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.     

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.     

Touching what is, touching what might be

How do you master change? You have to master the paradox of changing while staying grounded. To make use of the power living inside any new thing that comes your way, you first have to touch it--not tentatively but profoundly--at the same time that you maintain a firm connection with that which is deepest and most fundamental within you. Here, some ideas on how to create "touch points," the ability to look at a problem or impending change from many different angles, thus broadening your understanding and possible response. A key tactic in creating a variety of touch points is quite simple: Ask a lot of questions. Ask especially the questions that have difficult answers, or for which you suspect there is no answer.     

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.     

Professionalism is judged by appearances ... like it or not

Exploring the larger subject of executive professionalism should include the whole range of behavior issues that affect others' perceptions of you. In this competitive environment, with limited time to manage relationships, physician executives must take control of all aspects affecting their credibility and communications. This is not to suggest that you become the stereotyped, air-brushed news anchor, all style and little substance, but that you create a total package, one in which the "inside" and the "outside" of your presentation are complementary. Focus your attention on how well you have developed these factors as a physician executive: Appearance; demeanor; professionalism; and integrity. To create a "total package," it is helpful to consider the following recommendations: Write "commercials" for yourself and your organization; use every interaction as a selling opportunity; make every context a platform; don't hide from criticism--seek it out; and use every opportunity that comes your way to listen.     

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.     

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.     

From resistance to attraction: a different approach to change

How can physician executives interested in promoting change be more effective at the task? This article explores how to create an attraction towards change, as opposed to viewing change as overcoming resistance. Learning to recognize naturally occurring change, identify attractors, explore the rationality of others' points of view, and reduce risk are clear and constructive insights from research and emerging systems science. Other ideas to consider are: Understand the issues of those you wish to change, create changes that are "exothermic," produce system changes, accept responsibility, learn from failed efforts, and focus on building relationships of trust.     

25 Health care trends. What's hot,what's not,and what does the future hold

As we usher in 2003, America's health care system remains in a chaotic state. Will managed care live or die? Will quality improvement efforts pay off? Are we ready for the next bioterrorism attack? Will the shortage of physician soon rival the shortage of nurses? To help gauge where health care stands today and what the future holds, The Physician Executive asked doctors who serve on ACPE's peer review panel to list the hottest health care trends in the U.S right now. Then, we took the list to three respected health care futurists -- Leland Kaiser, PhD, Jeff Goldsmith, PhD, and Russel Coile, MBA -- and asked them for their insights on the trends. Yes, Kaiser, Goldsmith and Coile are opinionated. Yes, they're controversial. But no matter whether you agree or disagree with their views, the three health care futurists' comments could spark discussions that will help shape U.S. health care this year and beyond. The trends are presented in no particular order.     

The best leaders

Today's movements away from authoritarian leadership emphasizes team development. People are experiencing with a leadership that empowers, rather than a leadership that is, itself, powerful. But how do you become a leader who empowers others? What are the characteristics of "best leaders"? From listening skills to getting feedback and including people in the process of change, effective leaders help others move towards the goal, ultimately thinking, "We did this ourselves."     

The Zen of physician initiatives

Many physicians today feel ravaged by the brutal speed with which change has been occurring. They see the beliefs and practices of a lifetime being abandoned and replaced by the flavor of the month, management du jour. But if you are willing and able to take the brave step of approaching your physicians without an agenda, meeting with them to listen to their concerns, and can also avoid hanging a lightning-rod label on every bright new idea that comes out of the sessions, you'll be on the way to effective new management. This new style is a "Zen" approach (but don't give it that label) that lets real collaboration come into the place that is supposed to be all about healing--the health care organization. From "never call it anything" to "stay with them until they get it," ideas on how to be a Zen manager are presented, with the ultimate goal of truly partnering with physicians and infusing them with a desire to move beyond the frustration and disenchantment they are feeling.     

Why acting managers rarely survive

Can acting managers win the job? Or are the scales tipped so far in the outside candidates' favor that it's not worth venturing into this shaky territory? If you want to be your former boss' successor, take note of the cautionary tales offered here. From power and control issues to strategies for protecting yourself if the unmentionable happens--you lose the position to some outsider--insights are offered on why you should think twice about accepting the acting manager job.     

Becoming who you are.

It's difficult to predict success based only on educational background and career experience, important as they are. More is needed. And one of the aspects that needs to be evaluated is the degree of self-actualization. Self-actualized individuals have worked out their personal issues well enough that their personal life no longer has to intrude into their professional lives and actions. In a word, they are free people. In career terms, self-actualized people are "company people," but not "yes-people." They are executives who have freed themselves to be able to internalize the growth, development, and strategic planning of their organization--because they are able to rise above personal considerations, to shed emotionalism, and see more clearly. Some methods you can use to figure out where you stack up are: Conduct a self-evaluation; identify role models; do what is called "a 360 evaluation."     

公司财务与投资者法律保护研究述评

近年来,财务学的研究发生了一系列方向性的变化,其中之一是"法律与财务"交叉研究思潮的兴起,简称"Law and Finance".从宏观层面看,其主要研究法与金融发展和经济增长的关系;从微观层面看,其主要研究法,特别是中小投资者法律保护与公司财务的关系.文章从微观层面,系统地回顾投资者法律保护与公司财务的研究现状和发展动态,特别是对投资者法律保护与公司财务研究的八大热点问题进行系统的总结和评述,并讨论当前"法与财务"研究存在的两大问题,最后指出"法与财务"未来研究的三大趋势.     

High expectations mirror high stakes for physician executives

Because the stakes in health care are high, physician executives are challenged to meet high expectations set by their CEOs and boards. These may be unrealistic--for example, demanding that physician executives possess expertise in finance or strategic planning. Job stresses for physician executives are specific to the role, but are not unlike those faced by other senior executives. It's a fact that professionals leave jobs for any number of reasons; sometimes, not through their own choice or fault. Thus, every time a physician executive leaves a job, it should not be characterized as "being fired," and not every job-leaving should be taken as a failure. Accept that you may make mistakes while doing the best job you can. Rely on your own value system and integrity to see you through.     

Negotiate the salary you want

How can physician executives negotiate the salary and terms that they want for a new position? The idea of negotiation raises the anxiety level of all but a few people, those who thrive on the thrill of competitive bargaining. Most physicians do not relish the process and view it as a type of conflict. But without knowing what you want to accomplish and preparing to ask for it, you may well leave the meeting frustrated and unhappy with the offer. Determine what you want before you get into an important negotiation. You will get clear on what you want much quicker and you will remember the points better when you talk to the other person.     

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.     

Health care organizational uses of information technology

Let's say that, by having read the many inspiring articles on medical informatics in this issue of Physician Executive, you are now ready to move ahead with some serious applications of information systems in your organization. Or, you were already a believer in the usefulness of information technology (IT), and are wondering how to proceed. What types of systems should your organization be looking at to acquire or build? How should you get to there from here? Perhaps you'll find what you're looking for in what follows--an initial roadmap through organizational "IT Land."     

What kind of feedback are you soliciting?

How can you assess how well you're performing? From benchmarking to finding a mentor, here are some suggestions to help you solicit meaningful feedback to improve your performance. The feedback that's most beneficial isn't an opinion--even the CEO's, although it's important--because it's often the opposite of fact. You need standards against which to measure yourself that aren't tightly linked to your organization's culture, so you'll need to research what's going on with your competitor's employees and network with other professionals.     

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.