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Healthcare Games: Do Gas Cards and Lotteries Make Patients Behave Differently?

©Jennifer Walz/

©Jennifer Walz/

Here are two of the newest healthcare games on the market. First up, Rite Aid:

They’re giving $30 gas debit cards with the transfer of a prescription to their store. If the Rx stays with Rite Aid, consumer’s name stays in play to win the gas lottery — a $2,600 gas card.

And next, Aetna:

Aetna is sponsoring a study to see if a lottery can enhance patients’ adherence to prescribed drugs. The Aetna Foundation funded a University of Pennsylvania team to use prizes of $10 and $100 to reward consumers to take drugs as prescribed. An electronic monitor (the Med-E-Monitor) will track whether 100 participants are taking their warfarin. 50 patients will be enrolled in the lottery with a 1 in 10 chance of winning $10 a day, and 1 in 100 chance of winning $100. A text message will be sent each day to tell the patient whether he/she won the lottery, or if the dose wasn’t taken, whether they would have won the money. 50 people in the control group will be using the electronic monitor but won’t be incentivized with the lottery game.

Both these games are reported by Jane Sarasohn-Kahn at Health Populi. 

Posted in: Innovation, Medicare & Reimbursement

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Why are More Healthcare Management Job Postings Looking for Certification?



If you are working in practice management, you might want to explore the gold standard in certification through the American College of Medical Practice Executives (ACMPE). Disclaimer: I am Board Certified and a Fellow in the ACMPE but I receive no compensation for writing about the College or having a link to them on my blog.

Why certification as opposed to an undergraduate degree? I think this week’s opinion piece in the Wall Street Journal by Charles Murray says it better than I can. Read the article here.

Posted in: A Career in Practice Management

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How to Ask for a Raise

©Roxana González/

©Roxana González/

My son called me today and asked me how to ask for a raise. Here is how I told him I’d like an employee to ask me for a raise:

  1. Make an appointment with your boss and let her/him know that you’d like to discuss your compensation. Do not e-mail this request to your boss while s/he’s out of town, their first day back or has a big deadline coming up. Choose your moment. Ask for an appointment several days or a week in the future so you have time to prepare.
  2. Make a list of the things you’ve accomplished since your hire or last raise. Include things you’ve learned, ideas you’ve shared, projects you’ve participated in and benchmarks or goals you’ve met or exceeded. Add any new ideas you haven’t already shared. Print a copy of the list to give to your boss after your Mom has reviewed it you’ve spell-checked it.
  3. Research your job on the Internet and see how your wage compares with others of the same title or job description. Print out the information (if favorable) for your boss.
  4. if you feel heated about your compensation, take the time to write out your feelings or discuss them with someone who doesn’t work with you. Let go of any feelings of anger or frustration and make sure you are calm before the appointment with your boss. Keep yourself from holding any imaginary conversations with your boss before the meeting trying to guess what s/he will say.
  5. When meeting with your boss, thank her/him for his/her time and ask if you can share some information you’ve brought with you. After you’ve presented your info, let your boss know (if it’s true) that you really like your job and hope to be a part of the company’s future. Ask if s/he would consider increasing your compensation based on the material you’ve presented, and indicate that you understand s/he might need some time to review the information you’ve provided. Ask when you might be able to meet again to discuss her/his decision.

You’ve been professional, respectful, supported your request with information, and given me time to think about it. As a boss, I couldn’t ask for more.

Posted in: A Career in Practice Management

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Are Critical Conversations Hard for You?

©Dennis Owusu-ansah/

©Dennis Owusu-ansah/

A great column in last week’s BusinessWeek by Carmine Gallo gives the reader 4 steps to making difficult conversations with employees and coworkers more productive. I like his steps, but I have four of my own, and I’ll let you choose which works for you. Read Carmine’s suggestions here.

Here are my four steps:

Step 1. Always start with a question. I rarely feel that I know the complete story so I typically ask for more information about the issue or behavior in question. Nine times out of ten I learn something I didn’t know that helps the conversation. Asking questions and clarifying information usually gets both parties a little more comfortable.

Step 2. Express your concern about the issue or behavior and let the employee know why you’re concerned. More information helps the employee see how their work interacts with someone else’s or contributes to the organization as a whole.

Step 3. Ask for the employee’s input in solving the issue or behavior. There may be several solutions that would work, and choosing the best one together, or letting the employee choose one is a win/win.

Step 4. Restate the action plan for the resolution and close the meeting with an invitation for either of you to meet again if the issue needs revisiting.

It may be hard to talk to employees and coworkers about issues or behaviors, but if you are in a leadership position, you must learn how to have hard conversations of all types. The secret is asking questions and collaborating on solutions.

Posted in: Human Resources, Leadership

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Long Vacations are Good for Employees, the Company and Me!

When we first moved to the west coast, I was stunned to find that people routinely take two weeks of vacation off AT ONE TIME! On the east coast, my experience had been that taking more than a week off was reserved for getting married or going to Europe. Amazingly, and this was a revelation to me, people can take two weeks off at a time and the organization can go on! Now I am very much in favor of people taking longer vacations for a number of reasons:

  1. It forces the organization to cross-train employees and to make sure that there are at least three people in the company that know how to do every critical task.
  2. It requires the creation and maintenance of current, clearly written protocols associated with each job, in case the other two employees who are cross-trained on the job get sick, have jury duty, have a death in their family, or quit on short notice.
  3. It gives the company an opportunity to assess the workload and composition of a job from another person’s viewpoint. We’ve all had the experience where someone goes on an extended leave and you find out that the job is much more, or less, complex that you thought, or someone was telling you.
  4. It ensures that nothing untoward is going on with someone who has access to company money. Everyone’s heard of the manager who never takes a vacation, not because s/he’s so dedicated, but because s/he has sticky fingers.
  5. It gives the employee an opportunity to truly rest, heal, and remember that there is life outside of work (can you tell I’m thinking about myself here?)

Here’s an excellent article that has some great points about the ethics of taking Vacations. The author, Bruce Weinstein, PhD states:

Leaving work behind for a period of time is not only acceptable; it is our ethical obligation.

My advice to each of you is to fulfill your ethical duty as soon as possible.

Posted in: A Career in Practice Management, Human Resources, Memes

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While I Was Paying Attention to Other Things, a New Hoop Appeared for My Practice to Jump Through

©Pavel Losevsky/

©Pavel Losevsky/

Sometimes it’s hard to figure out what to pay attention to. There are projects, staffing, budgets, contracts, technology, Medicare cuts and on and on. While I’m trying to pay close attention to this stuff, along comes a program that I should have paid attention to and asked questions about before it launched, but I didn’t.

A local payer is requesting notification each time a physician orders an imaging study for a covered patient. In this case, the practice owns the MRI so practice staff are doing the paperwork. This advance notification is not DIRECTLY tied to payment, nor is it mandatory. I’ve been around the block a few times, however, and I know what non-mandatory means, and so I try to play nice when it’s reasonable to do so. But, I didn’t pay attention, and the next thing I know the practice is in a hubbub trying to insert the advance notification into a process that’s already unnecessarily complex. The reason it’s difficult is that the person who has the information the insurer wants, the physician, is two staff people removed from who actually is responsible for entering the data. As with most medical information, getting it from the physician to the insurer requires a series of hoops and a lot of dexterity.

The Wall Street Journal wrote about this type of advance notification program a few days ago, and I think it’s another interesting sign of the healthcare times. Read about it here.

Posted in: Medicare & Reimbursement

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Using What To Do What? Radiologists Use iTunes to…

©Ron Chapple Studios/

©Ron Chapple Studios/

Under the category of using existing software for new purposes, radiologists at Renji Hospital and Shanghai Jiaotong University School of Medicine are using iTunes to house and sort medical PDFs of images and research documents. Download Squad has the story here.

Posted in: Innovation

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5 Questions: A Deceptively Simple Performance Evaluation

©Dmitriy Shironosov/

©Dmitriy Shironosov/

Here is a VERY succinct performance evaluation that I’ve used for years. Called 5 Questions, the employee completes it, submits it to the manager, then they discuss and refine it together during the evaluation interview. Here are the questions:

  1. What goals did you accomplish since your last evaluation (or hire)?
  2. What goals were you unable to accomplish and what hindered you from achieving them?
  3. What goals will you set for the next period?
  4. What resources do you need from the organization to achieve these goals?
  5. Based on YOUR personal satisfaction with your job (workload, environment, pay, challenge, etc.) how would you rate your satisfaction from 1 (poor) to 10 (excellent.) 1 2 3 4 5 6 7 8 9 10

You do have to stress that question #5 is not how well they think they’re doing their job, but how satisfied they are with the job.

The great thing about this evaluation is that it’s one piece of paper and not too intimidating. Staff can use phrases or sentences and write as little or as much as they like. If it’s hard to get a conversation going with the employee, ask them “What was your thought process when you assigned your job satisfaction a number __.” Usually that opens the flood gates!

If you use a goal-oriented evaluation like this one, you’ll find that employees will grasp that you are asking for their performance to be beyond the day-to-day tasks, and to focus on learning new skills, teaching others, creative thinking and problem-solving and new solutions for efficiency and productivity.

For help with job performance words and phrases, click here.

Posted in: Human Resources

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On Having a BIG Birthday

I turned 50 Friday.

It was a BIG birthday. I wanted it to be BIG. I invited friends to the house. My husband ordered wine and practiced smoking pork three times to make sure it would be perfect for The Day. We hired a Yard Guy to clean us up. I bought potted flowers to make believe I can keep plants alive. Despite threats, I was given lovely wine, books, cards and a cane with a rear view mirror. My parents, all three of my brothers and both my kids contacted me to wish me happiness. We laughed in very large quantities. After taking aspirin, I went to bed at 1:30 a.m., a time I hadn’t seen in years. It was a blast (outdated boomer expression.)

I feel very thrilled with life. I am loved, life is more than a tad interesting, and I wish there more hours in every day to read, work on this site, sit mindlessly in the sun with appropriate sunblock, and talk to people. I only have one real regret in my life and that is that I didn’t take touch typing in high school.

I’m a little embarrassed to be so happy, but everything’s not perfect. We don’t live close to our kids or our parents, our retirement account is pitiful, and the rental house we live in does not allow us to have pets. People we know and love are sick and are suffering, someone just lost a job, we wonder how we will ever be able to live through losing any of our parents. We’re overweight.

But perfection is not what I’m looking for. I’m looking for satisfaction, meaning and an authentic life. I’d love to hear about your 50th birthday, and what you’re looking for.

Posted in: Headlines

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Every Ten Minutes is a New (or Lost) Opportunity

©Travis Manley/

©Travis Manley/

Here’s some information you probably already knew, but might have forgotten. After ten minutes of a presentation, the majority of an audience (your staff, your docs, your board, your referrers) tune out, or rather, their brains turn off. BusinessWeek’s Carmine Gallo recently wrote about John Medina’s book Brain Rules and the ten-minute rule.

If you want to hold people’s attention, I recommend you introduce some sort of engaging device at or shortly before each 10-minute increment of your presentation. This device doesn’t have to be complicated. A simple story will suffice, as will a review of the past 10 minutes. In my presentations, I often tell a relevant story, or better yet, show a video clip that is relevant to the previous discussion. If you’re presenting via Webinar software (BusinessWeek, 4/18/08), you can use a tool to push a poll or a question to your audience. Again, be sure to plan these exercises at 10-minute intervals. – Carmine Gallo

Some things I’ve used successfully to break up relatively dry information in staff meetings:

  • short dance break to wake everyone up ( James Brown’s ‘I Feel Good” is a classic favorite)
  • passing out party hats to everyone to announce a special event (can get silly)
  • visual interest slides at intervals – optical illusions (the gorilla on the basketball court is a classic but I don’t know if it’s available for groups unless you buy the DVD)
  • telling a tasteful joke if you can deliver it well – I personally can’t tell a joke to save my life
  • teach desk exercises to stave off stiff necks and sore backs
  • show pictures or movies from the last staff event, holiday party, etc.

Read the complete article here and let me know what you do to keep people from tuning you out.

Posted in: Human Resources

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