"New normal"
What does that mean?
I don't know about you, but to me there's nothing "normal" about any of this...
About a year ago I started this blog
Propelled by my own career experiences to write
To share with other physicians
So that they might learn from my success and failures
And be inspired to create a career that is both fulfilling and joyful
I also wanted to help patients who are overwhelmed
By the complexities and inconsistencies in our healthcare system
Preventing them from getting the care they need and want
There were periods of time that I couldn't wait to write
And then other moments when I didn't know what to say
The last few months have been one of those "moments"
I have more time with each patient now
Due to social distancing, sanitation of high contact surfaces and other guidelines
In addition to focusing on my patients' healthcare concerns, the costs of prescription drugs and recommended testing,
I now spend time discussing the pandemic, our nation's political strife...
And how I don't have the answers
What I do know is that the pandemic has forever changed us
Now more than ever we should strive to be innovative, entrepreneurial, flexible, and more humanitarian
And perhaps less polarized...
"New normal"???
How about "better normal"?
Monday, November 16, 2020
Thursday, May 7, 2020
and just like that...
Everything changed
For everyone
Everywhere
A tiny virus
Replicating without rules
The unthinkable
Death
Economic recession
No end in sight
New normal
But what better time
To re-engineer our healthcare system?
To grant autonomy and respect back
To the first responders, nurses & doctors who are on the front lines
As they may be the ones saving us all...
For everyone
Everywhere
A tiny virus
Replicating without rules
The unthinkable
Death
Economic recession
No end in sight
New normal
But what better time
To re-engineer our healthcare system?
To grant autonomy and respect back
To the first responders, nurses & doctors who are on the front lines
As they may be the ones saving us all...
a really big wave
Here we are in May 2020
Already...
Where did February through April go?
What happened?!
And why didn't we see this wave coming?
Why weren't we better prepared?
A pandemic wave
World War III
An invisible enemy
Many words and phrases to describe the unthinkable
A never-before-seen virus which has killed 100's of thousands across the globe
Which has crippled economies
And its effects aren't over yet...
What have we learned?
How have our lives changed?
Will we be able to ever return to the way it was before?
And should we return to the way it was before?
I encourage everyone to step back and view this through a wider lens
Not from the spherical bubble from which we live our lives
What positive changes have we made personally, spiritually, professionally?
Which of these changes can we maintain going forward?
The new normal might just be what we all need...
Already...
Where did February through April go?
What happened?!
And why didn't we see this wave coming?
Why weren't we better prepared?
A pandemic wave
World War III
An invisible enemy
Many words and phrases to describe the unthinkable
A never-before-seen virus which has killed 100's of thousands across the globe
Which has crippled economies
And its effects aren't over yet...
What have we learned?
How have our lives changed?
Will we be able to ever return to the way it was before?
And should we return to the way it was before?
I encourage everyone to step back and view this through a wider lens
Not from the spherical bubble from which we live our lives
What positive changes have we made personally, spiritually, professionally?
Which of these changes can we maintain going forward?
The new normal might just be what we all need...
Wednesday, January 1, 2020
perfect vision
Happy New Year!
Quips are already swirling regarding Barbara Walters' weekly quote "...this is 2020", the weekly television news series many of us grew up with which is still in production today.
I believe the "2020" title is in reference to the analogy of perfect vision, not the calendar year.
But here we are, 1/1/20 & there seems to be an energy fueling the start of this year.
Akin to 2000...Y2K...something "different".
So what does 20/20 vision mean?
According to The American Optometric Association, 20/20 vision refers to someone's visual acuity-the clarity of sharpness of vision measured at a distance of 20 feet. 20/20 vision is a point of reference, not the definition of perfection. For example, if one's vision is determined to be 20/30, that means she can see at 20 feet what others can see at 30 feet.
What is your point of reference for 2020?
Are you comparing your professional goals to what you feel you can reasonably achieve? Or to what you feel is expected of you? Or to what you see happening around you?
Outlining one's goals in a concrete manner can be and should be the starting point to professional success.
The simple act of defining one's goals and writing them down will organically catapult you to "what's next".
So in these early days of 2020, I encourage you to step back from the chaos of life and write down some simple, actionable professional goals.
Clarity.
Sharpness.
Vision.
2020...
Quips are already swirling regarding Barbara Walters' weekly quote "...this is 2020", the weekly television news series many of us grew up with which is still in production today.
I believe the "2020" title is in reference to the analogy of perfect vision, not the calendar year.
But here we are, 1/1/20 & there seems to be an energy fueling the start of this year.
Akin to 2000...Y2K...something "different".
So what does 20/20 vision mean?
According to The American Optometric Association, 20/20 vision refers to someone's visual acuity-the clarity of sharpness of vision measured at a distance of 20 feet. 20/20 vision is a point of reference, not the definition of perfection. For example, if one's vision is determined to be 20/30, that means she can see at 20 feet what others can see at 30 feet.
What is your point of reference for 2020?
Are you comparing your professional goals to what you feel you can reasonably achieve? Or to what you feel is expected of you? Or to what you see happening around you?
Outlining one's goals in a concrete manner can be and should be the starting point to professional success.
The simple act of defining one's goals and writing them down will organically catapult you to "what's next".
So in these early days of 2020, I encourage you to step back from the chaos of life and write down some simple, actionable professional goals.
Clarity.
Sharpness.
Vision.
2020...
Sunday, November 17, 2019
waves
"you can't stop the waves from coming at you but you can learn how to surf"
Words to me from the wisest and most loving person I know.
My absence from blogging these past few months can't really be explained well.
Writer's block, maybe?
Lots of thoughts swirling in my head, but not able to put pen to paper.
And then there were the waves...
Unexpected illness of my Mom.
Tropical Storm damage to our home.
Financial uncertainty.
Progressive erosion of our country's culture.
Further decline of our healthcare system.
But then I popped up.
And balanced my stance on that board feeling the wave beneath me.
Experiencing its strength as I was propelled forward in the surf.
Salt air, ocean, warmth, freedom, purity...
Find your wave.
And hold on to it.
Words to me from the wisest and most loving person I know.
My absence from blogging these past few months can't really be explained well.
Writer's block, maybe?
Lots of thoughts swirling in my head, but not able to put pen to paper.
And then there were the waves...
Unexpected illness of my Mom.
Tropical Storm damage to our home.
Financial uncertainty.
Progressive erosion of our country's culture.
Further decline of our healthcare system.
But then I popped up.
And balanced my stance on that board feeling the wave beneath me.
Experiencing its strength as I was propelled forward in the surf.
Salt air, ocean, warmth, freedom, purity...
Find your wave.
And hold on to it.
Friday, August 30, 2019
way over yonder
The delivery of healthcare in rural areas is in crisis with hundreds of hospitals closing.
According to researchers at Navigant, 10 states are at the highest risk of rural hospital closures. These include: Kentucky, Iowa, Oklahoma, Michigan, Arkansas, Minnesota, Alabama, Georgia, Kansas, and Mississippi.
Emergency and maternity services are most affected by this reality. More than half of all rural counties lack a hospital offering obstetrical care which increases the risk of pregnancy-related complications and poor birth outcomes. The increasing Obstetrician shortage is a significant contributor to this unfortunate issue.
When I opened my own Gynecology-only private practice 6 years ago, I never dreamed I would be delivering babies again. At that time, my plan was to provide "comprehensive high quality evidence-based office and surgical gynecologic care in a warm and relaxing environment". Which I did. But as the practice evolved, I realized the projected revenues were significantly less than anticipated (in part, due to my purposeful decision to spend more time with my patients accompanied by declining reimbursements). I began looking for extra work ("physician side gigs") as well as making the decision to return to school (more school?!) to learn the "business side" of Medicine.
For 18 months, I was a student in a hybrid (distance learning plus in-residence sessions) Masters Program for mid-career healthcare professionals. One of many "think tanks" where solutions to our complex healthcare system's problems are brainstormed. It offered me an incredible learning experience as well as the opportunity to work with national healthcare leaders.
I met two healthcare leaders from rural Kansas who through innovative strategies were successfully growing their hospital's Obstetrics service line as well as improving patient outcomes. This inspired me to obtain my Kansas medical license which led to my first rural locum tenens Obstetrics assignment.
Over the next two years, I've been fortunate to help hospitals in rural Kansas, Texas, and New Mexico. What started as a "physician side gig" has evolved into a renewed passion of practicing full-scope Obstetrics and Gynecology again. And helping others.
I encourage my physician colleagues as well as mid-level providers, nurses and ancillary support personnel to help our rural hospitals stay open. There are many locum tenens opportunities available throughout the United States with the flexibility of working a long weekend every few months to several weeks at a time.
"Way over yonder
Is a place that I know
Where I can find shelter
From a hunger and cold
And the sweet tastin' good life
Is so easily found
A way over yonder, that's where I'm bound..."
Carole King
According to researchers at Navigant, 10 states are at the highest risk of rural hospital closures. These include: Kentucky, Iowa, Oklahoma, Michigan, Arkansas, Minnesota, Alabama, Georgia, Kansas, and Mississippi.
Emergency and maternity services are most affected by this reality. More than half of all rural counties lack a hospital offering obstetrical care which increases the risk of pregnancy-related complications and poor birth outcomes. The increasing Obstetrician shortage is a significant contributor to this unfortunate issue.
When I opened my own Gynecology-only private practice 6 years ago, I never dreamed I would be delivering babies again. At that time, my plan was to provide "comprehensive high quality evidence-based office and surgical gynecologic care in a warm and relaxing environment". Which I did. But as the practice evolved, I realized the projected revenues were significantly less than anticipated (in part, due to my purposeful decision to spend more time with my patients accompanied by declining reimbursements). I began looking for extra work ("physician side gigs") as well as making the decision to return to school (more school?!) to learn the "business side" of Medicine.
For 18 months, I was a student in a hybrid (distance learning plus in-residence sessions) Masters Program for mid-career healthcare professionals. One of many "think tanks" where solutions to our complex healthcare system's problems are brainstormed. It offered me an incredible learning experience as well as the opportunity to work with national healthcare leaders.
I met two healthcare leaders from rural Kansas who through innovative strategies were successfully growing their hospital's Obstetrics service line as well as improving patient outcomes. This inspired me to obtain my Kansas medical license which led to my first rural locum tenens Obstetrics assignment.
Over the next two years, I've been fortunate to help hospitals in rural Kansas, Texas, and New Mexico. What started as a "physician side gig" has evolved into a renewed passion of practicing full-scope Obstetrics and Gynecology again. And helping others.
I encourage my physician colleagues as well as mid-level providers, nurses and ancillary support personnel to help our rural hospitals stay open. There are many locum tenens opportunities available throughout the United States with the flexibility of working a long weekend every few months to several weeks at a time.
"Way over yonder
Is a place that I know
Where I can find shelter
From a hunger and cold
And the sweet tastin' good life
Is so easily found
A way over yonder, that's where I'm bound..."
Carole King
Tuesday, August 13, 2019
flying solo
Given the complexity of our current healthcare system, is it possible to be successful in solo private practice?
Yes.
With careful and well thought out planning as well as patience, it can be done.
The rewards of professional autonomy cannot be emphasized enough.
Here are just a few:
The ability to take care of patients in an unhurried manner.
The freedom to set one's hours.
The opportunity to select your staff and empower them to work at the top of their licensure.
Keep things simple in the beginning, you can always scale up later if desired.
Think leanly in terms of start-up costs.
Negotiate, negotiate, negotiate.
(1) Develop a simple business plan
How many patients do you envision seeing each week?
How many hospital procedures, surgeries, deliveries can you do per month?
What gross income would you eventually like to earn?
How many days of vacation each year would you like to take?
Talk to your accountant about your plan.
(2) Contract with payers
Every physician has a unique NPI# which can be used to contract with insurance companies as an individual provider.
Calculate what your average revenue per patient encounter will be.
This will determine your projected gross revenue per month.
(3) Financial
Plan for a 6 month launch.
No income for 6 months so secure a nest egg of savings.
Set up PA or LLC with your state.
Bank account.
Business credit card.
Obtain small business loan.
Get liability coverage.
(4) Negotiate with EHR companies
Select one that can provide both documentation, e-prescribing and revenue cycle management.
Get several quotes from various vendors.
(5) Pick out an office space
How many exam rooms will you need?
Provide ample work space for front office staff and nursing staff.
Recommend two bathrooms: one for patients, one for staff.
Aesthetically pleasing waiting room.
Adequate parking.
Wheelchair accessibility.
Close proximity to ancillary services: imaging center, hospital, laboratory services.
Easy to find.
(6) Build out office
Negotiate cost of build out with landlord.
Sign longer lease to get reduced rent.
Furnish with second-hand exam tables, medical equipment.
Enlist help of office staff with selection of furnishings.
Phone system, fax, computers, printer, shredder.
(7) Hire staff
Two well-trained, devoted employees is all you need!
Recommend one employee as your Office Manager and the other as your Patient Care Coordinator.
Cross-train your two employees so they can cover for each other.
Meet regularly and enlist their opinions in setting up your practice.
(8) Develop marketing strategy
Inexpensive basic business cards.
Simple website.
Facebook page.
Reach out to existing patients.
Ad in monthly community newsletter.
Network with potential referring physicians.
Meet with hospital marketing representative.
(8) Schedule patients!
Dry run with mock patients prior to opening day.
Schedule lightly the first few weeks.
Send thank you notes to those who refer patients to you.
(9) Opening day
Fresh flowers.
Refreshments.
Begin celebrating the professional life you have imagined!
Yes.
With careful and well thought out planning as well as patience, it can be done.
The rewards of professional autonomy cannot be emphasized enough.
Here are just a few:
The ability to take care of patients in an unhurried manner.
The freedom to set one's hours.
The opportunity to select your staff and empower them to work at the top of their licensure.
Keep things simple in the beginning, you can always scale up later if desired.
Think leanly in terms of start-up costs.
Negotiate, negotiate, negotiate.
(1) Develop a simple business plan
How many patients do you envision seeing each week?
How many hospital procedures, surgeries, deliveries can you do per month?
What gross income would you eventually like to earn?
How many days of vacation each year would you like to take?
Talk to your accountant about your plan.
(2) Contract with payers
Every physician has a unique NPI# which can be used to contract with insurance companies as an individual provider.
Calculate what your average revenue per patient encounter will be.
This will determine your projected gross revenue per month.
(3) Financial
Plan for a 6 month launch.
No income for 6 months so secure a nest egg of savings.
Set up PA or LLC with your state.
Bank account.
Business credit card.
Obtain small business loan.
Get liability coverage.
(4) Negotiate with EHR companies
Select one that can provide both documentation, e-prescribing and revenue cycle management.
Get several quotes from various vendors.
(5) Pick out an office space
How many exam rooms will you need?
Provide ample work space for front office staff and nursing staff.
Recommend two bathrooms: one for patients, one for staff.
Aesthetically pleasing waiting room.
Adequate parking.
Wheelchair accessibility.
Close proximity to ancillary services: imaging center, hospital, laboratory services.
Easy to find.
(6) Build out office
Negotiate cost of build out with landlord.
Sign longer lease to get reduced rent.
Furnish with second-hand exam tables, medical equipment.
Enlist help of office staff with selection of furnishings.
Phone system, fax, computers, printer, shredder.
(7) Hire staff
Two well-trained, devoted employees is all you need!
Recommend one employee as your Office Manager and the other as your Patient Care Coordinator.
Cross-train your two employees so they can cover for each other.
Meet regularly and enlist their opinions in setting up your practice.
(8) Develop marketing strategy
Inexpensive basic business cards.
Simple website.
Facebook page.
Reach out to existing patients.
Ad in monthly community newsletter.
Network with potential referring physicians.
Meet with hospital marketing representative.
(8) Schedule patients!
Dry run with mock patients prior to opening day.
Schedule lightly the first few weeks.
Send thank you notes to those who refer patients to you.
(9) Opening day
Fresh flowers.
Refreshments.
Begin celebrating the professional life you have imagined!
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