FINANCIAL CHALLENGES OF THE 21st CENTURY MEDICAL PRACTICE

As we enter the second decade of the 21st century, medical practices face a host of financial challenges. The unknowns of health care reform, changing reimbursement and rising bad debt from the uninsured have introduced a multitude of pressures and uncertainties. Whether your practice aims to maintain physician compensation at desired levels, keep up with overhead expenses or invest in new technologies, the critical factor for success is efficient management of the revenue cycle.

Background

The revenue cycle comprises the numerous tasks of the bill­ing and collection process — namely, gathering and entering data about professional services rendered, and ensuring that bills are paid in full. Think of the medical practice’s revenue cycle as a wheel. The spokes are the critical functions of the billing and collection process. Each function has several key touch points, often in the form of tasks, that practice staff or providers must per­form. Unless each function is performed effectively, the wheel will fail to turn. If it stops for too long, the business will collapse. These critical billing and collection functions and their related touch points with providers and staff include:

·    Contracting with insurers: Managing and monitoring reimbursement agreements with government and private payers.

·    Eliciting and processing patient information: Scheduling and confirming appointments as well as referrals, registering patients in the practice management system, verifying insurance, obtaining pre-authorizations for treatment, and other tasks.

·    Capturing charges: Logging all services provided to patients, correctly coding services, providing required documentation and other tasks.

·    Billing: Producing and submitting claims to payers and sending statements to patients.

·    Processing payments: Posting payments, handling denials by insurers, and adjudicating accounts.

·    Handling accounts receivable: Monitoring performance and resolving or appealing payer denials.

·    Managing collections: Determining and collecting what patients owe, administering financial policies and receiving payments.

For each function and related touch point, a medical practice establishes and assigns the administrative functions that must be per­formed. Unfortunately, many medical practices do not take firm control over each of these many wheel spokes. Opportunities to interact with patients and payers are missed and, as a result, the revenue cycle does not operate at peak efficiency. The following are the 10 key opportunities where many medical practices can streamline their revenue cycle. In doing so, they will be better able to bring in cash faster and with less effort. You will clearly see the financial outcomes in the bottom line: reduced days outstanding in accounts receivable, lower overhead — and the greatest reward, higher collections.

Each major function in the revenue cycle has responsible parties: physicians, non-physician providers, nurses and other clinicians; and administrative and billing office staff. Everyone in the practice has a role — often several roles — to play in managing the revenue cycle. When the wheel of the revenue cycle slows or snags, it may be because responsible parties fail to understand their roles. Other times, a poorly designed function is to blame. Perhaps the practice doesn’t provide staff with the tools to carry out the function, or misplaces the task in its work flow. While dozens of steps can speed up the revenue cycle and avoid missed collections opportunities, here are the 10 most common prospects for improvements. These will, in the long run, produce accurate and com­pliant billing and ensure that your practice collects what its physicians have earned.

1. Recognize Where the Cycle Starts

The revenue cycle starts as soon as the practice defines the terms of its relationship with an insurer — or the practice’s policy regarding patients who have no health care coverage. When the patient makes contact with your practice, the revenue cycle wheel begins to turn. The cycle’s beginning includes stating the practice’s financial expectations, collecting from patients without insurance and verifying insurance coverage and benefits from those who do.

Medical practices historically viewed their billing offices as wholly separate units from the day-to-day activities of scheduling, registering, arriving and treating patients. This perspective comes from a time when practices routinely waited months for payment after providers rendered medical services. This state of affairs is no longer tenable in today’s fast-paced financial world, an environment where medical practices’ profit margins have grown ever narrower due to falling reimbursement and rising practice costs. Operating an efficient revenue cycle requires practice wide buy-in to the following principles:

•     Defining — and knowing — the terms of insurance contracts and establishing an appropriate but strict policy for patients without insurance.

•     Involving everyone in the practice in the revenue cycle — clinicians, as well as administrative staff — not just the billing office staff.

•     Ensuring the accuracy of each data element about the patient — demographic, insurance and other information.

•    Recognizing that the process of getting paid starts before the patient walks in the door.

Promote a broader appreciation of this final point — the process of getting paid starts before the patient walks in the door — by requesting schedulers to describe the practice’s payment expec­tations to patients at the time they make appointments. Require them also to reiterate these expectations in appointment-reminder phone calls. Finally, mandate that time-of-service collection is a core function of front-office staff. Developing a shared vision of where the revenue cycle begins and recognizing that everyone contributes to its success is the first important step toward a suc­cessful outcome.

2. Focus on Accuracy

An efficient revenue cycle results in faster throughput, but that does not mean haste. To ensure speed and accuracy, focus attention equally on improving the precision of the data submitted by clinical, administrative and billing office staff. For physicians, non-physician providers, nurses and other clini­cians:  establish a written policy for timely completion of patient records, full and accurate documentation of all services and recording diagnoses for each visit linked clearly to the services rendered. The policy should also clarify the roles of clinicians regarding waivers and pre-authorization for services. For administrative staff:  pay careful attention to the order in which assigned tasks are to be performed. What appears to be a logical sequence on paper may not play out in the reality of a busy reception desk. Provide staff the tools and technology to get assigned tasks done. For example, if the practice expects due bal­ances to be collected at the front office, staff need training in how to identify the correct amount, how to ask for it and establish a payment plan if the patient can’t pay in full — as well as immedi­ate access to a credit and debit card machine, and the change drawer. For billing office staff: clean claims and statements translate di­rectly into faster cash flow. Optimal staffing means having enough employees to allow billers the time to ensure charges are accurate before posting them. Assigning work by insurer allows billing staff to grow familiar with those payers’ rules. A practice can prevent many of the denials that hold up cash flow by submitting clean claims that get paid on first submission.
3. Submit Claims Daily
Send claims to payers as soon as they are ready. Use software or clearinghouse services to help identify problems in any denied claims so that corrected claims can be resubmitted as soon as pos­sible. Send billing statements promptly to patients who don’t have insurance or who are covered by an insurer with which the practice does not participate. Don’t mail statements only once a week, a protocol that just adds more days to your receivables. By sending statements throughout the week, you spread out telephone calls from patients who have questions about their bills. This bit of forethought allows managers to structure staff in accordance with anticipated work flow.
4. Employ Technology

As insurance deductibles, copayments and out-of-pocket costs continue to rise, a front office employee who knows how to obtain accurate information about patient financial responsibility is a tremendous asset. However, employees’ efforts to request time-of-service payments require the support of both information technol­ogy and operational design. For example, appointment schedulers should be able to quickly research patient balances and take credit card payments by phone. Deploy technology appropriately, and don’t overlook staff training. A stellar practice management system can’t form the basis of an efficient billing office if employees don’t know how to use it.

Using technology wisely also includes:

•    Verifying patients’ insurance coverage, benefits eligibility and financial responsibility automatically before services are rendered.

•     Pre-loading protocols based on coding and payer reimbursement guidelines to electronically scrub claims before submission.

•     Transmitting claims electronically.

•     Automating secondary claims submission.

•     Posting payments electronically through electronic remittance and funds transfer, rather than hand-keying.

•     Using remote deposit services so payments go into the practice’s accounts as soon as possible, not just once a day or, worse, at the end of the week. Other technology that can improve the billing process includes online bill payment, computerized payment monitoring and automated, credit card-based payment plans.

5. Stay Current

When it comes to billing and collections in health care, rules seem to have been created just to change. Many claims denials and lost billing opportunities occur because medical practices do not set aside a little time each year to track the annual changes made to the CPT®, HCPCS and ICD-9 and future ICD-10 coding systems. Each annual Medicare fee schedule also brings a host of new rules for covered services and reimbursement. Medical practices can turn to a myriad of resources to stay up to date. National specialty societies scrupulously track coding and regulatory changes that affect their members, and most publish newsletters and e-mail alerts about rule changes. To track updates at a local level, tap into state medical societies and professional associations for billers, coders and practice managers. Payers’ websites also can provide useful information about changes in payment policies, patient eligibility and other information critical to efficient revenue cycle management. Practices using paper charge tickets must be sure to revise them each year based on the annual updates by the American Medical Association to CPT codes. An electronic system will accomplish this annual task much more quickly. Because pay­ers make frequent adjustments to fee schedules, and because a practice may deal with dozens of payers, it’s worth asking payers for contract clauses requiring the payer to provide at least 60 days’ advance notice of any fee schedule change.

6. Leverage Payer Contracts to Improve Billing Performance

To resolve the frustration of an insurer engaging in unfair payment tactics or creating inordinate delays, look to the contract. Shrewd negotiation during contract talks can make the document your ally. Ideally, the contract contains clauses that disallow bad insurer behavior — just as it will prohibit you or your practice from taking certain actions. Contracts with payers deal with many common issues, such as provider enrollment, take-backs and fee schedules. Keep tab on each payer’s potential ‘hassle factor’ by creating a folder for each insurer. Staff can put copies of correspondence, notes and explanations of benefits revealing an underpayment or inappropriate denials into this folder. Retrieve the contents of these “hassle” folders to use at contract renewal to make sure frustrations with the payer are addressed.

7. Involve Patients

Because your medical practice bills the payer on behalf of its patients, it’s only natural to ask for the patient’s help when some­thing goes wrong in that process. If, for example, a payer denies a claim based on insufficient information from a patient, contact the patient immediately to prompt him or her to respond. (One way to prevent these potential payments problems is to address the issue of information-based denials in the payer contract. For example, seek a contract clause allowing your practice to transfer financial responsibility for the service to the beneficiary — the patient — if the patient does not respond within 30 days to the payer’s information request). Copy patients on any appeal letters sent to payers for services that were rendered to them. Seeing this information will likely stir pa­tients to pick up the phone and call their insurers. Of course, always send statements to patients when bills are their financial responsi­bility, and hold them accountable for payment.

8. Prioritize

Billing office employees are generally detail-oriented. Therefore, they may lose sight of the big picture and need help prioritizing their work. Abandon alpha-based sorting as the primary work organizer. Instead, encourage staff to work insurance invoices and patient balances in hierarchical order. Set a floor amount for second-level appeals. A $10 floor, for example, may reflect the cost point at which your practice ends up spending more on the secondary appeal process than the claim would be worth if paid. Use tools to facilitate prioritization, such as creating an electronic calendar with ticklers enabled or, better still, integrate alerts for due dates of tasks or expected responses directly into the practice management system.
9. Follow Through
Whether it’s an appeal letter or simply a patient’s promise to pay off a balance, make sure to monitor the progress of pending issues. Set up electronic reminders — ticklers — for information requests and appeals. It’s the only way you’ll guarantee results. Furthermore, follow through when threatening to report a payer to the state in­surance commissioner or turn a patient’s delinquent account over to the collection agency. Don’t bluff.
10. Monitor Payments Closely
Monitor key performance indicators by payer. At a minimum, for each payer, review the days in receivables outstanding, credits, aged trial balance and adjustments by category. Perform quality audits at least once a quarter by reviewing a number of accounts — say, 10 per physician — chosen at random. Demand that payers provide the allowable amounts for codes your practice’s physicians use most frequently. This information allows you to determine whether the insurers are living up to the terms of their contracts. To catch lower-than-contracted reimbursement, set up an automatic query in the practice management system to track each payer’s allowables for filed claims. Lower-than-contracted reimbursements are almost always due to the payer bundling charges, down-coding services or making other changes not called for in the contract. Flag every invoice for which the insurer reimburses 100 percent of the charge — that’s a sure sign that the practice is charging less than the allowable it is due. When a claim is paid, the payer reimburses the practice in the form of an allowable amount, often referred to as the “allowance.” For each procedure code, the difference between the charge and the allowance is considered a contractual adjustment. The billing office makes this adjustment at the time of payment posting. The adjustment process breaks down when billers treat other types of adjustments as contractual adjustments. These non-contractual adjustments may include claims not paid because the charges were not submitted promptly by your practice, or a payer refusing to remit payment because you were late in submitting the enrollment paperwork for one of your new providers. Be sure billers handle contractual adjustments separately from non-contractual adjust­ments. Otherwise, what appears to be a glowing 100% collection rate is, in reality, much lower. Keep these tips in mind as when look for ways to boost your prac­tice’s ability to collect the revenue it is due. Collecting revenue is the “revenue” in the revenue cycle. And remember: Improving management of the revenue cycle starts with staff. To make any of these 10 basic approaches work — or any other approaches, for that matter — you must hire motivated people and give them tools they need to do their jobs to continue that motivation.

Our eye is always on your "Bottom line" - www.HealthcareBusinessManagement.com

The Best ROI You Can Make For Your Practice

 The Best Return-On-Investment You Can Make For Your Practice

Let’s say you’re at a cocktail party. Someone walks up to you and says they can tell you the single most important investment you can make in your practice next year. They add to their already astounding statement that this investment will generate a higher return on investment than any other alternative.

Your brain begins to churn through the potential punch lines to this provocative set of statements: Malpractice insurance? EHR? Lobbying efforts to fend off government regulatory pressure? What could it be? Just then, the mysterious stranger delivers the punch line. The single most important investment with the best return-on-investment you can make for your practice is an investment in your staff.

A quick history primer
In the 1990s, a group of researchers out of Harvard developed a different approach to a business model. The researchers included the likes of Earl Sasser, Leonard Schlesinger, James Heskett, and several others. They proved that there was a direct link between employee satisfaction that generated higher quality service delivery, yielding customer loyalty and ultimately creating improved financials. In fact their research went so far as to say that a mere 5 percent improvement in customer loyalty could result in profit increases ranging from 25 percent to 85 percent. They labeled this business model the service-profit chain and it has become the foundation under which much research today surrounding customer loyalty, patient satisfaction, and word-of-mouth referral activity finds its genesis.

The links in the chain start with employees
So, let’s take this intriguing concept one step further and see how this works. It all starts by creating engaged employees. Employees who are passionate about what they do, are well-equipped and well-trained, and have the tools and information needed to perform at a high level every day. By creating these kinds of employee relationships, three important things happen.

First, you see a reduction in the churn rates of your staff. Let’s face it, all that time searching for a new staff member, screening and interviewing them, training them on your practice …all that time is costing your practice money. Much better to find good staff, keep them engaged and keep them onboard. Second, more engaged employees create an environment where practice operations run with excellence. Third, employees who are positive, authentic, and pleasant with your patients create stronger relationships with your patients (thus generating patient loyalty). We all have had that one nurse on staff that patients just adore — that nurse is an economic engine for your practice!

Operational excellence generates loyal patients
Next, when operations are running smoothly your practice begins to generate productivity efficiencies which impact your bottom line. Outstanding operations create superior experiences and interactions for your patients, who then become loyal patients — they stay with your practice, they bring their family, refer others, and they comply with your policies at a higher rate. Having a loyal patient base creates its own virtuous cycle wherein your staff gets to know your patients better and are able to customize and cater to their specific needs more and in turn your patients become “better patients” by learning your policies, procedures and processes.

Loyal patients generate premier financials
Those loyal patients behave in positive ways towards your practice. They refer others. They stay with you longer — even if you move locations or make some change in your practice. They’re less likely to create malpractice issues. They use your services more frequently and they use more of your services to meet their health needs. These are the patients every practice wants because all those behaviors generate positive financial results for you and your practice.

So there you have it. Through a series of cause-and-effect linkages, we’ve seen that an investment in your practice’s employees will yield an improvement in your practice's financial performance.

Maybe our mysterious cocktail party guest wasn’t so wrong after all. Start by improving communication flow in your practice. Identify ways to increase staff training. Ask staff openly if they have the tools and information they need to be productive and effective with patients. Get a dialog started this week in your practice with your staff. How can you create more engaged employees?

Human Resource Services HBM Provides

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

The Five "S" Methodology

The philosophy of continuous improvement is more than a trend in today's business environment, and the solution is the visual workplace - for improving quality, organization, efficiency, housekeeping and safety.

The 5S methodology, as described in Hiroyuki Hirano’s 5 Pillars of the Visual Workplace, is the foundation for making companywide improvements in both the production facility and the front office, so that the Just-In-Time production strategy (inventory management) can be implemented.

The 5S’s are based on the Japanese words seiri, seiton, seiso, seiketsu and shitsuke, and, when translated, mean organization (sorting), orderliness (setting in order), cleanliness (shining and sweeping), standardizing (standardized cleanup) and discipline (sustaining the process). These 5S’s are the basic formula for achieving “product diversification with zero changeovers, higher quality with zero defects, lower costs with zero waste, reliable deliveries with zero breakdowns and improved safety with zero injuries.”

A sixth “S”, “Safety”, is sometimes added depending on the workplace, and some argue that explicitly including this sixth “S” ensures that workplace safety is given primary consideration. But it is reasonable to assume that a properly planned and executed 5S program will inherently improve workplace safety.

Sorting

The main component of the first “S” or sorting phase is ridding a bloated production facility of any unwanted, unneeded or unused tools or materials. This happens by implementing the “red tag” strategy – applying a red tag to anything considered unnecessary in a production cycle, placing in a holding area to see if it is needed at any point, and then ultimately discarding anything not needed. “When in doubt, throw it out.”

Setting in Order

A lot like a home garage peg-board, or a surgeon’s tray of instruments, the second “S” gives each tool a permanent place to reside so that whether the employee is new or temporary, or doesn't speak English as a first language or just happens to need something right away, they know exactly where to find it and put it when finished. Driving even deeper into this strategy, tools are combined when possible to perform various functions, and placement in bins, in drawers, or on shelves accounts for chronological use and proximity to the user.

Shining

When the work area is clean and maintained, maintenance and repairs can happen instantaneously, because they come to a worker’s attention immediately. In a dirty environment, machines that could be easily fixed may break down because an oil drip was not noticed until it was too late.

Standardized Cleanup

Even once everything is in its place and the work environment is clean, don’t stop there. Determine daily (even shift) targets, assignments, methods, tools – then keep going. There is no limit to how often, how long, what procedure or what tools to use, until it is determined that once your daily cleaning duties are accomplished, your time can be better spent elsewhere.

Sustain the Discipline

Simply put, "Make a habit of properly maintaining the correct procedures." Without discipline, excess materials are purchased because they're not in the proper place, workers waste time searching for misplaced tools, the facility will get dirty again causing machines to break down, and accidents will become more prevalent.

5S for the Front Office

Record Saving

As any production facility is subject to the 5S methodology, so too are the front offices. Bookkeeping or record keeping lack a "self-cleansing" mechanism and the accumulation of paper or the "paper trail" (usually in triplicate) can be burdensome. The best answer for defeating this problem is starting before it ever exists - including finding ways to prevent organizational documents from accumulating in the first place.

Knowing what to keep and for how long, and dedicating time each month, quarter or year for cleansing the clerical space of unnecessary, unwanted or unneeded clutter is a necessary task to avoid the front offices from also becoming "fat." Records of reports and data that never get used are a major culprit. Not only is old information typically an unwanted accumulation, it tends to lose its value the older it gets. Front office cleanup campaigns should be implemented at least twice a year while daily organizational routines consistently work to sort what is necessary to keep and what is not.

Some records are necessary for certain periods of time and offsite record storage or annex buildings are sometimes used for this warehousing. But these buildings are also subject to the same issues as the main facility. When transfer of documents and records is necessary, store new documents separately from documents that are reaching their shelf life and remember to clearly mark all storage containers not only with what they hold but for how long they should be kept.

Desktop Templates

In eliminating time wasting effort by employees searching for tools they need on a regular basis in the production facility, the shadow board philosophy also works in the front offices in the form of a desktop template. Regular use of stationary and supplies should be noted and only those tools regularly used should be kept on desktops. This eliminates clutter and accumulated dirt and also serves another important purpose - savings on the cost of front office supplies in general. No stationary or supplies including pens, notepads, scissors, tape dispensers or any other should ever be stored in a drawer where they are inevitably forgotten. This is cause for unwanted accumulation of often expensive front office tools and unnecessary re-purchasing of these items, ultimately affecting the company's bottom line.

With proper planning and execution, any production facility can implement the 5S's for a visual workplace - not only in the plant, but the front offices and any secondary warehousing facilities as well. This methodology requires buy-in from the CEO all the way to the newest employee. Over time, it will benefit the organization as a whole, protecting workers safety, keeping things organized and running properly, and increasing the bottom line of the company.

Marketing Your Practice

COMMUNICATING YOUR VALUE should be your marketing mission!

Most practices dive right into direct marketing and attempts to obtain natural search engine optimization (SEO) for the "cost-effective" website their cousin built, without even determining what they want from their business. You might think you know but first things first! Patience is the key. Be aware that there are medical rules and regulations that you must adhere to so as not to lose your license.
There are infinite ways of marketing and advertizing your medical practice. To market it effectively, you need to think strategically about what you want to accomplish.

Do you simply want more new patients?

Do you want to change the mix of business to attract more of the kinds of cases you find more fulfilling and financially rewarding?

Are you looking to develop a strategy for adding more professional referral resources?

Do you want to obtain more referrals from your current patients?

Do you already market your practice but wish to improve the performance and increase the return on investment from your current marketing efforts?

Are you trying to achieve more consistency in your month to month revenue?

Are you planning to relocate?

Are you adding a new office?

Are you adding or replacing a provider in your practice?

Are you fundamentally trying to work smarter because you can't possibly work any harder?

Are you trying to protect what you have already worked so hard to achieve?

Are you trying to take your practice to the next level?

Marketing is almost entirely about 'Human Motivation', just as 'Sales' is. It's not about numbers and benchmarking; those things are only used as a navigation tool to help you determine which way to steer your marketing ship.

Competition these days is FIERCE; far greater than ever before. It's like turf wars; everyone wants the most lucrative cases. Competition is also fueled because of the fact that it's becoming a smaller piece of the pie. Costs increase, reimbursements continue to decline. Unfortunately, the more experienced the practitioner, the more conservative they are. The more experienced practitioner is not used to tooting their own horn. It makes them feel uncomfortable. Inexperienced doctors, however, have a tendency to accept new things and ideas. So, if you are a more experienced doctor, remember, while you are in competition with the inexperienced doctors, THEY have no hesitation do whatever it takes to get out there and market their talents to get that experience. They are cutting into YOUR piece of pie and have NO PROBLEM doing it! If you want to expand your practice income you MUST embrace new ideas and have no hesitation in implementing them.

Additional advice to consider - Do not make the mistake of using your sales and operational staff to market. They did not go to school and study marketing or advertising. They should be on board, however, and use the designated marketing strategies to accomplish the goals that are set. But they are not 'copywriters' or 'graphic designers' and even if they were, working strictly on marketing and nothing else, it would take years and years to successfully create and implement in the timeframe as would be needed to be successful at it. You need them to concentrate on sales and operations - keep it that way."

HUMAN MOTIVATION - DO ANY OF THESE SOUND FAMILIAR?

1. You're working really hard but need to market so you won't be stressed; you want to be successful enough to make time for family and friends, and to take some time you need for yourself as well.
2. You're working very hard and want the tangible financial rewards that go with it.
3. You want to build it - see how big you can make it grow - increase the gross, and increase your reputation in your community, increase your quality of care.
4. You have a great practice- but want you want a bigger vision.
5. You are grateful and want give back to your community, nation or people.

We can help www.HealthcareBusinessManagement.com

Character & Personality Ethics

CHARACTER & PERSONALITY ETHICS

Character Primary Ethic – Belief that success is based on basic principles of effective living.  People experience true success and enduring happiness as they learn and integrate these principles into their basic character.  Character ethic is foundational and catalytic and the core of it encompasses the following principles which enables to us to develop value-based motives.

o       Integrity

o       Humility

o       Fidelity

o       Temperance

o       Courage

o       Justice

o       Patience

o       Industry

o       Simplicity

o       Golden Rule

“Search your own heart with diligence, for out of it flow the issues of life.”

Vs.

Personality Secondary Ethic – Belief that success is more a function of personality, of public image, of attitudes and behaviors, of skills and techniques that lubricate the processes of human interaction. The personality ethic focuses on social image consciousness, quick fixes, techniques, image building, social band aids and social aspirin that masks chronic problems and only address acute problems which may seem to be fixed but only resurface again and again to become chronic.

Human & Public Relations Techniques

• Developing techniques to get other people to like you – NOT Beneficial
• Faking interest in the hobbies of others in order to get them to do what you want -  NOT Beneficial
• Using “The Power Look” to intimidate – NOT Beneficial
• Learning to intimidate your way through life – NOT Beneficial
• Learning manipulative techniques to influence people – NOT Beneficial
• Learning ‘Power’ strategies – Possibly Beneficial
• Education in the field of ‘Influence Strategies’ – Beneficial Secondary Trait
• Personality Growth – Beneficial Secondary Trait
• Communication Skill Training – Beneficial Secondary Trait
• Forming Image Building Ideas  - Beneficial Secondary Trait
• Acknowledging character as an ‘ingredient’ of success but only compartmentalizing it - NOT Beneficial

Positive Mental Attitude – PMA

• Maxims or Sayings:

ü ‘Your attitude determines your altitude’

ü  ‘Smiling wins more friends than frowning’

ü  ‘Whatever the mind of man can conceive and believe it can achieve’

• Developing and using strategies to build positive attitude – Beneficial Secondary Trait
• Embracing Motivational ideologies to rev yourself up and create impetus – Beneficial Secondary Trait

PRIMARY Vs. SECONDARY GREATNESS

ü  We may have become so focused on our own skill building that we are devoid of the foundation that holds all of it up. Trying to use human influence strategies and tactics to get other people to work better, be more motivated and to like each other without exuding the core-values foundation of integrity, and the ‘golden rule’ will only be seen as duplicitous and insincere, and will never be successful in the long run.

ü  Duplicity breeds distrust and in the end, everything that you are trying to achieve will be perceived as manipulative.  It makes no difference how good the intentions or how wonderful the rhetoric; if there is little or no trust, the foundation has not been built for any kind of permanent success.

ü  Trust is the glue of life.  Only basic goodness gives life to technique. To focus on technique alone is like cramming your way through school.  You sometimes get by; maybe even get good grades, but if you don’t pay the price day in and day out, you will never achieve true mastery of the subject you study or develop an educated mind.

ü  Try cramming on a farm.  Everyone would agree; it’s ridiculous.  Forget to plant in the spring? Play all summer, then ‘cram’ in the fall to bring in the harvest?  The farm is a ‘natural system’.  The price must be paid and the ‘process’ followed. You reap what you sow.  There is no shortcut.  This principle is also true ultimately in human behavior and human relationships.

ü  Human relationships are also ‘natural systems’ based on the law of the harvest.  In an artificial social system such as work or school, you may be able to get by if you learn how to manipulate the ‘man-made’ rules to play the game.  In most short-lived human interactions, you can use the personality ethic to ‘get by’ and make favorable impressions through ‘charm’ and ‘skill’ and pretending to be interested in ‘other people’s hobbies’, etc.  You can pick up easy techniques that may work in short-term situations.  But secondary traits alone have no place or permanent worth in long-term relationships.

ü  Eventually, if there isn’t ‘deep integrity’ and fundamental character strength,  the challenges of life will cause true motives to surface and human relationship failure will always replace short term success.

ü  People who only possess the secondary greatness to, for instance, strive for social recognition, or recognition of their talents, or strive for wealth, or prestige; but lack primary greatness or goodness in their essential character, will see it affect every long term relationship they will ever have.  They eventually end up creating havoc and chaos involving everyone around them, because they are using technique alone. There is no primary greatness of character.  No character ethic. 

ü  Whether it is with a business associate, a spouse, a friend, or a coworker, it is only primary greatness of character that communicates eloquently. If there is not a core-values foundation to build upon; no matter how emotional or determined we actually feel while saying the words, they will always be superficial.  Manipulation, then, wins at being the only way we communicate.  Without primary greatness of character, trust and truth cannot thrive and any relationship, no matter how strong we think it is, will wither and eventually dissolve.

We seek to understand at www.HealthcareBusinessManagement.com

Linear vs Non-Linear Thinking

While many jobs for American Masters of Business Arts (MBA) graduates are going overseas, those who have Masters of Fine Arts (MFA) will be in great demand. According to Gartner Inc, by 2010, 40 percent of IT jobs for MBA’s will be outsourced to workers overseas.  The reason?  A person can fill in a spreadsheet from India as easily as from Silicone Valley for one-tenth the cost.

However, corporations cannot outsource creative jobs as easily. The ability to go quickly from problem to problem, problem to solution, or from initial idea to unique product does not cross cultures well. The employee needs to be a part of the culture he or she is marketing to. As a result, American employees with Masters of Fine Arts degrees (MFA’s) are more in demand and earning more than those with MBA’s.

Why does someone who is trained in artistic abilities do well in business? It’s not the particular artistic talent, but the thought process that creates it. Fine artists have the ability to apply non-linear thought to problems, which is a valuable business skill. Companies are looking for those employees who can apply a non-linear thought process to business problems.

What’s the Difference?

Here is a simple exercise that will demonstrate the difference between a linear and non-linear thought process. Take out a sheet of paper. In the top left corner, write a letter “A.” In the center of the page, write a “B.” Halfway down the page on the right hand side, parallel to the “B,” write a “C.” In the bottom right corner, write a “D,” and in the bottom left corner write an “E.” Now draw a line from A to B to C to D to E. That is linear thought–arriving at the final answer by following a step-by-step process.

Now take your right thumb and forefinger and grab the left top corner of the page next to the A. With your other thumb and forefinger, grasp the lower left corner next to the “E.” Touch the A to the E. That’s non-linear thought–finding the solution without having to go from point to point to point.

Non-Linear Thinking is an Inherent Skill

From the moment you are born, you are an input device constantly making connections. In the first five years of life, your brain grows very rapidly and sets down patterns of recognition. For example, as a survival skill, infants smile at everyone. Next they learn to recognize mommy and daddy, then they develop a fear of strangers, and then they learn to reserve affinity for family and other trusted people. Finally, they choose their own friends.

Over time, people begin to lay down patterns of normal and non-normal. That’s why you can look at a situation and know something isn’t right. If you see someone in an airport who has recently had a stroke, you may not realize the individual had one, but you do know that something isn’t right. That is called non-linear thinking–moving quickly from an observation to an end-point. Depending on your experience, that endpoint might have an accuracy as low as 50-50. However, for people trained in creativity, the accuracy is about 99.7 percent. These quick, non-linear solutions, called snap judgments or instinct, are valuable in life and in business. Too often, though, these instincts are not used in the business world, but that’s about to change.

Creative, Non-Linear People Benefit Business

Creative people get in touch with the emotion of what they’re creating in themselves and use that as a guide to produce the same emotion in another person from the same society. Businesses see the value of that skill–an employee making decisions based on the mindset of a person of the general society, not as an employee tied to a business. Your non-linear, or heuristic, thought processes are when you observe from the inside out, seeing how your own emotions mirror the ones you observe in others.

Can people only achieve this non-linear thinking ability by earning an MFA? Of course not. Not everyone is willing to go back to school for another two to three years to get their MFA. Fortunately, you can encourage the same type of non-linear thinking in yourself and your employees.

* Eliminate your framing bias.

How you ask questions determines the answers you get. For example, if you manufacture candy bars and you’re ranked second in sales behind brand A, you may ask yourself, “How can we take market share away from brand A?” The obvious linear answer: make your product taste like Brand A. You have labs, testers, and linear thought people who can make Brand B taste like Brand A, or even better. Due to framing bias, they ask the focus group, “Which one tastes like Brand A? Which one do you like better?” Brand B wins, because now it tastes just a little better than Brand A.

But the problem with this scenario is that nobody ever went back and asked the basic question: Will our existing customers accept this change? The executives assume brand loyalty will drag customers along. But if they have a core group of fans who love the original taste of the product, in changing the flavor, they alienate them.

* Quantitate non-linear thought.

Learn to apply non-linear or heuristic research methods by taking a written inventory of your own feelings, prejudices, and thoughts on the subject at hand. Now you have the ability to walk into a situation and start observing how the situation itself affects you. That’s called “going with your gut.” If you are a representative of your culture, your environment, and your area of expertise, as well as in touch with your customers and what you experience and feel, then you have unframed your bias. If you are honest, you will be feeling the same reaction as your customers, and you have just gone from point A to point E without all the letters in between.

A business person needs to walk through the mental door to unframe his or her biases. For example, with the chocolate bar example, a good businessperson would go to the store, or go to the factory, or call his or her best distributors. The businessperson would evaluate whether the new product was flying off the shelf. If so, that’s good. But he or she would not let that framing bias affect the next time he or she goes through the door, as the opposite may be true then. Such an instantaneous response leads you to continue doing what you’re doing or more of it, depending on how well it’s going.

Learning Non-Linear Thinking and Dual Processing

A new intern fresh out of medical school is the ultimate linear thought machine. In medical school, students are taught that symptom equals possible disease. A equals B. They then run a test to confirm if B equals C. This process, however, is not conducive to all types of medicine. As soon as these new interns walk into an emergency room, they quickly learn non-linear thinking. After a few days of training, experience, and drilling, they become parallel processing machines. They still do their linear thought processes but they also tap back into the non-linear thinking they had before they got their higher education.

Most people who are now are drifting to an MFA degree already have their MBA. They’ve learned and honed their linear thought processes into a sharp edge; now they get their MFA to hone and reactivate their non-linear thought processes. At the end of all that education, they must learn to parallel process on their own, much like the emergency room interns.

In the future, people will pursue their MFA after getting their Bachelor’s in business. This way they will achieve both linear and non-linear thought processes and they’ll learn to parallel process. Five to seven years from now, we will see people start earning dual degrees, or universities may start offering a new degree that incorporates both.

In the meantime, businesses will need to find ways to encourage parallel processing in their employees. They can do this in a few days of intense training in a corporate retreat setting, or spread over several weeks in a coaching environment. Getting back in touch with non-linear thinking is not hard. Being able to parallel process takes some practice, but the payoff will be more success for businesses, a steady job outlook, and higher earnings for those who master this skill.

Find out how non-linear thinking might be YOUR CUP OF TEA at www.HealthcareBusinessManagement.com