30 Days into the Healthcare Field...

After several years in the retail industry and copious amounts of energy drinks and 80 hour weeks, I made a transition I, at the time, felt would be a considerable change. I moved from retail to healthcare. And as I ponder my first 30 days in the medical clinic, I have come to a confounding realization: Clinics are very similar to retail stores.

If you change terminologies here and there, most of the guiding principles are parallel. So here is the 30 day old wisdom nugget: Ultimately, success is dependent upon the quality of your people. Let me say that one more time. Ultimately, success is dependent upon the quality of your people.

Over the past weeks I have been showered with articles, periodicals and other reading to peruse through and familiarize myself with the industry. Many articles concentrate on margins and rising costs with fewer margin dollars to be gleaned from the communities in which the clinics call home. Many articles suggest that breaking even is a victory. I find it quite puzzling actually. And yet, the situation is eerily familiar.

How can one clinic of same size and panels with similar access and equal number of physician FTEs succeed while another fails? Is it location? Is it price? What is it?

Location doesn’t come into play as much as you might think. Easy locations to get to help but is rarely shown on surveys as a reason someone is leaving your clinic or doesn’t want to join. Price has a low register on the surveys as well. It is almost to the point to where most medical satisfaction surveys I have run across, in our system at least, don’t even ask about price fairness and competitive shopping. So what is it?

People. The people in your clinic determine your successes. From the business office clerks to the patient service representatives to the physicians and nurses actually healing the hurting, these people determine the clinic’s success. Never underestimate the power of one person no matter their yearly take-home pay.

My family’s Primary Care Physician was located about 15 miles from our home in Central Texas when we moved in 2005. We enjoyed our interactions with her and felt she was more than just a physician but also a friend. We didn’t mind the drive or the hard to get to location. She had been our doctor through many tough bouts of illness with my son and wife over about a three year period when we left her. She did nothing wrong but someone in her clinic did. I still feel ill about it.

Since we began going to that clinic, there was a woman at the front desk of the clinic that did check-ins and scheduled appointments who seemed annoyed with me. Not only me but my family. She never smiled. She never said hello. She was rude in person and on the phone. Despite being in the clinic at least monthly if not bi-weekly, she acted like she didn’t know us and didn’t care to. Finally my curiosity got the better of me and I started watching her interactions with all the customers. Horrid!

If I had run my retail store with that level of customer interaction we would have been closed down in a week! Yet it seemed she and the management were obliged to do nothing more than they had to. The experience of a visit or phone call was too awful to endure any longer and we switched. We didn’t leave because of the doctor. In fact we loved the doctor. We left because the overall experience was bad. Just one bad apple…

You can guess where this is going by now. It is now, more than ever, an experience based society. Every interaction is looked at with discerning eyes. An expectation has been set for good and bad service in our patient’s lives based on their experiences either with your clinic, one in your system or a competitor. Even more frightening, they create new measuring factors every day at restaurants, malls and repair shops.

How do we create an environment of good employees? The process starts with hiring. Multiple interviews and peer group interviews will often quell emotional hiring. Some people are great performers in interviews and then become the bad apple just weeks later. Multiple facings with varied groups can weed most of these people out. The people you do hire, train them with specific employees. Put them with your best employees to learn their habits, not just who is available that day.

Know your employees. Talk to them often and not just about the workplace. Learn their names and interests. Don’t be the leader who rules from a golden tower on high. Come down to the fields and meet the workers. Maybe even help them pull weeds now and again.

Ask your employees the “How would you…” questions. Asking for ways to improve their day to day work improves morale. Maybe it’s as easy as a new soda machine or a different keyboard at their workstation. And now that you have that feedback, whenever possible, show them you value their feedback by following through on feasible requests. Nothing goes further to better an employee than a grasped sense of value.
Teach them why we are here through your words and your actions. We tell them to be courteous at all times, to be friendly and help out our patients and guests. If we as leaders don’t emulate those behaviors, why should they?

Employees, who feel valued, respected, listened to and who have a good environment are happier at work. Happier employees smile more, are more eager to help and create a better experience for our patients and guests as well as their coworkers.

Better experiences create loyalty, word of mouth advertising and continued success. It becomes a question of “How can we fit in more patients?” rather than “How can we get more patients?” When we reach that point, profitability is an end result.

Three weeks

We've been loving these first three weeks with Anna Kate (these pictures are of her at 2 weeks). The weeks seem to be going by so fast. I really wish I could freeze time! She makes this face all the time. It is one of my many favorites!
Zeke is adjusting well. He tells me, "I love my baby!" about a hundred times a day. It is wonderful to see him being so sweet to her. He can hardly keep his hands off of her and wants to kiss her all the time. We are even having to tone it down some because the poor girl can't get any rest! One of the sweetest ways Zeke shows his love to "Rocco" is by singing to her when she is fussy. It makes me smile every time. And yes, he still calls her Rocco about 99% on the time- as do all his friends! I think it's pretty cute actually.
I love Sundays! Besides getting to worship my Lord, I get to dress Anna Kate in sweet dresses and bows! She loves it too! Just look how content she is!

She reminds me so much of Zeke, especially in this picture. I'll have to look through Zeke's newborn photos to post a comparison.
Zeke is showing us the gun show. He is so full of character! This turned in to a full photo session for him. This is just one of the great poses!

Boys Day Out

Zeke and I needed a little time away from the crying and pink pacifiers and diapers today. We
loaded up the car and went out to Frank's Marina on Lake Belton. I've been catching a lot of fish out there for the last couple of months so why not one more try? Zeke started catching fish almost immediately. And when I say catching I mean he was setting the hook and reeling them in and then slinging them over the rail. I have a few pictures for proof. He caught 12 crappie in the hour we were there and caught the only keeper. People there were asking how old he was and then gawked in amazement after I said he was three. Could he be the next Hank Parker or Bill Dance? Maybe. I'll let you decide.

Anna Kate's Journey

The Birthing Experience…. Part 1.

Contractions started this morning and were about 5-7 minutes apart with varying degrees of severity. To wait it out, I went to work and Emily went to school. I got a call about 8:30AM and drove pretty quick from Killeen to Belton to meet her at school. We finished packing and loaded the car and then called the hospital. The nurse in L&D told us to come on in. When they were checking Emily for Anna Kate’s heart rate, her heart rate dropped because of an extended contraction. The nurses and doctors came rushing to the rescue and gave her some turbutylene (sp?). After things normalized, we were admitted and went to the room. After a few checks and a couple of hours we decided to called for the anesthesiologist to come do the epidural. Dr. Bailey, an OB/Gyn resident came in and said she had done 40 or so and should be ok to do the epidural. After examining and prepping, she was having a bit of difficulty so she called Dr. Hoffer, the anesthesiologist on call. He was able to give a couple of pointers and Dr. Bailey got the epidural in without any issues. Shortly thereafter, Emily got really hot and started feeling nauseous. Her blood pressure dropped pretty low (80/40) and five or six nurses and doctors rushed in . They issued 20(?) of ephedrine to get her BP (and the baby’s) back up. Two minutes later everything was back to normal (as normal as it can be in a hospital). She is progressing nicely as of 3:40PM on May 2, 2008. I’m a nervous wreck but Debra is here and helping and Emily is drugged up so we are playing the waiting game.

Part 2……

Epidural was wearing off so we called for help. Resident Dr. Kyle McMorey(?) and Connie (a nurse, most likely an RN) came in. “Currently progressed to a -1 station from a -2 and between a 6 and a 7.” These docs and nurses are so nice. Eliana and Danya (our regular nurses since we have been here) have been great, coaching me along and trying to get me to relax. This will have to be my last child. It’s not that I don’t love kids. I just feel like my heart might explode if I had to go through this all again. I have been not so much a basket case but very much the watchful eye on baby monitors, heart rate monitors and the like. Emily’s TOCO readings are jumping in the 90s now so we could be nearing the pushing stage in the near hours, maybe hour. Kevin (Kevin Huddleston MD OB/GYN) our doc has had no sleep over the past few days and was on his way home when he got our call we were at the hospital. His wife is at home with some back trouble so he went to get nourishment for her (hopefully him) and maybe even a nap. We’ll see him soon enough. He’s delivered at least four babies in the past couple of days so I’m sure he is on top of his game with or without a nap. He always seems so darn cheery. If I had been on call all night and got called back, I can’t say I could even force a smile. He’s good.

Part 3……

Shift change @ 7PM. Still here. Baby’s not. Danya and Eliana are headed home and Linda Teague is here. She is taking over for the Darling Duo. We are in cruise control so she tells us.. Kevin is back and we are swapping honeymoon disaster stories. Cruise control indeed. Kevin killed a deer and put it in the back of a Plymouth Horizon. That beats my tow and slide story. Matt and Tina just got here. Still cruising. A quick check and we are prepping to push. It’s only a matter of time now. 7:20PM May 2, 2008

Part 4….

The pushing has started and Linda and Kevin are playing motivational football coaches. Push, you can do it! C’mon almost there! She’s sunny side up so we are prepping for a long term push. Zeke was the same (sunny side up). 9 pushes. About 10 minutes total. That’s all it took. We have a baby girl!!! Anna Kate joined us at 7:44PM on May 2, 2008. She weighed 6lbs 9oz and was 19 ¼ inches long. She appears healthy in all the tests they’ve checked and she’s doing great, as is Mommy at the time of this entry. She has just had her first bath and a video and photo session too! Kevin did a blessing just after she was born and we are truly blessed. Zeke is excited. He kept saying, “She popped out!” We will move rooms soon and I hope to get some sleep soon. I am the least tired here but that’s not saying much. I hope our clan and our docs and nurses all get that sweet sweet sleep after a long day.

Postscript: Additional people from Scott and White we would like to thank are Becky, Bobbi, Dr. Jeremy Gibson and many others we didn't get their names in some of the chaos. You have made a truly wonderful experience from many difficulties along the way. Thank you so much.