Medical Revenue Management Association of America

WHAT CAUSES MONEY DRAMA?

1/28/2020

by Vicki Rackner, MD, FACS

I’ve listened to the money stories of hundreds of doctors, and some conversations stand out.

One doctor Beth said, “My relationship with money just isn’t working for me. My money brings me little joy, but lots of conflicts, anguish and uncertainty. If money were a person, I’d divorce him. But we’re stuck together. For life.”

Many doctors echo a recurrent theme: money is not working for them. They are experiencing MONEY DRAMA.

Here are three ways MONEY DRAMA gets played out:

Inner Conflicts. Money is often associated with anxiety, embarrassment, guilt and shame.
Conflicts with Others Money often becomes the source of conflict within marriages and families.
Mysterious Forces that Drive Unwanted Money-related Behaviors This might include over-spending, jumping into Dumb Doctors Deals (DDD’s) or never truly enjoying the things their money can buy because it’s so painful to part with money.

Many doctors believe that their money drama would go away if they just had more money.

While it's true that MONEY DRAMA can get in the way of building wealth, more money usually leads to more drama.

Here are two questions you can ask to help you take the first step of ending money drama:

What are three ways your money-management style is working for you? You might say, “I do a good job of saving.” Or, “I’m generous with others.” Or, “I now know my monthly expenses.”
What are three ways that your money-management style is NOT working for you? You might say, “I have ongoing fights about money.” Or, “I don't collect what I'm owed.” Or, “I get so anxious about money that I just ignore it.”

Beth is right: doctors cannot divorce themselves from money. However, they CAN end the money drama and make peace with money.

The Real Cause of Money Anxiety for doctors...

12/10/2019

By Vicki Rackner, MD, FACS

I remember speaking with my patient Jean. She had undergone a long and protracted treatment course for breast cancer--a bi-lateral mastectomy followed by a bone marrow transplant. We were celebrating five years later. She was cancer-free!

I asked her, "Jean, what was the hardest part about getting breast cancer?"

Without thinking, she blurted out, "The waiting. Waiting for the pathology report. Waiting for the labs. Waiting for the MRI. I can deal with just about anything. I just need to KNOW what I'm dealing with."

You may face times of threatened financial health. Divorce. Losses from Dumb Doctor Deal gone south. The need to care for aging parents. This can lead to financial stress.

However, some physicians become immobilized by their worries. They are afraid to see where they really stand. They may leave their Fidelity envelopes unopened.

The true cause of money anxiety is the NOT KNOWING. Worried individuals often imagine a financial situation that's far worse than the reality.

While financial stress can inspire you to reach out for help, financial anxiety can pose a barrier to taking the next step. Worried doctors may put off seeking professional financial help because they're afraid of what they will discover. Instead, they stay up at night worrying, "I'll never be able to retire! What will it be like taking call when I'm 70?"

As you well know, things are usually better than anxious people fear.

If you're immobilized by financial anxiety, you're not alone; however, it's wise to never worry alone. Reach out. Look at the monster under the bed. Things are usually better than feared.

Once you gain clarity about where you stand, you can create a financial treatment plan to optimize your financial health.

Then you can create a financial treatment plan and celebrate as you enjoy restored financial health.

HOW TO MEET NEW PATIENTS AND DEVELOP YOUR PHYSICIAN BRAND

11/7/2019

by Vicki Rackner, MD, FACS

Every medical organization needs a steady stream of new patients. As you make your own plans for attracting new patients to your practice, here are three “buckets” you can dip into.

Family, Friends and Fans
I was at a family wedding when a 9-year-old budding journalist came to introduce herself to me. She said, “I hear you’re a doctor. What kind?”
I replied, “I’m a surgeon”
She asked, “What kind of surgeon?”
I said, “I’m a general surgeon.”
Her eyes got big as saucers and she said, “Oh. So you’re that person who puts the warning labels on the cigarette packs!”

The many people in your life who know, like and trust you—including your own patients and referring physicians— may know the specialty in which you are boarded. How well do they understand what you do?

There is something about the way you deliver care that puts you in a class of one. What is it? How well do you communicate it?

If you are a gynecologist, do your friends know that you welcome patients with a history of sexual assault who need a bit more time and compassion with the exam?
If you are a cardiologist entrepreneur, do members of your church or golf club know that you developed a highly effective smoking cessation program?
Do your patients know whom to send to you and the circumstances that would trigger an appropriate referral?

Create a positioning statement that communicates the problems you solve, the results you help patients get and/or the experience you deliver.

Power Partners
I worked with an orthodontist who wanted to grow his practice. When I asked him to describe his ideal patient, he said, “I like working with adults.” I asked, “What circumstances trigger an adult to invest in his or her smile?” He said, “Brides and people looking for new jobs.” We made a plan for him to reach out to job recruiters and wedding planners with special promotional offers.
To find your power partners, ask yourself these questions:

With whom do your ideal patients have relationships?
What products or services do your ideal patients purchase?
What interventions have your patients tried before they seek your care?

The answers will lead you to power partners. Meet them. Consider ways you can help your power partners to be more successful by sharing your expertise.

Information Seekers
Thirty years ago, my surgical mentor quipped, “The whole world is pre-op.” Now this is literally the case. Patients from around the globe consult with Dr. Google to get answers to their questions. They join online communities. They listen to podcasts and read books.

Imagine if these information seekers found YOUR answers to their questions. This is how my own teenage son found the orthopedic surgeon who eliminated his shoulder impingement pain.
If you’ve ever purchased a new food at the grocery store after accepting a yummy sample, you know the power of a taste test. Technology now allows you to deliver a taste of your value to large groups of people 24/7 at virtually no cost. You can create videos with answers to patients’ frequently asked questions. You can offer little pearls of wisdom, like the best way to remove a bandage, or suggest questions patients can take to their own doctors.

To successfully engage information seekers, avoid questions you think patients should be asking; instead gather the intelligence that helps you see the world through your patients’ eyes. Ask patients who call your office:

What questions do you have about your symptoms or your medical condition?
What keywords did you enter into search engine?
Which online communities have you visited?

You can also engage information seekers locally through radio interviews, TV appearances and local speaking appearances.

Attracting new patients to your practice is critical to your clinical success. Fortunately, with the right strategies and tactics, it’s easier than ever.

Vicki Rackner MD is a speaker, author and coach who calls on her experience as a practicing surgeon, clinical faculty at the University of Washington School of Medicine and serial entrepreneur to help physicians thrive. Her website is www.thrivingdoctors.com

WILL YOU OUTLIVE YOUR MONEY?

10/2/2019

by Vicki Rackner MD, FACS

As I caught up with an old friend, she shared that she’s in the midst of adding an in-law apartment to her home. She plans to have her parents move in with her.

I said, “That’s wonderful! I know how close you are. Now your kids can grow up with their grandparents.” She replied, “Yes, that’s true, but that’s not why we did it. My parents ran out of money!”

My friend’s father was a top-earning surgeon, and the Deacon in his church. How could this happen?

Today about half of physicians are behind in retirement planning. Here are some steps that you can take today to prevent outliving your money in retirement.

Create a vision of your retirement years.  You may have been told that your expenses will go down in retirement. However, if your ideal retirement looks more like a long vacation, budget accordingly.
Plan for a long life.  As you know from your own clinical experience, people are living longer. In fact, the number of Americans age 100 and older is up by 44 percent since 2000. How long will you and your life partner live? Best to prepare for a long life.
Factor in taxes.  During your earning years, tax deductions for contributions to your 401K’s and IRA’s look very attractive; it’s not as attractive as you pay taxes on the money you withdraw in retirement. Work with an expert who can help you minimize your lifetime tax burdens—both during your working years and in retirement years.
Sequence your retirement revenue.  You have a portfolio of investments. The order in which you tap into these “pools of money” can have a huge impact on your total lifetime investment income.
Invest in your health.  This is a great way to decrease health-related expenses in retirement.
Explore non-clinical sources of earned income.  You can serve as an expert in medical malpractice lawsuits, consult or speak. This income can accelerate retirement savings and augment retirement income.
Consider moving.  You can make your money go further in retirement by moving to a place where the cost of living is lower.

My guess is that you would prefer not to be forced to live with your children in your golden years. The best time to plan your retirement is today.

Vicki Rackner MD is a speaker, author and coach who calls on her experience as a practicing surgeon, clinical faculty at the University of Washington School of Medicine and serial entrepreneur to help physicians thrive. Her website is www.thrivingdoctors.com

avoid bad choices

9/3/2019

by Vicki Rackner, MD, FACS

I was awakened at 3 AM by a call from the ER. Nothing too surprising! This is a regular occurrence in the life of a surgeon.

The caller, however, surprised me by saying, “Hi, Honey. It’s Mom. I’m in the emergency room and the doctors tell me I need my gallbladder out. Will you fly out and do the operation?”

The right answer is, of course, “No.” But why?

It’s because when we doctors treat people we love, emotions can cloud our clinical judgment and compromise the medical outcome.

When the stakes are high, we want to make logical considered choices based on the best information available. This is true whether you’re helping patients optimize their health, or you’re building wealth.

Is this how people REALLY make choices?

In the book Nudge: Improving Decisions About Health, Wealth, and Happiness, authors Richard Thaler and Cass Sustein assert that real life decision-making is flawed in predictable and systematic ways.

This may explain why only about half of patients take medication as prescribed.

This may also explain why only about half of physicians report they are on track to retire.

Nudge author Richard Thaler of the University of Chicago received the 2017 Nobel Prize in Economics in recognition of his contributions to behavioral economics. This field explores how psychological biases cause people to act in ways that diverge from pure rational self-interest.

Here are a few predictable errors that erode financial health:
   •   Loss aversion  We will take greater risks to avoid loss than to experience gains. That means investors take risks at the time they should be erring on the side of safety.
   •   Over and under reactions  Investors tend to behave with optimism when the market goes up, and become much more pessimistic when the market goes down.
   •   Over confidence  Investors tend to overestimate their ability to beat the market, and underestimate investing challenges.
   •   Relativity Investors see the world through the eyes of relative experience. Imagine how you would feel if someone gave you a gift card. Now imagine how you would respond if someone gave you two gift cards and took one back. You have the identical outcome is each case, but it feels much different.

While this is not a formal part of behavioral economics, I observe two other investing mistakes that physicians and dentists make. First, many burned-out physicians use spending as a stress management tool. Second, many physicians are basing their choices on the wrong information.

Here are some steps you can take to avoid the bad decisions that can unwittingly undermine your efforts to achieve financial freedom:

Recognize the you are subject to psychological, social, cognitive, and emotional factors that may lead you to poor investing decisions.
Identify investing errors you have made in the past.
Explore the circumstances that made you more vulnerable to investing mistakes.
Create systems to protect yourself from investing errors. If you are dieting, you would clear unhealthy food from the house. Maybe you decide that you will check with someone before making purchases above a certain dollar amount.
Ask yourself, “Am I spending as a way to manage stress?” Could you think of other healthier options?
Ask yourself, “Am I paying attention to the right information?” For example, I recently came to understand the critical impact of taxes on wealth-building.

The most important piece of advice? Bring the principles that work well in the world of medicine into the world of finance. While I did not remove my mother’s gallbladder, I helped select the surgeon with the experience, skill and judgement to optimize the chances of getting a great outcome. I also wanted someone who would listen to my mother and be sensitive to the things that were important to her.

Please allow me to suggest that you want to have in your corner a seasoned expert who can help you assess your financial health, remain divorced from emotion and focus on the things that matter when it comes to diagnostic and therapeutic interventions with your money.

blog

WHAT CAUSES MONEY DRAMA?

The Real Cause of Money Anxiety for doctors...

HOW TO MEET NEW PATIENTS AND DEVELOP YOUR PHYSICIAN BRAND

WILL YOU OUTLIVE YOUR MONEY?

avoid bad choices

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