Top Ten Skills for Practicing Physicians

I am often asked by graduating residents for tips they can use as they begin their careers. After some thought, I decided I would jot down the ten most essential skills every successful practicing physician should have. 

1. Understand Your Financial Reports. You learned to determine the health of your patients, but do you know how to determine the financial health of your practice? We use lab data to help us determine the status of our patients, and we can use our financial reports in the same manner. The approach and mindset are the same both clinically and financially. Be comfortable with the income statement and know what is on your balance sheet. Understand how those two reports are connected to each other. Data from both of these reports will be used to determine the financial health of your business. 
2. Understand Your Mission and Purpose. You choose a career in healthcare for a reason. It probably had something to do with your desire to help other people. Take time and work on clarifying your mission and purpose. Your mission is what you do, and your purpose is why you do it. Perhaps you provide care for patients (what you do), so they can have healthy, happy, and productive lives (why you do it). Your mission and purpose also should be based in the world of your patient and for their benefit. The reason for understanding your mission and purpose is that it will help you keep focused on larger objectives. When the madness of the bureaucracies of healthcare, the pains of the EMR, and hoops you have to jump through to get your patients the treatment they need, knowing and focusing on your mission and purpose will give your fuel, strength, and energy. It will go a long way in helping you avoid burnout. 
3. Know Your Processes. Your front office and back office have processes that will affect the efficiencies of your practice. Sometimes they run in parallel and other times they will operate serially. If you want to have maximum efficiency, clearly understand their timing and impact upon each other. Efficiency is the ability to avoid wasting the materials, energy, effort, money, and time in accomplishing a goal or objective. It’s the ability to do things well, successfully, and without waste. This can only be accomplished if you understand how things work in your office. Take the time and put forth the effort to understand how your office functions fully. You’ll be glad you set out to solve problems in the workflows.
4. Pick the Right People. People are perhaps the most important asset of your business. Unfortunately, we tend to view them as expenses since they appear on the expense section of the income statement rather than the asset column of the balance sheet. Pick your people carefully. Always hire for skill and experience while always watching their attitude. Good people can be dragged down by someone else’s bad attitude. Avoid folks who think a little too highly of themselves. There’s a distinct line between humble confidence and arrogance. Spend time and money investing and developing your people as well. Since they are your greatest asset, care for them as you would any other asset in your company.  
5. Let Your People Flourish. In one of the hospitals I frequent, there was a campaign of “30 in 30 - 30 ideas in 30 days.” It was the administration's way of soliciting ideas for improvement to the services, processes, and quality of care offered there. They were sincere and worked to implement some changes to make the hospital better. They have witnessed improved outcomes regarding customer satisfaction, reduced errors, greater employee satisfaction, and the like. This process allowed their people to flourish as the employees took ownership of the ideas and made it work. Do be afraid of someone else’s good idea. Sometimes that good idea will turn into a gold mine.
6. Know How to Negotiate. If you want anything in life, you will need to negotiate it. Negotiating effectively might be the second most important skill of a physician. You will negotiate with your staff, partners, payers, and even patients. Knowing how to negotiate, having a plan, and following a procedure will help you go a long way towards getting what you want. There are great resources out there that will help you establish the proper mindset and teach you the negotiation-winning behaviors you will want to win at the negotiation table. 
7. Know Where Your Cash is Flowing Intimately know of where your cash is going. As a physician, you should have a solid understanding of your average costs and revenues for each patient you see. Where is your revenue coming from? What are you spending money on in your practice? Are those expenses or investments necessary to fulfilling your mission and purpose? How might you be able to reduce costs? An excellent report to help you see the flow of cash through your business is the cash flow report. Ask for it if you don’t already get one regularly. Read it carefully, and it will give you great insight into the lifeblood of your business - cash. You cannot control something if you don’t know what is going on. The cash flow statement will help you gain clarity into what’s going on in your practice. 
8. Monitor and Control Your Services. Know where which of your services are contributing profit and which ones are not. The best way to determine that is from the financial reports coupled with the operational reports. Review these reports together each month. You might discover one service line isn’t performing as well as you thought. That should prompt you to ask questions. Is it a payer issue? A volume issue? A process issue? Does this service line up with your mission and purpose? Always be monitoring your services and working to improve them regarding quality and quantity constantly. Finally, don’t be afraid to cut a service line if it isn’t contributing positively to the bottom line. That may be one of the most difficult decisions you’ll make, but it might just be the one that saves your practice.
9. See Problems for What They Are. Problems are everywhere and how we respond to them will define our success in dealing with them. I encourage others to view problems not as obstacles to be overcome, but as opportunities for improvement. Nothing ever remains the same and neither should your practice. Once you view a problem as a sign or symptom of a process that requires improvement, you’ll approach it with new energy and focus. Don’t avoid the problem. Instead, deal with it directly, immediately, and forcefully. Fix what you can as fast as possible. The more problems you fix, the better your practice will become. 
10. Be Teachable. Don’t become content with the status quo, especially with your fund of knowledge. Create and commit to a personal growth plan. Keep growing yourself because that will determine whom you attract to your organization which will determine the success of your practice. The best way to grow is to remain teachable and have a growth mindset. It’s been said, “Status quo means the mess we’re in..” Part of being teachable requires you to be discontent with the status quo. Always be looking for ways to be better and improve not only your practice but yourself. Encourage and help your team grow as learners as well. Whenever possible, look for ways to add value to them. Don’t be afraid to give and invest in your people. Henry Ward Beecher said, “No man is more cheated than the selfish man.” So, give and invest in your people.