Archive for August, 2009

Getting Money… Finding Money… Saving Money

August 29th, 2009

As a hospital CEO, one of the greatest challenges that I faced was that of resource allocation. Because my personal goals included making our organization:

  1. A facility that became recognized for its very high quality physicians
  2. A Planetree facility where you never had to “leave your dignity at the door”
  3. State of the art in every technological area
  4. The employer of choice in the area

…our financial challenges were sometimes overwhelming. This hospital was located in an area where the average salary was only $22,000 a year, the population continued to decrease, and there were three other hospitals within about eight miles of this facility.

money craneDue to these very real financial challenges, many of my nights during the eleven years of my presidency were sleepless ones. Consequently, it has become my personal mission in my consulting efforts to help remove the barriers for my former CEO peers so that they can meet their personal goals through a “Get, Find, or Save” philosophy.

Under the “Get new sources of funding” category, one of my successes was that of creating alternative solutions to very challenging problems. Many times we found new financial resources by following the “Road Less Traveled.” Although not all of these journeys were fruitful, the ones that were deserve to be replicated, so that other CEO’s might generate funds for their organizations using knowledge learned and perfected through these personal trials and errors. Included in this list were efforts in areas such as sophisticated diagnostics, the use of new high technology modalities, high-touch integrative medicine, special packages for wellness and prevention, a community workout facility, the use of molecular testing, and many more.

The “Find” portion of this equation comes from my associates at SunStone Consulting. Their particular skills and talents learned through years of work with the largest accounting firms have resulted in unique, proprietary software and knowledge that allows them to uncover monies already generated by your organization that otherwise might never be collected: Worker’s Comp, Transfer DRG’s, Pharmacy Charge master analysis, and a half dozen more areas bring these funds straight to your bottom line.

SunStone275

Finally, the “Save” piece of this puzzle is coming from a dozen new ideas, products, opportunities, and technologies that until very recently were generally unknown. Everything from software that provides your physicians with Continuing Medical Education Credits for researching their own patients to new Hazardous Medical Waste Recovery to FDA-approved technologies to identify wounds that have not yet manifested themselves. All of these are on the pallet for potential use in a hospital or clinical setting.

As the Executive Director of a 501(c) 3, nonprofit organization back in the early 1980’s, I remember hearing for the first time a hard core description of the personal qualities that should be considered by the executive when looking for a board member. While the original board member recruitment philosophy had been to seek out people who would either Work for or would bring Wealth or Wisdom to the organization, this particular advisor said, “We are looking for people who will Give Money, Get Money, or Get off the Board.”

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Well, if you are looking to find already-earned yet not collected resources, to create new resources, or to work with companies that bring you extensive savings and value, or if you are just looking for a little more sleep, look to those who have successfully navigated the white waters and thrived.

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Posted in Healthcare, Hospital, services

Nine Trillion Dollars in the Hole?

August 22nd, 2009

Let me be the first to admit that I was and am all about change. Change has been the only consistent thing in my life.  Today, however, when the deficit projection was revealed to be nine trillion dollars over the next ten years, my non-economist mind began to wonder where this is all going?

My son-in-law is coming home in the next several days from a one year deployment that saw him in harms way in Iraq for the last eight months, and now we all sit with our fingers crossed that we will not be facing a similar deployment not too many months from now to Afghanistan.

How does one maintain two wars, keep soldiers stationed post-World War II in Italy, Germany, and Turkey, to name a few, and in South Korea plus continuing to remain in Iraq, and now push more and more into Afghanistan without bankrupting this country?  Is it possible that very very smart people are not capable of figuring out that in a down economy, the finances will continue to go south until we are, like the USSR in the Cold War, going broke?

When do we begin to see that the previous several administrations lead us into a mindset of borrowing against our future to the extent that we may not have a future, and when will we say, “Okay, enough, let’s stop feeding trillions into wars, and start trying to figure out the rest of this economic equation?”  It clearly is no longer a war on terror, but what is it?  If it is an economic war intended to create jobs a.k.a., the argument for or against the F-22 cuts, can’t we find a better way?

health_debate_specterThe people who seem the most upset about the health care debate are clearly the people who have healthcare, and the people who are least likely to speak out are the young women and children who have no coverage.  Not only will they not speak out, they also don’t, for the most part, vote.  If anyone believes that we are not in some way paying for the 46 or 47 million uninsured now, they are clearly delusional.  Ask a hospital CEO how much the facility charges for an aspirin or a Q-tip.  It’s not because these items cost so much more in a hospital setting, it’s because there is not enough money to go around when patient after patient presents at their doors without healthcare coverage.

We have acquiesced to AIG, to the very large banking institutions, to the automobile manufactures, and to numerous major financial houses.  We have placed billions of our tax dollars into their hands and have watched as their CEO’s, like that of AIG, continue to make millions in salaries with millions more in bonuses.  We have continued to wage wars that were clearly called “Republican Wars” during the last administration, and have no name now.  And we are watching our Social Security and Medicare accounts dwindle more quickly than anyone could ever have imagined.

Far be it from me to take a political stand on such complex economic matters, but it does seem very certain that our futures are tied inextricably together and, unless we slow down our expenditures, find ways to be more fiacally responsible, and, take care of our fellow man, we seem to be heading down a very destructive path.  Alan Greenspan’s admission of missing the economic targets of not too many years ago rings in my ears as he said, “I underestimated the greed.”  Maybe we have all underestimated the greed for too long.

As a professional giver of advice, let me conclude by saying that we can make this work. We can pull back the reins, slow the spending, and still move the economy.  It’s no different than managing our own personal economics; live below your means, save, take care of the necessities, and realize that not all belts can wrap around a 44″ waist. But all of this takes some serious discipline, something that our leaders seem to have been missing for a very long time.  We can’t continue to talk our way out of trouble;  serious, positive action is the key.

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Posted in Healthcare, Public Policy

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Thinking at the Beach

August 13th, 2009

In January, my journey to create a new division for SunStone Consulting, LLC, began, and, with the economy in a deep slump, it appeared to be a journey fraught with almost insurmountable challenges.  How does one begin a new division during a time when most organizations were digging deeply into self-preservation mode?

Photo credit: Generation Y Travel
Outer Banks, NC | Photo credit: Generation Y Travel

The first concept that we explored was to help organizations, groups, councils, and associations assist their members while providing either a stream of income or discounts for these organizations.  Several companies responded positively to this idea: Chambers of Commerce, Hospital organizations, and others signed on for involvement in these relationships.

By March, nearly 20 companies had come on board and 12 more have followed since then.  We brought on two additional marketing specialists to assist us with these contacts.  The areas of interest ranged from Environmental to Government; software to construction projects, from hazardous waste to  fund raising, building quality initiatives into employee job descriptions; and economic development to educational training for management.

Once it was clear that this component of the new division was going to be functional and effective, we placed our focus and emphasis on direct consulting, which, due to the economy, was a much greater challenge.  This effort started very slowly as organization after organization expressed sincere interest but most also faced serious budgetary challenges.  Of course, for SunStone Consulting’s other financial divisions, because they specialize in finding the money that typically was already earned by the hospital or assisting with compliance and billing issues, business remained strong.

telemedicine_connectsDuring this time some very interesting assignments appeared including:  a university wellness program, multiple brain-oriented companies, as well as two PTSD, and two combat wound injury-related programs.  This part of the new division is now beginning to flourish with assignments ranging from the military to a hospital-based disaster recovery center, from telemedicine in rural hospitals to development efforts in Indiana, New Jersey and Pennsylvania, and California.

As we move forward into this next quarter, it is clear that the new division will produce results through rewarding relationships for all companies involved.

Some of you have asked me how this effort relates to having been a hospital CEO, and that answer is clear.  As a CEO, my days were filled with challenges, with literally dozens of special efforts emanating from numerous areas.  For example, here is a typical  list of topics dealt with on a CEO’s agenda:   meetings regarding the following:

  • Community Fitness Center
  • Tissue Repository
  • Breast Center
  • Hospice
  • OB department expansion
  • Pharmacy
  • Operating Rooms scheduling
  • Emergency Department
  • a construction project
  • marketing efforts for a new initiative
  • finance

If you can’t multi-task, the position of CEO is not a place to be, and keeping up with these consulting clients is just as stimulating.

By March, nearly 20 companies had come on board and 12 more have followed since then.  We brought on two additional marketing specialists to assist us with these contacts.
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Posted in Development, Healthcare, Hospitals

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Loyalty and The Life of a CEO

August 9th, 2009

Since stepping back from my CEO role, I have had time to reflect upon the toll that a position like that can take on any individual regardless of the thickness of their epidermis. I have come to realize that anyone who is completely in charge of an organization faces many of the same challenges.

CEO_scales256As a young man, I had serious delusions about what it would be like to be in the role of President. It was kind of a Superman fantasy: Yes, I would be kind, understanding, and fair. It would be my further commitment to be honest, forthright, and ethical in every way. My obligation would be to the people and the patients at all levels. My motto would be “Truth, justice, and the American way.”

Then the big day came, and my tenure began. It took about an hour to realize that it was now my personal responsibility to do everything necessary to generate all of the money needed to make payroll for the employees. In an area with a disappearing population base, that was an extremely challenging task, and as the Sisters of Mercy used to say, “No money; no mission.”

During the money quest, the issues of loyalty and fairness were always rearing their ugly heads. Could you, in this very self-centered culture, ever really expect people to be loyal no matter what your commitment had been to them? I would minimally try to play the role of a benevolent, servant-leader.

I was the guy who would reach out to people who needed a break and then provide them with that break; sometimes against the conventional wisdom. What did I expect in return from them?  Simple loyalty. Time and time again, however, those same people who might never have had the opportunity that they were given would turn on me. It became almost predictable.

It took them a long time to believe that they were capable of doing the job that I had personally selected them to take, but usually as soon as they reached their comfort zone they would begin to turn away. Maybe it is just human nature, but even Mighty Mouse would have been disillusioned by this recurring situation.

The other CEO reality is that fairness is situational and so subject to interpretation that it becomes impossible to please or satisfy everyone. The nature of our new collective employee psyches seems to be one of “If it’s not done directly for me, then it’s not fair.” The list of individuals who were brought to the leadership stage over my 22 years in healthcare was voluminous. Dozens of people were given consideration for their education, salaries, promotions, and advancements, yet if one other person was recognized in a similar way, the hue and cry was often, “It’s not fair.”

superman_couch

So, looking back over two decades of running hospitals, foundations, a research institute, and several other spin-off companies, an appropriate summary for any future leader is to “go with your gut.” With that in mind:

You are not now and will never be a superhero.

You are a human being with human frailties.

You cannot right the world or repair dysfunctional childhoods, marriages, or lifestyles through your benevolence.

However:

You can do what you believe will result in the most good for the most people.

You can respect the fact that your efforts could help to continue payrolls for hundreds or even thousands of families.

You can embrace the fact that the vast majority of your mistakes will not be fatal to anyone, but you also need to learn to cut your losses and deal with the disloyal.

One of my mentors used to pull me aside periodically and say, “Nick, you’re doing a great job, but you need to lighten up. We only pass through here once. So, try to enjoy yourself, my friend.”

Now that was good advice.

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Posted in Healthcare, inspiration, Leadership, Motivation

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