Frequently Asked Questions

The term coaching is loosely defined so perhaps the most important thing that you can do is decide what kind of help you need, and then find someone with the proper training and expertise to help you. Although a variety of coaching certifications exist, none of these have been validated in controlled trials. A Harvard Business Review article on the subject of executive coaching did not support the importance of a particular certification as a useful predictor of a coach's effectiveness.

Look for a coach who has experience and a track record of success in dealing with the issues of concern to you. Beware of franchises and one size fits all. Seek referrals from professional organizations and colleagues. Ask for the educational background and experience of the coach whom you are considering working with. Chemistry between you and your coach is very important. Finally, be sure that you understand the scope and cost of services of any program that you are undertaking.

No.
This question can be far more loaded politically than it appears at first.  Voting rights and privileges are established by the organization and may well be different for medical staff and hospital committees.

In general, medical staff committees often limit voting to active members of the medical staff, which new VPMAs usually aren't. Hospital committees usually allow all participants to vote.

Medical Executives should check the rules before making any public statements.  Attempts to vote on medical staff committees by new administrators can be interpreted as 'power grabbing' tactics and can create significant political unrest- especially in organizations that are already troubled.

While it may be tempting to think that “any idiot can become a hospital administrator”, if that was true in the past, it isn’t any longer. Career transitions to administration typically require planning.  Advanced business or other degrees are increasingly preferred, if not required and the competition is getting stiffer.

First, step back and consider whether you really want to give up clinical medicine, or simply find a way to practice more efficiently and effectively. If your thoughts about leaving relate more to a desire to escape the nonsense, than to a real desire for a career change, you will be better served by fixing the problems in your current practice.  There are many ways to do this.

If you really want to change your profession, talk to other people who have done this, and who have the positions you think you want. Volunteer for committees that deal with quality management and strategic planning issues.  Become a prominent member of multi-disciplinary teams and start to think about developing your professional network. You may or may not choose to pursue an advanced degree. You may not need to if you can demonstrate relevant commitment and experience in other ways. 

Communication failure is the number one cause of malpractice cases. In addition, poor communication and poor teamwork have been identified as major contributors to medical error.

It sounds as if your practice has no clear cut direction. Without a consistent approach, you are likely to waste time and resources in undertaking multiple projects, which compete with each other for time and money and lead to a situation in which few, if any, are successfully implemented. I would suggest that you define who the key stakeholders are for the future, which could include partners, employees, office managers, key support people such as an accountant, or others. Take some time out with that group to do a strategic planning exercise - which at its most basic means to

1) define your vision - where do we want to be in a perfect world in 10 years
2) define your values - integrity, profitability, work/life balance etc
3) define your mission - what you need to do in 12-18 months to be on track for your vision.

Establish project plans and DATES. Although an outsider can be helpful in guiding these discussions and holding you accountable for clarifying difficult issues and measuring results, some organizations, especially smaller ones, can undertake these tasks internally. Useful resources are available on line and in bookstores to support these types of projects.

We suggest investigating a volunteer opportunity related to your field. Many of us, including the author of this response have found great pleasure in volunteering in free clinics, either as clinicians or in other roles. For further information on free medical clinic opportunities, either to participate or to start one, visit www.vimi.org. DRD consultants started and support Caring Neighbors Health Care Center(www.cnhcc.org), a VIM affiliated clinic.

Baldrige criteria are designed to be applicable to all size businesses. Participants in the program validate the value of using the criteria to assess and refine processes within their business, whether or not they apply for the award. Several DRD clients have chosen to learn about the Baldrige criteria and to use them to establish direction and to find opportunities for improvement, without applying for awards. ROI has been significant.

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It depends what you are talking about. If you do not have a complete understanding about what the project will involve, in terms of your time and money, you will probably have a disaster. If you carefully assess your goals and needs, and engage the proper help to define a project that meets those needs, with realistic time and money estimates, you will have a better experience. Remember - it is possible that you cannot afford everything that you want - in those cases, making careful choices will facilitate a better outcome for you and your team. Unrealistic expectations have led to the biggest disasters in our experience.

Although there is much emphasis on implementing electronic medical records across the country, the answer for each individual practice is, it depends. Some practice types (primary care) routinely exchange information with other entities (such as hospitals, xray and lab facilities and consultants) and take care of patients who receive care in multiple locations. For those types of practices, integrated electronic records probably do make sense and the questions around how and when to do this will be addressed further in a moment. For other practice types, such as mental health perhaps, electronic record implementation may be less compelling from efficiency and safety standpoints. The style and cost of electronic health record implementation varies widely, on both the hardware and software side. The right answer for those decisions will depend largely on the size of your practice, what legacies systems are in place in your practice and what IT support you have available, both currently and in the future. Financing systems in a time of uncertain reimbursement is also a challenge - although the HITECH ACT provides for reimbursement to providers who add electronic systems, not everyone will qualify and depending on the selection of the electronic records, the reimbursement may be at, above or below the cost of the implementation. There is a lot of information available to help practices make decisions and most would be well advised to get some outside help before making a decision. The cost and kind of help varies widely and some government supported resources are also available.

Websites serve different functions for different practices. A website that provides simple information about your practice to potential customers, clients or patients who have already heard about you and are interested is an inexpensive and simple proposition that makes sense for almost everyone. The absence of such a site may create concerns about your credibility and ability to stay up to date, especially for younger consumers. A website that drives business to you is a more complex, expensive and longer term undertaking. Whether you need one or not depends on your business growth strategy and target audience - not everyone does.