In 2017, the ‘Three A’s’ No Longer Lead to Success


When I was a resident in the 1990s, I was told by many staff surgeons that success in my career would be dependent on my mastery of the “three As.” Being polite (and a bit of a suck-up), I would usually feign lack of awareness of this advice (and interest in it) so that the attending’s delicate feelings would not be hurt as he recited this well-worn trope. For anyone lucky enough to have never received this advice, the three As are: ability, availability and affability. The advice goes, “If you, as a surgeon, are competent, make yourself available to referral sources and patients, and get along with those populations well, you will be successful.” Read More

The Real Question in Value-Based Care is ‘Whose value are we talking about?’

Let us say I need to make a trip to Nashville, which is about 400 miles round trip. I can take my car, a vehicle I purchased and maintain, or I can take a flight in which case I outsource all the responsibility and indirect costs to an airline. If I take my car, I simply fill the tank with gas for about $40. If I take the flight, my ticket costs $350. Seems like a no-brainer, right? The flight seems to cost more, but the sophisticated reader will immediately recognize this is an apples-to-oranges comparison.

The Big Data Revolution Has Begun and the Guns Are Aimed at You

“Political power grows out of the barrel of a gun,”– Mao Zedong, 1927

On my first day as a “cow” (or junior) at United States Military Academy at West Point, I learned a lesson that has stayed with me my entire life and contributes to the lens through which I consider all business issues. During my time at West Point, all cadets were required to take SS307, “Introduction to International Relations.” As I was a pre-med math/science guy, I walked into the first day of this class having no idea what we would be learning, much less expecting to learn anything that would become part of my intellectual bedrock. I was dead wrong in the first 15 minutes of that class.

If You Have the Medicare Blues, Read This Before Doing Anything Rash

I remember repeatedly memorizing the Krebs cycle in both college and medical school, and hating it intensely. I did not know much, but I knew I was not interested in any job where knowledge of the Krebs cycle was important, and so I never seriously “learned” it. I would simply “spec and dump” it for the test, which ensured that within 24 hours I could only vaguely remember Krebs had something to do with ATP and acetyl-CoA — and that was always good enough to get me to the next level of training.  Not all cycles are so worthless for a surgeon to understand, though. The revenue cycle is equally as complicated as the Krebs cycle, but is enormously useful to understand when running a practice.

Orthopedic Business Language: The Derivation of Kappa, Part 2

In last month’s blog, we defined the equation: Opportunity = Delivery + Neglect, where “opportunity” is the total daily orthopedic value created in our local markets, “delivery” is the total daily orthopedic value delivered — what we do; take care of patients — in our local markets and “neglect” is the total daily orthopedic value left untreated in our local markets.

Orthopedic Business Language: The Derivation of Kappa, Part 1

In our education and training as orthopedic surgeons, we spent years learning a vitally important technical language, without which we could not exchange ideas and accumulate knowledge. Amongst ourselves, we may use a term like “varus derotational osteotomy” to easily communicate a complex biomechanical principle, but non-orthopedists would have little idea about what we were discussing. Without our technical language, we could not be successful as orthopedists. It is therefore easy to understand the value of language to any complex occupation.

What Is Your Practice’s Flash to Bang?

I refer to appointment procrastination as “flash-to-bang” time. During the Cold War, American soldiers were taught to count the number of seconds between the “flash” of a nuclear explosion and the impact of the pressure wave (“bang”). The time difference between the arrival of each of those two events could be reported to higher authorities (assuming the observer survived) to calculate where the bomb hit.

Learn how a similar idea impacts your practice’s ability to attract patients: Healio: The Business Minded Surgeon Blog

The Other Side of nextDoc Value: The Patient Experience

In conversations with our clients and groups interested in value-based physician scheduling, we tend to spend the majority of time speaking about the benefits to the practice. It’s true that physician practices have many headaches in scheduling patients efficiently and intelligently. But, often overlooked is the tremendous headache that patients face when scheduling an appointment. An outdated telephone queue does nothing to show a patient that your practice values their business. This is a nice blog piece that highlights an experience a patient had using the nextDoc app and why the patient experience can’t be overlooked when changing the appointment process. Patients are who we all serve!

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