Mitch’s Blog

Everyone has heard the phrase “Two heads are better than one. I’m going to say that, when it comes to being a manager or leader, this isn’t always the case.

One of the problems we have with government is that, sometimes, there’s too many people with too many differing opinions to get anything done. Not only that, but the minority party rarely gets heard at all, and even if they have good ideas, sometimes the other party won’t even allow the recommendation to come to the floor, for fear of allowing someone from the other party to look good.

I have conducted many business meetings in my day, and I learned fairly early on that, though I wanted everyone to participate in the process, in the end I was going to have to be the one to make the ultimate decision. The hope is that, when multiple people give you input on a topic, that you’ll be able to take the good ideas and parse them together to do something good for everyone. But sometimes, you won’t hear anything that you feel is as good as what you are already thinking, and in that case you just might have to go with your first instinct. One would hope, however, that you at least understand the position everyone else is taking, whether you agree with them or not.

And, of course, there are those times when group think actually agrees on something that turns out to be a bad idea, and in those cases one can usually imagine that it was the concept that got everyone on the same page, and not the fact that it was a good idea. If there’s no one with any real knowledge of an issue, then no matter how many ideas are thrown out, most of them aren’t going to be any good. To whit, I share the video below:

I add two things here. One, though I’d have thought this was a terrible idea, the male in me would have probably wanted to see it. Two, I’m betting there wasn’t a single woman on the panel that okayed this; if there was, I bet it never would have gone through.

There have been some amazing transactions over the past couple of days from our president-elect, Barack Obama. They’re unprecedented in history because he’s doing some things now, before he’s even taken the job of president of the United States, that no other president-elect in history has done.

For instance, within a couple of days of his winning the election, he had already named his first member of the cabinet. Then some days later, he held his first press conference, not to talk about winning the election, not to introduce anyone, but to talk about the financial crisis we’re going through now, and even took questions. This was after visiting President Bush at the White House; amazing stuff.

Earlier this week, he held another press conference, where he introduced his new financial team. They haven’t even taken office yet, but suddenly the stock market had its highest two day increase in history, and this was after falling to levels the market hadn’t been to since 1983.

Frankly, this is impressive, and a little bit scary when one realizes that we already have a president who’s still in place. The press conference President Bush had afterwards didn’t come close to generating the kind of publicity that Obama’s press conferences generated; just amazing stuff.

Is this the new face of leadership? Does someone really just grab the reins and run with them, even before they’ve got the job? Can anyone else point to a place in history where something like this has occurred, either in politics or in some other industry?

Truthfully, I’ve gone into consulting assignments and been asked to either take over, or asked for help, which in essence allows me to take over. But I was asked; I have never assumed a leadership position without the express permission of someone else. Is it possible that President Bush and Barack Obama have talked, and even the president realizes that it’s time to take the pressure off himself and allow his replacement to make his statement now, in hopes of helping the country?

I’m not sure what I believe, but I will say this. I’m amazed at what I’m seeing so far, and if President-Elect Obama can be this strong before he’s even assumed the office, we could be seeing the second coming of Franklin Roosevelt. And I must say, there’s nothing wrong with that.

First, the latest T. T. Mitchell Consulting Newsletter, Doing The Right Thing, is now available.

That topic seems to go well with this story, because it shows what can go wrong when people don’t do the right thing. A 19-year old male named Abraham Biggs committed suicide on Wednesday. He committed suicide after signing onto something called JustinTV, where one can talk live with others, said he was thinking about committing suicide, and every single person, 14 in all, egged him on to do it, while hanging out on something called bodybuilding.com. It seems that none of them took him seriously, including the moderators of the forum, even when he took the pills and rolled over, but some time later people realize he was not moving, someone tracks down his details, calls police and paramedics, who then broke into his house to come to his aid. Oh yeah, that was shown live also.

The people who run the site decided not to do the right thing and offer condolences. Instead, they put out a standard message saying this:

As for the broadcaster incident last night, we don’t comment on individual videos, however, our policy prohibits inappropriate content on Justin.tv. We rely on the community to flag videos that they feel are objectionable. Once a video is flagged, it is reviewed and quickly removed from the system if it violates our Terms of Use.

This was stated by the CEO of the company, Michael Seibel. Great way to prove what kind of leader you are, isn’t it? I do understand why companies would be scared to say much else, in these days of litigation and the like, but since we all know that there’s going to be a lawsuit, and his company is going to lose, and some other people might be arrested and charged with some sort of assault or even be implicated for murder (it’s happened before, by the way), one would think the company would have come out being a bit more contrite, offering something more sensitive than this irrational statement. Then again, on some blogs that posted this story, many of the participants who egged him to do it wrote, anonymously of course, that he deserved it because he was usually a pest. Is this what our society has come to?

There are some things you never play with in this world, and one of those is the mental state of someone else. I’m not sure what I would have done at the beginning, but I’m hoping that I would have called someone in this kid’s area and asked them to check up on him sooner. In this case, he did post a suicide note also, and that’s usually a bad sign. Even if the police showed up and he was just talking noise, they’d have taken him in for a psychiatric evaluation for uttering the threat in the first place. Saving a life is much better than possibly being complicit in one.

As for the people who pushed him to kill himself? Many of them have tried to delete their messages and close their accounts. Obviously they don’t understand how the internet or storage systems work. There will be a subpoena, and some people are going to be dragged in front of the media for all the world to see. The CEO, by the way, must have rethought his initial statement, as the company put up a quick memorial to young Mr. Biggs. At this point, it’s probably a bit too little, too late.

There’s no question that healthcare in America is in trouble. However, most of the time we hear about it from the patient’s perceived perspective of not being able to afford healthcare coverage, high insurance costs, physicians not treating them with courtesy, etc.

Well, there are two other perspectives that aren’t heard from all that often that came out this week. One was the fact that, with the economy running the way it is lately, fewer people are having elective surgeries than ever before. Elective surgery is usually considered things such as breast implants, liposuction, and the like, but elective surgery is really any surgery that’s not considered as life threatening, such as hernias, knee repairs, and the like.

This is putting a strain on an already tough healthcare market that saw a misleading news story pop up just a few days before this one. That story indicated that hospitals on average in 2006 made record profits with over a 7% increase. That sounds pretty good until you read the rest of the story, which said hospital expenses on average increased 6%. Thus, a 1% average increase overall, which means that possibly half the hospitals in the country lost money. Yet, when I read some of the commentary on that particular story, all one saw were people saying how greedy hospitals and physicians were; no one seemed able to equate the expense portion at all with how tough the healthcare environment is.

Next comes the latest story, where a survey of physicians was taken, and about 50% of them said they were either going to reduce services they provide or quit altogether. Over 60% said they wouldn’t recommend medicine as a career for anyone. This at a time when the United States has a shortage of internal or family doctors, as well as a major shortage of OB/GYN specialists, although other specialties seem to be doing fairly well. That is, for those physicians who aren’t feeling the pressure of too many patients and too many lawsuits. One finding was that 76% of the physicians said they are working at “full capacity” or “overextended and overworked”.

Healthcare reform of some kind is definitely needed, but it can’t be short sided or one sided. It not only has to take into account finding health coverage for as many people as possible. It has to also: make sure that reimbursements to hospitals and physicians are fair; put a cap on the amount that can be paid out for malpractice when it’s accidental (grading system for physicians is key here); reduce malpractice insurance; and encourage more people to get into healthcare by offering rebates or tax breaks for them to go to school, and maybe having a staggered rate depending on the types of vocations a physician is going into.

It’s not going to happen, of course, but if President-elect Obama needs some ideas, someone pass him my phone number.

President-elect Barack Obama was on 60 Minutes last night with his first in person interview since being elected. Right off the bat, you could tell that there were some questions he just wasn’t going to answer, and it was proper for him not to answer those questions. I’ll tell you why.

Mr. Obama was asked some general opinion questions on some of the challenges he’s going to face when he takes office, some of the problems which are occurring now. He was asked what he would do about those problems, and also was asked if he would change anything that was currently in place once he took office.

There would have been two problems if he had answered the more direct questions. One, he’s not in charge yet, no matter how much some people wish he was. There is still a president in office who’s making policy, and even though, while on the campaign trail, his job performance kept coming into question, sometimes with ridicule, he is still the man in charge, and to say what you’re going to do once he’s not there is disrespectful.

Two, if he had answered certain questions more specifically, what could he do if the current president, upon hearing this, and knowing that he’d had a vested interest in some of the policies that came about during his presidency, passed an executive order that Mr. Obama couldn’t overturn once he came into the office? If you don’t think it could happen, it happens every time a president is about to leave office, usually within the last couple of days. Many different types of things are passed at the last minute under executive order, pardons given, and those things become absolute at times, and didn’t need anyone signing off on them.

It’s always awkward having the person in the job working with, or having to deal with, the person getting ready to take the job. As a consultant who often does interim assignments, I’ve been in both positions, and, for me, it’s always easier giving up the job to someone than taking the job from someone. I’ve been in on interviews where the candidates have to talk themselves up, sometimes at the expense of your being there, because they want the job and know you’re only keeping the seat warm. But once that part is over, because they want to get up to speed as quickly as possible, they’re usually a lot more inviting and social. And, luckily, they see the bonds I’ve established with the employees they’re about to inherit, and don’t want to shake the apple tree all that much before establishing their own roots.

Sometimes leaders have to take a step back because even leaders aren’t always the ones in charge at the moment. Learning how and when to do it is a skill that takes some people a long time to hone. But when you can do it well, you’re more comfortable with yourself, and make others comfortable as well.

First, the latest issue of the T. T. Mitchell Consulting Healthcare Newsletter, 2009 CPT Code Changes, is now available.

At the risk of possibly offending some people, I’ve been wondering lately, as we get near the end of the Bush Administration, how most people would evaluate the leadership of our current lame duck president. To say that the past 8 years have been controversial would be an understatement. To say they’ve been boring would be a lie.

As some of you know, I have a series of CDs that I’ve titled Keys To Leadership, a two CD set on, well, leadership. In the first CD, I talked about six keys to leadership, telling stories that lead to my main point. In the second CD, I talked about the art of communications, then launched into 9 direct keys of leadership.

I thought, instead of my breaking it down, and staying only on topic, I would put it out to you folks to see where you stood on this issue of the leadership of President Bush based on the criteria I’ve listed here. I would ask that you be fair and only evaluate him on these 15 keys, although I really don’t expect it to stay that way for long. Still, it’ll be an interesting experiment.

And now, the list:

1. Position doesn’t make the leader, the leader makes him or herself

15. Don’t be afraid to lead

Okay, let’s see what y’all can do with these.

Yes, the look has changed once more. It seems that the other theme just wouldn’t hold its format, and it finally went bad on me today,even with the update to Firefox 3. I just couldn’t continue having that problem, so I’ve changed to this one, which I think is pretty nice looking, and a little bit different than the norm.

Anyway, I hope you like it, and I’d like to know your thoughts on it. Next time, more good stuff.

When I look back through my blog, I realize that I have touched upon the subject of having to deal with the consequences of one’s actions many times.

The first time was when I addressed the Jennifer Wilbanks story back in 2005 (she was the woman who disappeared a day before she was going to get married, then said she’d been kidnapped by a black man). Then I wrote about it again while telling a story about people asking for raises based on merit, then realizing it wasn’t what they wanted.

The next time I wrote on it, I was talking about a stupid radio DJ who, on his program, threatened to rape another man’s 4-year old daughter, while throwing out racial slurs. Then I wrote about people who believe they can say whatever they want to, yet still retain their privacy; please! And the last time I wrote about it, I was highlighting a week where many celebrities had done and said some stupid things, and wondered why people were angry with them.

It seems like there’s no dearth of information when it comes to people doing stupid things, then wanting to blame someone else for their actions. A day after Barack Obama was elected president, a minor radio DJ in Florida went on the air in blackface, a day after making a crack about seeing a bunch of black people standing in line and fried chicken, and days later was wondering why everyone was calling him a racist. Another news station had its reporter ask Joe Biden on the air if Barack Obama was a marxist, then complained when their access to him and his events was denied afterwards.

Earlier today, a Texas University football player was expelled from his football team for posting an email message he’d receive don his MySpace page. A couple of days ago a soldier was arrested in the city of Oswego, NY, for punching a college student who was happy that Obama had been elected president, and ended up knocking his head into a car and putting him in the hospital. He claims it was an accident; he will lose his career, and possibly go to jail for his stupidity.

I keep wondering when people will wake up and realize that they really can’t just go around doing whatever they believe they can do and not be ready to deal with the consequences of doing it. Everyone knows that you don’t take a hot tea kettle and stick your tongue on it, yet every day someone new is putting their foot in their mouths, or exhibiting some other kind of bad behavior.

Unfortunately, Citibank was incorrect; a major faux pas can’t be saved with a “thank you”. Reputations can be ruined by a moment of idiocy. No America, the world really isn’t equal, even with Barack Obama becoming president. No, you can’t go outside in blackface. No, you can’t pull out your old watermelon jokes. No people, you can’t slur gay people or heavy people or the disabled. You can’t pull out your old Polish jokes, and it’s not helping that you’ve changed them to Russian or French or Irish jokes either. You don’t get to leave your kid in the car in dire heat and say “sorry”. You don’t get to say “I can see Alaska from my house” then cry that no one is taking you seriously. You don’t get to crawl over the fence into someone’s back yard, take a picture, and claim freedom of the press.

Not without consequences. If you don’t care, then live up to it and move on. But if people don’t like it, don’t act surprised. Just hope it wasn’t overly stupid, and move on with your life. Sometimes you get a second chance. Then again, anyone heard from Michael Richards lately?

Every once in awhile, we all get upset or irritated by someone else, and they’re probably getting irritated with you at the same time. It’s hard in both personal and working relationships when this type of thing happens.

In the book Crucial Conversations, they give plenty of scenarios and tips on how to deal with people when one may not have the option of just getting up and leaving, and for the most part I agree with what they wrote. However, I don’t believe that every crucial situation necessarily needs both parties to sit there until everything has been resolved. Sometimes it’s a smart thing to get up, walk away for some bit of time, calm down, then prepare what you need to say, or even prepare for what you may need to hear. If you’re too emotional in the moment, you’ll never hear or understand what someone else has to say anyway, regardless of how it’s been presented.

I also believe that not every conversation that someone believes is crucial to them is crucial to you. Many years ago, I ran into one person who wasn’t happy with a newsletter I wrote about my dad, of all things, because my dad had been in the military. For three or four days this person wrote me long, rambling letters that didn’t make a whole lot of sense, even though I did know from the beginning what this person’s point was. I give it a shot at communicating, then thought about it and realized that this was someone who just wanted someone else to argue with, and it wasn’t going to be me. That he chose an article I wrote about my dad to start this trouble was infuriating enough. So, I stopped communicating, removed the person from the newsletter mailing list, and moved on with my life. Sometimes, people just want to argue for the sake of arguing; they need to argue with themselves.

Below is a video from Keith Ferrazzi of Never Eat Alone fame, and a recent short video he put on titled Know When To Walk Away:

I can’t believe I’ve never mentioned this before, but I have a new website dedicated to answering questions on issues related to medical billing, or the revenue cycle in general. The site is called Medical Billing Answers.

I’ve set it up in basically three categories, though you won’t necessarily see it that way. The first category is specific terms related to medical billing and the revenue cycle and relatively simplistic explanations of each of those terms. The second category are articles that I’ve written, although at some point I might add articles others have written that fit the theme of helping to give information.

The third category is probably the most interesting category of them all, which is what I’m calling Answered Questions. This is where I will post questions that are sent to me, and answer them so that anyone else who might have that same question can come and read, hopefully, a response to something they may have been thinking about also. At some point, if the questions get voluminous enough, I’ll probably categorize the questions and answers in some form.

One thing that’s not a category, which I’ve just recently added, is the option of paying for revenue cycle consulting services online. I’m not going to say much more about it than that, so if you’re interested, please visit the site. I hope it helps those looking for specific answers to specific questions.