Advice and Commentary on the World of Professional Consulting

Healthcare In A Minute - March 2016


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.

Ethics Means Different Things To Different People

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.

Permaculture Ethics
London Permaculture via Compfight

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.



3 Consulting Mistakes With Jon Denney

At the last Professional Consultant's Meeting, our guest speaker was Jon Denney, former owner and founder of Avalon Printing Services who's now the president of both Jon Denney & Associates Consulting as well as the Professional Business Coaches Alliance. He spoke to the group about different types of mistakes that both businesses and business owners regularly make. Even if they're not all big mistakes, each mistake can cost a lot of money both short and long term.

Jon Denney 2016

The first thing he talked about was how to make money by putting on seminars, something a great majority of people absolutely hate to do to begin with. Yet, many of our members have had the opportunity to speak in front of others and make the mistake Jon warned us about. His point was that people go to seminars listen, then go back to their offices with a lot of good intentions that they never follow through on.

His suggestion was to have an immediate takeaway, something that costs nothing but gets people at the seminar to take immediate action. He offers anyone who approaches him after his presentation a free 60 minute counseling session to see how he might be able to help them, with the offer good only then. He finds that there's usually a significant number of people who will take him up on that offer and he'll usually end up signing one or two of them to coaching contracts, which more than makes up for the free sessions he gives.

The second thing Jon talked about was how to introduce pain points into conversations with potential clients. Too many of us call and start talking about what we do and how we can help our clients, who have probably heard it all before. His suggestion was to begin by asking specific industry questions that most people struggle with, which he says will usually get them talking, and if the pain points are significant enough then introduce the possibility of a meeting to look at the issues and discuss what might possibly be worked out. His belief is that if you can start a conversation rather than looking like a sales person that you'll ultimately be more successful.

The final thing Jon talked about was not waiting for prospects to "think about it". His point was that overwhelmingly people use that phrase to get you off the phone and really aren't going to think about it. Instead, he likes the idea of offering up front money back guarantees where, if people feel they're not getting their money's worth after the first month he'll give them back whatever they paid and move on from there. He said that he's never had a single client who's ever decided he didn't help them in some way and that you not only have to have confidence in what you bring to the table but be willing to go above and beyond to address client issues, whether personal or business related.

This last issue generated a lot of discussion because it's a scary prospect. As consultants, we put a lot of time and effort into what we do and, even when we're confident that we can help improve things, we unilaterally hate making guarantees because clients might tell you one thing up front that you deliver on, only to have that issue change midstream or even take what you've proposed and attempt to do it themselves without you. Jon believes that success takes risks and that you'll end up having more success than failure by trying things this way.

All in all it was a spirited discussion on a bad weather day and Jon's presentation got us all juiced up and ready to let loose what we'd learned that day.

Does Your Business Have A B.A.I.L. Team?

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

Starting, expanding and running a business is challenging. Small business entrepreneurs have to know who to go to for specialized assistance. Many consultants use the term “BAIL Team:” to describe the essential team members.

The professionals that are chosen must be proficient in business dealings.

It is perfectly realistic to interview and shop around for BAIL Team members that your business can feel comfortable with. It might be a good idea to see if there is a charge for the initial meeting. Insurance agents cannot charge. They make their money when you buy. Remember, you will be looking for someone to form a long term relationship with and who can help throughout your business cycle.

NIU Business student team

NIU Business via Compfight


Give me a “B!”

Bank (or Credit Union) – Small business owners need a bank. Banks process deposit, maintain accounts and allows for a place to consult for seed money or working capital. Bankers generally have specialties thrust upon them by their superiors. The branch manager will most likely not be the one you will deal with for a commercial loan.

Give me an “A!”

Accountant – Want to lower your business’ chances of an audit? Accountants help keep your filings timely which keeps your business on track. Accountants are familiar with best practices of general business and category-specific information.

Give me an “I!”

Insurance – Protect and cover the assets your business has worked so hard to create. Adequate insurance is crucial to manage risk and provide proper coverage. Insurance agents must be licensed.

Give me an “L!”

Lawyer/Attorney – A proper question helps legal risks from becoming legal problems. Be sure the attorney is very familiar with business dealings and licensed to practice.

Anyone else?

Yes, how is your business marketing itself? Each of the professionals listed above are essential to small business. However, each of the individuals and their specialties are designed to protect the small business. Having a consultant or team member experienced in small business marketing is essential to help bring in prospective leads and close sales more easily.

Want to know more?

Let’s discuss your business’ marketing plan at no obligation. Call us at 315-472-0222 or email me at to arrange a meeting with a member of our team.

Sustainable Entrepreneurship With Terry Brown

At our last Professional Consultant's Association meeting, we had a presentation by Terry Brown, Executive Director of the Falcone Center for Entrepreneurship at Syracuse University's Whitman School of Management. In his role he also works with the South Side Innovation Center and WISE Center.

 Terry Brown

He started out by telling us about his experiences of being a consultant for an engineering company. They had many challenges but lived by the "can do" model, thinking outside of the box on many ventures that made him and his company successful. He told us that story while leading into the first part of his presentation which covered the subject of innovating or creating new combinations of resources, pursuing opportunities, acquiring or bringing together resources, risk-taking, profit-seeking and value creation. This was a credo he & his company lived by, and it incorporated all of these conditions.

The one that challenged most of us was the risk-taking idea. He talked about a project where his company put in a bid much lower than all other companies had. When asked about it, he said that his company intended to invent a machine that could do the work at a much lower cost than what everyone else was proposing to do. They got that contract... without having invented the machine. Yet they invented the machine, it worked as it was supposed to, and his company made a lot of money off the deal.

He next talked about the characteristics of entrepreneurs, and in his opinion all true entrepreneurs exhibit the following:

* Drive to achieve

* Calculated risk taking

* Tolerance for ambiguity

* Perseverance/determination

* Independence

* Self confidence

* Tolerance for failure

* High energy level

* Resourcefulness

* Creativity and innovation

* Vision

* Integrity and reliability

His ideal says entrepreneurs should always begin with the end in mind, your company, you personally and the clients you work with. This part garnered a lot of discussion because, with a group of consultants like ours, each of us has different experiences in working with clients, especially those who don't follow up on the advice we give thm and those who aren't sure how to value our worth.

Finally, he talked about the need to have a "dream team" of professional support, folks who can handle the important things for you so you don't have to, as well as the need to figure out how to differentiate your services and what you have to offer from everyone else. One important thing he said in this regard is that all of us need to be ready to reinvent ourselves and our business when necessary. In other words, we shouldn't always be defined by what we think we are and do but what the market might need from us.

It was a very good program from someone who's been there and is now passing his knowledge on to those who are ready to take over the world. Hopefully some of our own members picker up enough tips to be a part of the takeover.