You work hard for your practice. What steps are you taking to protect your business from someone stealing from you - especially someone who is on the inside? Fraud can cost a medical practice hundreds of thousands if not millions of dollars. According to the Association of Certified Fraud Examiners, the typical organization loses a median of 5% of revenues each year because of fraud. Globally, they estimate $3.7 trillion is lost each year due to fraud.

Small businesses suffer more due to fraud than larger businesses. Those with less than 100 employees are at greater risk. The biggest opportunity is in the small business back office with one or two employees. Preventing fraud is possible, but it requires two important things to be in place. First, you must be financially intelligent. Second, take the following steps to prevent fraud from occurring.

Ways to prevent/detect

Mandatory vacation. Require all employees to take a vacation, at least one full week, each year. It is...

I recently finished a great book titled Rest. In it, the author discusses some excellent points on recharging your mind and body. He provides excellent data and studies to support his points. I think many points in this book may be used to combat fatigue and physician burnout.

Go for a walk. Get out in nature and some fresh air. Enjoy the sunshine. Take walks daily and walk at your own pace. Avoid any distractions. That means no iPods, music, podcasts, or other things to distract you. Approach the walk, not as an exercise thing you must do but as a break for your mind. If we approach it as a physical activity, we might be tempted to bring along some of our work. That’s not the point of the walk. Instead, the point is to let your mind wander and recharge. Just walk and let your mind wander. We actually can renew our minds, bodies, and spirits by not focusing and letting our minds wander. It will be challenging at first not to bring some work along for the walk, but after a few...

I am often asked by graduating residents for tips they can use as they begin their careers. After some thought, I decided I would jot down the ten most essential skills every successful practicing physician should have. 

1. Understand Your Financial Reports. You learned to determine the health of your patients, but do you know how to determine the financial health of your practice? We use lab data to help us determine the status of our patients, and we can use our financial reports in the same manner. The approach and mindset are the same both clinically and financially. Be comfortable with the income statement and know what is on your balance sheet. Understand how those two reports are connected to each other. Data from both of these reports will be used to determine the financial health of your business. 
2. Understand Your Mission and Purpose. You choose a career in healthcare for a reason. It probably had something to do with your desire to help other people....

The most difficult thing in life is to know yourself. - Thales

When you're in a negotiation, it's crucial that you understand yourself and know who you are. By understanding yourself, you will appreciate the source of your emotions and more importantly your fear.

A quick way to determine your personality type is to ask two questions. The first is about your pace or motor. Are you faster paced or slower paced? Do you like to move fast and want everyone else to move quickly as well? Or do you want to move a little more slowly and think some people need to slow down? Take a minute and write down your pace.

The next question is what do you typically focus on - the people or the task. When you're dealing with a problem, do you concentrate on the people involved or are you more concerned with the task that needs to be accomplished? Think about it and write down where your focus lies, people or task.

Now you should have two words written down, your pace and focus. Let's spend a little...

Imagine you have a patient in your exam room. They seem healthy enough. They don’t have any complaints and appear happy. Their body weight looks fine, and the cursory physical exam is normal. You think everything is hunky-dory. Then you are handed a couple of sheets of paper with the results of the laboratory blood work. Now, if you’re a medical student, you glance over the paperwork hoping the report has normal values listed to help guide you. Better yet, the report will flag anything abnormal.

The reports from this lab don’t do that. All you get is a number. What do you do? Do you shrug your shoulders and determine the patient is fine and send them on their way? Alternatively, do you hit the pause button, research and learn how to use the lab results, so you make the best decision for the patient?

A competent physician would take the time to learn how to interpret the lab values and incorporate the data with other findings. You want to solve the real problems...

My daughter’s volleyball team played in a tournament recently. They had fun on the court. They celebrated their victories and laughed at their silly mistakes. When one of them would accidentally kick the ball or bounce it into a teammates head, they all burst out laughing. The error didn't change their mood. It didn't alter their perspective or goals. They shrugged it off and moved on. Their parents laughed with them and encouraged them.

The other team was a different story. This team was ranked higher than my daughter's team. They were probably better players. But they lost the match to my daughter’s team and were eliminated from the tournament. As the other team began to make mistakes, you could see them getting frustrated. When there was a lousy shot or misplaced bump, the other members glared at each other. Blame was beginning to be passed around the court. They took their mistakes seriously. Even their parents were getting angry. One mistake leads to another and...

I’ve witnessed some leaders, young and old, new and experienced, struggle with making critical decisions. They tend to get bogged down with data and fear. I believe fear contributes to a leader’s inability to reach their potential as an effective decision-maker. Fear is normal when we lead and make decisions. If you have difficulty making decisions, here are some tips to help you make decisions and overcome any fear.

1. Ask “Am I comparing the right things? Opportunity costs are everywhere as we make decisions. When we say “yes” to something, we are saying “no” to other options. However, when we are comparing our opportunity costs, make sure you are comparing the right things. The other day I was discussing with a friend a decision he was facing. He was faced with three different options he could choose from in dealing with his issue. As we began to examine the opportunity, I asked, “Are these all three of these opportunities...

One of the most significant disagreements I see amongst partners is the allocation of costs. They typically fight over who pays for how much of the expenses incurred by the practice. As I begin to work with them, I discover they all are not on the same page in understanding what a cost is. A cost is not simply a cost. There are many types of costs. If you want to track and control something such as a cost, you must first understand the nature of it.

What is a Cost?

The simplest definition of a cost is the value of money which is used up in the production of a good or service. It’s how much money you spend on creating your service. Costs may also be referred to as charges, expenditures, outlays, payments, and expenses.

There are two broad classifications of costs in business, fixed costs or variable costs. There are also direct and indirect costs. Usually what people fight over is the allocation of costs, and that involves the fixed and variable costs.

Fixed vs. Variable Costs

Negotiating may be tough at times. It can be stressful. There are a lot of forces that can act against us. When I am working with a client one of the first topics we discuss is the internal negotiation that must occur. Once this first and essential negotiation has occurred, the other external talks become easier.

Most believe the internal negotiation is the negotiation you have with your team, management, and staff. It is correct that we must have everyone working from the same sheet of music in any negotiation. We should negotiate the terms of what we want and what we want to happen next with our co-workers and superiors. This step is critical, so you avoid unknown saboteurs, and you and your team send out a unified message to the other side.

However, that’s not the internal negotiation I am talking about. The most crucial negotiation you will ever have is the internal negotiation you have with yourself. We usually don’t consider ourselves as someone we must negotiate...

Good leaders ask good questions. They do this so they can gain understanding and help those they lead understand as well. Change managers do the same and are always asking questions that will help them implement change effectively. Here are a few questions I ask as I approach any process improvement plan.

1. Does this process support the mission and purpose of the organization? This question first assumes you know and understand the mission and purpose of the organization. That’s the what and the why of the organization. It’s what you do and why you do it. Once you have firmly established the mission and purpose, you can then evaluate the process in relation to the what and why of the company. Does this process help move the company closer to achieving its mission and purpose? Is it required? How strongly does it support the mission and purpose? If the answer is no, why are you using the process in question?
2. Does this process add value? Does this process make a meaningful...