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 11400 Tomahawk Creek Pkwy Website: www.aafpins.com Suite 430 Leawood, Kansas 66211 Email: insurance@aafp.org The material and ideas presented in Your Financial Health are offered to provide accurate, timely and authoritative information with respect 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. Neither AAFP Insurance Services, Inc. nor the Academy is engaged in rendering legal, tax, accounting, investment or other professional advice. For assistance in these areas, or to determine if a particular suggestion herein might be desirable for your circumstances, the services of a competent professional should be sought. 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