Why don’t more doctors blog?  This perplexes me.  There are a ton of shows on television – notably House – that celebrate the think ing process and internal monologue of doctors.  Yet where are the real-life guys and gals using this inexpensive and relatively effective form of media?  Better yet, why aren’t medical writers creating blog content for doctors?  Please post your ideas because this one has my brain in a knot.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

How is your health?  When did you get your last physical?  What are the key metrics for your health success?  Will you make it to age 100? …age 80? …next week?  If you believe that the mind and body are aware of each other, then what is the subconscious part of the brain to assume if the body is breaking down and out of shape?  So why bother pursuing any other form of success if you can’t manage to keep your body consistently at high energy?

The best predictors that consulting clients will fail to meet their outcomes are (1) poor, undermanaged health and (2) a lack of supportive relationships.   Not surprisingly, the biggest business breakthroughs come when doctors revamp their health and/or relationships.  You may have heard Tony Robbins (I’m a fan of Tony) describe a concept called the “Wheel of Life”, where the major areas of your life are broken down as follows:

1. Physical health

2. Spiritual/religious connection

3. Spouse or significant other

4. Family and close friends

5. Job, profession or avocation

6. Money and investing

The wheel is drawn like a pie into six sections with each key area corresponding to one of the sections.  Give yourself a score from one to ten in each of the six areas.  Then draw your wheel so that the size of each section is proportionate to the 1-10 score.  The message is that if your wheel is not round, your life is out of balance.  Reallocate your time and your resources to even out the distribution.  You’ll attract better people and opportunities into your life if you do.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Just do this – your portion will only take about 15 minutes a day for two weeks. 

1. Get your staff to write down everything they do in your practice

2. Make a list of all the process in your practice – then prioritize them in terms of most to least important.  You will probably have categories and subcategories.  For example, telephone answering is a process, but auditing the phone quality (customer service, # of rings until picked up) is a subcategory of telephone answering.

3. Go back to your staff and have them write what 3 things they would spend the bulk of their time doing ideally.

4. Have each person write out the procedure for how they do what they do – starting with the things they like the best or are really good at.  

Now that you have this data, you are ready to do a process redesign in your practice.  You may want to get some help from here so you are putting best-in-class solutions into your practice.  It would be a waste of time to go back and redo everything the same way.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

My wife and I were talking about how the television show Jersey Shore was renewed for their second season but Tony Robbins’ show was cancelled after two episodes.  So as a nation we prefer Snooki to Tony.  What does that say about our IQ and our EQ (our level of emotional intellgence)?  Is it fair to say that we would rather be entertained than challenged to become a greater person than we currently are?

Sales trainer David Sandler talks about a concept he coins “okay-not okay”.  Basically he says that people feel more comfortable around someone who is not doing as well as they are.  When people are confronted by someone more successful than themselves, they emotionally “tighten up”.  Sandler says the guy at the airport dressed in a Valentino suit and alligator shoes whose flight is delayed will get less help than the guy carrying the suitcase with a string wrapped around it who says this is the first time he has ever been in an airport.   

Tony Robbins says that we are an emotionally unfit nation because we have not been tested.  There has not been the same  level of emotional challenge that there was in the 1930’s and 1940’s when a great depression was followed by a world war.  Robbins also says that in times of crisis you do more of what you already do.  So if you are a fearful person, you get more afraid; if you are an angry person, you get madder and if you are a doom and gloom person you become more certain that this really is the end.

The qualities we need now are confidence, ambition, creativity and vision.  The intensity of our current test is going to increase because we have financial instability – that is a fact of life.  Tony Robbins wants you to recognize that you are in charge of your life, not your emotional pattern.  He wants you to learn what your emotional pattern is, model people who are doing more of what you haven’t learned to do yet, and help people who are not doing as well to train you to feel grateful for what you have.  Snooki wants you to have a beer and a smoke, be yourself and mind your own f***ing business.

America has voted and the results are  in:

Snooki 1, Tony 0

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at http://www.ultimatepracticebuilder.com/.

The best way to build your practice is with the help of your existing staff, such that they do 80% of the actual implementation.  Here’s how it works:

1. You determine which function of your practice needs the most attention based on feedback from patients, a benchmarking of your financial performance and your gut feeling on what is the biggest pain in your practice.  (Trust your gut feeling but don’t be overly reliant on it,  especially if objective data contradict your gut.) 

2. You write a plan to improve the processes attached to that function.  Start by having your staff document what they are already doing and also have them identify where the bottlenecks are is in those processes.  Take this process plan to your consultants and managers and have them revise it as though they had full ownership of the redesign.  

3. You approve the final redesign after reviewing and analyzing everyone’s input.  Take questions and problems back to your consultants and managers for them to solve until you are satisfied.

4. You brief your staff on the redesign, give them timelines for implementation and charge them with full implementation.

5. You regroup the implementation weekly at a 1-hour staff meeting that does not take place during regular patient care hours.

6. You audit the process (with your managers help) for 6 months and bonus everyone on reaching the approriate benchmarks.  This is the critical step.

Try this process.  Start with something simple and practice on a couple of functions or processes to get everyone comfortable with the process.  Since your staff is going to have to operate these processes, they should be the ones to implement them.  You can also give your staff feedback on the process redesign – but never, ever, ever give them full authority for the redesign.  You can never delegate 100% of the process redesign to anyone, even your most trusted manager or consultant.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com

A business isn’t you do everything and hover over everyone and correct them as they go.  A business is you training people to do the things your practice needs and having an auto-pilot method to audit their performance and provide training if (when) they repeatedly deviate from the methodology.  Do you have a business or are you a one-man band? 

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

The best way I know of to help a practice is to use benchmarking.  Let’s face it, as doctors we are very smart and very opinionated.  It’s hard to listen to other people, especially if they don’t know as much as we do.

However, the way to success is to surround yourself with people who are smarter than you in the crucial areas so they challenge you to become better.

At Ultimate Practice Builder we compare your practice to similar US based practices and see where you are stronger and where you are weaker.  Then we have an objective basis to understand the best way to move your practice forward.

I think this is critical given the current healthcare challenges. (I hate to use the word ‘crisis’.)  Many people think the small independent practice will go away in the not too distant future because they will not be able to survive financially.  That would be a shame for me because I am much too independent and stubborn to work for someone else.  I am totally unemployable, if you want to know the truth.

If you have a medical practice and you are interested in the benchmarking data we provide, email us to find out how you can get that for your practice at no charge.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

There is a really useful book that I encourage my clients to read called, “What To Say When You Talk To Yourself” by Shad Helmstetter.  You can buy it on Amazon at  http://www.amazon.com/What-Say-When-Talk-Yourself/dp/0671708821.  I don’t know Mr. Helmstetter personally but I am a fan of his book.

Helmstetter’s point is that the subconscious part of the brain hears and records everything you say to yourself.  When you think, ‘I’m not going to do X, I’ll probably make a big mess of things’, the brain records that information, takes it as fact and goes to work to ensure you fail big time if and when you ever have to deal with X.

Goals are really operating instructions for the subconscious part of your brain.  It’s going to do as it’s told anyway, so why not load it full of interesting and exciting possibilities?

The best way to use your goals is to set them for the next year and write them out at the beginning of each day, essentially reprogramming your brain to find ways to make them happen.   

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

People who know me understand that I have something of an obsession about marketing for medical practices.  In most practices, marketing is not done as well as it should be.  Worse yet, a lot of the people who claim to be able to help doctors with this, really don’t help.  They may do great creative work (at high cost) but most marketers aren’t paid tied to results.  If they were, the industry would probably look vastly different.

What constitutes good medical marketing?  Whatever earns its keep.  My criterion is that each campaign must at least pay for itself within 90 days of implementation.  That means you have to track results against cost.

My creative side would love to design and test out 100 new bold, innovative and creative ways to get your name out there.  But really you don’t need 100 ways to do that.  You only need a few – but once you have them, optimize them to ride them for everything you’ve got.  

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

A lot of big, impressive-sounding words are thrown around when it comes to strategically analyzing a practice.  Rather than getting stuck in your own or someone else’s ideas, here’s a simpler way.  Give your practice  a score from 1-10 (10 being perfect) at how you rate in terms of the broad categories of finance, marketing and operations.  Then improve whatever you are weakest at until that is no longer your weakest area.  Then move on to the  next weakest area and the next until you are at least an 8 or a 9 in each of the 3 aspects.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.