# To Wrap Or Not To Wrap

# To Wrap Or Not To Wrap 

This the time of year when we think back to the very first Christmas, when the Three Wise Men - Gaspar, Balthazar and (the other guy whose name escapes me right now…so I’ll make up a name) Herb - went to see the baby Jesus, and, according to the Book of Matthew, "presented unto Him gifts of gold, frankincense, and myrrh." 

These are simple words, but if we analyze them carefully, we discover an important, yet often-overlooked, theological fact:  There is no mention of wrapping paper.  If there had been wrapping paper, Matthew would have written, “And lo, the gifts WERE inside 600 square cubits of paper. And the paper WAS festooned with pictures of Frosty the Snowman. And Joseph WAS going to throweth it away, but Mary saideth unto him….she saideth, 'Holdeth it! That is righteous paper! Saveth it for next year!' And Joseph DID rolleth his eyeballs. And the baby Jesus WAS more interested in the paper than, for example, the frankincense."

But these words do not appear in the Bible, which means that the very first Christmas gifts were NOT wrapped. This is because the people giving those gifts had two important characteristics:

1)     They were wise – They did not wrap

2)     They were men – They were not women (Even though it looks like they wore clothing that resembled skirts or dresses.  We’ll take that up at a different time.)

The point I’m trying to make here is men are not big gift wrappers. Men do not understand the point of “putting paper on a gift just so somebody else can tear it off”, as my husband, Bill, has said many times. It’s not just Bill’s opinion.  It is a scientific fact based on a statistical survey of two other guys I know. One is my late father, Jimmy, who said the only time he ever wrapped anything was if it was such a poor gift that he didn’t want to be there when the person opened it.  The other is my brother Marty, who told me that, yes, he does wrap gifts, but as a matter of principle never takes more than 15 seconds per gift. "No one has ever wondered which presents I wrap at Christmas," Marty says. "They are the ones that look like enormous spitballs."

I must tell you, Bill has also wrapped some gifts, but he hates doing it.  The reason he hates it is because he says he can’t ever “make it look right.” There is of some kind of defect in his motor skills because he can never COMPLETELY wrap them. He could take a gift the size of a deck of cards and put it in the exact center of a piece of wrapping  paper the size of a regulation volleyball court, but when he is done folding and taping, you can still see a section of the gift  peeking out. (Sometimes he camouflages this section with a marking pen.) If he had been an ancient Egyptian in the field of mummification, after the wrapping was completed, the lower half of the dead Pharaoh's body would be covered only by Scotch tape.  On the other hand, if you give me a 12-inch square of wrapping paper, I could wrap a C-130 cargo plane.  I, like many women, actually LIKE wrapping things. If I give a gift that requires batteries, I wrap the batteries separately, (Which, I must admit, is very close to being a symptom of mental illness.  But… I digress….) Anyway, Bill tells everyone that if it were possible, I would wrap each individual volt. Hmm, sounds like a challenge…bet I could do it!

Anyway, my point is that gift-wrapping is one of those skills - like giving birth to babies - that come more naturally to women than to men.  Men also DON’T UNDERSTAND that wrapping is an art-form; wrapping is a skill that must be cultivated, refined and individualized to the recipient; they just don’t get that fact that even the recipient of a piece of gum that is wrapped with care will notice the intent of the wrapper and think, “WOW! This is wonderful!!”  They will then gaze around the room and think, “Look, every package has the same theme.  This whole room, and even the tree are coordinated in blues and pinks this year; unlike last year when the ribbon had flecks of gold and copper that matched the lights strung on the bushes outside and the chargers on which the dinner plates were placed.  This person always puts so much time and thought into every little detail of decorating and, oh, how ingenious, even wrapped this piece of gum!  We all know it didn't cost much, but, the fact that it is wrapped just proves that it truly is the thought that counts.  They must really think I’m special to wrap this gum and give it to me.  Oh Yum.  What a great gift.” 

Bill says, “Not! They’ll think, ‘WOW! How stupid do they think I am…trying to camouflage this piece of gum with wrapping paper? What is it made of? Frankincense or myrrh or something? Why didn't they just give me the gum, shove a glass of eggnog in my hand, wish me a Happy Holiday and give me a hug? I'm tired of talking so much about this, it's BS, let’s watch the game!’”

That is why today I am presenting this simple advice for all males:

# Gift Wrapping Tips for Men

1)       Whenever possible, buy gifts that are already wrapped. If, when the recipient opens the gift, neither one of you recognizes it, you can claim that it's myrrh.

Side Note: The editors of Woman's Day magazine recently ran an item on how to make your own wrapping paper by printing a design on it with an apple sliced in half horizontally and dipped in a mixture of food coloring and liquid starch. I think I’ll try it.  Bill says, “They must be smoking crack!”

2)        If you're giving a hard-to-wrap gift, skip the wrapping paper!  Just put it inside a bag and stick one of those little adhesive bows on it. This creates a festive visual effect that is sure to delight the lucky recipient on Christmas morning.

Side Note:  WARNING! Bill says you might not want to try this option because he tried it once with his first girlfriend and lets just say, you won’t like how it turns out.  

            Here is what their conversation sounded like:

           GIRLFRIEND:         "Why is there a Hefty trash bag under the tree?"

           BILL:                        "It's a gift! See? It has a beautiful, shiny bow!"

           GIRLFRIEND:         (peering into the trash bag): "It's a generator?"

           BILL:                        "Gas-powered! Five horsepower! For Emergencies!"

           GIRLFRIEND:         "I’m breaking up."

           BILL:                        "Oh come on now honey, I also got you some myrrh…..”

In conclusion, remember that the important thing is not what you give, or how you wrap it. The important thing, during this very special time of year, is that it really IS “the thought that counts.”  But remember, when all else fails ….save the receipt and have some myrrh handy!

Oh and by the way, you can purchase your Frankincense and Myrrh at Creative Health Living .

Happy Holidays To You All!!

Social Media As A Medical Practice Marketing Tool

      

SOCIAL MEDIA AS A MEDICAL MARKETING TOOL

 

 

More than ever, it’s essential for hospitals and health providers to rethink their healthcare marketing mix to include social media.

 

The proof is in the numbers: 34% of consumers use social media to search for health information, according to research data from How America Searches: Health and Wellness.

While it’s easy to identify demand, many healthcare marketers are not exactly sure how they might tap into the social web to reach business goals. To help understand the possible applications, consider these five examples of how the social web can work for hospitals and others in the healthcare industry:

 

1. Tweet Live Procedures
In the past year, social media channels have helped open up an area of healthcare previously only available to a select few: the operating room. Last February, Henry Ford Hospital became one of the first hospitals to Tweet a live procedure from an operating room. Doctors, medical students and curious non-medical personnel followed along as surgeons tweeted short updates on the kidney surgery to remove a cancerous tumor. This healthcare marketing tactic can effectively create excitement and raise public awareness for a healthcare organization. In the case of the Henry Ford procedure, Twitter was abuzz that February day with users both re-tweeting the messages from Henry Ford and adding their own thoughts on the event. That buzz can help healthcare organizations both attract new patients and recruit medical personnel.

 

2. Train Medical Personnel
Some healthcare organizations are beginning to recognize the potential impact of leveraging social media channels to complement training efforts. Mayo Clinic Social Media Manager, Lee Aase, for example, incorporated social media into a recent training presentation for local chapters of the American Heart Association. (Check out Lee Odden’s social media interview with Aase for Online Marketing Blog.) During the presentation, Aase leveraged Twitter to encourage participants to contribute to the discussion using the #AHAchat hashtag.

Weaving social media into healthcare training initiatives can provide multiple benefits, including:

• Giving trainees a forum to ask questions and quickly receive answers
• Providing presenters with immediate feedback from trainees (i.e., if trainees have mastered a concept of if more guidance is needed)
• Enabling organizations to complement healthcare marketing efforts by sharing slideshows, video or pictures from training sessions on social sites like YouTube or Flickr

3. Reach Mainstream Media70% of journalists now use social networks to assist reporting, compared to 41% the year before, according to a  Middleberg Communications survey reported by PRWeek. With numbers that high, it only makes sense for healthcare marketers to leverage social media channels in order to achieve coverage by both mainstream media and industry publications.
As part of healthcare marketing efforts, organizations can use social media channels – including blogs, forums and microblogs – to share success stories from out-of-the-ordinary operations or treatments, medical research or other significant achievements. For example, when Aurora Health Care tweeted a knee operation in April, it received significant media attention, both from mainstream media and industry publications including Good Morning America, the local Milwaukee public radio network and Hospital Management Magazine.

4. Communicate in Times of Crisis
When disaster strikes – whether it be a flood, an earthquake or a terrorist attack – hospitals and healthcare providers are at the center of it all. Healthcare providers can leverage social media networks to provide real-time updates both for those directly affected by the crisis and those watching from afar.
During the November Fort Hood shooting attack, Steven Widman of Scott & White Healthcare – one of the hospitals that treated Fort Hood victims, used Twitter to provide up-to-the-minute news. Through Twitter, Widman provided updates on emergency room access and hospital operation status, re-tweeted news from Red Cross and communicated with reporters.
Widman shared with  "Found In Cache Blog" the results of the social media crisis communication efforts:

• Twitter followers increased 78% in just three days
• Scott & White Healthcare was listed on the front page of Twitter as a “trending topic”
• The hospital’s YouTube channel was ranked the 79th most viewed non-profit channel during the entire week surrounding the crisis

5. Provide Accurate Information to Patients
73% of patients search for medical information online before or after doctors visits, according to the HealthCare New Media Conference. With the magnitude of health information available on the web – both accurate and inaccurate – it’s likely that these patients can easily be misinformed.
By integrating social media into the healthcare marketing mix, organizations can share accurate, timely information regarding symptoms, diseases, medications, treatments and more. Social sites like "Inspire" are providing a forum for patients to share their health problems and questions about treatments with other patients, as well as qualified medical personnel. Inspire, for instance, partners with trusted health nonprofit organizations to ensure information is accurate and its community is safe. The benefits of integrating social media into healthcare marketing efforts are priceless – from improving patient care to gaining media coverage to attracting new patients and staff. If your healthcare organization hasn’t already taken advantage of social networking channels, now is the time. If you’re having challenges getting approval, check out “Social Media in Healthcare Marketing: Making the Case“.  How else can healthcare marketers leverage social media to complement their efforts?

Kudos To:
5 Examples of Social Media in Healthcare Marketing

By TopRank Online Marketing     B2C, Blogging, Microblogging, Social Media

 

See how www.HealthcareBusinessManagement.com can leverage Social Media to market your Practice. Call (949) 478-5821

THE EHR PROGRAM YOU NEED

 

 

 

 

 

THIS JUST MIGHT BE THE EHR
PROGRAM YOU NEED TO NAVIGATE
OBAMACARE REQUIREMENTS

 

"The Obama administration maintains that pushing hospitals and physicians to adopt electronic medical records will improve efficiency, increase patient safety, and reduce health care costs. But as more providers transition to EMRs, there has been an unexpected consequence: Billions of dollars in higher costs for Medicare, private insurers, and patients. EMRs may ultimately make health care provision easier, but they also make the process simpler for hospitals and physicians to bill more for their services, regardless of whether they provide additional care. According to the Centers for Medicare and Medicaid Services, cloning, upcoding, and overcoding from template-generated records are some of the abuses that have resulted from the change to EMRs," states Kenneth Artz, a freelance reporter for The Heartland Institute based in Dallas, Texas.

 

Whether these noises over EMR requirements are valid, or not, required EMR is here to stay.  We just have to navigate through the process, learn from our mistakes, and move forward along the internet  highway to a bright new future for practicing medicine.  I believe and trust that using EMRs will actually help the medical community deliver much better quality care than ever before.  Not withstanding the stimmulis incentive, the costs, both monetarily and logistically, of initiating an all inclusive EMR  look to be absolutely cumbersome and downright scary to what I call many chart-in-hand "Paper Physicians" who might actually be thinking of retiring rather than attempting the big switch.

 

EXAMPLES WE READ ABOUT 

 

Dr. Samuel Berkman planned to retire from his hematology practice once medical records went digital: “I figured I didn’t want to be bothered with this. For many people in my generation, we didn’t grow up on computers. The whole thing kind of scared me.” ..........until he found an EMR Program that enabled him to accomplish the whole transition and without paying a dime, he got his $18,000 stimulus check and “a new lease on life” for his practice.

Dr. David Wyatt manages his three facility practice in northern Atlanta with a flexible EMR, allowing him to access patient information anytime, anywhere.  "Our practice consists of three offices in the northern Atlanta area.  I have a total of 10 staff including two physicians, 5 medical assistants, a business manager/partner as well as a registered dietician who all access patient charts.  We deal with "walking-well" patients who are seeking weightloss, dietary, exercise and/or metabulism consultation. We see 95% adults. I have used Nextgen as well as PIVOT EMR systems in my previous work and when this business venture began, I wanted to find a system that could be customized to this particular type of practice, have low up-front costs, have easy set up, as well as a responsive support team. There are Bariatric (weight loss) specific EMRs on the market – costing between $7,500 and $25,000. But these were not internet based (ASP) and we did not want to maintain a server nor take on the issues of patient data safety and maintaining this data. We had the issue of patients needing to go in between offices and their charts not being accessible except by fax. Now all our charts as well as notes, medications, phone messages, and schedules are available though our EMR at any location. We have had great feedback from patients. In addition, our EMR helped with our ability to train new employees and establish a standard protocol for all the offices."

After trying out another EMR, Dr. Andrew Bronstein turned to this EMR for his Las Vegas surgical practice and quickly discovered more than a great price tag. "This is absolutely an invaluable software product, from how easy it is to implement to how robust it is compared to other EMRs that cost tens of thousands of dollars."  He was was originally looking for any EMR that could manage his surgical practice: “I had invested in an electronic health record system after paying approximately $60-70,000 in hardware and software. The install team didn’t show up on day two, and then I found out that the company went bankrupt."

This system, however, was very impressive as he went ‘Live in 5’ minutes and because it is an internet based system that they are changing at all times, he didn't have to buy a license fee for one year and then update it every year.

The system all of these physicians found to be robust, end-user friendly, malliable, simple to use and highly cost-effective is called Practice Fusion! You'll immediately appreciate the benefits of using Practice Fusion's free (YES....FREE), web-based solution. Their user-friendly electronic health records system can be activated in less than five minutes, eliminating the difficult conversion process that has become industry standard. Practice Fusion stands out in a marketplace dominated by expensive, complicated and ineffective EHR systems. We wholeheartedly recommend PRACTICE FUSION every time we get to all of our clients and cannot wait to see their fears fade away and excitement take it place as they begin to use it!

See how Healthcare Business Management can guide you into the future of EMR with our recommendations and experience.

 

What Can Healthcare Learn From The Cheesecake Factory?

 

Associate professor of surgery at Harvard Medical School and journalist, gives his perspective on how chain restaurants could provide key insights to delivering efficient and cheap healthcare.





“It’s easy to mock places like the Cheesecake Factory—restaurants that have brought chain production to complicated sit-down meals. But the ‘casual dining sector,’ as it is known, plays a central role in the ecosystem of eating, providing three-course, fork-and-knife restaurant meals that most people across the country couldn’t previously find or afford. The ideas start out in elite, upscale restaurants in major cities. You could think of them as research restaurants, akin to research hospitals. Some of their enthusiasms—miso salmon, Chianti-braised short ribs, flourless chocolate espresso cake—spread to other high-end restaurants. Then the casual-dining chains re-engineer them for affordable delivery to millions through a 'command center' recipe production protocol. Does health care need something like this?”

Armin Ernst has big plans for "a rollout of full-scale treatment protocols for patients with severe sepsis, acute respiratory-distress syndrome, and other conditions; strategies to reduce unnecessary costs; perhaps even computer forecasting of patient volume someday" and are "already extending the command-center concept to in-patient psychiatry. Emergency rooms and surgery may be next. Other health systems are pursuing similar models. The command-center concept provides the possibility of, well, command.

Today, some ninety 'super-regional' health-care systems have formed across the country—large, growing chains of clinics, hospitals, and home-care agencies. Most are not-for-profit. Financial analysts expect the successful ones to drive independent medical centers out of existence in much of the country—either by buying them up or by drawing away their patients with better quality and cost control. Some small clinics and stand-alone hospitals will undoubtedly remain successful, perhaps catering to the luxury end of health care the way gourmet restaurants do for food. But analysts expect that most of us will gravitate to the big systems, just as we have moved away from small pharmacies to CVS and Walmart.

Already, there have been startling changes. Cleveland Clinic, for example, opened nine regional hospitals in northeast Ohio, as well as health centers in southern Florida, Toronto, and Las Vegas, and is now going international, with a three-hundred-and-sixty-four-bed hospital in Abu Dhabi scheduled to open next year. It reached an agreement with Lowe’s, the home-improvement chain, guaranteeing a fixed price for cardiac surgery for the company’s employees and dependents. The prospect of getting better care for a lower price persuaded Lowe’s to cover all out-of-pocket costs for its insured workers to go to Cleveland, including co-payments, airfare, transportation, and lodging. Three other companies, including Kohl’s department stores, have made similar deals, and a dozen more, including Boeing, are in negotiations. Big Medicine is on the way.

Reinventing medical care could produce hundreds of innovations. Some may be as simple as giving patients greater e-mail and online support from their clinicians, which would enable timelier advice and reduce the need for emergency-room visits. Others might involve smartphone apps for coaching the chronically ill in the management of their disease, new methods for getting advice from specialists, sophisticated systems for tracking outcomes and costs, and instant delivery to medical teams of up-to-date care protocols. Innovations could take a system that requires sixty-three clinicians for a knee replacement and knock the number down by half or more. But most significant will be the changes that finally put people like John Wright and Armin Ernst in charge of making care coherent, coordinated, and affordable. Essentially, we’re moving from a Jeffersonian ideal of small guilds and independent craftsmen to a Hamiltonian recognition of the advantages that size and centralized control can bring.

 

Yet it seems strange to pin our hopes on chains. We have no guarantee that Big Medicine will serve the social good. Whatever the industry, an increase in size and control creates the conditions for monopoly, which could do the opposite of what we want: suppress innovation and drive up costs over time. In the past, certainly, health-care systems that pursued size and market power were better at raising prices than at lowering them.

A new generation of medical leaders and institutions professes to have a different aim. But a lesson of the past century is that government can influence the behavior of big corporations, by requiring transparency about their performance and costs, and by enacting rules and limitations to protect the ordinary citizen. The federal government has broken up monopolies like Standard Oil and A.T. & T.; in some parts of the country, similar concerns could develop in health care.

Mixed feelings about the transformation are unavoidable. There’s not just the worry about what Big Medicine will do; there’s also the worry about how society and government will respond. For the changes to live up to our hopes—lower costs and better care for everyone—liberals will have to accept the growth of Big Medicine, and conservatives will have to accept the growth of strong public oversight.

The vast savings of Big Medicine could be widely shared—or reserved for a few. The clinicians who are trying to reinvent medicine aren’t doing it to make hedge-fund managers and bondholders richer; they want to see that everyone benefits from the savings their work generates—and that won’t be automatic.

Our new models come from industries that have learned to increase the capabilities and efficiency of the human beings who work for them. Yet the same industries have also tended to devalue those employees. The frontline worker, whether he is making cars, solar panels, or wasabi-crusted ahi tuna, now generates unprecedented value but receives little of the wealth he is creating. Can we avoid this as we revolutionize health care?

Those of us who work in the health-care chains will have to contend with new protocols and technology rollouts every six months, supervisors and project managers, and detailed metrics on our performance. Patients won’t just look for the best specialist anymore; they’ll look for the best system. Nurses and doctors will have to get used to delivering care in which our own convenience counts for less and the patients’ experience counts for more. We’ll also have to figure out how to reward people for taking the time and expense to teach the next generations of clinicians. All this will be an enormous upheaval, but it’s long overdue, and many people recognize that. When I asked Christina Monti, the"  command center "nurse, why she wanted to work in a remote facility tangling with staffers who mostly regarded her with indifference or hostility, she told me, 'Because I wanted to be part of the change.'

And we are seeing glimpses of this change. In my mother’s rehabilitation center, miles away from where her surgery was done, the physical therapists adhered to the exercise protocols that Dr. Wright’s knee factory had developed. He didn’t have a video command center, so he came out every other day to check on all the patients and make sure that the staff was following the program. My mother was sure she’d need a month in rehab, but she left in just a week, incurring a fraction of the costs she would have otherwise. She walked out the door using a cane. On her first day at home with me, she climbed two flights of stairs and walked around the block for exercise.

The critical question is how soon that sort of quality and cost control will be available to patients everywhere across the country. We’ve let health-care systems provide us with the equivalent of greasy-spoon fare at four-star prices, and the results have been ruinous. The Cheesecake Factory model represents our best prospect for change. Some will see danger in this. Many will see hope. And that’s probably the way it should be. "

Consistent, organized protocols and policies can streamline your practice and promote quality of care. See what Healthcare Business Management can do for you today at www.HealthcareBusinessManagement.com

Read the whole riveting amazing article by Atul Gawande it in The New Yorker!

Ode To Motherhood - Paying It Forward

Ode To Motherhood

Thinking back, it now begins to make sense; the blank stares; the lack of response; the way one of the kids would walk into the room while I was on the phone and ask to be taken to the store. Inside I was thinking, 'Can't you see I'm on the phone?' Obviously not; no one could see that I was on the phone, or cooking, or sweeping the floor, or even standing on my head in the corner, because no one saw me at all. I was invisible. Some days I was only a pair of hands, nothing more: Can you fix this? Can you tie this? Can you open this?? Some days I was not a pair of hands; I was not even a human being. I was a clock to ask, 'What time is it?' I was a remote control guide to answer, 'What number is the Disney Channel?' I was a car with an order to pickup, 'Right around 5:30, please.' Weren’t these the hands that once held books and the eyes that poured over history and music and art and the mind that graduated with honors - but now those hands had disappeared into the crustless peanut butter & jelly sandwiches they made, those eyes had disappeared while reading the same sentence in the “Are you my Mother?” book over & over again and that mind had disappeared while stirring oatmeal idly over the stove every morning - never to be seen again. There she goes! She's going, she's going, she's gone!

One night, a group of us were visiting with a friend of ours over dinner. We were celebrating her return from a fabulous trip, and she was going on and on about the hotel she stayed in. I was sitting there, looking around at the others all put together so well, drinking their martinis, taking in the room while making smart, fabulous remarks and it was hard not to compare and feel sorry for myself. I was starting to feel pretty pathetic, when our celebrated friend turned to me with a beautifully wrapped package, and said, 'Here, I brought you this.' It was a book on the great cathedrals of Europe. I wasn't exactly sure why she'd given it to me until I read her inscription: 'To Ruth-Ann, with admiration for the greatness of what you are building when no one sees.' In the days ahead I would read - no, devour - the book. And I would discover what would become for me, four life-changing truths, after which I could pattern my actions in this life:

1) No one can say who built the great cathedrals - we have no record of their names.
2) These nameless builders gave their whole lives for a work they would never see finished.
3) They made great sacrifices and expected no credit.
4) The passion of their building was fueled by their faith that the eyes of God saw everything.

A legendary story in the book told of a rich man who came to visit the cathedral while it was being built, and he saw a workman carving a tiny little bird on the inside of a beam. He was puzzled and asked the man, 'Why are you spending so much time carving that bird into a beam that will end up only to be covered by the roof, No one will ever see it'. And the workman replied, ’Because God sees.' I closed the book, feeling the missing piece fall into place. It was almost as if I heard God whispering to me, 'I see you, Ruth-Ann. I saw the sacrifices you made and the little things you still do every day, even when no one around you does. No act of kindness you've done, no salty tears you’ve kissed away, no cub scout patch you’ve sewed on or scarf you’ve rolled ‘just right’ or derby car you’ve helped carve, no cupcake you've baked, is too small for me to notice and smile over. You were helping to build a great cathedral, but even now you cannot see what it will become.'

At times, my invisibility felt like an affliction. But now I’ve come to realize that it is not a disease that has erased my life. In fact, it was and still is the cure for the disease of my own self-centeredness. It is the antidote to my strong, stubborn pride. I keep the right perspective when I see myself as a ‘great builder.’ As one of the people who show up at a job that they will never see finished, to work on something that their name will never be on. The writer of the book went so far as to say that no cathedrals could ever be built in our lifetime because there are so few people willing to sacrifice to that degree.

When I really think about it, I don't want my children to tell the friends they bring with them while visiting on holidays, 'My Mom gets up at 4 in the morning and bakes homemade pies, and then she hand bastes a turkey for three hours and presses all the linens for the table.' That would mean I'd built a shrine or a monument to myself. I just want them to want to come home…that’s all. And then, if there is anything more to say to their friends, to add…. 'You’re going to love it there.' As parents, we are building great cathedrals. We cannot be seen, if we're doing it RIGHT. And one day, it is very possible, that the world will marvel not only at what has been built, but at the beauty and strength and potential that was added to this world by the sacrifices of ‘The Invisible.’ Only after becoming a parent myself, do I realize how invisible we are to our children growing up and I think back now to the sacrifices you made Mom, all the clothes you sewed for your girls, and the thousand little things you did every day and I want to say, “I see you Mom. I love you Mom.” “Thank you.”

Ruth Rhinesmith - Ode To Motherhood




Self Awareness - You Can Choose

The ability to Lead....to Create....to Empower Others.....These are the charactersitics of a dynamic Manager.  Whether you are the Boss, a Supervisor, an Administrator, a Divisional Director, a CEO, a Partner, a Physician, or part of a Team, you are managing. Even if you have no employees you are still managing.....yourself. One of the fundmental characteristics of a Manager is to process everything through the paradigm of "Self Awareness."

Are you self aware?  Stephen Covey possesses a wealth of character-centered strategies based on this dynamic and much more. 

If you haven't already read it, The Seven Habits Of Highly Effective People should be at the top of your list.  It could very well turn everything around that you feel is wrong with your practice or your life.  We all have power.  The power to choose..

Choosing Success

Become self-aware....become powerful.

Yesterday does not hold today or tomorrow hostage.

Healthcare Business Management is centered around The Seven Habits.

Help yourself be all you would like to be. Envision what we could do for you.

www.HealthcareBusinessManagement.com

Personnel Problems?

Do not let your fire go out, spark by irreplaceable spark,

in the hopeless swamps of the approximate, the not-quite, the not-yet, the not-at-all.

Do not let the hero in your soul perish, in lonely frustration for the life you deserved,

but have never been able to reach.

Check your road and the nature of your battle. The world you desired can be won.

It exists, it is real, it is possible, it is yours!

Personnel problems? Don't know what to do?  Healthcare Business Management can help you with your HR problems so you don't have to be the BAD GUY. 

www.HealthcareBusinessManagement.com

SERVICES WE PROVIDE:

• Personnel Manual - Create and Update
  
• Safety Manual - Create and Update
  
• Personnel Task / Job Training
  
• Initial and Annual Training for: Incentives, Operations, Computer, Personnel, Compliancy, HIPAA, OSHA, Financial and Safety
  
• Payroll Account Setup - Service Interface and Report Hours
  
• Acquisition - Replacement - Hiring
  
• Hours, Vacation, Sick & Holiday Calculation
  
• FLSA Personnel Documentation & Standards Compliancy
  
• Benefit Package Development, Implementation, and Coordination as instructed for: Medical (including Psychological Recovery), Dental, and Life Insurance, Disability, Key Personnel, 401K or Defined Benefit Pension Plan, Vision, etc.
  
• Initial and Annual Compliancy Assessment
  
• Personnel Forms
  
• Setup of Human Resource Compliancy Task Calendar and Tickler File
  
• Customer Service Coaching and Training
  
• Ergonomic Assessment and Implementation for OSHA Standards Compliancy
  
• BiAnnual Reporting

HEALTHCARE OPERATIONS MANAGEMENT

"Many experts believe that Operations Management has become one of the most highly intense and challenging roles in the medical industry."

The goal of Healthcare Business Management (HBM) is to ensure smooth operation of various processes that contribute to the production of quality services by your medical practice. Our role could be varied and encompass many operational areas depending on your needs.

The following are examples of five most common areas of Operations Management under which Healthcare Business Management might contribute:

• Logistics Management
  
• Budget Management
  
• Operational Strategizing
  
• Support Services Management
  
• Third Party Relations Management
  
  Fulfillment of expectations that come from wearing multiple hats is the most challenging aspect of operations management. Many experts believe that operations management of the medical practice is probably one of the most challenging roles in the industry and it has now become greater within the context of HIPAA, Electronic medical records, Social Media Marketing and navigating the legal maze of confidentiality as it relates to the internet.
  
  With over 20 years of management experience, HBM can play a key role in chalking out the overall operational policy of your practice; and then provide your practice and personnel with a susinct and detailed operations policies and procedures manual to help you navigate compliancy and day-to-day business protocol.
  
  SPECIFICS
• Electronic Scheduling,Recordkeeping and Billing compliancy deadline by 2012-2015
  
• Document Management System Setup
  
• Backfill and Index Records (Scan, Database)
  
• Auto Update EMR via current system interface
  
• HIPAA Certification of EMR System
  
• Expired Paper Document Calendar Setup and Destruction / Shredding
  
• Inventory Management of Asset List, Office Consumables and Controlled Substances (see "Compliancy")
  
• Task/Project/Compliancy Calendar Creation
  
• Whole Office Tickler File System Setup and Use Training
  
• Compliancy File System Setup and Use Training
  
• Vendor, Contact, Business Associate Info List Setup and Merge To Attestation Signature Form
  
• Ongoing Update and Filing System Training and Upkeep
  
• Forms Creation and Implementation
  
• Workflow assessment
  
• Office Presentation and Seasonal Decoration
  
• Ergonomic Physical Facility Assessment & Recommendation
  
• Grandfathered Chart Archiving as necessary
  
• Develop Relationships and Contract with Third Party Entities PRN to Setup a New Practice

Are you a new graduate MD?  www.HealthcareBusinessManagement.com can help you navigate the mirade of regulatory and compliancy issues governing your new practice.  Call us at (949) 478-5821 to discuss what Healthcare Business Management can do for you!

Social Media Mistakes And How To Protect Yourself

 

Social media was once considered a realm for teenagers to tweet about what they had for lunch, but now it has become a ubiquitous platform in the healthcare field. With the increasing amount of physicians using social networks for professional reasons, in 2010, the American Medical Association (AMA) established guidelines to prevent physicians from online misconduct.

According to a survey published in the Journal of the American Medical Association, common violations have been: inappropriate communication with patients, cyber-prescribing medication without an established patient relationship and misrepresentation of credentials online.

Guidelines that help prevent this type of unethical behavior is certainly important, however with the massive amount of physicians (or so-called “physicians”) exercising their free speech in the vast network of blogs and social media sites, who is responsible for monitoring the healthcare community when their activity extends beyond the hospital walls and into the gargantuan World Wide Web?

As it stands, the responsibility lies in the hands of doctors themselves. As a physician, if you’re not policing your own online behavior, a fellow colleague may report any misconduct to the appropriate authorities and you could face serious consequences for your actions. Take heed and follow the four tips below to avoid the possibility of jeopardizing your medical career.

Keep your patient’s ailment to yourself.

As a common rule, do not discuss a patient’s condition online. Even if you do not disclose the patient’s personal information, you may unintentionally violate your doctor-patient confidentiality privilege. In a recent case, a Rhode Island emergency room physician had detailed her patient’s ailment on Facebook, and although she did not explicitly mention the patient’s name or demographics, the characteristics of the injury were specific enough so that a colleague was able to identify the individual. As of April 16, 2012, the physician’s clinical privileges at the hospital have been terminated. Let this incident serve as a lesson – respect your patient’s privacy and preserve the public’s trust in the medical community.

Keep all comments professional – even your personal posts.

A physician’s reputation is very important and it’s not worth undermining your career by publishing negative or inappropriate comments that you would never utter in the workplace. Even if your social media account or blog is limited to a group of friends and family, it’s risky to have the mentality of thinking that the public can never trace the content back to you. Social media privacy settings are fickle and with the ability to archive public information, the Internet rarely forgets. Even if you realize your mistake and remove the content afterward, there is no telling how many colleagues have already witnessed your inappropriate behavior or how much damage it has already caused to your reputation in the healthcare community.

Do not prescribe medication online.

Social media platforms are no doubt an excellent resource to find information about current health topics and to connect with colleagues in similar specialties, however, it is not a place to practice medicine. Among the most cited infracts reported by medical boards is internet prescribing without having established a face-to-face relationship with the patient. In rare cases, this violation has even led to the death of innocent consumers. Aside from already having a real-life relationship with your patient, other factors that separate misconduct from legitimate online prescriptions differ significantly from state to state. To see a breakdown of regulations by state, click here to read the National Clearinghouse on Internet Prescribing established by The Federation of the State Medical Boards (http://www.fsmb.org/ncip.html). In all cases, a physician should already have a good understanding of the patient's problem, medical history and current health status before issuing a prescription online.

Do not “friend” your patients on Facebook (or other social media venues).

While the AMA does not explicitly prohibit physicians from “friending” patients on social networks, it's safer to keep your profile private in order to maintain a professional doctor-patient relationship. Although family vacation photos and wild snapshots of you at your hospital’s holiday party may be harmless, they may not project the professional image you wish to maintain in front of your patients. By allowing your patients to read silly wall comments left by your friends and family, you may have trouble influencing them with your authority in medicine if their view of your professional ranking has diminished. It’s best to keep clear boundaries between your social and professional life. Don’t worry about offending your patients by declining their friend requests – simply follow-up with a cordial private message that explains your policy of not linking to any patients in order to maintain professionalism in your field. Your patients will appreciate and respect this type of honest and direct communication and they’ll likely feel less awkward during future visits. Nevertheless, while it’s best to play it safe by abiding to the above rule, if you really have the determination to reach out to your patients using a social media platform, be sure to create two separate accounts so that your personal information can remain totally separate from your professional profile.

As a physician, it’s important to remember that you don’t just represent yourself online, but you serve as an example for the medical profession as a whole. Don’t let your online behavior taint the status of your colleagues or hospital. Be respectful of these guidelines and reach out to fellow physicians who may need a little guidance in their own online behavior. Social media has the potential to be a valuable asset to healthcare professionals, but it’s up to you to make sure that this technology is encouraged and not abused.

Marketing for Your Medical Practice www.HealthcareBusinessManagement.com


A MGMA Report from Matthew O'Donnell

ACHIEVING PROFESSIONAL ACCREDITATION

"Accreditation is a process whereby a professional association or nongovernmental agency grants recognition to a health care institution or facility for demonstrated ability to meet predetermined criteria for established standards of excellence."
To remain compliant to many state, federal and medical agencies, office based surgery facilities must maintain 100% compliance with each standard and basic mandate to achieve and maintain accreditation.  Each center must meet these stringent and ongoing requirements to ensure the safety & protection of all patients and medical personnel. Consistent physical facility inspection to update standards criteria establishes and continues standards and regulatory compliance, including requisite online data entry which ensures annual certification must be accomplished.

Remaining compliant with a professional organization or agency such as AAAASF establishes compliancy with and adherence to ALL applicable local, state, and federal regulations including but not limited to:

Licensure

Fire Drill - Emergency - Terrorist

Facility Inspection

Sanitation and Hand Washing

Building codes

Federal Law & Regulation Standards

OSHA

Bloodborne Pathogens

Hazardous Waste

American with Disabilities Act

Health Insurance Portability and Accountability Act - HIPAA

Continuous MSDS Update and Record Keeping

Healthcare Business Management securely maintains your required credentialing support documentation and information current in file for all personnel providing clinical services in your accredited healthcare facility and provides periodic inspection and primary source verification where applicable for recommendation and confirmation of outside sourced medical personnel providing services in your facility.

CERTIFICATION SERVICES

Healthcare Business Management provides the following services to ensure your positive outcome to continued certification:

• Peer Review Coordination
• Meeting Setup for Periods I & II
• Online data input including Unanticipated Sequelae and Infection Control documentation
• Timely submission of correct forms and documentation to the medical board regarding any untimely event
• Annual Self Evaluation Assessment Certification
• Third Year Inspection Gear up & Assessment and Certification
• Physical Facility Equipment & Quality Management
• Human Resource Interface & Training
• Receipted timely evaluation reporting
• Coordination and assisting auditors during inspection

Achieve Regulatory Compliancy with www.HealthcareBusinessManagement.com

Lean Six Sigma Certification? - One Size Does Not Fit All

“Six Sigma” originated as a set of practices designed to improve manufacturing processes and eliminate defects, but its application was subsequently extended to other types of business processes as well. In Six Sigma, a defect is defined as any process output that does not meet customer specifications, or that could lead to creating an output that does not meet customer specifications.

The core of Six Sigma was “born” at Motorola in the 1970s out of senior executive Art Sundry's criticism of Motorola’s bad quality. As a result of this criticism, the company discovered a connection between increases in quality and decreases in costs of production. At that time, the prevailing view was that quality costs extra money. In fact, it reduced total costs by driving down the costs for repair or control. Jim Smith subsequently formulated the particulars of the methodology at Motorola in 1986. Six Sigma was heavily inspired by the quality improvement methodologies of the six preceding decades, such as quality control, Total Quality Management (TQM), and Zero Defects based on the work of pioneers such as Shewhart, Deming, Juran, Crosby, Ishikawa, Taguchi, and others.

Like its predecessors, Six Sigma doctrine asserts that:

· Continuous efforts to achieve stable and predictable process results (i.e., reduce process variation) are of vital importance to business success.

· Manufacturing and business processes have characteristics that can be measured, analyzed, improved and controlled.

· Achieving sustained quality improvement requires commitment from the entire organization, particularly from top-level management.

Features that set Six Sigma apart from previous quality improvement initiatives include:

· A clear focus on achieving measurable and quantifiable financial returns from any Six Sigma project.

· An increased emphasis on strong and passionate management leadership and support.

· A special infrastructure of "Champions", "Master Black Belts", "Black Belts", "Green Belts", "Red Belts" etc. to lead and implement the Six Sigma approach.

· A clear commitment to making decisions on the basis of verifiable data, rather than assumptions and guesswork.

The term "Six Sigma" comes from a field of statistics known as process capability studies. Originally, it referred to the ability of manufacturing processes to produce a very high proportion of output within specification. Processes that operate with "six sigma quality" over the short term are assumed to produce long-term defect levels below 3.4 defects per million opportunities (DPMO). Six Sigma's implicit goal is to improve all processes to that level of quality or better.

Six Sigma is a registered service mark and trademark of Motorola Inc. As of 2006^[update]Motorola reported over US$17 billion in savings from Six Sigma. Other early adopters of Six Sigma who achieved well-publicized success include Honeywell (previously known as Allied Signal) and General Electric, where Jack Welch introduced the method. By the late 1990s, about two-thirds of the Fortune 500 organizations had begun Six Sigma initiatives with the aim of reducing costs and improving quality.

In recent years^[update], some practitioners have combined Six Sigma ideas with lean manufacturing to create a methodology named Lean Six Sigma. The Lean Six Sigma methodology views lean manufacturing, which addresses process flow and waste issues, and Six Sigma, with its focus on variation and design, as complementary disciplines aimed at promoting "business and operational excellence". Companies such as IBM use Lean Six Sigma to focus transformation efforts not just on efficiency but also on growth. It serves as a foundation for innovation throughout the organization, from manufacturing and software development to sales and service delivery functions. Although a cumbersome change to institute, many hospitals and large healthcare facilities are now adopting this Lean Six Sigma culture, replacing the even more behemoth Total Quality Management (TQM) "ball and chain" that has ruled their world in the past.

Six Sigma mostly finds application in large organizations. An important factor in the spread of Six Sigma was GE's 1998 announcement of $350 million in savings thanks to Six Sigma, a figure that later grew to more than $1 billion. Industry consultants like Thomas Pyzdek and John Kullmann dictate that smaller companies with fewer than 500 employees are less suited to Six Sigma implementation, or at the very least should adapt only the standard approach to see if it would work for them. This is due both to the infrastructure of the training belt hierarchy that Six Sigma requires, and to the fact that large organizations present more opportunities for the kinds of improvements Six Sigma is suited to bringing about.

Also, it is the fact that smaller companies must truly change their entire culture and every single employee must be enthusiastic and willing to devote their entire working day and job tasks to Six Sigma goals; a time-consuming, very invasive and daunting task. If just one out of 10 employees is not continuously encorporating the process into their workday, the entire result would be eliminated. We can, however, take away the lessons learned from Six Sigma and apply them to small business operations; streamlining their business processes and work-flow.

Time management, carving out excess waste and preserving the bottom-line pervades the mission of www.HealthcareBusinessManagement.com

MARIJUANA - SOME FACTS

In The Healthcare Environment?

To Test Or Not To Test - Benign OR Dangerous? 

Millions are using (and abusing) marijuana every day. In fact, 1 out of 7 high school students smoke it more than once a day. Marijuana is thought by many to be benign and recreational, so it is one of the most highly used drug of choice. For this reason, society should know its short- and long-term effects on the brain.  Marijuana can affect these two areas emotionally or physically. Also, in some cases physical damages causes the emotional response. The brain is the most complicated part of the human body. To understand, let's explain certain parts and their functions to better understand our brain and thus the possibilities of chemical induced complications. The brain with its 15 billion neurons and nerve cells operates using chemical and electrical messages. This is how we perceive our senses. Differences in the way our brain translates these messages can impair perceptions. Hallucinogens prevent the brain from receiving all these messages in order. All the information that we receive is through millions of transactions of neurons, like a computer and marijuana alters these transactions.

After smoking, or consuming marijuana, it is distributed in the brain. The concentration of marijuana in the brain may be governed by an active transport process in the choroid plexus network of blood vessels in the brain which regulates intra-ventricular pressure by absorption and secretion of cerebral spinal fluid. One scientific experiment gave an example of how the distribution of marijuana in the central nervous system could affect man. At a high dose of 30 mg./kg, marked sedation and pronounced motor in-coordination peaked at the one-hour interval subsiding in 8 hours when overreaction occurred to external stimuli; man reveals incapacitation of cognitive and motor function. High concentrations of marijuana are usually found in the following parts of the brain: the frontal cortex (the general association area), and hippocampus (short term memory and orientation). As a result, perception of time, mood and general coordination is impaired. Yes, marijuana intoxication affects neurological function, but what appears to disappear in 24 hours, can become a permanent malfunction. THC affects the limbic system which is vital to some everyday functions. The brain is made up of 3 basic cerebral types differing in structure, chemistry and organization (MacLean, 1970).

These are:

1) Reptilian or brain stem responsible for instinctive (survival) behavior (and regulator of vital functions of the body)

 2) Old Mammalian (paleo-cortex) or limbic brain surrounding the brain stem (like a lap or limbus) having an important role in emotional behavior and motivation (contains opiate receptors)

3) New Mammalian (neo-cortex) brain (thinking cap) with the capacity for symbolic (written and spoken language).

The 3 subdivisions of the limbic cortical system or ring are linked by 3 pathways to the brain stem. The lower part (hippocampus memory information) of the ring connected with the amygdala insures self-presentation (survival). The upper part is connected to the septum which is the area for pleasure. These 2 are connected to the olfactory that deals with sense. In addition, there is a third passageway dealing with sexual behaviors and visual activities. Any limbic dysfunction can result in emotional and mood disturbances, alienation, distortions of perceptions, and paranoid states. THC can reduce the blood flow to the hippocampus, which is the controller of short-term memory and orientation.

To make a simple conclusion to all this confusing data, marijuana results in chemical damage effecting emotional, motivational and hormonal disturbances. After only 3 months of light, or moderate, or heavy use, evidence of irreversible damage can be detected. The effects of marijuana are mostly short term, meaning damages that can be restored to a seemingly normal state. Most symptoms from heavy usage vanish in about a year and a half of clean time.  But emotional and memory abnormalities are never fully restored. Since more evident and severe short-term effects take about a month of being clean to subside, one can see the potential for a problem in a weekend smoker. That means that consistent users (about twice a week or less) aren’t EVER sober.

The brain is one third fat. Cannabinoids are fat soluble, and not only do they collect in brain cells, but they also accumulate in billions of other cells in the body and are consistently being released into the blood stream. In the case of moderate twice a week use, before half of the cannabinoids that are being stored are released, new cannabinoids are being introduced. The cannabinoids release process is very slow and if there is continued use, it can make the user always stoned! Maybe not all the effects of intoxication will be evident, but noticeable differences in thinking and talking are evident. It takes marijuana about 2 to 4 weeks to get out of your system. So, if you are smoking marijuana 1 to 3 times a week - think of the implications.

Pot not only seems to disrupt normal learning functions but also contains emotion altering properties.  een as psychiatric outpatients, showed a decrease in attention, logical thinking, personal hygiene, performance in school, and participation in physical and social activities compared with their pre-marijuana status. These changes revised when marijuana smoking stopped.  The effects of always being stoned even if they haven’t smoked that day at all, can still include poor social judgment, poor attention span, poor concentration, confusion, anxiety, depression, apathy, passivity and often slow speech.

Most marijuana smokers also suffer from anxiety disorders. The most common among users is social anxiety disorder where the user is nervous around large groups of people. Some only can function on one to one basis. Isolation of users is also common. Many people with slight depression use the drug to feel better. Marijuana will do that at first then it can intensify the depression. So, they continue to use the drug at higher dosages’ which results in still more depression. One can see how cyclical use of marijuana to cure the depression that comes from using it begins!

One of the biggest controversies in marijuana abuse is: Which is causal?  Are problems caused by heavy smoking of marijuana, or is it just that people with problems are more likely to end up using marijuana heavily?

One last finding of note is interference with the maturation process. Yes, this deals with young people, but has also been found to have permanently stunted the maturation process in adults who not only ingested and smoked weed when young, but then also sealed the deal with vaping THC as an adult. Not only is the maturing process halted, it is known to make adults emotionally regress to a teen and even a preteen inability to make cognitively consequential choices. These noted symptoms of the usage of marijuana that take place can now be scientifically proven. Most findings conclude that it affects brain function, including emotions. This usually wanes in youth after approximately 3 months of being totally clean of cannabis. Unfortunately, in adults (long-term users) the regression can be permanent, and the more use continues, the less chance there is of any, much less complete, restoration.

This is how marijuana can now be shown to have long term effects, with irreversible damage. Most damage can be seen in chronic smokers who have built a tolerance and a degree of dependency to the drug. Effects physically and mentally are also exhibited. Tolerance to a drug develops when increasing doses are necessary to obtain the initial effect of a lower dose. Dependence may be psychological and/or physical. Psychological dependence refers to a craving for a drug often leading to compulsive drug use. Physical or physiological dependence is a state whereby withdrawal of the drug leads to undesirable effects in mood or the physical body. Marijuana is used to experience a high and as a person continually introduces this chemical into the body, they grow accustomed to it. Hence, in order to get the same high, you must smoke more potent marijuana. Cells in the pleasure center of the brain are being damaged and as more are damaged, more marijuana is needed. Also, the natural high is harder to achieve.

Many studies show how marijuana physically affects the brain. In one experiment, monkeys were used.  After making the monkeys smoke marijuana for 5 months, they then kept them clean for 3 months, and documented the differences in physiology and behavior with totally clean monkeys to compare to. Surprising abnormalities included (RER) chaos and synaptic vesicle clumping. RER or rough endoplasmic reticulum makes proteins so that each cell can function properly. RER is in neat strands in the cell’s interior. But, in the heavy smoking monkeys there was chaos in all the cells. Synaptic vesicle activity accounts for our thinking, feeling and doing. The heavy smoking monkeys had synaptic vesicles that were all clumped together. The vesicles were also filled with abnormal deposits of unknown material.

The conclusion was that long-term cannabis use in any form will produce irreversible effects in the brain. It causes a degenerative “marijuana abused” brain; much like long term use of alcohol can cause what is called an irreversible degenerative “wet” brain. The permanent symptoms of a marijuana abused brain are lack of empathy, bad short-term memory, apathy, inability to perceive consequences, lack of motivation, depression AND surprisingly…. permanent physiological changes in the brain and DNA!

Don’t fool yourself, marijuana in ANY form is not benign.