Advice and Commentary on the World of Professional Consulting


There are a lot of jobs that have been eliminated that just aren't coming back. Manufacturing in America is dwindling, and there's not going to be a renaissance for that either. We can't compete with the pay rates that countries such as India and China are willing to accept. That, and not having to deal with unions, will kill large manufacturing in America.

Everyone isn't suited to work menial, low paying jobs; many people are overqualified and won’t even get a second look from employers. Some of us are older and physically can't handle stocking shelves for long periods of time, or standing for a long time; our backs can’t take it. Some people might be able to do it, but not everyone.

What's left then? Loral Langemeier, who shows up on Dr. Phil and other shows often enough, wrote a book called the Millionaire Maker. She helps people set budgets that they can live on, but also gets real with people. She works with them to understand that they may have to sell their homes, their fancy cars, and live a simpler life. She also recommends that everyone take a good look within themselves to figure out what skills they have to work for themselves and bring extra money into the household.

Working for oneself isn't a new concept. America was built by people worked for themselves, who had more than one skill, and that’s how they made their living. Self employment has always been a big thing in this world. This is why consulting makes a lot of sense for people who have skills that can help others and a need to work as much as possible without the restraints of internal politics.

In Langemeier's book, she tells the story of people who hadn't thought about skills they had, that either came as a result of the jobs they did, or as the result of hobbies they had. One man was a teacher who realized he could do tutoring after school to make money. It turned into a full time career, as he hired other people and paid them a portion to do tutoring for him.

There was also the story of a lady who could build websites, something she learned at her job, and she turned that into first a part time job, then her new profession.

There are many things people need someone else to do for them. They go looking for someone to help them in their local newspapers. Or they look online for those people in the area where they live. New entrepreneurs realize they can put ads in these newspapers, offering services that someone might be able to use.

Many unemployed people need to take the time, while sitting on unemployment, to not only look for a new job, but try to see what they can do that may bring money into the household. Since most communities have a Chamber of Commerce somewhere near, contacting them and learning when they have networking events give you another chance to meet people who just might need your skills, both individuals and larger businesses.

It's up to you to think about your own self and your skills, and to figure out what you’re good at. Talk to someone to help you explore the thought if you need to; if you have to pay a few dollars for it, it may be worth it. Anything you do that's a positive step forward only brings positive things into your life. You owe it to yourself to think of ways to be independent, even if it doesn’t work out; you’ll gain valuable information that you may be able to use later on.

The Professional Consultant's Association of Central New York gets many new visitors who are people that are in a career transition and looking to see if consulting is for them. I'd estimate that 85% of them find themselves employed within 3 to 6 months later, having decided that they're more comfortable with a standard job than having to deal with the pressure of being self employed. We don't condemn anyone for those types of decisions; it's probably something those of us who have been independent consultant's for a long time have entertained here and there in our professional lives.

America is changing; change with it, and you may find a career that fits you like a glove, and that gives you more control over your life. Consulting is a pretty nice career change to think about. It's not easy, takes a lot of discipline in a lot of areas, and sometimes you'll have your ethics challenged in ways you've never imagined. Overall, you'll love the freedom, the sense of purpose in knowing that your success is on your hands, and you might even see the world on someone else's dime. :-)

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by George Chapman, GW Chapman Consulting

VA privatization?  Recent problems within the VA healthcare system have prompted a special VA commission to consider allowing vets to receive their care at private facilities while the VA begins to close their own hospitals beginning with the obsolete and little used.  Several veteran’s groups have expressed opposition to the proposal saying their opinions/feelings have neither been considered nor solicited.  The VA operates 150 medical centers and 1,400 outpatient clinics, employs 53,000 licensed professional and cares for 8.3 million vets.

Cyber-attacks.  The hacking of healthcare data is becoming more frequent and sophisticated. Most of the attacks come from Russia, China and eastern Europe. Hackers are looking for protected health information and medical technology intellectual property to sell on the black market. “Ransomware” is designed to destroy backup files and databases unless the victim pays a ransom to have their data unlocked. The FBI is encouraging victims NOT to pay the ransom as to do so would only encourage the hackers. The defenses against these attacks are costing the healthcare industry billions.

MD assisted suicide.  California is moving towards legalizing physician assisted suicide for the terminally ill. It’s already legal in Washington, Montana and Vermont. Of course, the eventuality of California entering the market has prompted the manufacturer of Seconal, developed over 80 years ago, to gouge the public. In 2009, a lethal dose of Seconal costs about $200. Valeant Pharmaceuticals has raised the price to $3,000.

NYS mergers driving up prices.  A study by the conservative think tank, the Manhattan Institute, concludes that the 100+ hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. The Institute recommends greater price transparency among hospitals and to establish a commission mandated to monitor healthcare consolidation and costs. Mergers that result inI price increases would be subject to antitrust litigation. Accounting firm PWC agrees. According to their market analysis which included 5,600 hospitals, bigger hospitals have obvious economies of scale advantages over small hospitals; but it doesn’t carry over (so far) when these hospitals merge.  Hospital mergers have not resulted in noteworthy cost savings or improved quality.

Employer sponsored insurance.  Many thought the ACA would cause a decline in business sponsored health insurance.  According to the Congressional Budget Office, 57% of Americans, about 155 million, will still get insurance through their employer this year.  The CBO predicts this will drop slightly to 152 million in three years, but then remain stable through 2026.  The main reason for this stability is probably employees have come to expect coverage through their employer.

Controlling drug prices.  In an effort to control spiraling drug prices, Medicare is trialing a new payment model whereby physicians who prescribe drugs that are cheaper but equally effective as the higher priced options will be rewarded. The thought is to have both the physician and patient do the math. Physicians are still free to  prescribe the most expensive drug if they truly believe it is in their patient’s best interest.

Good Samaritans.  A survey of North Carolina physicians revealed that 93% took action in a medical emergency outside of their office.  The most common place for emergency services was on an airplane.

War on cancer.  This is one war we are actually winning. Cancer related deaths have decreased from 215 per 100,000 deaths in 1990 to 166 per 100,000 deaths in 2012. That is a 23% decrease in just 22 years. Cancer mortality has dropped across the board for all cancers. Since 1990:

breast -36%,

prostate -50%,

colorectal -39%,

non-Hodgkin’s lymphoma -28%,

ovarian -22%,

cervical -34%,

leukemia -15%,

lung -24%,

kidney -12%,

liver -70%,

oral -29%,

pancreatic -3%,

stomach -47%,

thyroid -25%,

brain -10%.

NYS #21. The annual United Health survey of states ranks #1 Vermont as the “healthiest” and #50 Louisiana as the “sickest”. The study considers factors like diet, smoking, alcohol intake and obesity in its  ranking.      

Measuring and reporting “quality” is expensive.  Your physician spends about $40,000 a year in staff time and money just to measure their progress against several quality measures imposed by Medicare and commercial payers. Many are calling into question the return on investment when it comes to value based payment.  What it costs a physician to comply and report almost negates any increased payment or rewards for meeting quality metrics. While measuring and rewarding quality is a laudable goal, the inefficiency in collecting and reporting the data clearly contributes to the negative attitude in the medical profession towards the whole concept.

April awareness month.  Alcohol abuse, autism, child abuse, distracted driving, minority health, world health and air quality.

 

By John Hunt, General Sales Manager, WOLF 105.1, Movin 100.3/96.5, 95.3/103.9 The Dinosaur And Fox Sports 1490AM

“A man who stops advertising to save money is like a man who stops a clock to save time” – Henry Ford

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Successful small businesses know advertising is an essential business plan component. For over ten years we’ve presented marketing workshops in conjunction with the Small Business Development Centers in Oswego and Onondaga Counties. These workshops are designed to help small businesses design the marketing chapter of their business plans.

We know that successful worldwide brands like Coke and Microsoft are household names. So why do they continue to advertise and market their products when they dominate their respective categories? Because – if they don’t, there is a better chance consumers will forget about the products and services over time. Marketing at this stage is designed to continue the brand experience in between the times when a consumer uses the product or service.

“That’s true, but small businesses don’t have the budget or resources that million dollar companies have.”

The principles that these successful companies use are the same principles all businesses are encouraged to use. Successful small businesses look at the patterns and strategies and adapt them for their own campaigns.

Start by looking at how the customers buy. What brings them to the small business? Follow the pattern.

Eventually, the small business will recognize the whole customer buying cycle. Now, focus the advertising at various points or milestones of the buying cycle so that the buying cycle will compress and encourage more frequent transactions.

“Our small business doesn’t have money to throw away on advertising. It needs to work.”

Our company believes all media works if it is used properly. If we know how customers buy from the business, our team can look at those patterns and help improve the buying cycle. There are patterns in every industry. If we compare our research with local small business’ trends, we will help see these patterns more clearly. Knowing these patterns brings about better results from advertising and marketing.

Want to know more?

Let’s review your business’ customer buying cycle at no obligation. Call us at 315-472-0222 or email me at jhunt@movin100.com to arrange a meeting with a member of our team. Or – if you have a group or trade organization that would like to host one of the small business marketing workshops at no cost and no obligation, we are scheduling appearances for summer and fall 2016 right now.

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by George Chapman, GW Chapman Consulting

Malpractice alternative.  Patients seeking damages would present their grievance to a panel of experts and an administrative law judge. Rather than wait years for a settlement, the claimant would be quickly compensated should their case have merit. This would ameliorate if not eliminate the adversarial relationship the current malpractice system creates between physician and patient. It would also allow providers to acknowledge an error without fear of litigation.  This Alternative Patient Compensation System model is being contemplated in Georgia, Florida, Tennessee, Maine and Montana.

Hospital jobs on the rise.  According to the Bureau of Labor Statistics, hospital employment is at just over 5 million people. Hospitals added a net 188,000 jobs in 2015. Most of the growth is attributed to acquisitions of medical practices, increased demand for outpatient services and gearing up for population health management. The entire healthcare sector employs almost 19 million workers. Employment was down in dental offices and laboratories.

Hundreds of US rural hospitals in jeopardy.   One third of all US rural hospitals  are in danger of closing. 70% of them have had negative operating margins for years. The loss to a community is more economic than clinical. While clinical care is typically available at other facilities in the area, rural  hospitals are often one of the largest employers in the county. States with the most distressed rural hospitals are Texas and Mississippi.  There are about two dozen small/rural hospitals in danger of closing in NYS. Two senators have introduced legislation, “Save Rural Hospitals Act”,  to provide funding to keep the doors of rural hospitals open.

Without special funding, most rural hospitals will close unless they affiliate with a larger hospital or join a hospital system.

Happy Danes.  Like most western nations, Denmark has a universal healthcare system. Danes are very happy with their lives and their healthcare because the bureaucracy that is typically associated with universal systems has been vastly reduced. The Danish system emphasizes locally focused control.  A lot of value is placed on close, unfettered relationships between patients and their primary physician. Danes average seven contacts (in person, phone, electronic) per year with their primary care provider. The US average is less than four contacts. The main goal in Denmark is to catch problems early and treat.  Danish per capita costs are about $5,000 compared to about $9,000 in the US.

Employer sponsored plans cause concern.  Large employers can avoid a lot of insurance regulation and requirements by forming and designing their own plans. The hospital association is lobbying congress to close loopholes in coverage requirements. In a letter to CMS, the AHA expressed concern over the fact that that some employer plans are not covering outpatient surgery in order to cut costs. The AHA argues this puts employees at risk both clinically and financially, meeting neither the spirit nor mandate of the Affordable Care Act which is to insure safe, affordable, accessible and comprehensive care to all Americans. The AHA suggests  that CMS establish minimum coverage standards for all categories of care including surgery.

Healthcare advertising on the rise.  The industry, providers and drug companies, spent $14 billion on ads in 2014, up 20% over 2011.  Competition for patients and market share is fierce, causing concern among consumer groups about over utilization and higher prices to pay for the increased ads. 

Moratorium on hospital mergers.  While mergers can save vulnerable hospitals and/or improve services, many have resulted in nothing more that monopolies which typically lead to price hikes. Connecticut governor Dan Molly has placed a moratorium on hospital mergers in his state. He issued this statement, “ We need balance. Fewer healthcare systems mean fewer choices for consumers, and that can dramatically affect both the quality of care and costs. It’s time we take a holistic look at the acquisition process.”  In the same vein, many are questioning the impact of insurance company mergers on eventual premiums.  

Medicare Advantage plans.  Last year, over 17 million seniors (about one third of Medicare eligibles) chose to enroll in an Advantage plan offered  by a private commercial insurer. Advantage plans attract seniors by offering  more benefits than traditional Medicare.  The feds entice private insurers to offer Advantage plans with more than $3 billion in incentives and bonuses. The insurer must reinvest monies earned into  additional benefits and new approaches to manage chronic conditions like hypertension, diabetes and obesity. United Health, for example, could earn over $1 billion in bonuses this year.  Overall, commercial insurers have done well under the ACA.

March awareness. Sleep, nutrition, brain injury, developmental disabilities.

At our last meeting, which was also our most intimate grouping of professionals, John Hunt of WOLF-AM, and a member of PCA, led the group in discussing the topic of ethics... and it turns out that even in business we tend to view it differently than in our personal lives. It's a topic that we previously discussed in 2012, so it was good to revisit it.

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On our PCA website we have a Code of Ethics that's been a standard for the organization since it was formed in 1995. It's the most visited page on the site, which means we must be touching upon some beliefs and thoughts of professionals all across the country.

As the conversation began, we dealt with the issue of what should be done when we see that clients we're working with aren't quite following the rules, sometimes on the verge of illegal behavior. A few members felt that we should be turning in our clients, while others felt that not only wasn't their responsibility but could be damaging to their long term careers. This led to a discussion of degrees of illegality, intent, and what roles consultants either should or could play in minimizing errors or having to come to grips with taking other actions.

One of our members talked about having to drop a long time client because he'd always known part of what the client was doing was inherently dishonest, but it had never touched his business until recent changes in tax preparer rules. Suddenly he realized he would have direct liability and rather than having to become an agent of the government as far as being an informant he decided to step away. A few other members talked about having to do the same type of thing, which shows that all of our members had personal ethics that superseded the sometimes dodgy world of business ethics.

Another member talked about providing something for a client, only to have that client cancel the contract and take that proposal to someone else, who did it almost word for word. He found his way of confronting both the client & the other contractor for their lack of ethics, but learned a valuable lesson in the process. Once again, a number of our members had suffered similar events over the course of doing business, and it left all of us just a little less trusting but infinitely wiser.

What we all walked away with was the reality that even if one has died and true personal ethics, sometimes when it comes to business you're going to be challenged between the two ideas of doing what's necessary versus doing what's right, but there's a lot of gray area in the middle.  What will you do for money? At what point do you realize you have to end your association, if any? What's your responsibility to the greater good versus your responsibility to yourself, your livelihood and family?

These aren't always easy questions, but I feel comforted that our members are all on the right path.