Sunday, April 26, 2020

Caring for cancer patients during the COVID-19 pandemic

The COVID-19 pandemic has created unique circumstances and challenges for cancer care. These challenges can be further compounded by variables such as geography and a variety of health setups.

Challenges for Cancer Patients


Due to their immunocompromised situation, cancer patients are more susceptible to infection. They typically require repeat visits to the hospital for care and receive a variety of potential immunosuppressive treatments such as surgery, radiotherapy, and chemotherapy. The risk incurred is significant, with one study suggesting that cancer patients are 3.5 times more likely to be infected than the general population. According to the WHO, they are 5 times more likely to die.

As such, specialists in the field of oncology must prepare swiftly for the reality of different treatment decisions, even involving rationing care to some of their patients.


Navigating Risk


In response, several cancer centers around the globe have implemented guidelines and protocols to reduce these risks, while still providing quality continuous cancer care.

Their efforts revolve around one central question: whether delaying care or bringing their patients into the hospital environment presents the greater risk to their patients.

In a recent article, Dr. Masumi Ueda and her colleagues draw conclusions from their own experience in Seattle, while considering a number of challenges such as infection and environmental control, outpatient care and treatment decisions, inpatient care, as well as ethical implications and the physical well- being of the medical staff.

With that in mind, I would like to present several effective ways hospitals have responded that are worthy of consideration:


Reorganizing the Hospital’s Physical Space


A critical challenge for hospitals is keeping patients and staff safe in what is a naturally crowded environment. Due to the unique aspects of the hospital setting, it is worthwhile to install the infrastructure necessary for quality virtual consultations. Now is a great time for hospitals to explore the various technological solutions for telehealth, something that could provide a long-term benefit. This should also be considered a way to allow for the early discharge of patients in order to free up beds for COVID-19 patients.

When virtual consultations are impossible, all patients, staff, and visitors should be screened for symptoms and a high temperature at specific entry points to outpatient and inpatient facilities. For those patients receiving intravenous chemotherapy, infusion chairs need to be separated by 2 meters.


Delay of Care


The most difficult decision to make is when to delay care in order to keep patients at home. Below are a few key guidelines:
  • All treatments and procedures unlikely to adversely impact the patient’s outcomes should be considered for delay.
  • Patients receiving adjuvant treatments with curative intent should probably continue with treatment, while following the recommended preventative infection care steps.
  • Patients with hematological cancers, requiring stem cell transplantation and other chemotherapy and biological treatments with curative potential, should continue and not delay their treatments, if possible.
  • Cancer surgery requires prioritization over all elective surgery, but in some instances, cancer surgeries may be delayed, and the patient may first undergo their other recommended treatments (hormonal, chemotherapy) before surgery can be scheduled.
  • Patients receiving treatments for advanced or metastatic disease could be considered for a delay in treatment. However, this might cause the patient’s status to worsen, losing the window period for treatment. Therefore, this needs to be balanced, taking into consideration the patient’s general condition, as well as their possible need for hospital admissions, stressing further inpatient resources.

Rationing of Care


A tragic outcome of the new stress that the COVID-19 pandemic has placed on the medical system is that an already limited number of resources must now be stretched across a wider population. Some medical systems must confront the fact that they may not be able to provide sufficient care for all their patients and attempts to do so will cause more harm. Hospitals must now have discussions about when and whether to discuss with cancer patients who are COVID-19 infected about end-of-life and palliative care. Ignoring this terrible subject will lead to difficult and harmful results when the decisions need to be made.

We must accept that COVID-19 is a severe infection and that cancer patients are at high risk. Stringent and dedicated interventions are necessary, as this represents a major healthcare challenge for humanity. It is upon the oncological community to work together to develop the best possible operating procedures to maximize patient outcomes and reduce risk


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Thursday, April 23, 2020

Strategic Planning: A lasting competitive advantage for medical practices

The COVID-19 pandemic has undoubtedly hit practices hard. I have many physician clients that have either closed their practices temporarily to non-urgent patients or have gone the route of putting most of their patients on telemedicine visits. But the business of medicine is not taking a break, and as the world gets a better grasp on the virus, your clinic will once again be busy as you gear back up with treating your patients. Consequently, physicians are taking this opportunity of decreased patient load and less clinic hours to focus on strategic business initiatives they have been putting aside. Along those lines includes strategic planning, and if you have not done strategic planning in the past two years, then your practice is long overdue. The strategic plan, to be of long-term value, must be treated as an ongoing business process. It must evolve and change to reflect changing market and industry conditions.


As a physician owner, you are busy. You have an endless to-do list, a full calendar, and many people to talk to, making you wonder how you are going to get it all done. However, as the practice grows and the healthcare environment becomes more complex, the need for strategic planning becomes greater. Creating a strategic plan and thinking strategically are not about doing more. They are about focusing how you spend your time so that you are more effective in reaching your goals and getting to where you want to go. That said, no physician practice has an unlimited amount of time, money, or people resources. Strategic planning can help you make the most of the resources you have, allowing you to have more enjoyment in your work while you are doing it.


Here are eight reasons for getting your team together for a strategic planning session.

  1. Vision. You will create a clear vision for what success looks like in the future. If you don’t know where you’re going, how are you going to get there?
  2. Priorities. You’ll identify priorities for the short and medium term. You can’t do everything at the same time, so focus on what needs to be done now and then do it well.
  3. Alignment. You’ll get alignment and buy-in around direction and strategy. Having these conversations will move your team from implicitly being on the same page to explicitly being on the same page. The clarity will energize the whole team.
  4. Identify Challenges. You’ll create an opportunity to talk about key issues facing the business (competition, changing trends, etc.). You want to ride the waves, not get smashed by them. Being reactive throws off your plans, and takes your eye off your goals.
  5. Direction. You’ll create a clear roadmap for the rest of the organization. Your staff wants to know where the practice is going and how they can contribute. An engaged staff is 20% more productive than one that is neutral (or, worse, disengaged). Your staff wants to win and this is how you can help them.
  6. Open Communication. You’ll create space for people to share what’s going on with them and what they want to see as the future of the organization. It will open lines of communication and improve teamwork.
  7. Empowerment. You’ll empower others to take on tasks that will move the practice forward. As a physician owner, that means less firefighting and more focusing on what you do best: patient care, leading, and executing.
  8. Values and Culture. You’ll create the culture, values, and behaviors that you want to foster within your practice. When your values are clearly articulated, your team will understand what you expect from them on a day-to-day basis. Culture and values are the glue that keeps a strategic plan together.

Strategic planning doesn’t need to take a lot of time away from the practice. The focus and the results will speak from themselves. Before the COVID-19 outbreak, we conducted a lot of strategy discussions with physicians onsite. Recently, we have shifted to doing these discussions virtually. They key is to have an outsider facilitate the meetings to avoid confirmation bias. Furthermore, the facilitator will be able to ensure your meetings stay focused, allow everyone time to share their thoughts, and ultimately leave you with a clear plan on how to move forward.


Medical practices which consistently apply a disciplined approach to strategic planning are better prepared to evolve as the local market changes and as the healthcare industry undergoes reform. The benefit of the discipline that develops from the process of strategic planning, leads to improved communication. It facilitates effective decision-making, better selection of tactical options, and leads to a higher probability of achieving the physician owners' goals and objectives.

Strategic planning can be a challenging process, particularly the first time it is undertaken in a medical practice. With patience and perseverance, as well as a strong team effort, the strategic plan can be the beginning of improved and predictable results for the business. At times when the practice gets off track, a strategic plan can help direct the recovery process. When strategic planning is treated as an ongoing process, it becomes a competitive advantage and an offensive assurance of improved day to day execution of the business practices.

Use of a consultant can help in the process and in the development of a strategic plan. As an outsider, the consultant can provide objectivity and serve as the "devil's advocate," as well as a sounding board. In the end, however, the plan must have the authorship and ownership of the physicians and managers who must execute and follow the strategic plan. It must be their plan.


Strategic planning, when treated as a work in progress, rather than as a binder on a shelf, or a file in a computer, provides a medical practice with a real and lasting competitive advantage. A living strategic planning process will help direct the business to where you desire it to be. Strategic planning is your medical practice’s road map to your vision.

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Wednesday, April 22, 2020

5 Things You Can Do Today to Sell More

Do your sales need a pick-me-up? You should see your sales improve when you try one of these five ideas. Just pick one for today.

1. Use your product


When was the last time you used the product you sell? It’s one thing to talk about the performance of your product; it’s another to be able to experience it yourself so you are more confident and knowledgeable about what that performance feels like.

Imagine selling chocolate chip cookies that you never tasted. You would be unable to share your enthusiasm for their taste and the delight you get when eating them. You would be a less effective salesman when you haven’t used your product.

2. Learn more about your product


When was the last time you read the marketing materials you send your customers? You might find that you forgot about a feature and benefit you could be sharing with prospects and customers.

3. Try something new


It’s easy to get into a rut and repeat doing the same things over and over. Why not consider doing something new?

What does your sales call preparation look like? How do you support your customers after the sale? How do you prospect? Now consider changing one small step.


You might modify your questioning strategy. You could change the types of prospects you pursue. If you do the same things you will get the same results. You have to modify something if you want different results.

You can’t improve everything at once. Often, a small improvement can yield big results.

4. Find out what’s working for another salesperson


Which successful salespeople do you know? They have often uncovered ways that work for them. While not every strategy is successful for everyone, you might learn a new way of approaching your selling.

I often remember the two commission salespeople I once worked with. They took one day a month to make joint sales calls in each other’s sales territories. One would be the observer while the other one was the seller. They both said that even though they weren’t making any money while supporting the other, what they learned from observing and coaching each other was invaluable.


5. Get some rest


One of the worst things that can happen to a salesperson is burnout. I have seen too many salespeople who work seven days a week. I believe in living your life without regret. Looking back you should be able to say that you worked hard and enjoyed your life. Workaholics don’t make great family members. Selling is hard enough. Have at least one day to take a break and focus on you.

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Tuesday, April 21, 2020

7 Ways to Make Your Startup Look Professional

It’s never been easier to start a small business. There are valid arguments for just diving in, and not waiting until you have all the details ironed out. But as the adage goes: You don’t get a second chance to make a first impression. An unprofessional launch could set you back, and you may find those things you planned to take care of later always get pushed to the back burner. In the meantime you could lose business.

1. Set up a website


Your website doesn’t need to be fancy, but make sure it professionally reflects your business and contains the information customers generally need to know, such as how to contact you, business hours, menu of services (or menu for a restaurant), etc. There are a variety of services that will help you create a simple but professional looking site; if your needs are more extensive, you may need to hire someone to create it for you.

While you’re at it, don’t slap up pages that say “under construction” or “coming soon.” Even if your site is a single page, make it look professional. You can always add more pages later.


A few businesses get away with not having a website, and instead use a Facebook business page or even an Instagram account. Think carefully about adopting this strategy, however. Almost anyone can access a website, but not everyone is a Facebook or Instagram user. And when you rely on a third-party platform, you lose some control over your prospects’ and customers’ experiences.


2. Create a professional email address


My daughter’s new dentist asked me to have her medical records emailed to them at a Yahoo email address. Not only is that not secure, it didn’t seem professional. Get an email address that matches your domain name; it’s simple and not expensive. Your website host may provide that as service, or you can use G Suite email for as little as $5 a month. (Note that G Suite email can give you an email address at your domain name, which looks better than an @gmail.com address.)

3. Get a business phone number


Have you ever called a business and been taken aback when the phone is answered with a blunt “hello” rather than a professional greeting? It doesn’t inspire confidence. That’s why you need a business phone number: If a phone call, text, or email comes in for your business, you can respond appropriately.

Fortunately, these days you don’t have to spring for an expensive business landline if you don’t want to. You can add a second line to your cell phone for just a few dollars a month. Here are five affordable services you can use to get a business phone number.

4. Use a business address


It’s perfectly fine these days to start your business from home, a coworking space, or really from anywhere in the world. But using a business address can add a layer of privacy and professionalism. If you aren’t ready to invest in office space, consider getting a PO Box. You can then use that address as if it is a street address. (Postal service instructions for turning PO Box addresses into street addresses can be found here.)


5. Invoice professionally and promptly


You won’t stay in business long if you don’t get paid. Some 70% of freelancers report they’ve been stiffed by clients. Two things will help you avoid this scenario: a contract and prompt invoicing. There are a variety of programs that make it easy to create and send professional invoices inexpensively. Many accounting platforms, for example, make invoicing painless. You may even be able to accept payments online through them. You may also want to check out And.co, which provides a standard freelance contract along with invoicing.

6. Establish a social media presence


Sue B Zimmerman became enthralled with Instagram when she owned a retail business. She instructed her employees to post on Instagram—within guidelines—and her business boomed. (She now teaches business growth strategies, including how to leverage Instagram.)

Your business doesn’t have to be on every social media platform, but find out where your customers congregate and consider developing a basic presence on the most popular ones. At a minimum, grab the social media handles for your business name before someone else does.


7. Build business credit


Your vendors, suppliers, and even some lenders may be willing to advance you goods or services that you can pay for later. Getting supplies on “terms” such as net-30 or net-60 can help your business cash flow. But often to get terms, you’ll need a positive business credit history. Start building yours when your business is young, and you can have strong business credit scores when you need them. Plus, anyone can check business credit—that includes future business partners.

These basic steps will help you put your best foot forward. This 14-Step Checklist to Make Your Business Legit will provide additional guidance as you launch and grow your business. If you’re feeling overwhelmed, consider reaching out to your local Small Business Development Center or SCORE office for help from an experienced business advisor or mentor.

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