Mission statements

Mission statements now seem to be an obligatory part of a company's portfolio of literature along with a statement on environmental policy and a brochure selling the company to graduates. But what are mission statements for? How do you know if you have a good one? And can they be harmful? These are questions I have been researching on and off for 10 years.     

How to cope with behavioral interviewing questions.

What should a potential employee do when asked behavioral or highly intrusive questions during the interview? Here are some suggestions to help you be prepared should the interviewer ask you personal or objectionable questions: (1) Take some time for introspection; (2) be prepared to draw the line; (3) complain; and (4) write it off. And remember: A show of determination and setting boundaries in an interview may advance your progress. Coolness under fire is an attractive personality trait.     

Is it change? Or is it noise?

How can you tell the difference between mere noise, and a profound change headed your way? Your gut instincts may not always be a reliable gauge. It takes a long time for most people to become an executive leader. If you are typical, you were raised and trained in a different era, with different expectations. You see things with different lenses. So what can you trust? You can trust first principles. Ask yourself what you know about the reasons that changes are happening in this environment. Then ask yourself about what is being proposed--how does it fit with the roots of the changes in health care and your organization? The three change filters presented here can help you to figure out if it's change or just noise. Ask yourself: (1) what are the changes occurring in the health care industry; (2) is your organization ready for change; and (3) how likely is it that your organization will easily adopt this particular change? These three filters together will help you decide what is a truly important change, how ready your organization is for change, and whether it will adapt to this change with ease or difficulty.     

Putting "teeth" in your résumé

How can physician executives get the kind of management experience they need to move to the next level? Is the MBA the end all or can significant management experience and top assignments impress recruiters and CEOs? Here are some important questions to ask yourself about each job you have held as you prepare to move forward in your career: How did I improve the organization? How did I contribute to greater efficiency? How did I affect productivity? How did my work increase the bottom line? Thinking about these questions can help you put teeth in your résumé and get you where you want to go. When you can answer those questions from your own experience, you will have created a powerful career track record that is likely to impress the next CEO whose staff you want to join.     

Habits of mind for turbulent times

How do you deal with change--in either personal circumstances or in the turbulent health care environment? Do you rail against the variables that seem to put you in the uncomfortable situation, blame yourself, take it personally? Are there ways to start looking at change differently and more effectively? Here's the key: It's all weather. Whatever you can't control, no matter who does it or why, is just part of the weather--where you are right now. How do we treat weather? We try to find out as much as we can about what's coming, but we keep its unpredictability in mind. We prepare for its extremes as wisely as possible. We grieve any losses it causes us, and celebrate the lovely spring days and quiet summer evenings it gives us. And never once do we take it personally, think that the weather is out to get us, or that lousy weather means that somehow we have failed. We just know that its not personal.     

Thriving in change

The turbulent state of health care and the rapid changes that show no sign of abating point to many career-related challenges for physician executives. How can you predict the impact of these changes on your career? What measures can be taken to prevent any negative impact of change? And how can you prevail when dealt a negative blow like job loss? The signs that foreshadow the unraveling of a physician executive's career are described. The warning signs are: Not keeping up with change, losing your influence; getting negative feedback; turning your "concerns" into complaints; the economy working against you; and being blindsided because we think leaders operate logically. Being proactive puts more control in your hands and leaves less to chance. You can prevent being blindsided if you: develop your people skills; get comfortable and involved with e-business; stay abreast of health care trends; pick up the pace; and develop "You, Inc." There is a final component to prevailing over adverse circumstances--find your work-related passion and apply it to your career.     

Watching the falling barometer

How can physician executives create a vision, a strategy, in the face of such overwhelming forces for change? The answer has two pieces. The first is the Weather Channel: scanning the future for warning, for opportunities, for new business possibilities. The second leads us to such questions as: What is your situation? Financially? In market terms? It leads us, as well, back to the question: For you and your institution, what is your reason for being in this business? In other words, what is your foundation? If you can become clear about who you are and what you are here for in the long run, and match that with some sense of the technologies and the political and financial pressures headed your way, then you can begin to create a vision of a future that works for you. In the coming years, we will begin to create entire new ways of doing health care, new roles for hospitals, new types of medicine--and the time to begin the creation is now. If you wait until the hurricane hits, it will be too late.     

The nature of action learning

Action Learning has developed to such an extent that there is now a demand to ‘know’ what it is. There is one way, and one way alone, of getting to ‘know’ what action learning is, and that is by doing it. For those who most clamour to ‘know’ what something might be are usually the victims of an educational system that leaves the vast majority who pass through it ignorant of the meaning of the verb to ‘know’ .... If, for example, I am asked “Do you know that woman?”, it is most probable that the questioner does not ‘know’ what he is asking me. Does he mean “Do I know her name? Or where she lives? Or am I able to introduce him to her? Or what she does for a living? Or do I recognise her by sight? Or have I been to bed with her? And, if so, what progress did I make?...” Thus, with action learning: “Have I read a book about it? Or attended a seminar at which somebody was trying to sell places on an action learning programme? Or visited a set of participants meeting as part of such a programme? Or tried to organise real persons tackling real problems in real time, and trying thereby to learn with and from each other? Or been an active participant myself in such a programme?...” To ‘know’ what action learning is, one must have been responsibly involved in it; since this cannot have been done merely by reading about action learning, it is impossible in this, or any other, note to convey more than the vaguest impression of what this educational approach may be. The day action learning becomes explicable in words alone will be the day to abandon the practice of it.     

IMES: A System for Identifying and Evaluating Computer Models for Exposure Assessment2

Although IMES is apparently a marriage of independently developed modules, the blend is nearly seamless-there are only minor differences in “feel” between the three modules. IMES is well organized and easy to use. There are help screens at every stage in each module. Selection is efficient-queries rarely take more than a few seconds on a 386 machine before a report can be generated. There are a few pitfalls in model selection which are difficult to avoid. Improper classification is one of them. For example, IMES lists MINTEQ as a multimedia model. It would be more appropriate from this reviewer's perspective to classify MINTEQ as a geo-chemical model (for which this version of IMES has no classification category.)One minor concern is that in two modules (Selection and Validation)IMES queries the operator “Do you really want to exit?” or “Exit?” when one simply wants to go back one level in the screening process. It would be less disconcerting to be consistently presented (as is done in the Uncertainty module)with a pop-up menu selection like “Do you want to return to the previous screen?” IMES was an ambitious undertaking that resulted in a useful and important contribution to Exposure Assessment Model community.     

Medicine, management, and me.

What is medical management? How do you learn about it? How do you get into it? Is there a future in it? Is medical management for you? Can you do it? What will it mean to your original plans for your life in medicine? Is it worth the sacrifice? Get comfortable. I have a story to tell you. It may help if you hear about medical management from a medical director who has preceded you. I doubt I can answer all your questions. I can, however, tell you about one physician's visions, expectations, decisions, experiences, and rewards from what can be loosely called "medical management." If you find something of help in your decision making in this account, my telling it is worthwhile.     

Just row.

To learn anything outside of our usual experience is to try on a new way of being. Doing something new--dealing with change--calls for a commitment to be where you are, to be present in the experiment, even while you are uncertain about the outcome. Being present and committed to the moment is as essential in management or self-management as it is in rowing a boat. How, for instance, can you tell the difference between intuition and fear? In the midst of a crisis, a change, a white water passage, a "learning opportunity," what if you get this gut feeling that something is wrong? If the feeling goes away when you drop into the present, into your body, and "just row," it's not an intuition, it's fear. The opportunity is to know the difference between opinion and intuition, between judgments and experience. Because judgments and opinions carry extraordinarily high price tags.     

Health care futures, Part 1. The emergence of the new health care consumer. Panel discussion

In Part 1 of this second annual panel discussion, six experts examine the new health care consumer. The whole concept of the patient as consumer still makes people uneasy when it's applied to health care. Whether you prefer consumer, customer, purchaser, end-user, ultimate buyer, or beneficiary, one thing's for sure: Many of us are as different from the bygone patient as an HMO is from the general practitioner who made house calls. One of the reasons for many Americans' new interest, knowledge, attitudes, and expectations about health and health care is the Internet, the second topic in this discussion. In Part 2, physician executives from the three leading physician practice management companies (PPMCs) join Jeff Goldsmith, Barbara LeTourneau, and Uwe Reinhardt for a spirited exchange about this burgeoning new industry in the American health care sector. They will tackle questions such as: Are PPMCs delivering what they promise? What will separate successful PPMCs from the rest? Can PPMCs meet Wall Street's earnings expectations and also help physicians deliver better care? When PPMCs win, who loses? And, what roles will physician executives play in PPMCs?     

Can the patient be the focus of managed care?

If the question were simply put: "What is it that succeeds or fails to meet patients' needs in managed care?" Dr. John M Ludden would have a short answer. "It depends. Success depends on whether you are talking about individuals or about populations of patients. And it depends on whether you are talking about meeting patients' needs or their desires. It depends on whether you're talking about well patients or sick patients, young patients or older patients, new patients or established patients, rich patients or poor patients. And it depends on your ability to balance each of these qualities." This article explores how to translate high-quality care for a population to high-quality care for individuals.     

The three R's of writing: reading, "riting," and risking

The mere thought of writing an article can be intimidating. But, even if you have the desire, despite the fear, to write an article, how do you get started? How can you produce satisfying work? Is there a way to begin writing, get your ideas down, and save judgments and editing for alter? Here are some steps--Reading, "Riting," and Risking--to help you write that article you've been thinking about. By separating the process into two stages, creativity or freewriting, and then criticism or editing, you'll find writing much easier.     

Are you obsolete?

Are you vulnerable, regardless of length of service at your organization and your unique skill sets? There are ways to test vulnerability and assemble some hard evidence that your management role makes a difference. You need to conduct a self-test for obsolescence. Ask yourself the following questions: Are your skills state-of-the-art? As a manager, how do you compare with others doing the same, or similar, job at competing organizations? Is your role essential? Where does your job fall into the big picture? Can you be replaced easily? If a thorough examination of your skills and your role convinces you that your contribution returns more to the organization than your salary, can you prove it? Consider these strategies: (1) Put together a portfolio, (2) ensure your boss' support, (3) advertise your successes, and (4) cultivate recruiters. The best reason to analyze your value to the organization is that if you are laid off, getting another comparable job--or a better one--will be far less of a hassle.     

Will you be ready when the pink slip arrives?

Are you prepared to ride the waves of change? Will you be ready when the pink slip arrives? Health care executives who can jump a little higher and run a little faster will go further in the draft. Those of you who are prepared for change will always be appealing to recruiters and prospective employers. How can you ride these turbulent waves and not capsize? This article explores some suggestions for positioning yourself: Proper positioning with the inevitable changes in mind will help you move your career in a forward direction.     

New, customized news

How can you get the news that you want, when you want it, no matter where you are? The idea of customized news is indeed new. Instead of sitting passively in front of the TV or turning the pages of your newspaper, you can program your computer to search for the news that is of interest to you from myriad sources. The idea of getting the news as you like it is all a product of the wonderful world of cyberspace. Browse the Web and find out if these news services are right for you.     

The purpose of a job interview is a job offer

Perhaps empathy has been overdone in recent years. Most of us would admit to some cynicism or disbelief when we hear the words, "I know how you feel." Having said that, however, I actually do know how you feel. If I can't identify exactly where you are coming from, I do know where you are likely to be going and how bumpy the ride is likely to be. I'm a physician and a physician executive. I am also an executive search consultant who is daily in the field interviewing physicians who may or may not be the right individuals for a client's situation. If I don't exactly feel your pain, at least I know its sources. I know how difficult it is to make the move from challenging clinical work to an administrative role in health care. While, as a group, physicians are multiskilled and multitalented, it's an unfortunate fact that some of the skills and talents that made you an excellent physician may be blocking you from succeeding in an executive capacity. My hope is that, through an occasional entry in this column, I can share my experiences and relate the remarkable wisdom of the impressive physician executives whom I meet every day. The first issue I'm opening up for discussion is employment interviewing: Why the interview is so important, what the interviewing process is, and how you can become more adept in this critical skill area.     

Life after retirement. Interview by Barbara J. Linney

Are you thinking about retirement? Here are interviews with four physician executives who have made the transition. Some are recently retired, while others have been retired for many years. The good news is that all of them are productive and exploring interests and hobbies that their careers had taken precedence over. All of them were asked the following: (1) How have you felt about retirement? (2) What are some interesting things you've done? (3) What advice would you give to others who are planning for it?     

Influence by learning how people process information

To have a successful career in management, you have to pay more attention to refining your communication skills than you ever thought was necessary. In a survey of 100 physician executives, 94 percent felt training was needed in communication skills if you are thinking about becoming a physician executive. When recruiters talk to us about the basic requirements for physician executives, one of the things they say the person needs to have is excellent communication skills. Most people have good communication skills, but what can move you into the category of excellent is paying careful attention to how the person you are talking to processes information. You can only do this if you listen before you do much talking. What do I mean by processing information? When we get up in the morning, the world is out there separate from us. We have to take in information about that world and make decisions all day long. We don't all do this in the same way. In this article, I am going to discuss four ways to process information.