October 2005

October was a month of collecting the final data to understand the collections issues that we have been challenged by. I accomplished collecting it all and analyzing most of it. I spent a lot of time with the billing staff doing time studies and talking to them about their jobs. We did fix some of the problems and streamline. There were some obvious problems that were easy to fix; others that we are still trying to solve. The attitude is better now than it was in the beginning. They did not like doing time studies!

The other highlight in October was that our lead doctor was upset about the salary cuts this year and finally expressed his anger. I was glad that he finally got angry. He holds much of the function of production in his hands, and has been a bit too insular, despite repeated discussions. Anyway, his anger seemed to fuel some behavioral change on his part that is good. Two unfortunate things happened with staff, and those are resignations. They both caught me off-guard since they have both recently had positive reviews and feedback. It puts me back into high gear for hiring, and it is very upsetting. One of them has a two-year contract, so I am figuring out how to handle the breach of contract. (I think it is hard enough with nothing else on deck. But, my due date is the beginning of December, so this problem along with the project of a newborn is a bit daunting.

Ginny and I have worked so much on understanding how the money goes in and out that we have talked about little else. Understanding the statistics particularly projecting the collections from our services - has been instrumental in my putting realistic goals and pressures on the staff. It has also made me very nervous. There is a lot of money that we are not collecting, and I am trying to get to the bottom of it. Ginny can 't help me that much in answering that question since health care is its ' own entity. She has recommended that I talk to an expert in health care consulting whom she knows, and I am going to follow up on that. Despite the upheaval and the questions that are outstanding our services have grown. Collections are still dragging so cash is tight, but I am more in control of what to ask and where to look for the income. It seems to be picking up. In the meantime, I let our new part-time salesman go. I think he departed before I let him go, in fact. He just stopped showing up. I have a new person on deck who will start part-time in the next few weeks.

The sales department still doesn't exist and I have fallen on my face a few times now so I am ready to get a good person who can produce. Next week I start to interview to hire new people for a couple of positions. I hope to find someone who is stronger as a front desk manager so that I can reduce my work on that front. Since our manager left in May I have been doing the management. The many hats are getting too heavy manager, doctor, entrepreneur and financial analyst. Too much, too much!