Posts From: Medical

A money manager of a large fund mutual fund recently told me, “The words ‘Tax Reform’ simply mean that politicians want to take more money from someone.” This explanation of Tax Reform lead me to ponder exactly what do the words ‘Healthcare Reform’ mean? Applying the money manager’s logic, Healthcare Reform simply means the politicians want to take money from somone in healthcare. Ostensibly, this Heatlhcare Reform is presented under the guise of decreasing costs, but still the monies representing the decreased costs are coming out of someone’s pocket.

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A covenant can generally be defined as an agreement that yields a relationship of commitment between two parties. Such a commitment once existed between physicians and society. Physicians, by sacrificing their 20’s (and in some cases, a good portion of their 30’s) and dedicating themselves to become proficient in the healing arts, would be granted by society a better than average living, an independent career and a place of respect in their community. This agreement, steadfast for years, has recently been abrogated by society; in the 1990’s with the advent of managed care and most recently, with the Affordable Care Act. So while physicians must still sacrifice their youth to learn the healing arts, society has capped their salaries, diminished their status in society and curtailed their independence.

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Jackie, my nurse, sheepishly said, “I think I gave him Penicillin by mistake.” “You think or you know you gave him Penicillin?” I questioned. Reading her face, I knew the answer before she spoke. “I gave him Penicillin and I’m so sorry Dr. Cassatly.” I told her to call 911 and say we had a patient about to go into anaphylactic shock; the most severe life-threatening type of allergic reaction.

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For the second consecutive year, a pharmacist at the local CVS store administered my flu vaccine. The young man was pleasant, personable and courteous. The facility was clean and the whole process from registration to receiving the shot took less than ten minutes. The pharmacist mentioned that he has been administering more than 100 vaccines per shift. This comes as no surprise really, as my medical insurance company awarded me a $25 gift card for getting my flu shot from a pharmacist, and not my physician. This is the same store I buy gum, batteries and greeting cards.......just adjacent to the gas station where I fill up my car.

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A Chief Medical Officer (CMO) from a large hospital asked me to speak with a hospitalist physician who had received a patient complaint from a hospital administrator. Interestingly, the administrator had recently been a patient in the hospital and felt that this same hospitalist was rushed and preoccupied when making rounds. Furthermore, the patient administrator felt the physician did not fully answer his questions. In the past, similar complaints had been received about this same physician, resulting in lower than average patient satisfaction scores. For simplicity, let’s call this physician Dr. A.

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Recently I have been consulting with a large specialty practice in the Midwest that is being purchased by the regional medical center where the physicians admit most of their patients. Both parties, the physicians and the medical center, do not understand the other parties motives for entering into this new relationship and thus, are jeopardizing the success of the new venture. Before I show how executive business coaching can be beneficial in this situation, let’s take a look at why physician-hospital relationships are changing.

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The transition in healthcare from a fee-for-service payment model to one based on value-based-purchasing is driving the concurrent transition of physicians from clinicians to physician leaders. Just as there are fundamental differences between the two payment models, there are stark foundational contrasts between physician clinicians and leaders. Adding to the physician’s burden, they very often must fulfill both roles simultaneously. Let’s examine the differences between the two physician roles and then, look at how to help physicians successfully make the transition.

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I think it is safe to say that most patients feel physicians are not good communicators. In fact, many patients even feel that their own physician’s communication skills just plain stink! So, beginning in fiscal year 2013, how will Physicians capture the incentive bonus mandated by the Affordable Healthcare Act, when 30% of it is based on physicians and nurses communication skills? Let’s take a closer look at the incentive bonus and then, I will present a blue print for your hospital to maximize the incentive.

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In my 35 year career in healthcare, I always thought of healthcare as a crossword puzzle, albeit, a crossword puzzle with an ever changing set of rules. Nonetheless, with a little ingenuity one could successfully solve the puzzle. For instance, early on, the rule changes were often due to medical advances; a new more powerful antibiotic or perhaps a new medical technique.

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