Tuesday, February 9, 2010

Even when change isn't easy, it's often worth making.

Providing excellent patient eye care is easy.  Being the leader in your practice is hard.  I wish I had learned more about this 25 years ago.

From Time Magazine.  


Switch: How to Change Things When Change Is Hard

By Chip Heath and Dan Heath; Broadway Books; 305 pages

Whether you're a manager, a parent or a civic leader, getting people to change can be tricky business. In Switch, brothers Chip and Dan Heath--authors of the best-selling Made to Stick--survey efforts to shape human behavior in search of what works.

Lesson No. 1: tell people what you want them to do in a way that will make intuitive sense to them. The U.S. government's Food Guide Pyramid says adults should eat 5 to 7 tsp. of oil a day. Know how many teaspoonfuls of oil you ate yesterday or why you should care?

The Heaths find a better example of a public-health campaign in West Virginia. The message used there: drink 1% milk because a glass of whole milk has as much fat as five strips of bacon. That's specific, vivid and easy to remember when you're in the grocery aisle.

Next, engage with emotions, not just brains. Consider the ironfisted accountant at the Massachusetts Department of Youth Services who wreaked havoc on nonprofit partners by withholding funds unless forms were filed perfectly. When his boss forced him to visit some of the group homes the department funded, he saw the specific kids being helped--not to mention the pandemonium that often ruled--and started figuring out ways to work with the nonprofits instead of antagonizing them.
Or, in an example that may hit closer to home, think about how you would go about paying off a series of credit cards. Mathematically, it makes the most sense to start with the bill with the highest interest rate. Yet the Heaths argue that beginning with the one with the smallest rate is the better approach. Why? You're more likely to successfully pay it off, feel good about yourself and keep going with plan.

Finally, remember that environment helps lead people to act the way they do. When a hospital administrator in San Francisco wanted to reduce the number of mistakes nurses make in administering medication, she realized the main culprit wasn't carelessness but constant interruption. The solution: a bright-orange medication vest that told everyone, including doctors, to leave nurses alone so they could focus. At first, nurses hated the tacky vest--until medication errors dropped 47%.

Even when change isn't easy, it's often worth making.


Read more: http://www.time.com/time/magazine/article/0,9171,1960268,00.html#ixzz0f2p01A49

Wednesday, February 3, 2010

First Impressions Matter

A post shared with me from Ric Munz, OD.  Since 1976 Contacts have become somewhat more mundane but the lesson persists.

As a student, I visited Dr. Bob Morrison in his Harrisburg office in 1976.   I think his reputation as an innovator is well known, but not perhaps as a master of presentation.  


To introduce the first soft lenses to his patient, he had them brought into the exam room on an engraved silver tray in baccarat crystal shot glasses.
   
He held a lens up on his finger and said to the patient: "Isn't this amazing"....and let them admire the lens.

He placed it on each eye and had the patient shut both lids before saying:  "And when you open your eyes,you will be able to see without glasses."

His style was far from my own, but his immensely successful practice, being composed of movie stars & royalty, taught the value of presentation.

---He sold the sizzle.

And from Ted Watson, OD:  Words Matter, Regarding Digital Retinal Imaging.

Regardless of the wording the procedure of imaging the retina regardless of "routine" or "medical" is a very important one.

I know they are only words but how words are used have been known to start a war.

I would suggest that we start trying to change our wording of this procedure from "Routine Photos" to "Digital Retinal Imaging" instead of something like:

"Getting pictures of the back of your eye."  "We recommend getting photos of he back of your eye."  etc.
We are not Olin Mills Studios.

I would suggest that we start using terms that very specifically describe what we are doing.  I don't think it gets beyond the patient's ability to understand what we are doing but in my opinion it does seem to make a difference.  We have been using these terms in the GBlvd DVC for a few weeks, working hard to get away from the use of pictures and photos and moving more to retinal imaging, digital retinal imaging, high resolution imaging of the retina.

Small thing...but can and may make a difference.

To that end, all offices should be using the Digital Imaging Explanation.





Monday, February 1, 2010

CMS Coding Pocket Reference

I came across this handy tool while looking for something else on the Trailblazers Site.

Try it, you'll like it.

Of course to use it you will either need to understand and use either the 1995 E/M or 1997 E/M Coding Guidelines.

Sunday, January 31, 2010

Every Worker Should be the CEO of Something

An article from the New York Sunday Times today that resonated with me.

If you ask your employees to state what their responsibilities are -- and what you expect of them -- and they can answer you without hesitation  I believe that you are 75% of the way toward leading them, and yourself to success.

A major problem with many companies is that employees don't really understand what, exactly, is expected of them.  If a staff member can't answer "What are you the CEO of?" its time to get to work.



Sunday, January 17, 2010

Stem Cell Transplant Restores Sight

Stem cell treatment restores sight to damaged eye.


BBC News (12/22) reported that a UK man, Russell Turnbull, who "lost the sight in one eye in 1994 when he was squirted with ammonia" and "was left with Limbal Stem Cell Deficiency...a painful condition which requires constant treatment," has had sight restored in his damaged eye.

        The UK's Telegraph (12/22, Alleyne) reported that surgeons removed "a millimetre-squared section of" Turnbull's "left eye, complete with stem cells," then grew "it to 400 times that size in the laboratory." Next, they stitched "the new outer skin of the eye...onto the badly damaged cornea in place of the damaged membrane." To date, this "technique, developed by scientists and eye surgeons at the North East England Stem Cell Institute (NESCI), has been used on eight patients," nearly "completely" restoring vision for most of those patients.

        The "procedure has so far been carried out only on those who have lost their sight in one eye," the UK's Daily Mail (12/23, Sims, Hope) reports. However, "trials are already under way on patients who have damage to both their eyes -- and millions could one day benefit from the treatment," particularly those "whose eyes have been damaged by contact lenses, in industrial accidents involving thermal or chemical injuries, and by diseases." Details of the procedure are published in the US journal Stem Cells.

        According to the UK's Guardian (12/22, Sample), researchers said "25 more patients will be treated before the results are submitted to Britain's National Institute for Health and Clinical Excellence (Nice), which could approve the procedure for use in the NHS next year." The UK's Press Association (12/22) also covered the story.


New Years Resolution -- A "Stop Doing" List

Thanks to DeAnna McCall for sending this on to me.  Provides food for thought:

Best New Year's Resolution? A 'Stop Doing' List

USA Today
by Jim Collins

Each time the New Year rolls around and I sit down to do my annual resolutions, I reflect back to a lesson taught me by a remarkable teacher. In my mid-20s, I took a course on creativity and innovation from Rochelle Myers and Michael Ray at the Stanford Graduate School of Business, and I kept in touch with them after I graduated. 

One day, Rochelle pointed to my ferocious work pace and said, "I notice, Jim, that you are a rather undisciplined person."

I was stunned and confused. After all, I was the type of person who carefully laid out my BHAGs (big hairy audacious goals), top three objectives and priority activities at the start of each New Year. I prided myself on the ability to work relentlessly toward those objectives, applying the energy I'd inherited from my prairie- stock grandmother.

"Your genetic energy level enables your lack of discipline," Rochelle continued. "Instead of leading a disciplined life, you lead a busy life."

She then gave me what I came to call the 20-10 assignment. It goes like this: Suppose you woke up tomorrow and received two phone calls. The first phone call tells you that you have inherited $20 million, no strings attached. The second tells you that you have an incurable and terminal disease, and you have no more than 10 years to live. What would you do differently, and, in particular, what would you stop doing?

That assignment became a turning point in my life, and the "stop doing" list became an enduring cornerstone of my annual New Year resolutions — a mechanism for disciplined thought about how to allocate the most precious of all resources: time.

Rochelle's challenge forced me to see that I'd been plenty energetic, but on the wrong things. Indeed, I was on entirely the wrong path. After graduate school, I'd taken a job at Hewlett- Packard. I loved the company, but hated the job. Rochelle's assignment helped me to see I was cut out to be a professor, a researcher, a teacher — not a businessman — and I needed to make a right-angle turn. I had to stop doing my career, so that I could find my real work. I quit HP, migrated to the Stanford Business School faculty and eventually became — with some remarkable good luck along the way — a self-employed professor, happily toiling away on my research and writing.

Rochelle's lesson came back to me a number of years later while puzzling over the research data on 11 companies that turned themselves from mediocrity to excellence, from good to great. In cataloguing the key steps that ignited the transformations, my research team and I were struck by how many of the big decisions were not what to do, but what to stop doing.

In perhaps the most famous case, Darwin Smith of Kimberly-Clark — a man who had prevailed over throat cancer — said one day to his wife: "I learned something from my cancer. If you have a cancer in your arm, you've got to have the guts to cut off your own arm. I've made a decision: We're going to sell the mills."

At the time, Kimberly-Clark had the bulk of its revenues in the traditional paper business. But Smith began asking three important questions: Are we passionate about the paper business? Can we be the best in the world at it? Does the paper business best drive our economic engine?
The answers came up: no, no and no.

And so, Smith made the decision to stop doing the paper business — to sell off 100 years of corporate history — and throw all the resulting resources into the consumer business (building brands such as Kleenex), which came up yes, yes and yes to the same questions.

The start of the New Year is a perfect time to start a stop doing list and to make this the cornerstone of your New Year resolutions, be it for your company, your family or yourself. It also is a perfect time to clarify your three circles, mirroring at a personal level the three questions asked by Smith:

1) What are you deeply passionate about?
2) What are you are genetically encoded for — what activities do you feel just "made to do"?
3) What makes economic sense — what can you make a living at?


Those fortunate enough to find or create a practical intersection of the three circles have the basis for a great work life.

Think of the three circles as a personal guidance mechanism. As you navigate the twists and turns of a chaotic world, it acts like a compass. Am I on target? Do I need to adjust left, up, down, right? If you make an inventory of your activities today, what percentage of your time falls outside the three circles?

If it is more than 50%, then the stop doing list might be your most important tool. The question is: Will you accept good as good enough, or do you have the courage to sell the mills?
Looking back, I now see Rochelle Myers as one of the few people I've known to lead a great life, while doing truly great work. This stemmed largely from her remarkable simplicity. A simple home. A simple schedule. A simple frame for her work.

Rochelle spoke to me repeatedly about the idea of "making your life a creative work of art." A great piece of art is composed not just of what is in the final piece, but equally important, what is not. It is the discipline to discard what does not fit — to cut out what might have already cost days or even years of effort — that distinguishes the truly exceptional artist and marks the ideal piece of work, be it a symphony, a novel, a painting, a company or, most important of all, a life.

Monday, January 11, 2010

Think you are too young or too old to invest for retirement?

As bad as stock market returns were in the past decade its helps to know that you CAN make a positive influence on your retirement investment by taking a few easy steps and staying the course. 

See this interesting New York Times article:  Your Money - For Steady Savers, It Was Hardly a Lost Decade - NYTimes.com  

What I learned:

1. Diversify.  Stocks and Bonds
2. Unless you are better than 99% of the public at choosing stocks or bond funds use Index Funds
3. Invest regularly
4. Rebalance annually

4 steps to a secure retirement?