What is Your Office Policy on Doing (Other) Work at Work?


I’ve been very meticulous about not doing anything that has to do with this blog while I am at my real job.  I do know, however, that there are others in my organization who do work that is not related to the practice while being paid by the practice.

At a previous job, a newly hired 20-something medical assistant was day trading while he was working the clinic floor.  When other employees reported this to me, I was dumbfounded.  Not that he was doing it, but that he thought it was okay to do it.  And he was surprised that I thought it wasn’t okay to do it.  As far as he was concerned, if he didn’t have something to do, he was free to pursue another vocation in his spare moments.

Here’s a partial list of things I’ve seen employees do while on the clock:

  • Pay bills
  • Balance checking accounts
  • Shop online
  • Make grocery list or Christmas gift list
  • Address invitations
  • Answer personal e-mail
  • Apply for other jobs
  • Look for other jobs for friends and spouses
  • Look for new apartments, homes and cars
  • Write letters to the editor
  • Sleep
  • Study
  • Read books, magazines, and newspapers
  • Plan a wedding (this was a manager!)

My questions are threefold:

  1. What do employers have a right to expect from employees during the workday?
  2. What do employees (of all generations) have the right to do during the workday?
  3. What policies should employers have in place to protect their human resource investment, yet acknowledge the changing needs of employees?

If you have this problem in your workplace, please comment and let me know what your thoughts are.

Posted in: Human Resources

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Grownup Back to School: Make Fall a Time to Reorganize Your Virtual Backpack and Pencilbox


LifeHacker had a great post today that I thought was worth sharing.  It’s about using the change of seasons as a catalyst to get yourself reconoitered and back on track.  The article advises you to:

  • De-clutter your computer
  • Empty your Inbox – he uses the trusted trio of Followup, Archive and Hold.  I like Followup, and Do Not Delete and Archive.
  • Reorganize your paper filing cabinet
  • Teach yourself keyboard shortcuts (*My son taught me Ctrl+C (copy) and Ctrl+V (paste) not too long ago and I have no idea how I ever did anything without these two friends – try them instead of using right click or tool bar icons and you might be surprised how automatic it becomes and how fast it is)
  • Consolidate your email addresses, phone numbers, and calendars

Here are my additions to the list:

  • Learn three things about Excel that you continue to do the long/hard way because you’re too busy to learn the shortcut (yes, I’m talking to myself here.)  Try this siteor this one.
  • Catch up on your shredding (at home I have a box of to-do shredding, and a to-be shredded drawer that needs emptied – yes, I’m talking to myself again.)
  • Reorganize your online filing cabinet – here’s a great beginner article about files and folders, and here’s a short video tutorial from Expert Village on organizing files in Windows.
  • Delete unneeded email or understand archiving – here’s a website with information on using AutoArchive in Outlook (me again.)

What’s your secret weapon to getting/staying organized and ahead of the information deluge?

Posted in: Learn This: Technology Answers

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Learn This: Game Systems for Those Of Us Who Don’t Know the Difference Between Nintendo, Sony and Microsoft Consoles


Twenty years ago we bought our son a Nintendo.  That was the last time I felt up-to-date on the game system world.

Today gaming isn’t just for kids anymore.  It’s for kids and adults of all ages; it’s for fitness, eye-hand coordination, relaxation, sports improvement, strategy-development, cooking and much more.  I recently asked my 21-year old daughter to give me some insight into the current world of gaming.  Here are her descriptions of the three competing gaming companies and her comments on each.


  • Japanese Company
  • Translated from Japanese to English, Nintendo means “leave luck to heaven.” (Potential Jeopardy question.)
  • Product evolution is Nintendo (NES), Super Nintendo (SNES), Nintendo 64, GameCube (GCE), Nintendo Wii (pronounced “we”) which was introduced in 2007 as the world’s first interactive gaming system.
  • Handheld players evolved from Gameboy, Gameboy Color, GameBoy Advanced, GameBoy SP, to Nintendo DS (Dual Screen.)
  • Least expensive systems.
  • Most famous game of all time from any company is made by Nintendo: the Mario series.
  • Add-ons include the cross-bow and the steering wheel.
  • Comments: More family-oriented; games are colorful and happy.  The Wii took the company from competing on graphics to competing on interactivity.  My favorite games because there’s never been much blood.


  • Japanese Company
  • Product evolution is PlayStation 1, PlayStation 2 and PlayStation 3, introduced in 2006.
  • Widely recognized as the gaming system with the best graphics.
  • More premium systems can play older version games.
  • PlayStation 3 has a Blu-ray high definition DVD player.
  • The handheld player is the PSP (PlayStation Portable.)
  • Comments: I never had a strong attachment to this player; I watched my brother play but never wanted to play myself.  I think the games available are limited.


  • US Company
  • Product evolution is XBox and the XBox 360 introduced in 2006.
  • The XBox 360 has a DVD player and an HD DVD player can be added.
  • Music can be uploaded from CDs and can be listened to regularly or instead of game music.
  • MS introduced the Halo series, which is a first-person shooter game and is one of the best-selling games of all time.
  • The system allows play by Internet with players around the world.
  • No handheld is currently available.
  • Comments: Cool that you can play your music through it, but I despise Halo because of its violence.

Now go impress your kids, your grandkids, your neighbors’ kids, and that new doctor you just hired.

Posted in: Learn This: Technology Answers

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Prepping for a Microsoft Field Trip: Watching House Calls for Healthcare Professionals


Yep, I’m heading to the Microsoft campus this week to take part in HUG, the Health Users Group Conference. I’m doing my homework and trying to get the most out of my visit by catching up on what Microsoft is doing in the healthcare sector.

I found two great videos by Bill Crounse, MD (hope I get to meet him!) talking about the cool stuff going on at Microsoft Research. Bill is Senior Director, Worldwide Health for the Microsoft Corporation and according to his site HealthBlog, he is responsible for providing worldwide thought leadership, vision, and strategy for Microsoft technologies and solutions in the healthcare provider industry.

It takes a few minutes to download these videos (about 15 minutes long to view each) to your favorite player, but it is worth it, IMHO. I will also consider showing these videos, particularly the 1st one, at my next staff meeting as something to stimulate ideas and give everyone a flavor for what our future might be.

Look for links to his videos in his post and at the bottom of his post: Microsoft Research: How we watch the computer, how it watches us

I’m going to take a leap of faith and try to record a video during my two days at the HUG Conference. Check back to see if I’ve been successful!

Posted in: Innovation

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Nuance (Dragon) Comments on Blocking the Consumer Edition from EMR Integration

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©Lidian Neeleman/Dreamstime.com

My August 20th post (read it here) noted that Dragon voice recognition software has been quietly gaining acceptance as a mainstream solution to hefty transcription costs and EMR integration. 10% of the healthcare providers in the United States are currently using Dragon Medical.

Yesterday, HISTalk noted that:

At least one doc is unhappy that Nuance has blocked the use of Dragon Naturally Speaking with EMRs in Version 10. Nuance states “…we found that some large hospitals were using the consumer editions of Dragon and not getting the accuracy, quality and manageability that would be achieved when using Dragon Medical.”

Nuance responded on HISTalk via comment, saying in part:

“Nuance has made a significant investment in building, tuning and distributing Dragon Medical for exclusive use by the health care industry. The integration and engineering required to deliver the ease-of-use of Dragon Medical with all major EMR vendors, including Allscripts„¢, Epic, Misys®, GE® Healthcare, NextGen®, Siemens, eClinicalWorks, Meditech, McKesson®, Cerner and Eclipsys®, requires a Herculean effort, comprising thousands of man hours in developing and testing. As one would expect, there is a premium associated with the delivery of this capability and the resources devoted to further hone and evolve the product to meet the specific needs of the medical end user.”

Nuance also points to the Microsoft model of charging differently for enterprise/professional software and consumer software offerings.

I don’t dispute a vendor’s right to charge accordingly for a product that has taken a lot of R & D to bring to the market, but like everything else that has a place in the medical world, it will cost much more based on the healthcare application. A set of plastic drawers for home costs $9.99 at your local store and lists for $99.99 in a medical catalog.

Posted in: Electronic Medical Records, Innovation

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Who’s Using Voice Recognition? 70,000 Healthcare Providers, That’s Who

©Thomas Lammeyer/Dreamstime.com

©Thomas Lammeyer/Dreamstime.com

Five years ago I worked for a physician who used Dragon to dictate his office notes. He put in the time to teach Dragon his voice and successfully dictated, edited, and printed his own notes. He eliminated all transcription costs, and was a favorite of the staff as no one ever had to scramble to find his notes. Not surprisingly, he was my physician IT Champion.

For every physician who was able to make it with Dragon five years ago, there were probably ten who didn’t tough it out. Today there are 70,000 healthcare providers using Dragon, which is an estimated 10% of the total healthcare provider population. What’s the big motivator? One, saving money, which becomes more important every year as there become fewer places to cut costs. Two, direct input into the EMR, which saves time and closes the loop on electronic management of physician assessment and recommendations.

Posted in: Electronic Medical Records, Innovation

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

©Jennifer Walz/Dreamstime.com

©Jennifer Walz/Dreamstime.com

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/Dreamstime.com

©Roxana González/Dreamstime.com

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/Dreamstime.com

©Dennis Owusu-ansah/Dreamstime.com

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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