care from their primarily administrative positions. Yes, the quality and quantity of medical care will decrease. Patients will be demanding more from the healthcare providers and not getting it, which is the perfect situation for increased medical malpractice litigation. The one bright side seems to be the entrepreneurial attitudes of doctors. Creativeness, desire to make things better, and the personal need to help all mankind continue to lead to solutions in healthcare that haven't even been thought of yet. When the present surge of interest in concierge medical practice runs its course, what's next? The gauntlet of medical practice must include business trained doctors and health care providers who are in private practice. The exception that seems obvious to me is that at any place in time there are those doctors who leave the managed care systems for private practice, and even they are not off the hook for small business education.   August 2011-- "Discipline Determines Your Destiny" It seems to me...........      During the last 8 years or so, while I've been totally involved in business and marketing issues, I have repeatedly run into references by the experts relating to the topic I'm about to talk about today.  You make the disciplinary rules you want to live by to accomplish what you want in your life.  So why do we fail to follow the rules we establish, change the rules so often, and never quite understand why things aren't working out as expected?          It's quite a lot more complex than simply seeing the logic and sensibleness of creating our own rules of behavior that benefit us.  The value of discipline in our lives  takes on a far greater importance after we have experienced the difficulties of not having limitations or rules to follow, or at least seeing the results of what happens to others who have no rules for their behavior.      Discipline we construct for ourselves has to be learned and practiced.  Beyond that, discipline must be applied to every aspect of our lives in order to provide ourselves with the tools necessary to reach the ultimate highest level of our careers, talents, skills, and potentials.  Think about why so many physicians do so much better in their careers than most others.  Most have comparable levels of intelligence and skills related to medical practice, yet seem to do so much better financially and reputation wise, even from the same medical school class.  Discipline used to it's maximum is the answer.      The secret to success at work and personal potential is the product of discipline.  You are guided by the disciplines that result in the most advantages and opportunities.  Successful people normally set their professional goals, then establish the disciplines to follow to get there, while disregarding the less important, time wasting, energy destroying, and side ventures, which don't contribute to the performance goals.      Definition of discipline: an activity, training, exercise, or regimen that develops or improves a skill.  Ultimately, where we go from there, how successful we become, how much money we make, and how happy we become is totally dependent on disciplining ourselves.       I must have slept through that "discipline" class at school.  Like a lot of young people, I did have a good idea what I wanted to do in life, but at that time I had no idea if I had the patience, skills, talents, or determination to make it happen.  I thought I'd take a shot at getting into medical school and, if that was not possible, I'd go into chemical engineering.       Desire can't do anything for our destiny, career, goals, or ambitions.  Desire and ambition fade with time into procrastination and regret.  Desire may be the match that ignited taking action, but the discipline we structure ourselves keeps it burning. Then, it becomes a matter of degree and persistence of the discipline we keep to reach career goals.  Discipline and the Holy Spirit within us enables our strength for such things as: 1. Self-control 2. Making the right decisions 3. Creating opportunities that otherwise won't be there 4. Setting and attaining goals 5. Accomplishing almost anything you desire 6. Makes for an orderly life 7. Permits access to levels of respect and integrity otherwise unattainable.  Why discipline is so important:      Without discipline, we accomplish nothing in our lives.  Without it everything becomes  spontaneous, unpredictable, and unreliable.       The enemies of discipline are our environment, our natural desires (mixed good and evil), and needs of our flesh. We are constantly pulled in all directions by our peers, family, bad advice, turmoil, stress, fear, and passion.  Natural desires and instincts confuse us, make us vulnerable, and surge into our minds at the worst of moments.  Our bodies require food, water, and shelter.   Even more important is self-discipline of our thoughts and mind.       Discipline is a choice, not required, and is effective only when applied.  Because of the free-will we have been given, discipline runs contrary to it and requires adding it to our lives a batch at a time.  To keep discipline and order in our lives it takes practice using it in a persistent manner.  Discipline and self-control have significant rewards: (These have nothing to do with your medical skills and talents) You develop character and are a better person. You make the right choices more often. You are more respected and responsible. Others trust you more. Opportunities become more prevalent. You will be healthier and happier. You are more dependable, reliable, and productive. Life is less stressful and more determined. Critical use of your time is top priority. Goals are reachable--short or long term. You are much more selective of friends and associates. You impact others around you.      When you program discipline into your life, what you value the most becomes  evident. The greatest difficulty is sticking to the program.  It's not easy.  You just keep restarting over and over until it becomes a habit pattern.       The value you place on you selected path is determined by your diligence.  If the value you place on being the best doctor in your city is very important to you, your diligence in keeping on the right track will be extreme.  Your diligence is fueled by the Spirit inside you and the passion you feel.  You can't have one without the other.  Comment:      I can't help but think about how much more I could have done in my professional life if I had been taught, or learned, early-on the value of setting goals, the effects that discipline could  have had on my college and medical career, and the importance of good career advice that was non-existent at the time.  These elements are found as part of every successful person I have ever met, no matter what business they were in, career path, or personal goals they selected.      It seems likely that I did have some of those elements at the time, perhaps unconsciously working for me and still do.  It's sad that these things are not spoon-fed to children and reinforced in high school today.  Schools teach "getting by" and not "success."  However, it all boils down to the fact that every person is responsible for their life, starting in adulthood.  That doesn't detract from the responsibility of parents to inspire them, and make them aware of these essentials whether they understand them at the time or not.      The greatest challenge I believe is to get beyond the issue of, "You don't know what you don't know."  Word Count = 1089 Keywords = career goals,discipline,success at work,professional goals,performance goals,personal goals July 2011--- "Professional Medical Ethics And The Biblical Forces Of Evil Temptation" Force yourself to maintain your personal integrity.      In the throws of desperation it is impossible to know what a person or medical professional is willing to do, how far they are willing to go to reach or maintain a professional level of accomplishment in spite of the legal, moral, or ethical consequences.      After one has practiced in their profession long enough, you come into contact with examples of professionals who have gone astray personally or professionally for many reasons.  It is heart breaking to see what can happen to a professional who reaches a point of personal desperation that forces them to compromise themselves and their professional career as a means of relieving their desperation.      A high school friend of mine became a medical doctor, came back to practice in our small home town as a primary care doctor, and within a few years became addicted to drugs.  The medical board made him undergo drug rehab and serve in the nearby hospital under the watchful eyes of his peers for a prolonged period of time.  I lost track of him after that.  He never returned to our town.  In a sense he betrayed the people and friends he grew up with, his patients, and the town that respected and trusted him.      Another close doctor friend of mine with a great sense of humor that made others like him for his congeniality, gave up his practice out of desperation.  Behind his cheerful personality was a mindset about medical practice that became so dominant in his thinking that he had to take on a life of locum tenans bouncing here and there around the country.  During the years I worked with him, it was clear that he had mentally structured a rigid set of medical practice rules to live by, which he would never break.  It eventually led to the failure of his practice, compromise of his family, and left him a lonely person.       I believe that I was one of those physicians who reached a point of desperation in my own medical practice.  My marriage fell apart over time and my episodes of mental depression as a result of PTSD in combat in Vietnam kept me on the verge of suicide for many years.  A single malpractice suit resulted in me being blackballed nationwide by every malpractice insurer who refused to cover me for Obstetrics led to failure of my medical practice financially.  Gyn practice only would never sustain me in practice.      It became necessary to give up my state medical license as a result of the one lawsuit so I interviewed for hospital and clinic positions across the USA where I would have malpractice coverage because the insurance was not obtainable for me in private practice anywhere.  Several other states where I already had unrestricted medical licenses then terminated my medical licenses, essentially leaving me with no career or profession.      Eventually, I was hired to work in a Women's Clinic of a hospital where they were not able to keep doctors they had hired before me.  My job there rescued me, kept me in the profession, and went well because they were able to get malpractice insurance for my full ob-gyn privileges.  It went well there for me as an employee doctor.      As you can surmise, I had a great deal of stress while I continued to run my practice in a very professional and ethical manner.       There were two primary factors that actually destroyed my career--one malpractice suit where I made a bad judgment in OB (in my 30 plus years I had 4 actionable suits, 3 settled, 1 trial that I won).  In California at the time an OBG doctor averaged one suit every 3 years.  The second reason was the inability to get malpractice coverage for OB.      In spite of all the circumstances I was at the top of my specialty by all standards until the one malpractice lawsuit that settled out of court and killed me.  I can only say that as a physician in practice for the first 23 years I never had a problem with licensure, medical boards, criminal offenses, staff privileges, or unethical practice methods.       Now that I've revealed all of my many faults, even though they are all public record, it may make the tabloids happy and give them something to do.  The punishment for my frailties still goes on today in one way or another.      Let me be clear.  I expose myself to you not for pity, or sympathy, but to point out to you that there are good reasons to have multiple streams of income.  You need to get those going very early in your medical career and continue them.  With medical practice being pelted today and in such a sever manner, it should be a wake-up-call to you to consider the future probabilities of your remaining in the profession as time goes on. My greatest concerns about desperate physicians:         After investing so much money and time in education, a professional career, and your effort to live the life you deserve after all that effort, you certainly don't want to lose what you've gained.       I can see now that the desperation physicians feel regarding their practice and profession has been greatly enhanced by never being taught how to relieve that pressure and worry with good business systems and marketing strategies.  Doctors have no place to hide, no place to run to, no place for help without costing huge amounts of money.  It behooves a physician to get the business knowledge and training whatever the price.  In the long run, you win the race.  Some published reports about unethical procedures or testing that can ruin a medical practice and career: 1.  Overcharging for services rendered. 2.  Charging for services not rendered. 3.  Performing procedures that are medically not indicated. 4.  Kickbacks of fees for referrals. 5.  Performing procedures you are not trained to do. 6.  Selling drugs to patients or over prescribing narcotics. 7.  Scheduling follow-up visits that aren't necessary. 8.  Spreading one appointment and medical problem into three appointments. 9.  Piling on charges by billing for services or supplies that are usually part of your       overhead costs.   10. Billing for phone consults with patients without exams. 11. Attaching fees for incidental supplies and free drug samples. 12. Cheating on business write-offs, travel expenses for personal use. 13. In-office pharmacy business--buy meds wholesale for sale retail to patients. 14. Charging for procedures like unapproved diagnostic procedures--thermograms.      I'm sure that you can add many more to this list.  I know that when any medical doctor or health care professional has a sound education in business and marketing there will be no reason to go to such extremes to make more money, prevent burnout, pay for college for their kids, fund your retirement plan, and etc.  Because you will have the ability to earn money the same way a successful retail store owner makes his money without having to stretch or break the laws and put yourself in jeopardy.       My new ebook available now, contains all the information you need to create your financial empire by doing it yourself. Click Here for more information.   June 2011--- "Choose your poison--medical practice is rapidly changing to a place where you haven't been" It seems to me.................. In a very short period of time ahead the medical profession will become comprised of two medical practice categories--physician employees and Concierge physicians.  When the Medicare medical fee restrictions and regulations drop another 10%, I believe that the other 60% of physician holdouts that still continue to treat Medicare patients will have to stop their coverage of Medicare patients altogether.  Treating those patients will reach a point where Medicare patients are being treated for free, and doctors are subsidizing their medical care while severely compromising their practice income enough to lose their practices. Private medical practice as we know it now, won't exist.  Private health care insurers will not be able financially to sustain coverage even for private patients.  It's likely that health care insurers will convert to other insurance to remain solvent.  This row of dominos is well on the way to flat-lining. Even the most prestigious marketing and business experts are now looking at the health care industry economics and are prognosticating the rapid rise of "cash only" medical practices (Dan Kennedy being the most vocal about that).  My suspicion is that most of the physicians will procrastinate on performing any practice changes until they are forced by decreasing incomes to convert to one of the Concierge models of practice.  Probably, they will follow the practice structures of plastic surgeons who are essentially in cash only practices now.  In my view, with the persistence of the frustrations physicians are now demonstrating about their practices will reach a tipping point where they will become burnt-out fighting the health care system and give up the medical ghost.  To my mind that means instead of physicians modifying their present practices to comply with the economic circumstances, fee restrictions, governmental control, and legal environment, physicians will completely change their medical practice, move if necessary, convert to a Concierge model at the blink of an eye.  Using a little logic, it's not hard to recognize that the act of complying and modifying their practices will continue to be necessary over and over again. It's far easier and much more sensible to completely transform their practices to a cash only basis at the start.  Clearly, the restrictions will never be reduced and probably continue to increase over time.  The best time to do the transformation is now, not later when hundreds of doctors are doing it at the same time. The flourishing Concierge practices at the present time are group practices composed of several concierge minded physicians with the same goals.  A single specialty group would seem to be the most financially advantageous for doctors.  Doctors will share the overhead, equipment, and personnel thereby avoiding the very slow growth of most solo concierge practices that must forage for income the first few years of the practice.  Multi-specialty concierge medical groups certainly will do well, especially with cross referrals to each other.  Patients love to have all their doctors in the same place, same building, same office complex.  Other than sharing equipment and overhead costs, the most beneficial aspect of this model of practice are the internal referrals of patients.  Because cash only solo practices must be located in an affluent area to begin with, it restricts choices of where to set up a medical practice, and requires a great deal of research to find the best sites, free of competition, and with a large affluent population. In the case of multi-specialty groups, they have many more choices of practice locations because they need a full age-range of patients to work with, but yet have to have money enough to contract with the concierge group for their care.  Both solo and multi-specialty concierge groups have a major disadvantage in that referral of patients from the local doctors to them is very uncommon.  Patients with health insurance seeing a local doctor may very well find their private health insurance costs rising to the point where it is not affordable.  These patients, if they have jobs, may have access to HMO's for their care.  However, patients my find that the cost of contracting directly with a concierge private doctor group likely will end up being a fraction of what other health insurance carriers are charging, including the HMO health plans. The concierge medical practice system is expanding rapidly.  The systems have been tested on many fronts and in many areas of the USA.  People are already drawn to the system and like the services provided them that are way beyond those of our standard health care systems, even private practice. When you as a physician look carefully at the concierge system of practice, you may be quite surprised at advantages gained by all these physicians.  The standard concierge solo practice carry about 300 to 500 patients compared with 3000 found in the usual medical practice.  When you multiply the approximately $2,000 per year charge per person for all their medical care for the year by just 300 patients, the gross $600,000 you earn is paid ahead and goes to your practice bank account instead of the health insurance company's. It's much easier to convert your own medical practice patients you already care for over to a cash only practice, because they trust you.  It can be done slowly as you present your patients with the options and advantages of a concierge system, that most patients have no knowledge about. I advise all practicing physicians to seriously consider a concierge medical practice.   May 2011--- "The Increasing Pressure To Eliminate Private Medical Practice" It seems to me................ ......there's no end to what our government is willing to do to terminate private medical practice. The recent blurb in the recent Wall Street Journal again points out how the new health care law intends to force the coordination of what hospitals and doctors do.  The new organization is named ACO (Accountable-Care Organizations).........like we need another bureaucracy. This new system and business is there to prevent the duplication of medical tests among doctors and hospitals to reduce the costs of Medicare.  They seem to have forgotten that EMR (Electronic Medical Records) has already been mandated by law for implementation in medical care offices soon, which will and can eliminate the need for any ACOs, in my view.  By simply clicking on the EMR one can see the tests already done and not reorder them. The most frustrating part of what the political medical masochists have not considered as worthy of attention, are the massive problems other countries in Europe and in Canada, among others, have had with their socialized medical programs, especially the fact that the availability of medical care to patients is significantly reduced through restrictive rules that intentionally limit medical care (rationing) to certain segments of the population.  True especially, where it costs the system too much money to care for unproductive people and those with terminal diseases--just left to rot. When countries are going bankrupt, it adds an even bigger problem--no medical care available at all, at least some times. During my meditation times, the last 20 minutes I'm sitting on the toilet, I can think of many ways in which the presence of private practice medical doctors are in a position to provide health care to patients even if the whole government collapses.  Does it make you wonder if the national health services in those countries permit their contracted doctors to provide care to anyone that needs medical care, or just to those who are members of the organization?  It follows, when 95% of doctors are locked to the national health systems and it fails, where do all the patients go for care? Patients who are left with choices of who they prefer to have manage their medical care are at a great advantage far and above those cornered in any form of national health systems.  The circle of dictation of medical care to patients started by doctors telling patients exactly what was to be done in the old days, switched to dumping medical care choices on patient's shoulders while doctors waited for the patient to decide era, and now is back to the government doing the dictating to patients as well as doctors. No one denies that the best medical care happens in a private medical practice office, except for the idiots who always have a ulterior selfish motive in mind. One last comment about what seems blatantly obvious to me. For my about 50 years in medical circles and exposed to about every kind of medical practice and delivery of health care one can think of during that time, I keep hoping that organized medicine at its highest levels would be able to save the profession from the clutches of government. I am sure it can't.  All of the lobbying by the proponents of maintaining private medical practice are not able to change the minds of politicians.  Its for the same reasons we see now that ruling by consensus opinion has eliminated reasoning and the power to change anything.  It's no different than what you experience in hospital staff committees.  It might be a very good idea to cinch up your suspenders, hope that Dec. 21, 2012 will have a positive effect on everything, and stand up for what you believe.  And, if that is not enough, I have some other ideas for you to think about.   April 2011--- "About the dumb teaching the dumb about business" It seems to me................ ......that business and marketing training for medical doctors and other healthcare professionals is a non-issue even in the postgraduate arena.  Wouldn't you love to go to a medical professional conference at least one time in your life when the focus of that meeting was strictly on the business of medical practice?  At least once to have an experience where a single critical aspect of medical practice success is finally taken seriously by the medical profession itself. I happened to notice in my college newsletter (ACOG) in Mar. 2011 that a Junior Fellow ACM course was to be taught to doctors transitioning from residency to practice.  I was delighted to see that one of the speakers was giving a presentation about the business of medicine.  Being curious about what background Scott D. Hayworth, M.D. might have for this important topic, in light of the fact that medical schools could care less about teaching medical students, I Googled him on the net.  Although there were more than a bunch of search engine listings about him, I found that he had no background education concerning business or marketing--only personal experience. So, once again I see a medical doctor teaching other doctors who apparently has the same knowledge about business and marketing as the audience does---indicating to me again that this education topic about the business of medical practice is unimportant in the eyes of the medical hierarchy.  Beyond that, whoever offered him the lecture topic on business must have had the same impression about the value of the topic.  That is....unless they couldn't find anyone else willing to give a talk about business who was seriously qualified to do so.   Could it be that the committee didn't have enough money to afford a highly qualified person to give the lecture? When I faced the exact same situation coming out of my residency with my family and ready to start my practice and almost broke, it would have been the perfect time for some expert on business to have dumped all their information and knowledge on me.  It certainly would have made a huge difference to me about what I would do next.  In our present economic environment, another transitioning phase has evolved following the end of the training phase, which affects all new physicians.  Judging from the educational debt on the shoulders of new doctors, it's quite obvious they would not have enough money to start a private practice, unless they were independently wealthy, or had a rich uncle.  It forces new doctors to become an employee for 5 or 6 years to save up enough money to start private practice.  I'm not saying that's bad, but it certainly delays any medical practice dreams, goals, and expectations a young doctor might have, while managing the other aspects of life, family, and politics. Combine all the above with the lack of legal caps on malpractice verdicts, increasing fee restrictions by the government, a rapidly decreasing respect for physicians and their status, and having to live in a low middle class lifestyle and you have every reason for being terribly disappointed with the profession.  My conviction is that a great deal of these stresses, barriers, and millstones around the neck can be relieved only by having a sound knowledge of business and a working knowledge of marketing at the very least---or by Dec. 21, 2012.  Although I will continue to bang my head against the "walls of tradition and dogma", I still get great satisfaction in knowing I may have made a little difference in a few individuals along the way, and maybe, somehow, someone will pay attention to my preaching and finally do something about it.  If I had 5 million dollars, I certainly would be shaking up a few heads.   March 2011--- "About medical practice marketing needs that are often not  met and reasons why" It seems to me................ ......medical practice professionals and healthcare providers who are in their own businesses are feeling the overpowering economic tsunami threat taking place everywhere, biting fingernails and probably praying a little more than usual, while sensing their own vulnerabilities to being able to protect their careers, professions, and businesses.  That said, I can assure you there are thousands of brilliant people out there who are willing and able to share their knowledge with you and help you rise out your business hopelessness that has infiltrated to some degree every professional's mind.      A few days ago I had an opportunity to strike up a conversation with a second year medical resident while he was observing the practice activities of an endocrinologist.  The process of choosing a place to practice had him confused.  I could sense his frustration, but it was also obvious from his comments that he felt he had started thinking about a place to practice way too late.  Not only had he never researched various places, cities, regions, or opportunities to any significant extent, but also appeared not to be very worried.       His pleasant attitude to my questions indicated he was comfortable with the concept that "I can practice anywhere" I choose.  Clearly, he was being held in bondage to the outdated and traditional medical practice attitude that medicine is an art and not a business.       Further questioning confirmed what I have repeatedly been saying about the deficiencies of medical education--the lack of any business or marketing training necessary to succeed.  Nowhere in his educational process, he admitted, had anyone indicated the need to have or to get that knowledge.  He did understand that he should have that expertise, but had no idea how to get it in the middle of his education process.  I cringe every time I see an example of another young doctor being educationally crippled by lack of business and marketing education.      Who, besides me, has taken on the challenge of correcting that deficiency?  The rationalization I hear so often from those who could take a stand is the usual stuff.  Doctors should hire some business and marketing experts to do it for them.  The ridiculousness, even laughable nature, of that thought is so often refuted by the financial compromises doctors are being forced into.   Major numbers of doctors and other professional health care providers aren't making enough money to afford to hire experts to help them in their business.  Either way they lose.      If our world remains intact, and if the medical profession remains important (I often think that it isn't) in the near future, the only direct means of fixing the business and marketing knowledge problem is to have the professionals do it on their own.        It requires: Convincing medical professionals that the knowledge is necessary for survival.   Persuading physicians and other providers that their maximum potential in their career can only be obtained through the use of documented business and marketing strategies.   Providing them with the materials to learn the strategies.   Introducing them to creative ideas about what can be done with those materials.   Showing them the systems to use to increase productivity.   Giving guidance how to manage their business effectively and convincing them to do it right.   Showing them that business and marketing systems improve income a thousand percent.   Unsticking them from the traditional mindset of not needing these factors.   Promoting step-by-step blueprints for creating each modality.   February 2011 -- "About business systems and their value" It seems to me................ ......that I should be paying more attention to the very specific things that you are hungry for.  Last week I exchanged emails with a subscriber to my newsletter which set me to thinking about going back and completing a project I had placed on the back burner.  This businessman had actually taken the time to send me an email thanking me for the information I have been providing in my newsletter.  It wasn't so much about getting a pat on the back, but much more about what I discovered during our exchange of emails.      He's in a business of consulting with physicians, other health care providers, and hospitals regarding billing systems and collections.  During those sales and repair problem visits, he admits being asked repeatedly about the medical businesses need for information how to market their business in this tough economic time. What he felt was needed by these medical businesses was not video tutorials, referrals to websites, or a book to read on how to run their marketing or business projects.  They just need something easy and simple like a 3-ring binder where they can flip the pages to the spot they need info about, and read down the list of steps about how to set up a system and maintain the process indefinitely.      From my personal view, that binder would have to be expanded to a dozen binders, and cover the hundreds of pages necessary to adequately provide the following necessary items: the setup instructions step by step process barriers and problems to avoid or overcome reasons for doing each step a certain way timing of each step and why it's needed descriptions of how each step meshes with the business as a whole segment assigned to teaching new employees the processes and many other associated features to make it all work           The reason that it would be such a multiple binder project is that the information would have to be presented in an easily understandable format, worded and described in such a way that any office business employee would be able to pick it up and promptly understand what it tells them to do, understand how to do it, and understand the reasons why.  In general, copywriting of most advertising and marketing promotions has to be worded for about a 5th grade level of education.  And that, my friends, is probably why the idea has been on a back burner for so long now.       However, as is often true of entrepreneurs, that sudden spark of creativeness jolted me out of my comfort zone leaving my shoes behind.  We learn that the word "impossible" has several different meanings depending on the degree of inspiration one is fired up with.  For those whose feet are nailed to the floor, it means no one can do anything about it.  For those who are watchers, it means that they intend to hang around awhile because someone might be able to actually find a way around the impossible thing, and they want to be there when it happens and they they'll know how to handle it as well.      For entrepreneurs, it means that regardless of the perceived difficulty that might be involved, "impossible" amounts to a virtual hologram that one can walk right through--when one finds a way to get past it.  That thought put me in a mindset that, creating the binder and the data can be done not as a compulsive person would do it, but, by the way a practical minded person would do it and save a lot of paper and ink.  Compulsive perfection for doing projects is a definite handicap.       I have learned about business, projects, marketing, and any other life work that it is a complete waste of time trying to make everything perfect before you try it or sell it.  Presenting a lousy speech which has excellent value to the listeners is much better than the opposite.  There's a lot of substantial body of evidence why we should only shoot for "good enough." Evidence why "good enough" works: 1. If I created a 1,000 page marketing "starter file" which anyone could read and understand, likely no one would attempt to read it or even use it.  If it's 1,000 pages, the perception is that it is way too complicated to be understood, without ever trying to read a section of it. 2. No matter how much you seek perfection in what you do, there will always be glitches, unexpected external intrusions, things left out or not consciously considered, things that have to  be changed or modified, and supernatural ghosts who keep drinking from your coffee cup. 3. Imagine for a minute what Michelangelo could have accomplished in his painting if he had not been such a perfectionist.  Compare his work with that of Van Gough, who smeared gobs of paint on the canvas until he thought it was good enough.  Is one better than the other? 4. Because doctors and healthcare providers are in reality selling their expertise to their patients, it is reasonable that in order to see more patients and make more money, they have to reduce their sales pitch to a "good enough" level with patients.  So, how do we decide on what's "good enough?" I didn't know it at the time, but my intent to explain things in depth, answer all questions, and enlighten all patients as my way of doing a good job in my practice burnt a huge hole in my bank account for years.  I should have been tied up and whipped for that ignorance.      My decision--I'll create a binder doctors and their employees can use for marketing planning and promoting their medical practice business.  I'll make the time to do it, even if I'll miss my daily back scratch. Tell me what you think about all this!  What do you need in your medical business?  Don't be a pansy---tell all!   January 2011 -- "About medical practice management" It seems to me................      After reading a recent article about business management and the difficulties that business administrators have in doing their jobs, I immediately could visualize the close connection to why most physicians not only have difficulty with the administration of their own medical practice business, but also why all professional medical providers are victims of their own attributes.       It's well recognized and accepted that entrepreneurs make lousy managers and administrators.  Medical doctors are, by definition, entrepreneurs.  It would be difficult to argue against that premise because doctors function in the same environment, or world, as all entrepreneurs.  Almost every patient comes to the physician with a symptom, or complaint, or medical problem that may not present an easily recognizable pattern of a disease or diagnosis.  So, here in the first minute of speaking with his patient, doctors find themselves outside their comfort zone and involved in mental creativity.       The doctor can then open their mind to all kinds of possibilities for diagnosing the problem as well as possible treatments, all of which are subliminally squeezed out of the memory banks by the subconscious mind.  From there, the search becomes more focused, and the possibilities are narrowed down.  The whole pile of information and findings are funneled down to the most obvious cause which usually has a most common treatment.  If that's not the case, the doctor ends up in entrepreneur heaven with bundles of ideas and a great opportunity to solve the problem anyway, and show the world what they're made of--perhaps even the elite medical school they graduated from.      Getting back to those attributes I mentioned above, several are those that are a real pain in the ass for those doctors in private practice who avoid taking full control of their office business, avoid the responsibility for management of their medical business, and avoid attempting to learn and implement time proven business principles every physician must have for maximizing their own potential in practice, but also the highest potential for their business income and efficiency.  For doctors in this hypnotic state of avoidance, the inevitable consequences always show up, often, when it's too late to do much about their circumstances. The crime is that it should never happen to any physician when it is entirely preventable.      Probably, the greatest distaste for management to a physician is that too much of the administrative work is either too routine, or not challenging enough to peak their interest.  You know that the worst thing that can happen to you in medical practice is to have two jobs at the same time.  In one you are your own employee working for that invisible corporation you set up to run the practice business.  The other is being the owner and CEO of the business which requires management of the business done by the only person responsible for the success of the business-----you!      Pushing the management job on to an untrained employee who thinks she or he can handle the job is downright stupidity.  As the old saying goes, "Ignorance can be overcome by education, but stupidity lasts forever."  Hiring a person trained in management, dramatically improves the office business functioning, but does not remove your overall responsibility for supervising the manager and maintaining your control of every aspect of your medical practice business.  Managers earn higher salaries, so you must earn more to pay them, which is often a problem for physicians nowadays.      Another trait doctors have that makes it difficult to manage their office is difficulty in delegating duties.  Most doctors want things done a certain way.  They often are not satisfied with how someone else does a job and would much rather do it themselves and have it done "right."  A mistake made by the majority of doctors who do delegate duties to their staff is that of not taking the time to explain to the employee exactly what he wants done in detail.  If it's done without a detailed explanation, you will get back what the person thinks you may have meant.      Delegation of duties, including outsourcing, is a critical issue for business growth.  Physicians must learn to be satisfied with, "good enough" work done by others.  No one can do it all themselves.       The distasteful idea of replacing yourself, your importance, your supreme talents, makes a huge dent in the ego and self esteem, which is another barrier to good management for doctors.       We all develop habit patterns in our lives to make our life experiences easier and quicker.  It's been reported that 80% of our daily activities are composed of habit patterns.  For doctors, it's just another problem in their adjustment to a managerial status, where most everything in management is constantly changing, new problems, new innovations, new procedures, new employees, new systems, new toys, etc.       If there is one essential factor to keep in mind while thinking through all of this stuff, it's one that's known to all success business people, business experts, management experts, and maybe even your wife or husband.      You need to make your productive time even more important than it is now.  You must free up the time to do the $100/hr. job instead of doing the $10/hr. job.  It's very easy to find an employee to work for $10/hour but you rarely can find an employee capable of doing what the $100/hour requires.  That, is what you must do yourself, no one else can do it.  In most medical practices that job is marketing your medical practice and establishing a constant flow of new patients into your practice. How to weasel out the time to do the management process for your practice business will be one of my articles soon to come.      ****************************************************************** Please Note: This is a page from my VIP Membership Team Site that I have modified somewhat to fit into the free newsletter.  I give my views on medical topics, my beliefs about medical practice, and tips about staying out of trouble while in medical practice as well as other helpful issues, which should be learned early in medical practice instead of finding out late in practice what you should have been using and doing all along. My intent is to create a series of substantial content dealing with the integrity of medical practice business and marketing as well as self-improvement. ************************************************************ Call me:  702-236-6337 (direct to me) Email me:  cgmdrx@gmail.com (Articles, Advice, Opinions, Beliefs) Fax me:  702-258-0415 The author, Curt Graham, is a highly experienced business and marketing expert, copywriter, and entrepreneur who has been published in various media over 50 years while in medical practice and after. Discover what it takes for you to reach the optimal limits of your potential in medical practice, and how to do it: Click The Link NOW! www.howtopropelyourmedicalpracticeincome.com © 2004-2011, Curt Graham M.D., L & C Internet Enterprises, Inc., All rights reserved.   © 2004-2012, Curt Graham M.D., L & C Internet Enterprises, Inc., All rights reserved.
Curt Graham, M.D.                            L & C Internet Enterprises, Inc.                       2404 Mason Ave.  Las Vegas, NV 89102                                E-mail = cgmdrx(at)gmail.com      © 2004 - 2010 Curtis Graham, M.D., L & C Internet Enterprises, Inc.  All Rights Reserved.