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Keys for Adapting to Any Career Change



By Dr. Marty Martin

Regardless of your employment situation, one thing is certain; at some point, your career will change. This is especially true right now in healthcare. It could be a gradual change, such as a job slowly evolving or phasing out, or it could be a sudden change, such as the board of directors mandating a reduction in staff immediately. Regardless of the exact scenario, the key trait that will enable you to reposition yourself and thrive after a career setback is your ability to embrace adaption.

Unfortunately, many people lack a belief in their ability to adapt. As such, they become immobilized by fear when change is apparent. So, rather than adapt their mindset, approach, and even skills, they choose to stay stuck in their comfort zone, even though it’s no longer comfortable at all.

Realize, though, that adaption is natural. For example, when you travel to a location that has a different climate than what you’re used to (such as going from Miami, Florida, to Chicago, Illinois, in the winter), the new weather feels harsh for the first day. But after a few days in the new climate, your body adjusts, and the colder temperatures don’t feel as frigid. Your body and mind acclimate, and you get used to the new environment.

This natural ability to adapt at a physiological level also applies to dealing with changes in your career. You simply need to tap into your natural ability to adapt and apply it to your professional life. The following suggestions will help you achieve that.

Reflect on Your Past: When change is upon you, reflect back on a few times in the past when you overcame adversity. Identify what you had to do to get through those difficult times. Ideally, choose examples from your past work. If you can’t think of any, then go back to your school days and your personal life. If you really have led a challenge-free life thus far, then think about books or movies where you’ve learned about others overcoming adversity.

Once you choose a few situations to reflect upon, determine the actions and attributes that helped you or others in the past. There’s a high probability if you repeat the mindsets and actions that worked in the past, they’ll work for you now as well. This exercise helps you shift your energy from victim to victor. You prove to yourself that success is possible.

Choose to Associate with Like-Minded People: To keep your mindset strong, surround yourself with individuals and groups who support you in doing something different, rather than those who try to keep you chained to the status quo. Of course, this step is always easier to say than to do, especially when your family or closest colleagues are the ones holding you back.

First, assess your transferable skills. For example, if you were a manager whose department closed, your skills likely include hiring and staffing. Look at what other promising or growing positions use those skills, and network with people in those jobs. This enables you to actively make connections with new people in an area that has more opportunity than your current work.

If your loved ones are contributing to your negative mindset, sit down with them and have an honest conversation about the current situation and your options for change. For example, if you realize you need to relocate and your spouse does not want to move, show the reality of the situation. You might say, “If we remain here, we can’t maintain our lifestyle. We’ll have to downsize to a one-bedroom apartment or move in with family. If we relocate, we can maintain our lifestyle, just in a different zip code. What makes the most sense to you?” Be calm and use specifics when you talk. Chances are the loved one will see the necessity for whatever change is needed.

Do Scenario Planning: Write out detailed scenarios about what can happen if you adapt, if you fail to adapt, and if you somewhat adapt. You need to sketch out all three rather than single point planning, because single point planning can set you up for frustration if the plan doesn’t go exactly as outlined.

This sort of triple scenario planning is based on stress inoculation training, which encourages people to anticipate a negative event and explore how they might deal with it in various ways. Should the negative event actually occur, the person has an idea of what to do to overcome it, which makes the negative event less stressful. The scenario planning works a lot like stress inoculation training.

For example, if you’ve been laid off and can’t find a new job in your area, you may decide that your best case scenario, if you adapt, is to find a job you love – one that pays great and offers high satisfaction – albeit in a different part of the country. If you fail to adapt, that scenario may include you moving back in with your parents and working at a low paying job that you hate. And, if you somewhat adapt, perhaps you find a good paying job in your town, but you’re doing work that doesn’t give you much joy or satisfaction.

With these three scenarios detailed on paper, you have the option of choice. Which scenario do you want to pursue? Now, instead of becoming paralyzed with thoughts like, “I don’t know what to do next,” or “Until I figure out what is the right decision, I’m not going to do anything,” you can make an informed choice of the best way to overcome your current situation. If you are involved in joint decision-making with family, share what you wrote with them so they can be part of the process.

Embrace the New Reality: Make no mistake, everyone’s career is going to be affected at some point in his or her life. This isn’t an “if” scenario; it’s a “when.” So, even if your work life seems to be going well, start developing your capacity to adapt so that when change occurs, you know what to do.

If you’re in the midst of a change and need to adapt quickly, remember that learning is inherently difficult because you often feel awkward, incompetent, and insecure for a while. Eventually, though, you become so fluent in the new knowledge or routine that you can’t imagine your life any other way. Therefore, the sooner you start cultivating and embracing your ability to adapt, the sooner you can thrive in your new situation.

Dr. Marty Martin is the director of the health sector management MBA concentration and associate professor in the College of Commerce at DePaul University in Chicago, Illinois. His second book, Taming Disruptive Behavior, will be published this year by The American College of Physician Executives (ACPE). He is currently working on his third book, Do You Have Career Insurance? For more information visit www.drmartymartin.com.

[From the April/May 2013 issue of AnswerStat magazine]

Conquering a Sick Day



By Dr. Farzanna Haffizulla

It’s a crisp Monday morning. Your agenda is interwoven with meetings, projects, and the usual “catch-up” from the week past. You awake with shaking chills and muscle pains and feel like you’re being pulsed by a million tiny lasers. Every time you swallow, your saliva feels like gasoline fueling an already rip-roaring fire in your throat. You have too much to complete at your office; staying home is just not an option – or is it? How do you know whether to stay or go? Though some employees often feel that they should fight through and go to work, there are many signs that indicate that you could be contagious, which is definitely a good reason to stay home.

It is imperative to avoid spreading your infection and be evaluated for treatment to accelerate your recovery. Signs that you are contagious, which should simplify your decision to not only stay home but to seek medical care to accelerate your recovery process, are as follows:

  • Fever
  • Persistent productive cough with fever
  • Outbreak of rash with or without fever
  • Red eyes with mucus discharge that seal your eyes shut in the morning
  • Severe sore throat
  • Muscle pains and achy joints with any of the above symptoms
  • Vomiting with, or without, diarrhea
  • High fever, stiff neck, and headache

The spread of either a viral or a bacterial infection can cause a negative trickle-down effect on the entire workplace. Realize that not only are your co-workers at risk from contracting your infection, but so are their families and loved ones. This may include family members who may have fragile immune systems, including the elderly and newborns. Plus, it is unlikely that your co-workers will thank you when they contract the same cold or flu! When your co-workers develop your illness, resulting in many other sick days across a department or office, productivity inevitably declines. Many sick days could have been prevented by you taking one or two days out of the office. There are many ways you can manage your workload while sick, especially if your co-workers or boss are willing to lend a hand and be flexible.

Some strategies that will allow for productivity during this “down” time include:

Work via remote computer: There are many projects in day-to-day office life that could be completed from your home computer while you are in your pajamas in bed. If you can link your office computer to your home desktop or laptop, you can tackle any computer-based projects you have lined up. Another option is to have work scanned and sent to you for your home viewing and completion, allowing you to stay on top of your workload and recover at the same time.

Convert physical meetings to telephone or Skype: Utilize technology to your advantage. Most cell phones have the ability to add in multiple callers, allowing you to set up conference calls. If you are supposed to call in to a conference line, have one of your co-workers send you the number and instructions. Ask a co-worker to set up an automatic, outgoing message with your “number for the day” and your Skype information. Not only will you impress your colleagues and clients with your innovation and dedication, but you also show your consideration for not spreading your infection.

Take work home: This scenario works well if your symptoms start the day before. Bring home that proposal that must be finished before the end of the week and work on it in between naps. Always prepare for the worst.

Pre-arrange for back-up coverage: Along with letting your boss and other co-workers know that you will be at home, arrange for a specific co-worker to cover what they can of your workload. Let them know of any pressing work or engagements, potential problems, or expected calls. This will allow a “physical” presence if one is needed in your line of work.

Do your “back-up work:” This can be anything that needs to be done but often falls by the wayside: expense reports, industry research, or other tasks that you have pre-assigned yourself and are readily available. If you manage a department or group, this is a good day to review your budget, employee productivity, and financial trends.

Although we cannot predict when an illness will impact our lives, we can certainly try to prevent associated annoyances. The old adage, “An ounce of prevention is better than a pound of cure,” rings true here. There are many ways to protect your immune system and body against such infections, including diets high in vitamin C, minerals, and antioxidants that boost your immune system; avoiding sleep deprivation, smoking, and alcohol; washing your hands regularly; encouraging your workplace to have hand sanitizers strategically placed for staff use; and taking time to de-stress.

You should also have regular medical checkups to screen for any underlying diseases that can compromise your immune system. If you do find yourself sick and your primary care physician is not available to evaluate you, you have other options. You can either go to an urgent care center or have a telemedicine consult with a physician via Web or phone. There are also many walk-in clinics at various pharmacies that can evaluate and treat you efficiently.

Many of us have experienced how a sick day can set us back. As professionals, parents, and productive citizens, it works in our best interest to not only plan for these unforeseen sick days but also incorporate prevention and maintenance of our wellness into our daily lifestyle. A healthy attitude and a positive spirit are the foundation to achieving the art of health balance. We are the architects of how we choose to deal with obstacles, such as sick days, that sometimes unpredictably insert themselves into our busy lives. Conquer them; don’t let them conquer you!

Dr. Farzanna Haffizulla is a speaker and expert in work/life balance. Her book, Harmony of the Spheres, offers methods to streamline workloads, solve interpersonal workplace issues, and offers practical advice on integrating work and home life.

[From the April/May 2012 issue of AnswerStat magazine]

Managing Interruptions and Your Time



By Danita Johnson Hughes, Ph.D.

According to the great American inventor, Thomas Edison, “Time is really the only capital any human being has and the one thing he can’t afford to waste.” Consider that:

  • Time gets lost. People kill time. Time flies. It gets wasted.
  • Time weighs heavy on our hands.
  • We spend time. Time passes. It drags on or it hurries by. Those behind bars are said to be doing time.
  • Sometimes, we have no time left; we’re out of time.

The perception of not having enough time for the things we must do or, just as importantly, the things we want to do, is a leading cause of stress in society today. This is quite apparent in the healthcare industry, where workers are continually asked to do more. Continued exposure to stress can have an adverse effect on both a person’s physical and mental health.

Because you spend a great deal of your time at work, meeting your employer’s expectations becomes increasingly important. Managing your time effectively, however, is often hampered by interruptions at work. Constant interruptions can significantly hinder effort, curtail creativity, and decrease productivity by disrupting thought processes and workflows, causing individuals to lose focus and take longer to complete tasks. A high rate of interruptions can be a serious issue in the workplace and can be a barrier to success.

A Typical Day at Work: Think back to your last day at work. I bet it went something like this. You arrive at work, sit down, and slowly begin to get into a groove. You begin working on that report that’s due at the end of the day. After about an hour and a half, you quit to go to a meeting that was scheduled a few days ago. After the meeting, you think, “What a waste of time. They could have just sent a memo for us to read and not interrupted my work day.”

You go back to your office and try to get back to that report. The phone rings. It’s Tom. You decide not to answer. Whatever it is, it can wait. Two minutes later, Tom is knocking on your door. You bite your tongue and invite him in as you’re thinking, “Can’t he take a hint? I’m busy!”  He spends twenty minutes discussing the meeting you just had and how he thought it was such a waste of time. He leaves.

The phone rings again. It’s Jenny. You don’t answer. You really need to get this report completed by the end of the day. Jenny sends you an email. You open it. She needs to discuss a matter of mutual concern regarding another work matter. She’d like to do this at your earliest convenience. You email her back that you will meet with her later in the afternoon. Gee!  Another meeting!

While emailing her, you notice several emails received since yesterday. You think, “Maybe I’ll read some of these and get them out of the way.”  Two hours later, it’s past lunchtime and you haven’t eaten. You take a break for lunch. When you return, Jenny is waiting to start the meeting you agreed to this morning.

Jenny leaves. Before you restart your computer, you decide to take a bathroom break. You run into John in the hallway. He comments that he hasn’t seen you all day and wants to know what you’ve been up to. You tell him you have a report due and need to get back to it. The two of you talk for ten minutes.

You finish the conversation and complete that trip to the bathroom, resolving to get back to that report as soon as you get to your office. In your office, you remember a file you need to finish the report. You don’t remember where you put it. After 30 minutes, you locate it. Finally, you get back to your computer.

As you’re typing away on your computer, your boss walks in, pats you on the shoulder, and wants to know how it’s going. You try to keep a straight face as you’re thinking, “It could be going better if I could get around all these interruptions.”  After a light conversation, you’re alone again.

Time Stress: Does this sound familiar? If so, you may be experiencing “time stress.”  Learning to manage your time more effectively by controlling interruptions is the key to reducing stress and being more productive and successful on your job.

Here are some helpful strategies for taking control of your time and using it more effectively:

  • Regularly organize and prioritize your work.
  • Assess the types of interruptions you experience most. Are they necessary or not?
  • Distinguish between available time and time that is off limits.
  • Postpone unnecessary interruptions until you have some available time.
  • Be willing to say “no.”  There are only so many hours in a day and only so much you can do with that time.
  • Recognize that some interruptions are unavoidable. When these occur, encourage the interrupter to get to the point quickly. Don’t engage in “small talk.”  Establish how much time you have initially – 10 minutes, for example – and stick to it.

Time management is a journey. By keeping control of your time and managing how it is spent, you may find that you have just a little more to spend. Thanks for taking the time to read this.

Danita Johnson Hughes, Ph.D. is a healthcare industry executive, public speaker, and author of the forthcoming Turnaround. Through her work, she inspires people to dream big and understand the role of personal responsibility in personal and professional success. In her first book, Power from Within, Danita shares her Power Principles for Success that helped her overcome meager beginnings and achieve professional, community, and personal success. For more information email danitahughes@edgewatersystems.org.

[From the June/July 2011 issue of AnswerStat magazine]

A Formula for Success: Accountable Care + Patient Experience = Accountable Experience



By Tina Minnick

“Capitation with gain-sharing,” “Improving outcomes and increasing value,” “Revisiting integrated delivery tactics among primary care physicians, specialists, and hospitals,” or “Bending the healthcare cost curve for managed populations,” whatever your definition (in whole or in part) may be, Accountable Care Organizations (ACOs) pose a strategic opportunity for hospitals and large physician practices alike. If ACOs can overcome concerns from a Stark and anti-trust perspective and are successfully implemented, patients and ACO market leaders will see stronger physician alignment, improved quality, cost reduction, and an improved patient experience.

What is and who will drive the ACO movement? The Medicare Shared Savings Program in the 2010 Patient Protection and Affordable Care Act broadly defined the ACO concept to include the many healthcare organizations across the country. While the organizational structure of an ACO is loosely defined, it does require that primary care physicians be a component. The ACO pilot program looks to work with Medicare populations beginning in January 2012, and healthcare observers agree that commercial payers will follow the Medicare lead.

The goal of the ACO movement is that provider organizations be accountable for the value of a population’s healthcare costs. Doing so “will require focused efforts to improve care for the 10% of patients who account for 64% of all U.S. healthcare costs,” according to both Peter Orszag and Ezekiel Emanuel.

The reality is that the U.S. cannot continue its current approach to healthcare delivery. Analysts predict healthcare will be one fifth of the nation’s gross domestic product (GDP) by 2019, and ACOs are part of the prescription to affect cost and quality. Coordinated care that provides value and reduces cost will become the standard. ACOs will be looked upon as major drivers of reducing the healthcare cost curve.

Both hospitals and large physician groups are prime leaders for the ACO movement. Growing market share is key for hospitals, and a strategy focused on retaining and gaining new patients will be needed to offset lower utilization. According to an article by John M. Harris, Daniel M. Grauman, and Rashi Hemnani, hospitals should “focus on retaining cases from the population that previously had been ending up in different hospitals, despite having been treated by the hospital’s primary care physicians.”

Large physician practices are also likely to want to lead ACO efforts. Physicians often self-refer, and the thought of obtaining additional “gain-sharing” funds by reducing hospitals’ census could be a motivating factor. Whether a large primary care group forms its own ACO or remains as an affiliated hospital partner, hospitals could see volume shift as primary care physicians choose alignment patterns. Domination of the market will occur by those who act and succeed first.

Critical Success Factors for ACOs: Dominating Market Share and the Patient Experience: Market share is the percentage of total sales volume in a market captured by a brand, product, or firm – in this case, by a practice or hospital. The patient experience will drive brand loyalty, result in repeat patient visits, and generate new business.

Contemplating healthcare market share can sometimes be difficult because many think “once a patient, always a patient” or are the only provider for a particular service or insurance type. In the past, these thoughts may have been valid, but with transparency and patients’ options, provider appeal and reputation need to be top of mind.

ACOs have to develop business plans for service area, target market, reimbursement, information technology (IT), quality, providers, and organizational structure. Each of these areas stand on its own as a major strategic decision, and execution of these plans will determine an ACO’s success. Independent of these components is the fact that ACOs are designed to increase value and decrease costs; it is imperative that market share and the patient experience be critical success factors in plans to maintain or grow revenue before, during, and after ACO implementation.

In considering where to begin, honestly answer these questions:

  • What are patients specifically saying about communication to and from their doctors and nurses?
  • How are you responding to patients’ comments, whether they are good, bad, or indifferent?
  • What reporting is available to help gain an understanding of your patient experience?
  • Would your patients recommend you to friends and family?
  • How are you capturing potential patient inquiries in the community?
  • How are you serving your community to grow awareness?
  • How are you managing unnecessary processes in a crowded and busy emergency department?
  • How consistent is your patient follow-up for both patient experience and quality care?
  • What tools are available to promote work/life balance for your physicians?
  • What risk management strategies are in place to document after-hours patient interaction and provide peace of mind for your employed physicians?

These questions and your answers can help you grow the patient experience, and you may also find that revenues increase and costs decrease because of your consistent follow through. For example, The Studer Group asserts that healthcare organizations making discharge follow-up calls achieve a 20 to 30 percent reduction in preventable readmissions. Furthermore, patients receiving discharge calls place in the 90th percentile as likely to recommend a hospital to friends or family. Practices and hospitals alike need these kinds of sustainable results to be successful in an ACO environment.

What proof do we have that ACOs might work? Geisinger Health System, based in Danville, Pennsylvania, is a fully integrated system. It is physician-led, employs 800 physicians, and spans 43 counties serving 500,000 patients annually. In a recent interview with Health Affairs, Dr. Glenn Steele, president and CEO, shared that high utilization and high cost may also be an indicator of low quality. He believes Geisinger’s use of the LEAN concept as a re-engineering technique helped to redefine processes to cut cost and improve outcomes and enabled the organization to determine in which direction they should go. It isn’t just about how to give care and the associated processes, but also how the patient interacts with physicians and nurses and the overall patient care experience.

Geisinger bent their cost curve by 7 to 8 percent because of their LEAN processes and their advanced medical home model that is a community approach to care called ProvenHealth NavigatorTM. “Our costs are still going up, but they’re 7 to 8 percent lower than what they would have been because of our fundamental re-engineering of our community practice-based care,” reports Dr. Steele. They worked with their primary care and specialty physicians to create unique incentives, and they collaborated with insurance company nurses and placed them in primary care and skilled nursing settings to keep patients with multiple chronic diseases healthier.

Hospital admissions and readmissions are lower for these patient groups because they, and their families, are keenly aware of the symptoms they need to be cognizant of. By knowing the symptoms and taking care treatment steps at home, they avoid going to the emergency department.

What about the patients? Are they happy with the outcomes? Kevin Brennan, executive vice president for finance and CFO of Geisinger Health System, says, “We participate in patient surveys for our ProvenHealth Navigator program, and we have unbelievably high degrees of satisfaction. And that carries over to our physicians, too. We manage our members and their care plans.”  Plus, on the cost side, they aren’t paid less for managing care better.

Mr. Brennan sums it up nicely, “At Geisinger, one of our organizational goals relates to our legacy – leaving the organization with a better-prepared set of leaders than existed before. We encourage innovation, especially with care processes, believing that quality and efficiency are inextricably linked. The environment is changing, and we have to adapt.”

Driver or Passenger? The ACO pilot project will launch in January 2012, and providers that choose to be involved will be responsible for lowering costs and improving quality of a defined Medicare population. Those that hesitate with a “wait and see” attitude because of the many unknowns related to ACO structure may find themselves sitting in the passenger seat; they will have a great view, but no control over the destination.

ACOs will make healthcare leaner and, based on what we’ve seen thus far, will create a more innovative approach to care giving. Whether or not you choose to drive ACO development, growing market share and the patient experience is vital to building and sustaining viability in an already competitive environment.

My advice? Don’t get left behind. Get in and drive the ultimate patient experience.

[From the April/May 2011 issue of AnswerStat magazine]

2010 ICARE Award Winners



By Patty Maynard

Each year, RelayHealth recognizes those customers who best share the key principles and mission contained in the corporate vision, ICARE. Originally adopted in 1998, the ICARE principles stress that successful relationships between companies are often the result of shared common values, which also serve as a cornerstone of their cultures.

ICARE represents:

  • Integrity: do what’s right
  • Customer first: you only succeed when your customers succeed
  • Accountability: take personal responsibility and expect the same in return
  • Respect: treat people with dignity and consideration
  • Excellence: insist upon quality

The ICARE customer awards are an extension of internal company awards designed to acknowledge and honor those customers who exemplify the principles of ICARE, including innovation, talent, and attention when interacting with their customers. This commitment to quality has delivered overwhelmingly positive results to their organizations.

The following organizations achieved this status by re-engineering existing processes to ensure that best practices were implemented throughout the contact centers and also developed new services in reaction to changes in their local marketplace.

Resurrection Health Care – RES-INFO Line, Illinois: Challenged with an organization-wide “break-even” strategy to balance the budget, the RES-INFO Line contact center utilized the reports and statistics gathered from their call center software to make staffing decisions regarding call volume. The data provided key information about mission critical activity and analyzed appropriate cost savings. The guiding principles of ICARE were evident in their decisions, and the result was a decrease in FTEs and hours while simultaneously expanding services. Their action achieved the goal of reducing the budget and assuring the call center will remain viable and a key component of the organization’s mission.

CareNet Inc, Texas: The CareNet nurse advice line uses care coordinators to conduct the intake process via director-approved medical screening criteria to quickly identify urgent health situations. In order to ensure they were providing the proper high quality care at the right time, they instituted a process to review their urgent call prioritization procedure. Initial assessment demonstrated that one of their service lines was overusing the “urgent call” processing procedure. By analyzing call center data and reports, CareNet management recorded the percentage of appropriately documented “urgent” calls that resulted in a disposition of 911 or ED. The report data allowed comparison of the care coordinator’s document to the recommended disposition from the clinical staff. Since the analysis and implementation of new quality control guidelines, the urgent call prioritization process improved by 38.6%. By establishing appropriate usage of the urgent call prioritization process, CareNet is achieving their goal of providing the right care at the right time for all their customers.

Scott & White, Texas: Overcoming a possible closure of the call center many years ago, this innovative organization rallied behind physician support to revamp and reorganize the center and focus on availability when it was needed the most. Once the decision was made to change to an “after hours” business model, the organization added an Unlicensed Assistive Personnel (UAP) position to place inbound calls into a queue for handling by RNs. By focusing on these two changes, the organization was able to positively adjust service levels and decrease abandoned call levels. Today, the call center is positioned to return to a 24 x 7 operational model. They clearly achieved their goal of increasing the quality of care to their patients and providing key support for their physicians.

Avera McKennan Hospital and University Health Center, South Dakota: The call center needed to increase efficiency of time and resources, both in terms of personnel and equipment, and to increase patient referrals and procedures. The first initiative was to take over the after hours calls from a local paging company. Even with a volume of 700+ calls per month, they managed to reduce number of physician page-outs by 69%.

The second initiative was to assist with helping manage the call center efficiency at the heart hospital to, addressing idle time in the diagnostic systems. To address this surplus of resources and increase the inflow of new patients, procedures, and referrals, the call center began scheduling heart screenings for minimal cost. Since August 2008, over 4,400 screenings were conducted with heart and related cardiac medical risk factors found in 1 in 3 screening participants.

Finally, the call center assisted with reminder phone calls for mammography, MRI, and pain clinic appointments. Since the inception of the reminder call program, no-show appointments have decreased by 66%. The call center has clearly demonstrated how to add both efficiency and new services for their healthcare system.

Congratulations to all of these ICARE winners!

For more information, contact Patty Maynard, CECC solution line leader – patient solutions with RelayHealth, at 480-663-4722 or Patty.Maynard@RelayHealth.com.

[From the August/September 2010 issue of AnswerStat magazine]

Labor for a Lifetime



By LeAnn Thieman

There were 100 little babies laying three and four to a cardboard box, strapped in the belly of a gutted cargo jet. It was 1975, Saigon was falling to the Communists, and I was accidentally caught up in the Vietnam Orphan Airlift. It was a stressful situation; if you don’t have coping skills, you learn them fast!

As our plane took off, I was haunted with image of three days before when I stood on the runway and watched as first planeload of orphans crashed after takeoff, killing half of the adults and children board. I clutched our newly adopted baby boy to my chest. Would this plane be blown out of the sky too?  I trembled so hard I could barely hold our son. To cope, I started slow, deep, easy breathing…the kind I’d learned from Lamaze classes several years before. The same breathing that I used to bring our daughters into our family, I was using to bring our son.

Since then, my many years as a childbirth educator have convinced me that those child-birthing techniques are not just labor skills, but life skills. I taught couples laboring tools: breathing, relaxation, positive thinking, and visualization. These are imperative for coping with challenges of labor and are equally applicable in coping with “labors” in our lives.

Breathing: Like similar activities, rhythmic breathing releases endorphins, which act as our body’s own pain medication. We have it to tap every day, but we forget to do activities that release it!  I taught laboring moms that when they are afraid their bodies increase adrenalin production, inhibiting the release of oxytocin, resulting in poorer contractions and a longer labor. Rhythmic breathing decreases stress, thereby decreasing adrenalin production, facilitating a better, shorter labor. If stress and adrenalin do that to labor, what does it do to our everyday lives?

We need to breathe like laboring moms– in 2,3,4 and out 2,3,4. As we breathe in, think the words “I am” and as we breathe out, think “relaxed.” It works. When I was en route to Vietnam, the national officers of our organization met me at the airport with $10,000 to smuggle into Vietnam. So with the most expensive padded bra in world history, I headed through customs. An angry looking Vietnamese guard with a gun barked at me, and I feared he’d take one look at my chest and know this was not an act of God. Trembling with fright, I knew I’d give myself away. So I started that deep breathing– in, $1,000, $2,000, $3000, out $4000…

Relaxation: It’s said relaxation is 90% of a good labor, and that applies to life too. Keeping our bodies relaxed keeps our emotions under control. I told laboring moms we are only as relaxed as our hands and our face. We can’t relax if we’re making a fist or clenching our teeth or the steering wheel.

We schedule so many activities into our days, yet we seldom schedule relaxation. Still, we must allocate at least fifteen minutes every day for relaxation, meditation, or prayer. Ideally, we should set up a “relaxation” place at home where we can listen to guided relaxation exercises or soothing music while doing our slow, rhythmic breathing. Involving all five senses is best, attained perhaps by lighting a scented candle or gliding in a rocker. Once we’ve mastered this relaxation technique, we can utilize it in the break room, the ballpark, or the bedside.

Positive Thinking: I am absolute believer in the power of positive thinking. We get what we expect from life. When we expect positive things, we act accordingly and get positive results in return. When we expect success, we usually succeed; when we expect failure, we usually fail. When we expect health, we make healthy choices; when we expect illness, we are often sick. In childbirth classes, when worried couples doubted their ability to survive labor, I quoted Henry Ford, “If you think you can or you think you can’t, you’re right!”

Research shows that emotion– positive or negative– affects human health. There is mounting scientific evidence that hope, faith, love, the will to live, purpose, laughter, and festivity can actually help control disease. These aren’t just mental states but have electromechanical connections that play a large part in the working of immune system.

Positive thinking also affects our performance. The Texas Rangers baseball team years ago lost twenty-one straight games. The manager knew an evangelist was in town and made the team wait in the dugout while he went to have their bats blessed. He came back an hour later with “blessed bats.”  The team won nearly every game after that– and the pennant!  Were the bats blessed?  It doesn’t matter; the team got what they expected.

Positive Visualization: We can take positive thinking one step further by incorporating positive imaging. Positive visualization is a powerful and mysterious force in human nature that is capable of bringing about dramatic improvement in our lives. Einstein said, “Imagination is more powerful than knowledge.”

I instructed laboring moms to visualize their baby moving down the birth canal, their cervix opening, and finally holding their baby in their arms. I literally watched their bodies respond. We know the expected response is true in biofeedback, when blood pressure and pulse rates are reduced with imaging techniques.

Cancer patients say they have less nausea and vomiting when visualizing a serene white beach in Maui, cascading waterfalls, and peaceful sunsets. But, it seems that can work in reverse. One cancer patient saw her doctor in the grocery store and it brought back such intense images of nausea with her chemo, she threw up on the spot.

Breathing, relaxation, positive thinking, and positive visualization work for sick people and labor patients, and it will work for you. It’s unlikely that you’ll ever be asked to rescue babies in cardboard boxes in war-torn countries, but God knows you rescue people every day in what you do. Remember to use your labor tools to affect not only your happiness, but your health as well.

LeAnn Thieman is a nurse, author, and Speaker Hall of Fame inductee. She is co-author of Chicken Soup for the Caregiver’s Soul, as well as Chicken Soup for the Nurses Soul and Chicken Soup for the Nurse’s Soul, Second Dose. To learn more about her books and presentations, call 1-877-THIEMAN.

[From the June/July 2009 issue of AnswerStat magazine]

Caring for the Caregiver



By LeAnn Thieman

Terry stacks the breakfast dishes into the sink, hands the freshly packed lunchboxes to her son and daughter, bundles them into their coats and boots, and hustles them to the school bus. With a smile and a wave she promises, “I’ll pick you up after school. We’ll make Christmas cookies for your Girl Scout meeting, and then we’ll go to your basketball game.”

She scurries back into the house to spoon-feed one more before leaving for her part-time job. After wiping his hands and face, she kisses his nose, helps him into the car, buckles him in, and drives him to daycare. Hugging him, she promises, “I’ll pick you up at lunchtime, Dad.” With a vacant look in his eyes, he asks, “But what about breakfast?”

Terry is one of the 54 million Americans caring for a family member. Over 40% of families who provide care for an elder have children at home under the age of eighteen. Seventy-five percent of caregivers are women. Part of the “sandwich generation,” many will spend more years caring for a parent than they will raising a child. Not only are they ministering to their parents and children, many are caring for their children’s children. From 1990-2000, the number of kids living with grandparents increased 30%.

Alarmingly, women who care for grandchildren have a 55% greater risk of heart disease. Caregivers of someone with a chronic illness have a 63% chance of dying early. It’s no wonder caregivers often experience troublesome feelings such as depression, resentment, worry, helplessness, exhaustion, guilt, anger, and sadness resulting from the reversal of parent-child roles. But when caregivers care for themselves, these statistics and severe emotions can be drastically reduced.

Caregiving depletes a person not only physically, but also emotionally and spiritually. Because 25% of the world population is caring for someone, we all know a person in a caregiving role. Here are 12 easy tips for you to help care for that caregiver:

  1. Extend compassion and empathy first.
  2. Encourage them to care for themselves as attentively as they do others. Remind them to get regular checkups, to eat properly, exercise, and get adequate sleep.
  3. Suggest they take time out for themselves and use relaxation or stress management techniques such as meditation, visualization, biofeedback, or yoga.
  4. Advise them to pay attention to their own feelings and emotions and to seek counseling and support groups if needed.
  5. Listen.
  6. Help them to stay actively involved with friends and hobbies.
  7. Assist them in finding respite care so they can regularly take time for themselves.
  8. Subscribe them to supportive caregiving periodicals and magazines and give them spiritual, inspirational, and encouraging books.
  9. Help them tap into community-based and national resources for support. The National Family Caregiver’s Association and the Area Agency on Aging are great places to start.
  10. Deliver a heat-and-eat meal.
  11. Offer to sit with their loved one, even for 30 minutes, so they can take a bubble bath or a walk.
  12. Tell them how much you admire them for all they are doing.

These small efforts to care for the caregiver create a win/win/win situation. Your relationship with the caregiver will flourish; the family member will receive care from a happier, healthier caregiver; and that caregiver will feel cared for, too—a much needed and overdue gift, any time of year.

LeAnn Thieman is a nurse, author, and Speaker Hall of Fame inductee. She is co-author of Chicken Soup for the Caregiver’s Soul, as well as Chicken Soup for the Nurse’s Soul and Chicken Soup for the Nurse’s Soul, Second Dose. To learn more about her books and presentations, contact 1-877-THIEMAN.

[From the April/May 2009 issue of AnswerStat magazine]

Google Trumps the CDC



By Peter DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStat

Google announced that it knows about flu outbreaks before the CDC (U.S. Centers for Disease Control and Prevention) — really.

It’s an amazingly simple, yet elegant solution. Using their vast database of user searches, Google has determined that they can predict and report on a flu outbreak up to two weeks before the (CDC), merely by watching for an increase in flu related searches.

According to the Website google.org/flutrends, “We’ve found that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity in your state up to two weeks faster than traditional flu surveillance systems.”

Check it out — especially the demo in the “How does this work” section — it’s really quite interesting.

By the way, at this point in the flu season, we’re doing better than most years.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.  Read more of his articles at PeterDeHaanPublishing.com.

[Posted by Peter Lyle DeHaan, PhD for AnswerStat magazine, a medical healthcare publication from Peter DeHaan Publishing Inc.]

Living and Working Stress-Free



By Jacqueline Sidman, PhD

Everyone knows what stress feels like. Things seem out of control, your reactions don’t fit your situation, your expectations are unmet, you experience painful losses, you believe untruths about yourself, and your emotions are toxic. But for some people, stress is a normal way of life.

Many people spend their entire lives struggling with their own self-imposed limitations, being frustrated and bound by them. While they have dreams, they don’t always achieve them. Everything feels frustrating and challenging, and nothing is ever good enough. When people don’t achieve a solution to these inner struggles, internal conflicts create stress, which can wear a person down to the point of physical and emotional exhaustion.

Can stress actually make a person physically sick? Statistics reveal that stress actually causes eighty to ninety percent of illnesses. Stress-related illnesses can be anything that makes you miss a day of work, from a common cold to a migraine headache. They may also be chronic and degenerative. If you suspect stress has affected your health, or affected the way you work, consider the following information.

How Does Stress Make You Sick? Two forms of stress exist. The first is known as situational stress and may be caused by the weather, traffic, another person’s behavior, or some other external factor. External stress cannot be controlled and doesn’t lead to illness.

However, the second form of stress can cause illness. This type is known as internal stress, and is caused by reactions to external influences. For example, if a colleague at work challenges or confronts you, you may feel tense, irritable, or angry. These negative reactions to the same triggers over and over again, are really over-reactions that increase over time and foster internal stress.

Internal stress originates from the conflict between your conscious and subconscious mind. So while you may blame an external source for your frustrations, your own interpretations are the underlying cause. While no one ever chooses to be sick, the conflict between the conscious and subconscious mind creates inner conflict, or stress, that may cause the immune system to break down. This build up of tension also imposes extreme stress on the internal organs, which can be converted to physical or emotional illness.

Some of the ailments that have been linked to stress include A.D.D. and A.D.H.D., arthritis, allergies, asthma, cancer, chronic back problems, chronic fatigue syndrome, colitis, cystic fibrosis, heart disease, hypertension, migraine headaches, premenstrual syndrome, psoriasis, strokes, and ulcers. Not every illness is caused solely by stress, but an emotional component is often part of the problem.

Is Your Ailment Stress-Related? Some symptoms of stress may be that you’re tired all the time, you’re unable to sleep, you experience chronic back pain, and you don’t feel like leaving the house or doing the things you used to enjoy. You should be aware of your lifestyle, how your body feels, and what’s not working for you.

If you’re diagnosed with a stress-related illness and prescribed traditional medication, you should integrate some stress management as part of your treatment. A physician will always tell you to improve your lifestyle, get enough sleep, and eat healthier. If they know you work in a high-stress profession, they’ll tell you to pace yourself. Medical professionals understand that external pressure causes internal organs to tighten up, and when this happens the body doesn’t function properly. While traditional medicine can effectively alleviate the symptoms of many illnesses, you must also address the stress component.

What Can You Do To Relieve Stress-Related Illness? If you can free yourself of this internal tension, your body will return to its natural healthy state. You have the ability to be at peace. To achieve inner peace, addressing and relieving the tension will bring your body and mind into harmony. When your subconscious and conscious are in conflict, that’s when the stress-related ailments develop. When you are overwhelmed by failing to control uncontrollable outside influences, lack of hope surrenders to defeat, and the body permits illness to enter. To free yourself from stress, follow these guidelines:

  •  If you suffer from stress-related illnesses, look at the way you’re treating your body. Are you eating wholesome, nutritious foods? Do you need to drink several cups of coffee or soda to stay awake at work? How much alcohol are you using? Look at the substances you’re putting in your body and how you’re moderating them.
  • Next look at how you’re balancing your time. Are you balancing your time at work with time doing things you enjoy? Are you allowing yourself time to rest, meditate, and enjoy your life? Do something that pleases you to counterbalance some of the stress in your life.
  • Another way to relieve stress is to look at your general development. Do you tend to go along with the crowd when it doesn’t please you, such as going to a rock concert when you really prefer jazz? If so, then why do you go at all? Go where you like to be.
  • Develop your creative side. Take up an activity that allows you to express your innermost feelings, such as writing, painting, taking a crafting class, or playing a musical instrument. Believe it or not, people who do manual labor for a living often experience less stress because they are constantly active and relieving their tension. So find something to do with yourself that makes you less uptight.

Stress Relief in the Future: While stress is part of life, excessive stress can have detrimental effects on your health. When you let tension build up in your body, your internal organs can tighten up and actually stop functioning properly. Stress can also weaken the immune system and allow illness to take over the body. Many common ailments have been linked to stress, and for optimal health, stress relief should supplement traditional forms of medicine.

Participating in activities, even simple things, that you enjoy can relieve tension and help your body return to a healthy state. By reducing the amount of stress you experience, the quality of your life improves, and you gain a wonderful attitude. When you have a wonderful attitude, your life becomes enjoyable.

Jacqueline Sidman, PhD., is an author, speaker and life coach. She is author of Instant Inner Peace and is an expert on eliminating phobias, addictions, relationship problems, career struggles, and health issues. For more information on her book, speaking, or consulting work, call 949-251-9550.

[From the August/September 2005 issue of AnswerStat magazine]

An Interview with Industry Veteran Joseph Sameh



By Peter Lyle DeHaan, Ph.D.

Peter DeHaan, Publisher and Editor of AnswerStat

AnswerStat magazine (AS): Joe, you own and operate Mediconnect, a telephone answering service for the healthcare industry. How did you get started and how long have you been in business?

Joseph Sameh (JS): I was a business/clinical practice manager beginning in 1976. Growing practices was among my primary responsibilities. Each practice did quite well but we learned at every turn that the existing patient-to-provider communications process didn’t meet our needs. Mediconnect was founded in 1985, partially as a result of these experiences.

AS: How big has your call center become?

JS: We have hundreds of clients. However, numbers can be misleading. Several years ago, a hospital consortium consolidated all their practices and became one of our clients while increasing billing significantly. A better measure is call volume, which exceeds four million a year.

Many clients have multiple projects running simultaneously and some of our project-based work requires hundreds of seats. In order to provide this level of service we have been sharing calls with many other call centers on a project-specific basis for many years now.

AS: What are some of the changes you have seen over the years?

JS: Automation to lower labor cost has eliminated the human touch. This has not always been well planned. Many practices overuse of voice mail has resulted in unhappy patients and overburdened staff. Medical staff routinely spends hours daily retrieving their voice messages while patients experience delays in callbacks. This has given us access to daytime messaging business, which accounts for 96% of all patient communications activity. From a vendor perspective, we have recognized the value of specialization and how it can affect the marketplace. We’ve been very fortunate in this area.

AS: What are some of the challenges facing you today?

JS: Insurance and other costs represent serious internal challenges. Downward pricing pressures add to the challenge. But the greatest challenge of all will come from the Internet. The Internet has disrupted the smooth methods of every industry with which it has come in contact. We must harness it or fight it.

Another is companies entering the secure messaging marketplace. This has the potential to affect us in health care just as voice mail affected live service provision to Heating Ventilation and Air Conditioningcompanies. The greatest threat is coming from well-heeled companies that provide electronic patient record systems to major hospitals and are now making patient access to their systems a reality. These companies do not believe the role that an answering service plays is essential and have no plans to include them in the future. Other emerging technologies are also vying for our traditional piece of the pie.

AS: How will medical answering services change in the future?

JS: Physically, there will be more at-home agents taking calls and much more call sharing and load balancing between centers essentially creating on demand virtual contact centers. Organizations with integrated technologies (IVR/voice/live/Web) and convergent data base power will lead the field.

In the future, we will need to be nimble to address changing needs of clients and patients. There are increasing numbers of practice websites sprouting without patient access. The problem may not be obvious. The practices are inviting people to visit their website but when visitors arrive there, there is no access. Imagine inviting people to visit your vacation home while you are away but disregarding the need for keys or the alarm access code.

Practices could not afford to overlook after hours patient access by phone, yet their website is not considered within their communications sphere. This presents a huge opportunity for our industry.

AS: The healthcare industry has changed a great deal in recent years, how has that affected your operation?

JS: We have always been sensitive to two taskmasters: the needs of our stakeholders – patients as well as clients – and emerging technology. This has emboldened us to create products that have become industry standards. As such, we are providing a significantly expanded menu of services to meet the needs of the marketplace.

AS: The recent trend has been for doctors to leave private practice become employees of health organizations. How has that changed the doctor-answering service relationship?

JS: The relationship was more of a one-on-one relationship with the doctor. We once had over 1,000 clients and represented far fewer physicians than we do currently. Today, the office managers are often our primary contact point. They have a much more sophisticated level of service expectation and consistency as well as understanding of the communications process. That has become a big boost to our business. As a result, we are occasionally recognized as a profit center rather than a cost center, which dims the aura of cost cutting as the main driver. Of course, cost cutting is always part of “the back of the mind” conversation.

AS: In addition to telephone answering service, what are some of the supporting and complementary services that you offer?

JS: We offer a large and growing menu of client services. Through Phone Screen we provide patient recruitment and retention services to the pharmaceutical clinical trials and medical device industry. In January 2003 we introduced NeedMyDoctor®, an Internet patient-to-provider communications tool.

AS: Joe, tell us more about PhoneScreen.

JS: Our services are used by many pharmaceutical companies to screen volunteers for clinical trials. We developed a model for screening and found that as we evolved there was a huge need for centralized call center services for clinical trials. We founded our PhoneScreen division to provide services to aid recruitment and retention of subjects for the pharmaceutical industry. It has since become its own company.

AS: And what about NeedMyDoctor?

JS: NeedMyDoctor® is our vision of the future. Patients overwhelmingly want to use the Internet to make requests of their doctors. However, doctors don’t want to adopt the Internet for patient communications for a number of excellent reasons. Most telling and according to Providence Health System is that 50% of those patients would consider switching providers to those that accept alternative communications methodology.

We believe NeedMyDoctor® is a communication tool that meets the needs of both patient and doctor. Patients get to leave their request on the Internet while doctors don’t need any Internet access at all. This HIPAA compliant tool integrates the Web with the practices existing call center provider without any changes to the practice protocol. Since this is not email, there is never any spam.

AS: What else would you like to share with readers?

JS: Our attitude towards our competitors has become one of co-opetition. It has allowed us to do more than we ever could on our own – and for that we are very appreciative. I know I’m speaking for the industry at large since so many people we’ve never worked with described similar experiences.

AS: Thank you for your time and willingness to share with the readers of AnswerStat magazine.

JS: Thank you!

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.  Read more of his articles at PeterDeHaanPublishing.com.


[From the Summer 2004 issue of AnswerStat magazine]