I engaged this week in what might become my favorite annual holiday event – crashing the medical staff Christmas party at a hospital where I’m not on staff. My good friend Anjali called, again asking me to be her rent-a-date. Last year her husband had to travel, but this year he’s apparently studying for final exams for his master’s program. I think it sounded like a convenient excuse to avoid being around doctors talking shop, but was happy to go with her again even though last year’s party had more EHR discussions than social time. Now that I’m freelance, it doesn’t hurt to network when I can.
Last year there were some, shall we say, “senior” physicians wearing some rather loud plaid jackets. I almost died laughing when I saw that some of the more junior physicians had taken the trend to an ironic new level, sporting so-called “Ugly Christmas Sweater” suits. The first gentleman was wearing the blue and red number above with a pair of white patent leather shoes. I tried to get a photo, but with the dim lighting, it was impossible and I didn’t want to be too conspicuous with my flash. Several of his companions had similarly awful ties and cummerbunds and I can’t help but think that this is going to be a new trend and I’d better secure my invite for next year’s party early.
I ran into a couple of old friends who recently moved from my previous employer to this hospital’s medical group. It was somewhat gratifying to hear that they found the grass wasn’t really any greener in their new positions and that they find their new EHR just as awful as the one I used to be responsible for. Given some of the major shifts going on with value-based care and new reimbursement models, it will be interesting to see if physicians begin shifting alliances or if we start to see even more consolidation among the employed physician ranks.
My other excitement this week was the quarterly provider meeting at my practice. Because of travel conflicts, it’s the first one I’ve attended. Given some of the news that was announced, I was glad to be there in person so I could see my colleagues’ faces. Effective immediately, we are opting out of the Meaningful Use incentive program. There was actually applause and a couple of high-fives. This weekend the EHR will be modified to disable all the extra screens that were added so we could check all the boxes that ended up not being all that relevant to our model of care. The providers were ecstatic to say the least.
The practice owners are extremely process-oriented and determined that the changes to the system will remove literally hundreds of thousands of clicks for users over the next year. I admire their dedication to detail and their gutsiness in deciding to just say no. Our patient volumes have grown dramatically since I started working with this group and it’s fair to say that the revenue from additional patients we’ll be able to accommodate if we can work more efficiently will more than cover any penalties. Having been in the EHR driver’s seat for so many years, it’s been very interesting to work with them as an end-user.
They asked me to stay after for a few minutes. I’m the most part-time of all the physicians and work the fewest hours each month, but had previously volunteered to work some of the less-desirable shifts to allow the full-time staff to have more time with their families. I suspected that they were going to ask me to pick up a couple of extra shifts over the holidays since I had mentioned to the COO that I’m not traveling this month. What I did not suspect, however, was that they would offer me a leadership position in the organization.
I would be going back to formal CMIO duties with a bit more operational authority than I’ve had in the past. I’d also be spending dedicated clinical time at one of our expansion locations, which the organization plans to use as a pilot site for new initiatives and for vetting workflow changes. Our workflow is already pretty serious as far as quality, efficiency, and patient satisfaction are concerned so I’m very flattered by their belief that I could help take it to the next level. I have to say that the idea of being able to return to a CMIO position without dealing with Meaningful Use or hospital politics is seriously tempting.
Although I’ve enjoyed doing more consulting this year and have learned a tremendous amount, the travel quickly becomes less than fun. Based on what I’m being offered, they’ve done an outstanding job of figuring out what makes me tick and what I might find compelling enough to give up my frequent flyer status. They know me well enough to not expect a quick decision on such a weighty matter and I’m sure we’ll have additional discussions over the next few weeks. A wise man once told me that you should spend 10 percent of your time looking for your next gig. Sometimes I guess your next gig might just fall in your lap, though.
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