A digest of money management tactics for the family physician
Special Business Edition, Fall 2010
Ten Tips:
HOW TO RE-IGNITE THE
FIRE IN YOUR BELLY
The nature of being a shareholder/partner/
owner in a medical practice, invites burnout.
Medicine alone can be challenging enough.
However, you don’t get to be “just” a doctor;
you must also be an administrator, manager,
HR specialist, time management expert, and
more. That can take its toll over time. What
can you do about it? Here are ten ideas
you might want to consider.
3. Get adequate sleep... no less than six hours
a night. Now, you already know this.
Nonetheless, doctors are well-known
for going long hours on little sleep, so it is time
to remember it. Long-term sleep deprivation
can distort thinking and reduce productivity.
On the other hand, adequate sleep tends
to enhance stamina and clear-headedness.
Life always looks better after a good night's rest.
Make it a priority.
How to re-ignite the fire in your belly:
4. Dedicate time to mental regeneration
every day, and that’s not just medical reading.
Devote 30 minutes every morning to meditation,
inspirational reading, or listening to uplifting
material on your iPod while walking or biking.
Management expert Steven Covey calls it
"sharpening the saw." No matter the name,
it helps keep you focused, productive and
mentally in balance.
1. Have goals and dreams… goals and
dreams so real and important to you that
you can taste them, feel them. They go
beyond doctoring and even beyond money.
They involve your passions… both in
medicine and outside your practice.
What stirs your soul? Where do you want
to be next year? At age 55? At age 60?
At age 90? Let yourself dream without any
of the "yeah, but..." stuff that can cause us
to lose confidence or faith in ourselves
and our dreams.
Maybe it’s something as altruistic as devoting
time to serving in a third-world nation or
assisting in the homeless shelter downtown.
Or it may be something more personal,
such as training for a marathon or being
able to devote two weeks each year to
fishing in the Florida Keys on your own boat.
Find what it is that truly motivates you.
2. Become an expert at separating work
and play... and be sure to take time to play.
Try not to discuss work after a certain time
in the evening, for example. Also make the
kitchen, family room and, most definitely,
the bedroom a "No Business" zone.
5. Exercise daily, even if it involves only half
an hour of walking or peddling away on the
exercise bike. Yes, you know how important
it is. Just make sure you take the time to do it.
Bonus: Get double duty from this time by
reviewing medical issues on the bike or
treadmill or listening to something other
than elevator music while out jogging.
6. Believe in what you're doing. Remember,
what you do is important – life-saving important.
Yes, many doctors are frustrated these days with
the paperwork and bureaucracy. If you no longer
think that medicine is worth it, then leave.
However, if you plan to stay, give yourself
a reality check: Remember how vital and
important what you do really is to your patients
and your community. Do not lose sight of that
amid the day-to-day routine. If you do not
believe in what you're doing – or are just doing
it for the money – you need to rethink what is
important to you.
Re-ignite the Fire in Your Belly!
7. Be organized. The business person side of
you needs to maintain clear objectives and
activity plans for the year, quarter, month,
week and day. Muddling along without any
sense of direction is a major stress builder.
Be sure you know where you’ve been,
where you are … and where you intend
to go. If you are struggling with this,
hire a competent office manager and/or
bookkeeper. There is no need to go it alone.
8. Work smarter … not just harder. This
is an addendum to the above point about
being organized. An hour of planning can save
ten times that in increased productivity. Follow
the carpenter’s rule: Measure twice, cut once.
Imagine that you waste just one hour a day in
unnecessary busy work. Now imagine that you
eliminate that lost hour. You will actually add
five hours in a five-day week, more than 20
hours in a month, and more than 240 hours
in a year. That adds up to more than eight
weeks – two months – of “found” time.
9. Don’t settle into success. That can be
the greatest cause of burnout. Repetition
of a successful process or activity can lead
to mind-numbing boredom for some people.
If this describes you, try to take at least one
calculated risk – even if it’s whimsical and
off the wall – each year. Or go back to school
to learn a new procedure.
(continued on next page)
• Keep your personal lives out of the examination
room. Conduct yourselves professionally at all times
while working. Public displays of affection, personal
conversations or other signs of intimacy can embarrass
and alienate other workers. Worse, they can disrupt the
smooth flow of the office.
• Keep the practice out of the bedroom, or anywhere
else in the house, for that matter. If you are so busy all
day that you don't have much time to talk about what’s
going on at the office, take half an hour or so after hours
to catch up, unwind together and make the transition
from work to marriage. Then put work away for the day.
The idea is to strike a healthy balance between your
professional life and your personal life.
• Get away with each other. Plan work-free vacations
and get-away weekends so you don't ever forget that
you are much more than co-workers.
• Get away from each other. It is unrealistic to believe
that you can be side by side 24 hours a day and still
maintain a healthy outlook and attitude. Develop outside
interests in things that belong strictly to you. Maybe one
of you golfs, the other loves tennis or boating. It is okay
to do some things separately.
In fact, it is necessary.
• Capitalize on the benefits of working together.
Maybe one of you works just 20 hours a week or
splits hours between home and the office. You have
the luxury of setting your own hours and planning
your own schedules.
HUSBANDS & WIVES
WORKING TOGETHER
It can be tough having to deal with partners in your practice. Add your spouse as a
co-worker or employee – whether it be as two doctors working together or one serving as a nurse,
administrator or office manager – and the potential for problems climbs dramatically. The result can
be pure craziness or total bliss. It all depends on how well you structure the working relationship.
There are distinct drawbacks to husbands and wives working together. The biggest is that trouble
at home can easily spill over into the office. Worse, if the couple splits, the practice can become a
pawn in the “great divide” known as divorce.
The bottom line: If you and your spouse work together
as professional partners or co-workers, or employeremployee, you know that it can be both challenging
and invigorating. By carrying out the above suggestions,
you can make it even more rewarding. You may even
have fun together. (continued from previous page)
Still, the benefits can far outweigh the potential disadvantages. Couples who know how to work
closely together share a unique dedication and loyalty to the organization’s success. And let's face it,
it's also fun to be able to work shoulder to shoulder every day with your life partner in a common
purpose. That's why, best of all, husbands and wives who are successful in the office together tend
to enjoy greater peace and harmony in their personal lives as well.
10. Maintain your priorities. Medicine is important ... but
not at the expense of your own health and happiness,
or that of your family. Also, remember that our
relationships outside of the practice are what give true
meaning to what we do. Seek balance and moderation.
If you are part of a husband and wife team in your practice, here are a few suggestions
to help ensure that both the practice and the marriage continue to prosper:
The bottom line: If you are doing it right –
if you are giving your practice and your life your all,
you will always run the risk of hitting burnout.
You can reduce that risk by remembering and
applying the above ten ideas to keep you
not only productive, but also focused and
satisfied in your profession and in your life. • Divvy up responsibilities. Maintain clear and separate areas of responsibility. Write down
job descriptions. Then leave each other alone. Perhaps one of you manages the office, while
the other focuses on patients. Or perhaps, if you are both doctors, you may want to keep your
patient list separate. Otherwise, you run the risk of, literally, stepping all over each other.
HIRING YOUR KIDS
FOR THE SUMMER
The good news/bad news about hiring your children for the summer: On one hand, it gives them a taste of what it is like to work in medicine.
Perhaps they will go back to school with a better understanding of the frustration and excitement that drives you every day… and maybe decide
that they want to follow in your footsteps. Even if they decide that medicine is not for them, a summer on the payroll could strengthen the relationship
between you. On the other hand, it could lead to family strife and disrupt the smooth workings of your practice.
So, consider the following before adding
your son or daughter to the payroll this summer:
• Make sure you both want to do this.
Many children would rather flip burgers
down the block than spend the summer
under your scrutiny.
On the other hand, if this is something that
is important to you, try diplomacy and tact.
But also keep in mind that some things just
are not meant to be. If you have reservations
about your child's maturity or your own ability
to cope, encourage him or her to seek
summer work elsewhere. You will both be
happier... and the office will be better off.
• Make sure it is a real job… with real
responsibilities and pay. Bringing Junior in
to do a make-work job for an inflated paycheck
and come-and-go-as-you-please hours will
undermine the morale of other employees ...
and be a disservice to your child. Of course,
there are situations when you may want to
pay your child an above-average wage for
tax and/or college tuition reasons. If this is
the case, keep the arrangements between
you, your child and the bookkeeper.
• Make sure you know who will supervise
your child. Parents tend to be either too lax
or too strict. If you are the kind of parent who
cannot coach your child's sports team without
blowing up, do not try to manage your child in
the office. Get somebody else to do it. But
be aware that supervising the boss's kid is
no honor in the eyes of most employees.
Make sure this person can be fair, and has
your total support ... especially when Junior
starts talking shop around the dinner table.
• Tax considerations: If you decide to hire
your children for the summer, be aware of
the ins and outs of your tax situation. Hiring
family members can create a unique set of
opportunities and problems. Here are the
basics, according to the IRS:
If you are incorporated, you must pay
Social Security taxes on wages,
regardless of age.
Your child can deduct up to the standard
deduction (it was $5,700 for 2010) without
owing any income tax.
The bottom line: If properly arranged and
carefully planned, hiring your kids for the summer
can create a win-win situation – both financially
and personally – for you and your children, while
also generating some attractive tax benefits.
Check with your tax advisor for details. Your child's salary is deductible as a
business expense. This can reduce
taxable income. If the money is to be
used for college expenses, you are
effectively paying tuition with pre-tax
dollars.
If your practice is a sole proprietorship
and your child is under 18 years of age,
you pay no unemployment or Social
Security taxes on wages earned.
They may want to follow
in your footsteps.
WHAT EMPLOYEES REALLY WANT
Employees generally want more than just a paycheck. Sure, dollar-value benefits are important. Just as important, however, they want
what could be called "life-value" benefits. They want to work in an environment in which they have the opportunity for personal and professional growth.
As for the specifics… studies abound on the subject, going back as far as 1946. Surprisingly, the basics have not changed in decades.
The following chart, compiled from a number of studies conducted between 1946 and 2005, show differences between what employees say they want
and what employers think their employees want:1
What Employees Say They Want
(in order of importance)
What Managers Think Employees Want
(in order of importance)
Note: Good wages are less important to most
1. Full appreciation for work done
1. Good wages
2. Feeling “in” on things
2. Job security
3. Sympathetic help with personal problems
3. Promotion/growth opportunities
4. Job security
4. Good working conditions
when, in reality, the most desired benefits are
5. Good wages
5. Interesting work
6. Interesting work
6. Personal loyalty to workers
“life-value” benefits… and they do not cost any
7. Promotion/growth opportunities
7. Tactful discipline
money. The number one perk is a positive work
8. Personal loyalty to workers
8. Full appreciation for work done
environment that encompasses respect and a
9. Good working conditions
9. Sympathetic help with personal problems
10. Tactful discipline
10. Feeling “in” on things
employees than employers think. Too often,
managers attempt to throw money at a problem
sense of being part of a team.
Suggestions: Yes, pay your employees a decent wage. Additionally, consider some of these other low-cost, high-value perks:
1. A simple “Thank You” for a job well done.
2. Asking for staff input on appropriate issues (change in office hours,
remodelling or redecorating, administrative improvements, etc.)
3. Flexibility on scheduling, when possible, including encouraging
employees to participate in their own scheduling of work hours.
4. Bringing in breakfast (bagels, yogurt, etc.) every now and then.
1
5. Promoting from within the organization whenever possible.
6. Being flexible and understanding when personal problems or needs
require employees to take time off.
7. Following the rule that you should praise in public, criticize in private.
8. Giving an employee of the month award, complete with framed
certificate. “Top Ten Things Employees Say They Want,” SelfGrowth.com, site visited on August 31, 2010.
BIZ QUOTE …
BIZ TIP …
“First-rate people hire first-rate people.
Second-rate people hire third-rate people.”
Have a written job description before your hire an employee.
This helps both you and the candidate properly define responsibilities.
Also, have current employees write their own job descriptions.
You may both learn a lot.
Quincy Crawford
Your Financial Health is sent to Academy members courtesy of
AAFP Insurance Services, Inc. Material for this publication is
written by John R. Ingrisano – author, educator and journalist on
money management, business, and financial matters.
Mr. Ingrisano has served as an advisor to AAFP Insurance
Services since 1985.
© 2010, AAFP Insurance Services, Inc. Phone: (800) 325-8166
AAFP Insurance Services, Inc.
Fax: (800) 223-7463
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Website: www.aafpins.com
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Leawood, Kansas 66211 Email: [email protected]
The material and ideas presented in Your Financial Health are offered
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to subjects covered. However, obviously, only generalized comments
can be offered, designed to bring relevant topics to your attention but
not necessarily applicable to any given individual’s circumstances.
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suggestion herein might be desirable for your circumstances, the
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