Enter, Guns A Blazing

I used to work as a gunslinger. No, silly, not that kind of gunslinger. I made my living as a medical practice turnaround specialist — that kind of gunslinger.

In other words, I was the ‘hired gun’ brought in by doctors or their accountants to do whatever was necessary to get their office operations efficient and their financial health well again. This was often after the physician partners paid practice expenses by loaning their funds to the corporation. Yes, some practices were that bad.

It was a serious job, and did I ever take my role to heart!

Day 1 ~ The Eagle Has Landed

I would arrive at the new facility on the date specified in the engagement letter. I drifted down like Mary Poppins, wearing my black kevlar business attire (tastefully accessorized with an asbestos shield, by the way) and toting my full array of tactical gear.

With a snappy salute and a perfunctory clicking together of the heels of my sensible-yet-stylish dress shoes, I wasted no time getting things done (GTD) — in textbook David Allen fashion.

I got into this kind of work primarily because I couldn’t say no.

I’d be remiss if I didn’t point out that I was also trying to prove my relevance in this world to someone — pretty much anyone — back then. And, oh boy, did I trip the light fantastic to please my doctors.

Metrics Busting Was My Thing

At the end of each of my stints as a practice rescuer, I would assemble all the docs in the conference room to give them my “Here’s what your practice looked like when I got here” and “Here’s what it looks like now” presentations.

To increase the wow factor and emphasize my improvements, I visually presented the financials in neat three-ring tabbed binders full of colorful charts, beautiful graphics, and bold revenue numbers.

Audited Financials

Some would suggest that it’s not bragging when what you’re crowing about is true— and my presentations were always accurate. Validated bank deposits and accountant-prepared financial statements endorsed my assertions. Woo Hoo!

Trust me, boys and girls, nothing flips the switch and turns on the happiness in a room full of doctors like flashing the color green. And by green, I mean green money that ‘drops below the line’ and therefore is available for distribution to the physicians as income. And after all, isn’t that the primary reason any of work in the first place?

Doctors’ spouses and partners loved it when the green light was strobing. When already-happy doctors made their loved ones at home happy by bringing home more bacon, the work environment got even jollier.

The reverse was also true. We’ve all heard the saying: ‘When Mama (or Papa) ain’t happy’ … well, you get my drift.

Stepping Up

While on assignment as Mary Poppins/Annie Oakley, I didn’t just work my magic on the financial side of the house. It was also my job to handle hot-potato personnel and performance improvement issues that dilatory predecessors had allowed to languish unattended — sometimes for years before my arrival.

Pretending I was a superhero, I stood in the blast furnace and took the heat on behalf of the physicians. Channeling Wonder Woman, I caught speeding bullets with my teeth, day in and day out.

My role required me to implement wholesale —and  often very unpopular — changes to the status quo. Physician boards in these practices debated, ratified, and oversaw all significant changes beforehand.

When the slightest hint of blowback from disgruntled employees wafted their way, certain darling physicians cowered and immediately hid under my skirt. Suddenly, they feigned amnesia and behaved as if they had no prior knowledge of (their) pre-approved action plans.

This sometimes annoyed me, but it was part and parcel of why they paid me so well.

Yeah, Whatever

I remember one particular doctor trying to flatter me by calling my management style one of “approachable gravitas.”

Yale-speak at its finest, all that meant was that I always stepped up and did whatever was necessary (i.e., their dirty work) and that surviving staff members weren’t too afraid to walk past my door —most days.

Speaking Of Which

While working with one particularly memorable practice, the darling doctors had to get a TPO (temporary protective order) to ensure my safety after one extraordinary board meeting.

With year-end distributions contingent upon the final numbers — everyone was particularly focused on overhead percentages.

To save on salary expenses  in the future, the doctors ignored my vehement objections and voted to terminate a young registered nurse with three small children — the week before Christmas.

This pleasant young lady had no clue that the doctors were unhappy with her performance. Her clinical skills were not questioned; their beef was that she wasn’t ‘turning the rooms’ fast enough. The sad thing was that her supervisor had never counseled or even spoken to her about a possible performance improvement plan. Come on, anyone who’s ever read even half an article on human resource management knows better than this.

Mere minutes after this young nurse left the building, her angry, verbally abusive husband called the office demanding to speak with me.

When I came to the phone, he threatened my life and that of my family members as well — on a recorded phone line. The man didn’t have a brain trust.

What was I going to do? I certainly couldn’t throw the doctors under the bus.

I had to be professional, even if they weren’t. So, until the dust settled, staff members gave me the side-eye, moved to the other side of the hallways, and ducked into empty exam rooms when they saw me coming.

Just another day in the Wild Wild West. LOL

I am so glad that the days of trying to prove anything in the career world are behind me because my ability to suffer fools is gone. The thought of ever identifying as a gunslinger again — in real life or on TV — is preposterous. (But I did keep the shotgun).

It wasn’t all wasted time, though; I did learn a few things:

• With age comes wisdom.
• Wisdom says only idiots try to catch bullets with their teeth. (Dental insurance is too expensive for that nonsense.)
• And that whole business about people laying hands on me to use me as a human shield? I told you — I kept the gun — so step back, Jack. LOL.

Sigh … try as I might, I can’t seem to resurrect Mary Poppins … or Annie Oakley. (May they rest in peace.) I’ve exceeded my bandwidth limits.

These days, the only processes I care to organize and manage are daily laundry, bed-making, and kitchen clean-up.

Oh yes, I guess I could include organizing and managing the writing process, but then again, it could be argued that it doesn’t appear that I’m very good at that. It’s more like shooting from the hip. Smile.

For Everyone’s Good

Trust me; retirement was the right decision. I’m a woman who knows too much — way too much.

I’ve been around a long time, and I know where all the [proverbial] bodies are buried. Come closer so I can whisper: I know who leaves all those incomplete charts, and I have contacts in the Medicare audit department.

Hold on, don’t anyone get your knickers in a knot! That was humor — a joke. Geeze Louise! Take a chill pill.

Rest assured, I spent too many years helping doctors to ever drop a dime on any of them. Besides that, I’d have to care to summon the energy to do that, and frankly, I don’t anymore. Grandma’s too old and tired.

No, dear darlings, Ms. Approachable Gravitas has left the building. There’s not enough money in the Vatican or Fort Knox to entice her into throwing the car into reverse and backing up into that hot mess again.