A Little Less Conversation

It was Elvis Presley who first called for, “A Little Less Conversation – A Little More Action.”

In our office, this has been a time to just get some stuff done. Our “To Do” lists were long and getting longer and it was starting to feel like we just kept talking about someday.

Last month, we committed a cardinal sin for a Mike Rothschild practice. We CANCELED a staff retreat!

If you have known me very long, you realize this is a big deal. I have written, lectured and filmed videos on the necessity of off-site retreats to ensure that the entire team is on the same page and all are motivated to work hard to accomplish the mission. But my gut was just telling me, "Now is not the time." I don't always do what my gut says, but I did this time.

Instead we scheduled an in office work day. We asked for everyone’s “buried” lists and compiled a big Master Task List. We itemized, categorized and prioritized, and we went to work. We moved furniture, threw stuff away, painted, sanded, broke and built. Basically, we had a Spring Cleaning.

It’s All About the Team

Running a quality practice is not possible without the hard work of a strong, coordinated team. Teams are made of people and people are people. People have concerns outside of the practice and levels of dedication can vary wildly. Situations are always shifting and it is a challenge to keep up with what is always best.

The secret to having a strong team that cares is to never stop trying to make your team better. Our staff development "framework" calls for two planning retreats every year. But sometimes, we break that rule if the situation isn’t right. But we always do something!

We have training plans, education days, processes, and policy manuals. We give personality tests, performance reviews, salary adjustments and give occasional “prizes.” We have staff parties, attend conferences and facilitate online learning programs. All to try to make the team better.

This month’s Building Block will focus on our framework for building a better team. I call the mission and values a foundation, because it is what we build on. It is solid. But a framework needs enough flexibility to bend to the person and to the situation. There is room for improvement AND mistakes.

                                (READ ABOUT our Framework for Staff Development) 

We will deliver a webinar about developing an Orientation program and facilitate an in-depth dialogue about what works in our members' practices. This is a topic that always draws a lot of attention. I am sure this will be no exception.

I hope to see you soon,
Mike

P.S. My daughter's high school graduation is stirring up some significant emotions. This singular event has our family entering a new season of life. We have spent a lot of time reminiscing lately and have enjoyed looking back and are trying to get ready for whatever is next.

This makes me realize that practices are much like families, that also go through seasons. Understanding this concept helps me realize the delicate nature of keeping it going the best we can.

Turn, Turn, Turn by the Byrds says there is a time for everything under heaven, including a time to cast away stones and a time to gather stones together. The lyrics from this song are actually from Ecclesiastes. (I wonder if Elvis' lyrics are biblical?)

Now Amir is Preaching

Dr. Amir Khoshnevis and I recently had a chance to catch up.  Amir is passionate about communications with patients and with all of the developments in how we communicate; he helps me understand how to stay in touch.

Review of Optometric Business just released a conversation I had with Amir about staying in touch.  Amir has always called me “The Reverend” due to my southern preacher method of delivering a message.  While he taught me a lot about staying in touch with patients, watch this video to see what I am able to teach Amir. 

Amir, and his practice partner Dave Lupinski, have also taught me a lot about maintaining high quality in the optical area of my practice. 
I have been involved in optometry since childhood and there has always been some “villain” who is trying to take away our business.  When I was a child, I remember my uncles complaining about Pearle Vision and now we are worried about Warby Parker. 
The fact is that since the beginning of business, there has always been someone who is looking for a way to do it better.  When someone is taking your business, it is simply because they have found a better way – at least for some of your “customers.”  So you can plop down and cry about it, or you can get to work. 

 

I say "Let's Get to Work"


Trust me when I tell you that your optical needs attention.  They all do.  We all neglect the optical from time to time.  It is usually ok for a while because we tend to put strong team members in the optical areas of our office that can keep us afloat for a while.  But the industry is changing so fast that we must stop from time to time to get a handle on it.

In the month of May, our Building Block will work to improve our performance in the optical. Leadership OD members will have an opportunity to focus on the optical in this month’s Building Block.  We will begin the Block with a webinar by Jennifer DaQuano from NuVue Optical in Charlotte.  She pioneered the methods used in this high end eyewear practice that sets the standard for the rest of us to strive toward.  Jennifer will share proven techniques to  implement strategies for long term success in the optical. 
To prepare for our Face2Face Block discussions, Vision Leaders and optical staff will receive short surveys to inquire about the issues most pressing in our opticals today and compare that to our goals.  After the Leadership OD team has compiled this information, we will meet online to bring it all together in a plan.

I always feel a sense of renewed energy in the Spring and this is no exception. I look forward to working with our members this month while we bring that energy into our optical. 

-Mike

April Fool's Day is a great time for discussing money.

When it comes to spending money, I have my quirks. 

I tend to buy nice things, I don’t like to use coupons and I would rather do without it than settle for low quality.  On the flip side, I refuse to waste money.  I will put paper back in the printer that has something printed on one side and I would rather replace the soles on my shoes than buy new ones.  It is tough for me to explain the “logic” I use for spending money.  
 
At the Executive Retreat in January, Dr. Mick Kling helped me understand some of my quirky financial habits in his lecture, The Emotional Impact of Money.  He taught us that most of us make financial decisions based on feelings more than rationality.  
 
The most common emotional factors in our financial management are greed and fear.    When managing the finances of our practices, we too often allow our feelings to make those decisions for us.  Sometimes it’s fear that prevents us from making that investment we need to grow.  Other times, we spend too quickly because we get excited at a trade show and sign up for that new service that just doesn't make sense for us. 
 
We also avoid uncomfortable conversations about money which is why most of us fail to always make good recommendations to our patients until we know how much they will have to pay “after insurance.” It is also why we give broad percentage raises to all staff regardless of how well they perform individually.

(Here’s on old BLOG about giving raises)

 So how can we overcome this tendency to manage by feelings?
 Our surveys show OD’s consistently ranking their own management of finances lower than any other area of the practice. On a scale of 1 – 9, we rank ourselves at an average of 4.88 in Financial Management - compared to a 7.76 in Patient Care. 
 
At Leadership OD, we have put together tools to help bring some of the logic into your financial management strategy.  Our members always have access to their budgeting calculator, and now we are releasing a tool that we use at WGEC to track all of the metrics we can think of within our practice. 

USER GUIDE

 And on April 14, our own Dr. Mickey Kling will host a webinar helping us gain control of our Cash Flow.  The title is “Where did all the money go?” and attendance is free to members.
 
Our Face2Face meetings this month will focus on financial management, bringing doctors and staff together to talk about real challenges we are all facing and how to improve. 
 
We still have more opportunities for than barriers.  We just have to keep working on it.
 
Happy April Fool’s Day,
Mike
 
p.s. To have a better understanding of your Money Personality, some say it is a good exercise to recall your very first memory of money.  I will tell you my first memory….if you tell me yours.
 

Are You Staying Busy?

Staying busy is one of the most discussed business topics in all of optometry.  Usually, when optometrists talk about how busy we are, we are referring to our appointment books.  We also discuss how far we are “booked out,” indicating how long I would have to wait if I wanted to schedule an eye exam in your office. 

It is critical that we have steady traffic in our offices to keep things flowing properly.  There are multiple strategies and services that we employ to keep our appointment books filled.

A primary component in every marketing strategy is in earning the loyalty from patients so they will decide to choose us again next year. Degree of loyalty is quite variable and strongly determines the likelihood of a patient’s return to your practice year after year.

“Recall” is the term most practices use to describe the system they use to administer their loyalty programs.  It always begins with a strong recommendation to return from the doctor then may include a pre-appointment, a postcard, an email, a text message and a phone call. 

Recall systems have undergone a lot of transition in the last few years due to changes in insurance coverage, electronic medical records, transient lifestyles, and the huge shift in the ways we communicate.  There are multiple services now available that can dig into our records and automatically send messages to bring people back.  Some are run by people and others by technology. 

We have tried to make a number of adjustments to our system and have settled on a recall system that seems to be working well for us.  Here is a LINK to our current recall system.

Take care,

Mike

Book Recommendation

Setting the Table

I think you will like this book

I came across a book that I think you will enjoy, Setting the Table by Danny Meyer.  He is the founder and owner of several restaurants in New York and made himself famous by filling unmet needs and bringing hospitality into his establishments.

I have sent a copy to all of the active members of Leadership OD.

 

Danny Meyer's first restaurant becomes successful and he wrestles with the decision to open a second location.  Then, he fails to meet income projections and struggles to find what can do.  He tries something different, and it doesn't work.  So, he tries again.

Doesn't this all sound familiar?

-Mike

Optometric Management

Do you ever have problems with your staff?  

Leading a team to excellence is more of a challenge than ever before.  Communicating your vision, motivating the team to care and keeping them inspired through tough times requires constant attention.  And frankly, most of us are too busy to dedicate the time and energy needed to succeed.  So we continue to settle.

This year can be different.

At the Executive Retreat, we hold each year, we introduce and explore proven techniques of building strong leadership teams within your practice.  
 

Thank you to the editors of OM for publishing Mike's article on Staff Leadership.  This article gives a sneak peak of the methods used in his practice to consistently get the most from his team.
 
If you can't make it to the Executive Retreat, at least read this article.  It is a great place to get started.  

 

Do you know this man?

 

I have worked with several offices who have experienced a burglary.  I have listened and counsoled, with empathy. With my best consultant voice, I always give good logical advice on cleaning up, moving on and taking steps to keeping this from happening again. 

I thought I understood, I didn't.

Like you, we have implemented security measures, but we don't review them enough: 

  • Our security system didn't work with our new VOIP phone system, so the police were never called.
  • Our cameras did capture the guy, but it was too dark to really see him.  
  • The exterior lights by the window he came through - were out.

We were lucky, no one was hurt and nothing was actually taken.  But a bad guy broke in, damaged our office and was messing with our stuff.  

We are all fine, but there is a feeling that I have and I think the entire staff shares.  I can't explain it.  It is a mix of anger, anxiety, remorse for not preventing it and a desire to get back at this guy.  The best word I have for this feeling is "rattled."  

I know all the logical things to do but I am not sure what to do about this "rattled-ness?" 

If you have ever been through this kind of thing before or if you have any insight, please advise me.   I sure would appreciate it.  

Thank you, 
Mike

The Season of Candy Corn

The Season of Candy Corn

Don't you love this time of year? The weather is getting cooler, football is hitting it's stride and the leaves are just beginning to change. But I think this time of year is best represented by the candy that is now readily available.

Candy Corn is the small triangle shaped, tri-colored, waxy sugar bites that can be found around Halloween. You can find Candy Corn until Thanksgiving, but it is usually a little stale by then.

If you think about it, most seasons can be represented by some sort of treat. After the season of Candy Corn comes Pumpkin Pie season and then Peppermint Season. The New Year will usher in the season of no sweets because of our resolutions. Then of course, "Box of Chocolate" season; everyone's favorite.

In the time that I have been practicing, the seasons that affect the flow of the practice have been shifting. When I was in school, all of the staff doctors said, "You never do any business during the month of December."  Now, we all know it can be one of our busiest months because of end of the year benefits. 

Like most people, when I talk about "seasons", I mention things that are outside of my control, like the weather that leads us to call them "seasons" in the first place. But also outside of our control are insurance enrollment dates, specials from the competition, the internet, ICD-10 implementation, E-Bola and El Nino.

Yet, we can still influence the seasons of our practice. We do it all the time, but usually in a reactive manner.  (We ramp up marketing efforts when it is slow.)  We should do what we can to keep our practices steady, by knowing what the trends are within our practices, plan for them and shift them in a direction we want.

Above is an income chart for a typical practice by month. Each color represents a different year. What "seasons" can you identify from this snapshot? I see some inconsistency in the front half of the year, but fairly flat income. Then every August, there is a big spike in income, followed by a big drop. Then, the last part of the year either has a really strong finish or just fades away.

This practice needs to identify what happens every August and implement a strategy to finish every year strong. Is this by design or is it by accident? Either way, it is an opportunity.

For our members, we have created a recommended seasonal flow chart to help you focus on various areas of your practice in a planned manner. It doesn't eliminate reactions, but it helps make sure that your reactions don't allow you to neglect major parts of the practice.

Leadership OD members can access this "Recommendation Sheet" on their membership page.

Enjoy the season of Candy Corn and have a great weekend.

Sincerely, 
Mike Rothschild, Leadership OD

P.S.  If you are not a member yet, it's easy and you can JOIN TODAY. 

Are you ever really ready?

Are you ready?

There are many moments in a person's life where they are presented a challenge that they may not feel ready for. There is one moment that exemplifies this more than any other…..the birth of your first child.

Many have had this experience and most everyone knows someone who has. There are months of preparedness, education and celebration getting ready for this special day. We had done it all, went to the hospital, followed the directions, greeted family. We were all ready.

And there she was!  

I can recall an unrecognizable, yet very strong emotion that contained elements of joy, excitement, love and fear. The fear was not being ready for this.
Whatever we had done to prepare was suddenly inadequate and I knew it. I clearly remember thinking, "I am not ready, I haven't done enough, I need more time. And hey, I thought it was supposed to be a boy?"

That baby is now a senior in high school and we are preparing for another life altering event, sending her to college. We are preparing, but I know I won’t be ready. I anticipate the same thoughts as she drives away next Fall.

This fear of not being ready often spills into our professional lives. No matter how much logic we can bring into our preparedness, the things that most often hold us back is emotion. It’s the fear of not knowing what to do.

Not knowing is OK

Just like it is unrealistic to expect to know everything about parenting when your child is a newborn, you rarely need all the answers to make a big change.

Practice Ownership decisions are the most common that are not made in due to fear of the unknown. Buying / Selling / Starting / Partnering / Soloing - all full of unknowns. There are formulas and criteria that are frequently published, but there are no guarantees.

Other big decisions that often don't happen in our practices because of fear:

  • Hiring a new associate
  • Buying new equipment
  • Offering new services
  • New location
  • More staff
  • Less staff
  • Staff Development

I understand that you want all the answers, but you almost always have to move forward without them. Do your research, make a decision and go. It’s ok that there are still some unknowns.

Moving Forward......

“What’s the worst thing that can happen?” Most ask it all the time, but rarely answer it.
This time, stop and really answer it. “What is the worst thing that can happen if you...open a new practice?...... hire a new associate? .... buy that new equipment?"
Then decide.

You can do it, 
Mike

p.s. I would love to hear what decision you are not making, because you just can't decide.  If you are willing to share, just COMPLETE THIS FORM.  We will share comments in an upcoming message, protecting your privacy of course.  

Look at me when I'm talking to you!

Look at me when I'm talking to you!"  

Do you remember hearing this demand when you were a kid? Or do you ever just stop talking until someone looks up at you? It is natural to want to be looked at when you are saying something that matters.

Looking at someone when they are talking to you is a big deal and we all know it. We all grumble when we talk to the top of someone's head while they are staring down at their phone. And we are all guilty of thinking that we are engaging in two conversations at the same time, when we really aren't in either.

Do our Exam Rooms make this problem worse?
My grandfather was an optometrist and today's exam room looks just like his did 60 years ago. Except now, exam rooms have a computer where my Granddaddy kept his cigarettes. 

As more doctors bring technology into the exam room, more of us are turning a cold shoulder to our patients. We all worry about it and say that we aren't doing it, but we are. Using laptops and tablets helps some, but the reality is that if we are using a computer in the exam room, we are turning away from our patients more than they like.

I visit a lot of practices and nobody is doing it well. Everybody says, "Well, I sit like this and twist my body so I am facing blah, blah, blah......"  No, Doctor, you stick your nose in that computer and ignore your patient while you try to find that button that gets you MU points.


We have tried it all
We have been experimenting for the best way to overcome this challenge in my practice for well over a year. I have seen many concepts and tried them all.  

We built a "robot" to act as a computer stand that rolled around the room, but we kept bumping it into things. We mounted a monitor to the pole in the exam lane, but the patient kept looking behind them to see what we were looking at. We tried balancing laptops, but I am clumsy. Tablets were OK until you needed to type something, plus you have a tendency to stare at that thing longer than you think.

I have come to the conclusion that the big desk in the exam room is the real problem. In every exam room, the desk is against the wall and that's where you put the computer.  
 A quick Google search of Optometrist Exam Rooms proves scientifically that all rooms have the same design since Granddaddy's time.  
 

Here is a solution that really works:

Patien't View.jpg

We removed the desk and replaced it with a small, rolling computer desk that can be moved around the room.  We put the monitor on an arm that protrudes from the wall. The wireless keyboard is on a tray that can be placed comfortably in our laps or stay on the rolling desk top. Since the big desk is gone, we can put our backs to the wall, face the computer and the patient.


And if we want to show the patient the monitor, we just shift it. The arm has enough flexibility so the uncorrected myope can lean in to see it.

 

Doctor's View.jpg

We keep a second keyboard in the room for the scribe to use. (Two keyboards/1 computer -- it works.)  To hide all the junk that was in the desk, we keep a little drawer cabinet, and put a printer on it, so we won't try to use it as a desk.


 

I tried to create a professional diagram showing you our new concept, but I've got stuff to do. So, here is a quick sketch for you.

Let's "show" our patients we are listening again.
Optometrists have always seen themselves as doctors who "get to know their patients." It is time for this big data collection "experiment" to come full circle. So we have collected and entered all of the necessary information to get paid and meet MU requirements. We know the meds, the conditions and the A1C. But now, let's concentrate on the person again and look them in the eyes when they are talking to us.

Let's talk soon,
Mike
P.S. If you want one of those big refraction desks, I have a couple for sale.  And some computer robots.

Old Blogs

Here are some Classic Messages

Summer is winding down and for the first time I can remember, I find myself longing for the routine of Back to School.  We have had a summer that has been unimaginably busy, almost.  

I feel compelled to deliver meaningful content to our newsletter subscribers on a regular basis. I know that you get enough emails, so we make a point to not send the same message over and over. But sometimes, everybody goes through a writer's block.

With that in mind,  I am reaching out to our members for help and I am taking some time to re-think my practice and share those thoughts with you.   

In the meantime, I want to share some of our classic messages that are always available on the website.
Enjoy:

  • Everybody wants to be Rocky - This message was our second most popular ever. I now play Rocky music in my office. LeadershipOD.com/blog/461
  • Close Your Eyes. Then Open Them - This New Year’s Eve message really should be read every year. LeadershipOD .com/blog/445
  • Do You Want a Raise? - We adjust salary's every summer in our practice and here's how we do it. LeadershipOD.com/blog/360
  • Showrooming - This topic is finding its way into circulation again. Read this "classic" message from Leadership OD. LeadershipOD.com/blog/285
  • My Hair! - It is a sad fact that this message from 2 years ago remains the most popular blog entry. LeadershipOD.com/blog/218
  • Are you buried? - This message came two years ago to the day and I feel exactly the same way today. Is this a coincidence or do I need to change my summer routine? LeadershipOD.com/blog/198
  • Thinking like a CEO - This valuable lesson came to me too late and I have been trying to spread the word for a long time. LeadershipOD.com/blog/52
  • Motivating Your Team - Every office I have been in has helped me realize the importance and the challenge of this daunting task. If there is anywhere that we all need help, this is it. Yes? LeadershipOD.com/blog/59


Mike Rothschild
p.s. If you are interested in contributing some messages to this newsletter or participating in an online discussion, let me know......please.

It is finally starting to "click"

What was the first video game you played?  Since Santa Claus is awesome, I actually had an Atari game system in my house with a joystick controller and a paddle wheel for Pong.And I recall putting all of my quarters into Space Invaders at our local skating rink. I spent a lot of time in the arcade because I couldn't skate backwards and was scared to ask a girl to “couples skate.”  

The secret to Space Invaders, like most video games, is in the “clicking.” You've got to use your fastest hand to click the shooting button. Because the faster you clicked, the higher your score. You could always spot the lefties, because they played the video games cross-handed to maximize clicking speed. Not all games require reckless clicking, but most did and still do.   

I never became much of a gamer.  I still like a video game for a few minutes, but once I got facial hair I was able to give it up for the most part.  Hopefully, I was good enough to regain my “clicking” ability, because we are going to need it.  

Lately, I have been writing about my recent revelation about what is happening to our profession and what we need to be doing to get ready. This has led to many deep conversations with a number of our Leadership OD members and I want to share some details about what I am continuing to learn.  

But I can sum up in one short sentence what we need to do...Get good at clicking.  

There are three things that will control the future of healthcare - data, data and data. The doctors that are going to thrive in the near future will be the best at collecting it, sharing it, and showing that they got it.  And you can be one of them, if you get going now.  

So why are we talking so much about clicking?

The clicking matters because the only data that will matter is what goes into the right spot in your record.  We all understand the need to dilate a diabetic patient and carefully evaluate for retinopathy.  But it is becoming equally important to “click” G8397 before you file the claim and/or “click” the appropriate button when filing to their vision insurance.  And sending that letter to the PCP is also good, but you have to click the button that says you sent it.  

I am actively looking for buttons I am supposed to be clicking in my EHR and finding ways to start clicking them.  And I have finally stopped complaining because they are not automatically clicked for me.  I just have to get over this for now...Just Click It.

What are our Members Saying?

Instead of sending out another impersonal survey, I decided to try to talk to as many Leadership OD members as I could.  While I didn't talk to everyone, we were able to have several conference calls and some one on one.  In these calls, I wanted to better understand two things:

  1. Which Leadership OD member services are most valuable?
  2. What we are doing to get ready for the wave of healthcare changes?

To read my full summary of these calls, just Click Here.

Like you, I am a little nervous about the unknown of what these changes mean. But sitting around waiting for things to happen just doesn't help. Let's get busy and we will be ready.

Have a great weekend,

Mike Rothschild, Leadership OD

 

Survey Results

We had a really high response rate to our survey.  There were some results that surprised me, but mostly my presumptions were confirmed.  
And our diversity of musical tastes were also confirmed.  At the end of this email you will see the winner for the Song of Summer.

First the surprise

Almost all (92%) of those who responded to the survey have already adopted EHR into their practices and most of them are not looking to change.  Of the 8% who responded they had not yet taken the plunge or are looking.  
I was surprised how high these numbers were.  Does it mean that subscribers to this newsletter are more likely to incorporate new technologies? Or is it that people who tend to reply to online surveys lean toward technologies?  Nonetheless - pretty cool!


3% of the responses came from Canada and Meaningful Use doesn't apply.  For the rest of us, 23% have no intention of following MU because it is “too much trouble.”  

 

Our Opportunity

The following results are where I think we have the biggest opportunities.  They are related to communications with our patients and their primary care physicians.  

How do we decide when to send reports to other doctors? After thorough analysis of the data, the answer is, “it depends".  But only 3% responded that they send reports to PCPs for “Almost all patients of a certain age.”

 

90% of us are interested in communicating with our patients directly through our EHR.  But when asked how we are doing, most of (58%) responded, “Not really - I can and want to, but don’t much.”  That says to me that many of us are under-utilizing one of the most powerful marketing tools in our practices.  


This is where I want to focus the continuation of this conversation.
We need to have some real conversation about getting the most out of all of this that we can. There are opportunities for better marketing and improvements to patient care.
But HOW do we capitalize?
We will be setting up some calls with our members to get a better take on what we are doing and what we can do.
Not a member of Leadership OD yet? Don't worry, we will share with you the results of our calls right here. But to make sure you contribute to the conversation, just join. It's easy and we would love to hear what you have to say.

 

And the Song of Summer

 Last year, it was very clear the winner would be a country song and last year’s winning song, “Cruise,” received two votes this year.  There were a handful of other country music votes, but not many.  We did get several votes for Beach Boys songs and tracks from the “Frozen” soundtrack.  

 

Some will be working on building their faith this summer with “We Believe” and “Strong Tower” getting some votes.  While others seem to have intentions to be a little naughty with a vote for “Talk Dirty to Me.”  There was one paying respects to our profession by choosing “I Can See Clearly Now” as their song of summer.  

 

The overall theme was fun, optimism and relaxation.    Votes for “So Happy We’re Together,” “Play It Again,” “Cruel Summer,” and “Girls Just Want to Have Fun.”  There was even one for the Michael Jackson hit released posthumously, “Love Never Felt So Good.”


This year’s winner - There was only one song that received more than a handful of votes.  It supports the theme that most of our votes represent and will serve well as Leadership OD’s 2014 Song of Summer.  

“Happy” by Pharrell Williams.  

To coincide with the single release, the website 24hoursofhappy.com was launched featuring a visual presentation of "Happy" advertised as being "the world's first 24 hour music video".

 

Happy Summer,

Mike

p.s. Members - be on the lookout for some upcoming calls about our new project.

Ready for Healthcare? Survey.

Last week, I sent a message about some lessons I learned about what is coming in healthcare. I was impressed by the conversation that this message created.  It seems like many of us are anxious about these changes.  There is a general sense that we need to "do something - but what?"I would like to keep the conversation going, so I put together this 5 question survey to get a feel for where we are on this path to the future.  I would appreciate it if you took a minute (literally) to answer these quick questions.  I will share the results next week and see where we need to focus future messages.

I added a familiar summertime question, just for fun.

Thank you, Mike

Take the Survey

What I Learned @ 2014 PIO

I had the opportunity to facilitate the Partners in Optometry conference put on annually by PEN. This year's conference concentrated on the impending changes coming to our profession and to all of healthcare. These topics were TOUGH, but made me realize, I may have my head in the sand on this.

My job was to help the attendees know what we should do with the new information and to be funny.

The first speaker was Dr. Chuck Posternack who is a practicing gastroenterologist.  He is a specialist in the demographics of the healthcare crisis in America and the Affordable Care Act. Clear statistics made a strong case for the necessity of the changes. He demonstrated that too many Americans are without healthcare and that the fee for service model is on its way out.

Then we had an enlightening lecture from Steve Baker on the availability of new technologies affecting how we practice. From communication tools to data collection to applications that collect and share medical data. We talked about how fast it is coming and what we can do to try to keep up.

The major insurance companies are looking for optometrists who can work within their systems to collect and communicate medical data effectively. Drs. Richard Hom and Howard Braverman are OD's who are big shots with two of these companies. Both are actively involved in developing the programs that will dictate how we deliver care to our patients in the future.

Dr. Hom's biggest take home point for me was the amount of data they collect and how far they will go to get it. I realized that coding just to get paid is not going to be enough in the future. To be attractive to insurers, we are going to have to be good at sending data - lots of data.

Dr. Braverman's message reminded us what got us here in the first place. Continue to work to make your optical and your contact lens practice becoming profitable pieces of the puzzle. We know how to do this, but we find ourselves worrying about all of these healthcare changes, and we sometimes forget what we do well.

Take Home Points:

  • Everybody has to have EHR now - All insurers are going to want more information than you can provide if you are not using EHR, get it now.  (Let me know if you need help picking one)
  • I have to get good at EHR - Regardless of MU, we have to figure out how to populate every field in our EHR, including height and weight.
  • We all need to be great at sending reports to other doctors.
  • Learn how to become a "Physician Extender" - and don't take it personally.
  • Almost everyone will have insurance now and very few people are going to be retiring with a lot of money.
  • We need to find new ways to deliver great care, not just repeated office visits.
  • Get good at communicating with patients via your EHR - if yours doesn't have a secure patient portal, start looking around.
  • Settle in to these changes - they are here to stay

In the near future, providers will not be chosen based on how good of a job they do but more of how good of a job they do reporting the data. I don't have to be the best at it, I just have to be better than my competition. And I will be.

You Must Know The Players

Know the Players

John C. Maxwell has written a lot of books. Many of them have been instrumental in helping many business owners understand how to be better leaders of people.  We based our entire Leadership Team program on one of his books.

A while back, I bought his book The 17 Indisputable Laws of Teamwork.  I was captivated by the title, but hesitant to get started.  Sometimes these guys who write a lot of similar sounding books start sounding like they are just looking for new ways to say the same thing.

But, I always want to do everything I can to strengthen my team.  Ultimately I relented and decided to crack open the book.

For doctors who want to build a stronger team, I do recommend the book.  If you don't want to read an entire book, let me give a quick summary:  Building a great team takes a lot of work and you can never stop working on it.  

I particularly like the Law of the Niche, covered in Chapter 3.  The concept is that to reach their full potential, every team member needs to be in the place where they can make the biggest difference.  The same concept is discussed in Jim Collins' book, Good to Great when he talks about getting people in the right seat on the bus.

Maxwell says to get the people in their right place, you MUST:

  1. Know the Team - Classic "Vision" Blog
  2. Know the Situation - "Open Your Eyes" Blog
  3. Know the Player - Classic "Listening" Blog

How do you "Know the Player"?  

Most of us have the tendency to treat all of our team members the same. But the fact is, every person is different and responds differently.  Getting to know our team is something we could all do a little better.

At Leadership OD, we offer an in-depth Personality Test called the CPI 260.  It gives an intensive look into the work styles and motivations of any individual.  The test reveals an exhaustive evaluation into any personality.  Knowing the differences and similarities of a team allows a greater understanding the team.

Here is a look at my results from a few years ago.

We review every test with the doctor;  here are my notes about my own results.

While the test is available to everyone and includes a review with one of our consultants, our members receive a free test and big discounts on additional tests. When you decide to invest in "knowing your players," we recommend letting everyone on your team take this test.  We are doing it in our office now.

Purchase Personality Tests (Non - Members)

Membership Login Page

During a recent presentation I heard a profound statement from my friend, Dr. Amir Khoshnevis.  He was lecturing on the power of a strong culture and how a unified staff was an integral part.  He said that dealing with staff issues and attitudes was at one time the most challenging aspects of managing his practice.  Now that he routinely puts time and energy into staff development, it is one of the most rewarding.

He uses personality tests in his office.  I'm just saying.......

Have a great weekend,

Mike

Get out of the weeds

Get out of the weeds 

Spring is the time of year for gardening.  Flowers begin blooming, the grass starts getting green again and the trees are putting on a new coat of leaves. Nature seems to be waking up.  Spring is the season of growth, the season when plans made during the quiet of winter come to life.

Spring is also the season of weeds.

Weeds have plans of their own during this time.  My botany professor said, "Weeds are plants whose beauty has not yet been discovered."  Weeds are a problem in every garden and in every lawn.  There are different ways of dealing with this problem but the traditional method is to pull up the offending plant by the roots.

I am certainly no gardening expert, but I have pulled some weeds in my time.  Some say it is therapeutic work - I do not agree.   There are some measures you can take to prevent weeds, but every garden gets some.  And the best time to get a handle on your weeds is early.  If your weeds get out of hand, you won't have a garden at all.

Sometimes, I feel like I am spending all my time working in the "weeds" of my office.  I go to work with a prepared list of things to accomplish and never look at my list.  Other days, the only thing on my list is to make a list, and I don't even get that done.  But I work hard all day.  A day like that every once in a while is ok, but doesn't it seem like every day is like that at times.

I call those times being  "Caught up in the Weeds."  It's during these times of no real productivity that I feel unfulfilled with my daily work.  For me, the "weeds" represent the unplanned issues that arise due to my lack of preparation.  The day to day problems that require my immediate attention.  Staff who are complaining about each other, patients complaining about their wait time and insurance companies that don't seem to know what they do and do not cover.  Not to mention ICD-10, Windows Vista (or is it XP?) and the taxes that are due this week.

"Weeds" sometime seem to overwhelm and every moment is spent dealing with one little issue after another.  I solve one, then three more seem to pop up and just when I see the end of the problems, you turn the corner and see everything is covered with new "weeds", new sets of problems that got bigger because I was too busy "pulling weeds" in another section of the office (or do I mean garden?)

If you are in a leadership position and your entire day is spent dealing with issues that pop up, you are "caught in the weeds."  You are hurting your practice and yourself by dealing with issues that need to be dealt with by other members of your team.  Stop weeding, get up and take a look around the practice.  The "weeds" that you left, who else could be helping with that?  What is being left undone, what future plans are not being developed because you are concerned about to many minute details.

Leadership OD members have access to the BluePrint™ program which we designed to help practices with this very issue.  It works and we are finding that it works over and over.  Members of my team have begun the BluePrint™ program for the third time.  The newest team members have heard us talk about it, but will be experiencing it for the first time.

To get out of the "weeds", follow these steps:

  • Realize what you are doing
    • Step 1 in solving any problem is realizing that you have a problem in the first place.  The single most common comment I hear from overwhelmed doctors is, "I have so much to do that I can't get anything done."
  • Stop it
    • Often the most difficult part is to stop spending so much time doing things that you think have to be done now and have to be done by you.  Practice saying this, "I am sorry but I can't think about that right now.  Do what you think is best."
  • Revisit the Vision / the Mission of your practice
    • BluePrint™ Alumni can log back into their program and read the Executive Summary, page 1.  There is the Vision of the practice.  Others can go out to the reception area to read that Mission Statement.  Others just take a minute to reflect on the reason you have a practice in the first place.
  • Look at the current situation through realistic viewpoints
  • Make a list (include the weeds)
    • Only after you have reminded yourself of the overall vision of the practice AND been realistic about your current situation can you make a meaningful task list.  I like a old fashioned flipchart, some like notepads, others like computers.  Just document all you need to get done, including those "weeds."
  • Communicate the plan to the team
    • Don't try to do all of this alone.  If you don't have regular staff meetings, then call one.  If you can't do that, send some sort of mass communication to let everyone know the plan.  Include in the plan how you will delegate various parts and how you will monitor progress.
  • Get to work

Happy Gardening,

Mike

 

p.s. Just another reminder that the BluePrint™ does all of this for you and yes, I really took a class in botany.

Everybody wants to be Rocky

On Being "Rocky"

"Everybody wants to be Rocky at the end of the movie."

I first heard this phrase from Dr. Kent Edwards years ago and I recall it whenever I am going through a phase where I gripe about how tough things are at any particular moment.

Anyone who is a fan of the original Rocky movie quickly understands what Dr. Edwards means by this statement.  For those who are new to the Rocky concept - a quick tutorial.

Rocky is a movie about a down-on-his-luck boxer who is close to giving it all up as his career looks like it's going nowhere.  He earns a meager living breaking thumbs for a Philadelphia loan shark, but dreams of making it big as a boxer.  He's paid his dues.  He has a good record fighting in smoke-filled arenas bringing home pennies to get his head knocked in.  Rocky had it rough.

Then, he gets his big break.  The world champion, Apollo Creed, offers Rocky a shot at the title and Rocky takes it.  He makes the most of his shot and his goal is to "go the distance" so he can prove that he wasn't "just another bum from the neighborhood."

In 1976, Rocky was nominated for 10 Oscars and won three, including Best Picture.  Still today, people run up the steps at the Philadelphia Museum of Art, standing at the top, arms raised high, sharing a moment of glory, like Rocky.

Everybody wants to be the Rocky who has given it all and stands there calling out for the love of his life, Adrian.  Everybody wants to be the Rocky who inspires millions to be better, to keep trying.  We all want to run up the stairs and bounce on the top with confidence and enthusiasm.

But none of us talk about being the Rocky that is filled with doubt and fear.  We don't want to be the guy who runs half way up the stairs, grabs our side in pain and has to walk back down in humiliation.  Nobody strives to be a gentle hearted thug who lives in the slums with only a dream to one day work his way out.  We never want to be the guy who gets beat up night after night for the hope of a big break.

But Rocky continued to pay his dues with no promise of a future.  He continued his dismal life, working for that big chance.  He never gave up.

The fact is that nothing worth having is easy or fast.  We all have aspirations that can be symbolized by Rocky's celebrations.  But it always comes with work, and usually the work is not glamorous and is not celebrated.

Most of us have a vision of a strong practice that operates efficiently and allows us to build relationships with our patients.  We dream of being stopped in town and being thanked publicly for changing someone's life.  We spend the money that we know we will make and accept awards with honor from our various associations.

Many times, success seems to come naturally to others around us.  They seem to have been given a big break or have a God given talent that gives them an unfair advantage.  But the truth is that more times than not, the most successful just didn't give up when others did.

Sometimes things are tough and plans don't always work out like they should, but keep fighting.  Things can change so quickly and sometimes we feel like everyone is out to get us.

Just know, Leadership OD is always in your corner.

Go the distance,

Mike

p.s. Rocky is now a Broadway musical and I was lucky enough to see a preview with my wife on Valentine's Day.  (It is often called a "love story.")

I am no expert on musicals - but we loved it!

Red Sky At Night, Sailors Delight

In this message I want to talk about 3 things:

  1. The Weather (big topic these days)

  2. Benchmarking

  3. A Membership Benefit

Years ago my dad taught me this little weather forecasting poem:

Red Sky at Night, Sailor's Delight

Red Sky at Morning, Sailors Warning

According to that poem, a beautiful red sky can predict the weather based on whether you are seeing it at sunrise or sunset.  This rule of thumb dates back over 2,000 years.

Does it work? I don't know.  I recall that poem every time I see a red sky, but always forget about the sky by the time I can test it out.

Weather forecasting has come a long way.  After the poem, early forecasters predicted weather based on cloud patterns and changes in temperature, humidity and barometric pressure.   Then came radar and live satellite images and constant computer models.

 Atlanta's Channel 11 used to advertise that they would show the weather forecast in the first eleven minutes of every newscast. Another station had a "ding, ding, ding" sound that played to get everyone's attention when they gave the 7 day forecast.  They know all we care about is the weather.

Now that we all have the weather on our phone, who even watches the news?

Forecasting in our optometric practices has also come a long way.  Today's practice software programs have every imaginable piece of data about our practices. But unfortunately, most of us don't know how to use the data.  The problem is there is so much data and information, it is hard to know what to pay attention to.

We may as well be using poems.  How about this one?

                                      Tonight's deposit was pretty big, I think I am going to dance a jig.

                                     Yesterday I only deposited a little, so for the week - we are in the middle.

 

Forecasting and Benchmarks

Most business consultants establish a set of benchmarks to measure and monitor how things are going with the practice.  The best set of benchmarks looks into the future to pick up on problems BEFORE they occur.

What to measure

It is important to maintain a good strategy on collecting and evaluating data from your practice. There is a balance of how much to measure and there is no set of data points that is perfect for every practice.  If you don't look at any data, you will eventually run into trouble.  If you look at too much data, then you aren't really looking at any data.

 I have come up with over 100 benchmarks that all individually make sense to monitor within a practice.  But only two are for every single practice:

  1. Number of exams

  2. Income per Exam

For the rest, some need to be monitored constantly in some practices and occasionally in others.  Figuring it all out can be a daunting task.

                                                          Leadership OD Membership Service

This month, Leadership OD members are invited to log onto their membership page and schedule their own 45 minute Benchmarking Call with Dr. Mickey Kling or Mike Rothschild.

 Mick has taught me a lot about setting up financial strategies for practices and we confer with each other regularly about the best methods. We don't always agree with the best measurements to make, but we do develop a strong plan for any practice.

If you are not a Leadership OD member follow these steps to set up a benchmarking system:

  • List all the distinct areas of your practice that generate significant income.  Some examples are Clinic, Medical Testing, Surgical Co-Management, Contacts, Optical, Lab, Vision Therapy, and Administrative (insurance).

  • Identify 1 or 2 key indicators in each of those areas to measure their effectiveness.  Find a quick, easy way to routinely measure those benchmarks.  Most of ours come from a report, but some involve a stopwatch.  I think it is a good idea to get information from a variety of sources.

  • Try to think of something that happens when problems are coming. This is an art and the real challenge in tracking data.

  • Create a system to look at the data, follow the trends and react accordingly.  The report system is the most common failure point.  If you look at the data when you think about it, then you look at it only when it is too late.   I usually recommend reporting on 2 - 4 benchmarks at weekly staff meetings.

Looking at historical data may be my least favorite part of owning a practice.  I think it is because I like looking forward so much more than looking backwards.  But I do know how easy it is to get off course and I realize how important it is to monitor progress.

So for me, I work hard to make it easy, effective and fast.  And I will keep trying until I hear "Ding, Ding, Ding - The forecast for the practice is good."

Happy Valentines Day,

Mike

Pay Attention!

My professional strength is finding new, better ways of doing things.  I put a lot of effort into looking at how things are done, comparing that to how I wish it was done and finding a way to bridge that gap.  Some say, it is my passion.

But it takes a lot of effort to stay focused long enough to get it done these days.

Let me share an example of how sometimes struggle:

Monday morning, I came into the office with a well prepared list of things I needed to get done.  My list included talking to various staff members about projects they were working on, accomplishing some nagging tasks that were overdue and reevaluating our optical strategy to explore how it fits into this changing world of managed care.  

 As usual, before I start the day, I stop to give my email a quick check.  Nothing major in the email, but I do need to go ahead and reply to a few, so I do.  Some require that I look at my calendar, so I do that and I realize that the Spring is really filling up quickly.  

 For a minute, I gaze at my calendar wondering how am I going to do all that I am supposed to do this Spring without putting a strain on my family or my practice.  We will all band together and we will get it done.

 Back to the emails. A quick look under the "Promotions" tab, those usually all get deleted in mass, so this will literally take two seconds.  

 Jessica drops in at this moment and asks if this is a good time to review the frame count.  I say, "Yes, I am almost finished here."  Jessica leaves to gather up some people to talk about one of the things on my to do list. 

 One of the Promotions email was about 360 Business Tours for Google Maps.  I have seen these before and must say they are pretty cool.  From the Street View, some businesses allow you to go inside virtually.  Hotels have been using this technology for years.  Then real estate companies and lately, I have been noticing some restaurants with them.  My memory does seem to recall seeing an optical shop with this technology, but is that a real memory?

 Let me explore for just a minute - so Google and I do a little research.  I want to know which Atlanta area businesses have these 360 tours.  

So I punched something into Google about Atlanta area 360 tours.  This brings up a sketch from SNL about the Southern gentleman who lashes out about how Georgians were crippled by the recent 2 inches of snow.  While I must admit it was funny, I began to wonder, does everybody think all Southerners are Colonel Sanders from KFC?

 After a good laugh, I was reminded that I heard snow is forecasted again for this weekend.  Is that true?  So a quick check of local weather revealed that we will be fine this weekend, highs in the 50's.  

But there are so many things to look at on this weather website.  I checked out a video about a man that was at sea for 18 months and there is an advertisement about Rocky on Broadway.  

 Now, we are going to New York to see that on Valentine's Day, very cool!  Should I watch that trailer again?  

 Now I have three patients waiting. I guess we can talk about the frame count later.....

Routinely, I catch myself doing things that I don't need to be doing and this is one of those times.  I am using emails as a Procrastination Tool.  I tell myself that I need to check in to make sure I am not missing out on anything.  When in reality, rather than doing what I need to do, I am trying to see what everyone else wants me to be doing.  I am not paying attention to what matters most.

Time for this to stop.

Starting now, I will check my email for the first time at lunchtime.  If you need me before lunch, you should call.

In the BluePrint, we help our members differentiate between what is important and what is urgent.  It is a classic lesson from Stephen Covey's original Seven Habits book.  It is a tough concept to comprehend, and it is easy to forget.  My habit of keeping my nose in emails is the excuse I have been using to find "urgencies" to distract me from "important" tasks.

I have renewed my habit of planning my day, working on my tasks, then at lunch, I will see what everybody else wants.

Wish me luck,

Mike Rothschild

p.s.  Yes, I do understand the irony of sending this message via email.