Monthly Archives: October 2012

I've been reading the (fascinating and fun) book Moneyball. It's amazing how it exposes that any business -- even the $7 billion professional baseball industry -- can be guided by market mythology that is intuitively satisfying but not entirely accurate. The book tracks the efforts of the Oakland A's in the early 2000s to become more data-driven in choosing new players.  The A's were motivated by their relatively puny player budget.  They hoped to somehow assemble a winning roster even though they didn't have enough financial resources to bring on a single superstar. Historically, dozens of statistics were regularly tracked about baseball, but only a certain few favorites got all the attention.  The A's dug into the data, and arrived at the surprising insight that the stats that got all the attention weren't the ones that actually correlated with team performance. One of my favorite parts of the book is when the general manager finds that the lure of the old, 'gut feel' approach to managing a baseball team was so powerful, he couldn't watch the games live without risking incorrect decisions driven by emotion.  Only by looking at data alone -- and not observing the quirks and ups-and-downs of actual play -- can he trust himself to decide correctly. What a powerful idea for managers of all sorts. In the daily pace of a medical practice, how often do emotion, misperception or unquestioned assumptions get in the way of good decision-making?  In our work, we bring surprises to our practice management clients all the time, by simply analyzing data as objective outsiders.  Are you operating under assumptions, or emotional conclusions, such as: -  "I've always coded like this, and never had a problem" -  "Our no-show rate is about average" -  "Saturday clinics wouldn't be popular around here" -  "We couldn't make more money in the current reimbursement environment" -  "No one on our staff would ever steal from us -- we're like a family" -  "We don't use outside collections - I'm confident our receivables will be paid eventually"  Are unchallenged assumptions hurting your practice?  Just like baseball, medicine is a combination of passion, talent, art

The New York Times recently published an illuminating article entitled What Do You Do With Brilliant Jerk?  The piece struck a chord with me because the process the article described -- a brilliant founder, essential to the creation of an organization, eventually becomes a thorn in its side -- is something we see all the time in our work with practices. The emergence of the Brilliant Jerk in medical practices is a natural and predictable consequence of changing demands as practices grow. When practices change, personality traits that were invaluable can become highly problematic, e.g., a brilliant clinician who cannot artfully interact with his colleagues or staff on operational or  business matters. The plight of the Brilliant Jerk is not enviable. Practice profitability is a function of the efficiency and productivity of the entire clinical and administrative staff. For example, Brilliant Jerks often fail to appreciate management guru Peter Drucker's advice, "Accept the fact that we have to treat almost anybody as a volunteer." The Brilliant Jerk's behavior is generally at odds with a harmonious and efficient operation because they fail to appreciate the value of others within the organization. It isn't easy to contemplate whether you've become the Brilliant Jerk, but it is certainly worth considering, since your career and financial well-being are at stake. First, consider how many of your professional relationships are strained relative to your colleagues'. Second, consider how much you have adapted to the changing needs of your organization.  If you are finding yourself in strained business relationships within an organization that has experienced considerable change while you have the same attitudes and "standard operating procedures," well, it's quite possible you're becoming your practice's Brilliant Jerk. If you suspect that you are the Brilliant Jerk, you have an excellent opportunity to test your brilliance in adopting an urgently-needed program of remediation. An objective assessment from a consultant that has the breadth of experience to give you some practical advice, or perhaps from a career coach, can be a good place to start. And you might be surprised how much you get out of the effort: improving relationships with your colleagues

We've contributed a bi-monthly column to Repertoire magazine for the past several years.  Our goal is to give some insight into the challenges of medical practice management to reps who sell devices, pharmaceuticals, EMR and other services to physicians.  For September, we looked at the surprising ways physician practices are vulnerable to theft, overcharging and fraud. Read it here: How Doctors Get Ripped Off