Over the past month, two of my blogs have focused on decision-making. As you may be aware, I do talk to many people in the field, and I try to find patterns in the stories I hear. A troubling one is re-emerging. Like all things, the profession of O&P seems to be cyclical in nature. History surely repeats itself!

It’s ironic, this blog. Ideas come to me and I can write, but sometimes I suffer from writer’s block. A theme I can get connected to generally emerges and I can go to town. This week I was suffering, that is until we got take-out Chinese food last night! After dinner, we did the obligatory fortune cookie thing, and one “fortune” about decision-making stuck out.

In this blog, since getting paid for what we do is fairly important to most of us, I want to focus a little on a critical, but often overlooked communication opportunity.

In his book “Blink,” Malcolm Gladwell describes how we “think without thinking:” how we make choices in the blink of an eye that really are not as simple as they seem and that are nearly impossible to explain to others. In a similar vein, we are often told to “trust our gut” when making business or even patient care decisions. There is a lot of evidence to support the success of those snap decisions, but there is a major caveat.

Lately, my conversations revolve more and more around personnel issues. From probable scams to personality incompatibility, HR challenges can take their toll. Of course, each case is different, but there are some steps we can take to help mitigate any negative ramifications of what can be emotionally charged challenges. As an employer, you are expected to know certain things and behave in certain ways. As an employer in the health care field, you have Federal and State agencies creating requirements for you. Probably the most important thing you can do is…

The World Health Organization noted that the global prevalence of depression and anxiety increased by 25% in the first year of the COVID pandemic. In March of 2023, KFF reported that 90% of US adults believe the country is facing a mental health crisis. I don’t know about you, but I have not seen 90% of the adult US population agree on anything in a decade or two. We see it every day. Last week I talked about the weariness we see in O&P. I think a lot of this stems from the fallout of the COVID catastrophe. In addition to the obvious issues, so much of our community was torn asunder.

Often, we use those terms interchangeably, but I believe there is a significant distinction. As I talk with owners and managers about the state of the profession, more and more I hear confessions of being tired. I get it. I vividly remember, early in my days of O&P, standing in Kathy Dodson’s doorway at AOPA telling her about my plans for dealing with CMS and how we were going to change the world! She looked at me with a wry smile and said she remembered feeling the same way when she first got started in government affairs for AOPA. She said she admired my confidence but warned me that CMS is a machine “designed to wear you down.” It will tire you out.

For the most part, we are very small businesses. We do not have HR staff or even a single HR expert on our payroll. The owner does it all. We are pushing marbles uphill every day, and it is nearly impossible to keep up with everything. Then something totally unbelievable smacks you right upside the head. In employment law, there are many little things you can say or do that add up to really big consequences. You are probably not even aware that what you are doing is potentially putting your company, and your life’s work, at risk.

I hope you had a great Independence Day celebration when we are reminded of the struggles, we as a nation endured to gain freedom and assert our individual rights. Among those is the right to do stupid stuff. Wait, really?

This weekend I was doing a little extracurricular reading and ran across the name “Cesar Millan.” Cesar is perhaps best known as “The Dog Whisperer.” On his website, there is a tab on “Dog Psychology,” and in that tab is a feature called “10 Principles for Achieving Balance.” Principle 3 is “Know the difference between story and truth.” Imagine my delight when something random ties into something I had just written. Cesar says that “humans tell stories, while dogs tell the truth.”

If you interact with society today, you probably sense that there is discord in the social structure. Without judging right or wrong, it is clear that there are differing world views and those differing world views are often at odds with each other. Our workplaces can be a microcosm of society, so we are probably seeing some signs of that discord at work. Nearly four and half years ago I wrote about how we can positively influence the culture in our workplace so that there is greater harmony and less discord. I think the concepts in that November 2018 blog are worth another read. I hope you do too, and I hope this week’s blog makes you stop and think, even if just a little. Remember, no matter how much we try, we only have power over our own reactions.

What is the future of O&P? If your office sees patients in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, or Washington, you have an opportunity to secure the future of O&P. I’m not joking. You see, CMS is launching a new pilot project intended to “advance value-based primary care, especially in rural areas and among underserved populations.” I know…we are not primary care…But is there an opportunity for you to benefit? I think so.

Outcomes are more than just for patients. An “Outcome” is the effect or result of an event or process. They can be good or bad, desired or undesired, anticipated or unanticipated. What outcomes are you achieving in your practice management processes?

About a month ago, we held the first in-person Bootcamp since COVID. The response was fantastic, and the people all seemed to like the way we structured everything. A key takeaway was a tool to help identify the biggest challenge each person is facing and a process to help solve the challenge.

Do you use Microsoft Office Products in your practice? If you do, your company’s behaviors were probably part of the data they use to compile their annual workplace-productivity trends. They analyzed trillions of Microsoft 365 productivity signals, along with labor trends from the LinkedIn Economic Graph to spot trends that are probably impacting you!

Keeping your data safe can seem like a never-ending challenge. New breaches of health data seem to be announced almost daily, and organizations of all sizes — including the government — have fallen victim to data scams. 

But there is good news on the data security front, too. The migration of many systems to the cloud means that much responsibility for security is now handled by true experts who focus on that task —rather than practice owners and managers who are overseeing a lot of other important priorities. 

There are also a number of quick, easily implemented tactics for reducing many of the most common risks of data loss.

Most of us are in this profession because we are passionate about the care of people who need our services. That passion is a double-edged sword. It is great when it lights a fire under us to do our jobs well, but it is dangerous if it leads us into emotional decision-making. It is incumbent on us to take the time to understand why something happens in the practice rather than assuming we just know that it is due to some intellectual deficit of our co-worker!

Do you ever have conflict in your office when the administrative staff and the clinical staff disagree on who should do what and when? This is not unusual and is not limited to O&P practices. If you have taken nothing else from everything we have been saying at OPIE, I hope the concept of “People, Processes, and Tools as a three-legged stool” has stuck. Without all three working in harmony, your practice is going to be limited in what it can do.  The three distinct aspects of your practice must be working together.  No one thing will let you be great.

CEOs are encouraged to bust silos so often you’d think half their job is driving bulldozers over grain farms:

‘Employees must learn to work with different departments in cross-functional teams!’

‘Lack of awareness and understanding of other’s roles leads to inefficiencies and confusion!’

‘Lack of a “Mission-Focus” creates uncoordinated effort!’

All true, and that’s why the “no-silo dream” is a compelling one for executives. But there are a couple of problems with the dream: Your people are probably comfortable in their silos, and they’re often not working in an environment where they can easily get out of them.

If you read through my past blogs you will see a pattern emerge. I find there are five key principles of effective leadership that weave through the process. And because every article I read seems to have acronyms, I figure it’s time I try it. I think effective, strategic leadership allows you to “stack the deck” in your favor. So the word of the day to represent the key principles is STACT! Read on to find out what that means!