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Healthcare Leadership: A Discourse

Healthcare Leadership:  A Discourse

Tag Archives: business management

It’s the Same Old Story – Everywhere You Go

16 Tuesday Jun 2015

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business leader, business management, business solutions, communication, health care management, hospital management

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Although it is outside of my context, I can’t help but hear Paul Simon sing: “Keep the Customer Satisfied” when I’ve told my teams—regardless of the make-up of that team and their pay grade, status, and job responsibilities—that we all must practice good customer service each and every day.

I remind them in team meetings and individually that by giving all of our patients good customer service that we build relationships, encourage communication, cut down the number of missed appointments, and improve results for everyone involved.

I’m sure that I don’t need to lecture anyone in healthcare that this is one of the three components of the Institute for Healthcare Improvement (IHI) Triple Aim of optimizing health system performance. Many of us feel that this point drives the other two. Specifically stated, we need to:

Improve the patient experience of care (including quality and satisfaction).

In healthcare (as it is in retail and other businesses), the customer who presents himself with a physician’s order or walks into the shop is easily identifiable. What I’ve done in my training is to make my staff aware that everyone—including not just the patients and referral sources, but also their peers at work—are customers. They all deserve to be approached and catered to as valued customers.

This refrain echoes the Golden Rule, but I feel that it rings just as true as ever. And, like practicing the Golden Rule of “One should treat others as one would like others to treat oneself,” I understand that compliance is not always easy. The challenge here, however, doesn’t lessen the importance of this goal.

–

Can you teach good customer service? Is it innate? Can you change people’s behavior?

In the military, boot camp goes over and over certain actions that usually do not come naturally to most men and women: think bayonet drills.   It is said that when you are placed in a challenging situation, you will not survive by resorting to your instinct; the constant drilling makes sure that you, instead, fall back on your training.

With this mantra in mind, I teach and regularly review chosen relaxation exercises with my patients. This repetition, I’ve found, assures that my exercises become embedded, nearly second nature, and effective for my patients who are striving to find peace following trauma.

Good customer service training is critical and it is imperative that all of your staff knows what you mean and what is your expectation for their performance.

–

Social workers beware! Being empathic, caring and approachable is not always the same as good customer service. These traits, however, are key in establishing a relationship, but don’t necessarily line up with how your organization wants you to perform.

For many new trainees, learning an organization’s protocols and approaches may feel foreign and so patience and nurturing needs to be built into the education. Written manuals that are distributed to staff to review and be quizzed on periodically in the first three months is pretty standard and can serve as a benchmark for the trainer to know what lessons need more explanation and who needs more education.

The leader/trainer, at the same time, becomes a model of customer service.

Like children, we all watch and imitate senior staff especially in jobs that are new to us. At the same time, if we identify inconsistencies or a loophole, like teenagers, we will exploit it and shrug off the earlier lessons. After all, as a wise man once said, “A man hears what he wants to hear and disregards the rest.”

So here is another challenge in leadership: Walking the talk.

Not unlike conscientious parents, leaders nurture, provide guidance, show patience, and present opportunities for growth to our staff. Furthermore, leaders do not show preference to one staff over another or abuse the power one pay grade or hierarchical position has over another.

–

How do you measure customer service success?

Can it be done with customer endorsement, new referrals, new revenue sources, improved patient satisfaction scores, or low staff turnover?

The answer is yes.

But time, two to three years, is important to pass with the implementation of customer service education to truly determine if it is the leadership approach is making the difference, rather than a slow feedback loop for collecting data or a delayed accounts payable system.

Strive to be that Bridge Over Troubled Waters. (Sorry, Rhymin’ Simon)

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Healthcare Leadership in a Time of Change

13 Tuesday Jan 2015

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I do not think that I am alone when I have been directed to be a leader when, in fact, what the demand was for me to be a manager.

What some people don’t seem to understand is that there is a difference. Those of us being managed or led, however, know the difference. Essentially, leaders are those who have set a vision for the organization and then influence others into action. They take time to get to know their people, their career goals, and what drives them. Leaders need others to lead and leaders focus on who and why.

General George Washington inspired and led other Americans against formidable odds. He knew the difference in leadership versus managing and what happens when people are empowered. He wrote: “Perseverance and spirit have done wonders in all ages.”

Managers, on the other hand, supervise and control systems and processes to meet organization goals and objectives. Managers also know when the task needs to be completed, but do not necessarily need subordinates to carry out the task. Managers set the what, where, when, and how. They make sure that the trains run on time.

When it comes to getting tasks completed, leaders have already laid the groundwork by continuously educating their teams on the vision and the role they all play. As a result, even assignments that are initially a hassle are faced knowing that what they are doing is moving the organization forward. Managers don’t spend as much time in educating and mentoring subordinates because their focus is not on the “who”, so when orders are issued, they are usually received grudgingly.

It has been my experience that most of us would rather report to a leader who has made an equal investment in his organization and his people.

You don’t need a weatherman to know which way the wind blows. This phrase famously appears in Bob Dylan’s “Subterranean Homesick Blues” and still speaks to me in spite of this global weather craziness.

Changes in healthcare are steadily blowing all of us from a competitive world to one of collaboration and integration. I personally enjoy this environment of sharing and cooperation, but this paradigm change can also pose new challenges for managers and leaders alike.

For your organization’s and your success as a leader in this endeavor make sure that you:

  1. Identify the market and population and the service/product with which you want to collaborate.
  2. Specify what other organizations you are willing to collaborate.
  3. Make sure that you, your boss, and your boss’s boss are all clear on the borders of the collaboration. Discuss, write down, and sign off on the rules of this collaboration prior to any contact with the other organization.
  4. Once contact is made, communicate regularly in writing to your boss and your boss’s boss on your progress of the collaboration and about any issues.

Lets be clear that your organization wants to hold onto its market share it has planned and fought so hard to obtain. Still, there are opportunities here that can be of mutual benefit and to the community.

Successful collaboration is breaking down the walls between competing organizations, advocating a paradigm change and demonstrating how it is done, and handpicking and inspiring a team that has the skills, but will look to you for the resources, the ideas, and the communication and feedback. This is a call for leadership.

An Appreciation of this Moment

04 Thursday Dec 2014

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WHAuden

One of my favorite quotes is from W.H. Auden.

Thou shalt not sit with statisticians nor commit

A social science.

Thou shalt not live within thy means

Nor on plain water and raw greens.

If thou must choose between the chances, choose the odd:

Read The New Yorker, trust in God;

And take short views.

The last stanza, as many scholars will tell you is a nod and wink to Reverend Sydney Smith who handed off this football coach-like advice: Take short views, hope for the best, and trust in God.

W.H. Auden was a brilliant and bold writer who was known to make few compromises in his art or in his personal life. He was also no football coach.

As a social scientist and a manager I couldn’t agree with him more about with whom to sit or socialize although I have found many anthropologists to be witty drinking buddies.

I part ways, however, with Auden and the Reverend Smith about taking the short view although I’m all for living in the moment without being hamstrung by the past I can’t change and the future I don’t know.

It has been taking the long view, however, where I have developed a profound understanding, and yes, sympathy, of people, events, and even organizations. By taking the long view, I back up from the situation, take a few mindful breaths, and discover what I perceived as black and white is really more variations of grey. With grey comes empathy, recognition of the ambiguity of life, and, hopefully, acceptance and peace.

Some people may appear not to be capable of taking the long view like the elderly and the dying, but having spent time with the elderly and dying, they, too, even in their suffering are thinking about the future and most often, the future that doesn’t include them. They are thinking about their legacy. That is if they are conscious and are still able to navigate their fate. Here is an opportunity for the rest of us who are not as aware of the slippery slope that is life, to watch or help and learn.

Breathe.

Living in the moment, on the other hand, is liberating and can be a goal of a Yoga practice. Listening closely to instructions, not anticipating, and focusing on every movement and breath allows us to transcend the monkey brain that all of us grapple to control.

Like a Yoga practice, Mindfulness is challenging and liberating. Mindfulness is a therapeutic approach composed of the three key interdependent elements of:

1. Awareness,

2. Of present experience,

3. With acceptance.

By becoming aware of the minute details of every activity like eating, walking, and even breathing, many of my clients, especially those plagued with anxiety, will find a peace that had been eluding them since their injury. I tell them: By slowing the breath, the heart and the mind will follow.

Short view or long view, the act of living deserves observation and appreciation.

David Henry Thoreau famously said: The mass of men lead lives of quiet desperation.  Believing that to be true, how can we spend so much of our time hating one another? Yet hate and fear appear to be the motor driving many people’s ambitions and relationships with others. My experience has taught me that life is fragile and needs to be handled accordingly. The Yogi Emily Dickinson observed: To live is so startling, it leaves but little room for other occupations.

I do love those New Yorker cartoons.

Breathe.

Relevance and Resumes

17 Friday Oct 2014

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business, business leader, business management, business solutions, Scott Southard

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“Never believe that a few caring people can’t change the world. For indeed that’s all who ever have. ”

― Margaret Mead, The World Ahead: An Anthropologist Anticipates the Future

Margaret Mead, perhaps one of the most popular modern anthropologists, is best known for her work in explaining that gender roles varied from culture to culture and that all cultures should be weighed equally. She did this in profound and yet sweeping statements that made a lot of sense to those of us entering adulthood in the early 70’s. We were rejecting the truths of our parents knowing that there were better answers out there. I found great joy that her research and conclusions made many members of the Greatest Generation red with rage. And here Margaret Mead was of that same generation.

Not related to Margaret Mead or to those living in Samoa, I have found first as an only child to two career minded older parents and later making some independent (and sometimes foolish) choices that I missed out on having siblings to mock and roughly guide me along my life journey.

My parents, God love them, gave me unrelenting praise and plenty of freedom and rope to hang myself. My impression is if I had a sister or brother that they would jar me into reality every time I would be feeling good about myself with an insult or a smack in the back of my head: immediate feedback.

On my career journey I have discovered a wisdom I was not expecting. I have found that I do not have an audience (or even pigs towards which to toss!) these pearls. I think that people in my generation are discovering we have failed in our experiment to improve society and are becoming less relevant to the generations that are in our wake. America needed a Generation X president. Have you ever wondered why so many men over fifty years old are consultants or Something or Other Emeritus? These situations are the career opposite of being turned out to stud.

Regardless, one such pearl I’d like to toss out is that you need to make sure that you have more tools in your skill toolbox than Cute. Cute has a limited life span of which I located my end just recently. Actually, I no longer had Cute in my toolbox when I turned 39 years old, I just didn’t know that until I was about 59 years old. Yes, my house has mirrors, but I don’t have siblings to set me straight. Also, I am nearsighted.

Be aware, however, that Experience may not be the word you want to replace what Cute might have done for you in the past. Experience equates to Old and that is not a highly sought out asset in the eyes of many. It is better to take on the qualifications of the job you seek head on and pray that someone looking at your resume knows you.

I have another pearl that I want to share that may be helpful for those seeking new employment. Attitude is crucial for success especially with interacting with people who don’t know your history. Related to this is that I have found in my readings published in this new millennium is that I can happily draw a line connecting many of our major religions. This line is that you have to let go of hate and to love your enemy to be truly free. Nice.

The cynic in me might declare that this conclusion is simply a ploy to calm those who thrive on hate and/or to better prepare others for their inevitable loosening of their mortal coil; but I choose not to be that cynic today. Good for me!

Margaret Mead appreciated the world as a salad bar of so many elements and combinations only limited by one’s imagination. Gender, like color, like culture, like age were to be wondered at and embraced simply for their intrinsic humanness. I love her, and miss her, when I quote her: “I measure success in terms of the contributions an individual makes to her fellow human beings.”

Leadership as a Calling

23 Monday Dec 2013

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business, business management, hospital management, leadership, Scott Southard

Image

Policeman: Do you have any disgruntled employees?

Nathan Arizona Sr.: Hell, they’re all disgruntled. I ain’t running no damn daisy farm. My motto is “Do it my way or watch your butt!”

Policeman: Well, do you think any of them could’ve done it?

Nathan Arizona Sr.: Oh, don’t make me laugh. Without my say-so they wouldn’t piss with their pants on fire.

From “Raising Arizona”

With all my heart I want this fictional film character to just stay that:  fictional.

I would guess that we have all had a boss like Nathan Sr.  Without a detailed character sketch, one can see that he saw his employees as something less than human and pretty stupid at that.

Reflecting on why I chose a career path of leadership—a path that is never linear and more vulnerable to sniping than even Nathan Sr’s employees—I wonder how I arrived there.  One explanation I have is that much like the claims I’ve heard from priests, I’ve always felt that I, too, had a calling.  I had a call to leadership.

Early memories from elementary school include being asked by teachers to keep an eye on the other students when they left the room and being elected class president and editor-in-chief of the school newspaper.  Junior high and high school was more of the same with being elected to positions of leadership to sports teams, band, varsity club, and the executive board.  I took much of this for granted and just figured it was because I had an inclusive personality, I wasn’t afraid to speak up, and that I was more responsible than my peers.

One key experience one summer with the Leadership Development Corps of the State YMCA of Michigan at Camp Hayo-Went-Ha gave me the opportunity to learn about the responsibilities of leadership with my own group of campers.  Leading a group of boys, often only a few years younger than me, and not my peers from high school that retreated to their homes and families at the end of each day, made me realize the power of being a role model and of being a dependable support person during the long stretch of summer.  Honestly, this model of teenagers leading teenagers, had the potential of becoming “Lord of the Flies”, but it didn’t go there.  What I found was that I could be more than a benevolent big brother or a surrogate parent.  I was the leader most boys wanted: fun, positive, supportive, protective, zero tolerance to meanness, patient, and available.  I saw how quickly trust developed between us and I learned about the stuff of which I was made.

I liked what I discovered about myself and how it made me feel.

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Now health care operational leadership, like camp counseling and like parenting, if you are doing it right, never really stops.

If your job is to oversee more than one shift or you have staff working every day of the week, you need to be available whenever they may need you.  On my designated times off, I first wore a pager and then a cell phone so that I could be alerted immediately in times of emergencies or sick staff or issues that couldn’t wait until I got back to my job the next morning or on Monday.  There have been several occasions when I had to leave a movie theater to answer a call and times I had to go in to help with coverage or talk to a physician or an athletic director.  Could this be considered a hassle?  Sure, but it is part of the job and I know that my staff, often flying solo, needs me to be no more than a call away.  I know that this is the kind of leadership I would want and so it is the standard to which I hold myself.

I’d like to make it clear that I make myself available not just to my fledgling staff, but also for those who have been out in the field for decades.  I have to be, after all, a role model for all of my staff, displaying by example my dedication to the job, to them, and to our organization’s goals.

–

The more I watch “leaders” and read about leadership—and there are more articles on the internet dedicated to detailing what elements are necessary to being a leader then you could read in a life time—I am always a little disappointed. See, I find this cookbook approach to leading deceiving.  Unlike baking a pie, one does not simply fold all the “necessary ingredients” into any one container with the anticipation that another leader has been made.

Employees know when they are being lead or being managed or being manipulated.  Creating teams, instilling a vision, and guiding people in developing their careers, takes the care and attention that I found manifesting in myself as a State YMCA LC and camp counselor.  Wouldn’t it be a perfect world if our managers treated us like someone’s son and daughter that they have the responsibility to protect, educate, and nurture as opposed to being a human resource?

Yet, you’re right about one thing thing though Nathan Sr.  I need to do a better job watching my butt.

The Mary Jane Legacy (It’s not about what you may assume…)

04 Monday Nov 2013

Posted by Scott Southard in business communication

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business management, health care management, health care professional, Scott Southard, scott southard mm

This month marks the fifth anniversary of the passing of my mother, Mary Jane Southard.  She was a hard worker and a very smart woman with several graduate degrees, held a position in public education of which she was the first Michigan woman to do so, and was responsible for launching the education of innumerable children in our community.

Grandma S. copy

Even now, people in her town still recognize our shared last name and ask about her or have an endearing story to share of her seemingly unceasing generosity and kind heart.  It always fascinated my sons and me when out with her that people in their fifties or sixties would approach her and ask if she knew who they were.  And, like some sideshow act, she would look into these people’s eyes and without fail recognize them and call them by the name they preferred as a five-year old… and then go on to ask about their siblings by name.

Amazing!

Mary Jane and Charles, her husband, adopted me over five decades ago.  This couple provided me with an idealized sheltered middle class upbringing in a homogenous suburban community in America’s Midwest.  It seemed like everyone knew me, but now, looking back, everyone knew Mary Jane.

The most enduring lesson my mother taught me was her point-of-view about humanity.  See, she believed that all human beings were fundamentally good.  I heard her express this philosophy with:

  • “There are no bad children, only children who have made bad choices.”
  • “Give people enough time and they will do the right thing.”

I, of course, heard this at the end of every day when we sat and discussed our day.  She always found time for me between the hours of her more than full-time job, school board meetings, graduate school, PTA and church activities, and caring for her ailing father.

By a strange quirk of timing, Mary Jane’s philosophy fell into alignment with my high school years that included the Summer of Love, Flower Power, and “If you can’t be with the one you love, love the one you’re with.”

Was Mary Jane’s message of humanism, love, and respect imprinted into my developing psyche?  You bet!

One of my early bosses in health care warned me to be careful to not make myself vulnerable to everyone.  I guess what he wanted me to do was to be careful of those who may want to manipulate me or, if that fails, destroy me.  I’m not sure how Mary Jane would have reacted to this advice, but I continued to believe that if I provided the right role model that everyone would eventually fall into the ranks of collaboration and love for one another besides our different opinions.  My reasoning continued that this would eventually lead to business success.

As my career developed and I found myself either elected or promoted to positions of leadership, I was still my mother’s child:  driven yet patient about the challenges facing others; competitive yet nurturing; impatient with myself yet supportive to others who lacked my understanding: willing to forgive ignorance, but intolerant of meanness.  I also wanted to connect with people, learn new things every day, and have fun in the places where I spend most of my waking hours.

I freely and frequently talk about my vision for growth and new program development with my staff.  I feel that by keeping them in touch with the bigger picture that they will have a wider context and appreciation of why and how things happen.  This is part of my approach to educating my teams in the ways of the business of health care and, hopefully, developing future leaders to our organization:  educational fun with a purpose.

To my surprise, I have found that not all of my bosses appreciated my approach to management.  It couldn’t have been because my programs and offices were not meeting their fiscal or growth goals or because my staff didn’t turn over.  I know this because my leadership was making that happen.  What I was neglecting was the unspoken and unwritten needs of my boss in what is an inherently uneven relationship.  I was unknowingly working off an educational model once prevalent in public schools where teachers were tenured and had a kind of autonomy in their classrooms not always allowed in other work settings.  Oh.

Mary Jane, however, never lost sight of the importance of establishing and maintaining her relationship with her bosses who were all men.  I know this because she would often haul me along with her when she would visit them in the evening or on the weekend.  I learned early on to bring a book or two when we went on “errands.”  She once even helped one of her bosses move into a house down the street from our home.  Regardless, I learned much about public education administration and the many details it takes to make it run for the benefit of all involved.

And Mary Jane succeeded in her profession where no women before her had.  Even with numerous turnovers in bosses, principals, superintendents, and school boards Mary Jane worked in an organization in which she believed, including its culture, its mission and its management.  Furthermore, she felt that her work had a meaningful impact on the lives of others.  She never lost sight of her guiding principles and, an anomaly nowadays, had only one employer for almost forty-five years.

Now that I have forty-two years of being in the working world, I think that what we all aspire to is to have what Mary Jane found, loved, and nurtured.  Thanks, Mom:  I’m still learning.

Thriving Amongst Giants

28 Tuesday Feb 2012

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business management, hospital management, Scott Southard, ScottSouthardmm, small business, thriving amongst giants

The United States is witnessing an unprecedented number of acquisitions, mergers, and seemingly unbridled growth of mega-health care organizations.  Undeniably there are fewer health care dollars now than a decade, or two, ago.  Larger metropolitan hospitals are merging their boards in order to dominate their region’s industry.  Smaller hospitals are finding that their traditional community-orientated health care model is no longer financially viable.

If you are a small or even mid-sized hospital, what do you do when a larger health care organization sets its sights on your market?

Two things you don’t do:

  1. Continue to do what you have been doing because it has been working just fine.  This is the complacency model.
  2. Attempt to go toe-to-toe with matching services.  This is the suicide model.

In both cases, the larger organization will find ways to beat you.  Simply put, they have more resources than you in money, people, influence, and time.

So what do you do?

  1. Create a new product or innovative approach and strongly market it so that any attempt to do the same will seem lame and duplicitous in comparison.
  2. Find a niche product that would require too much effort and expense for the larger organization to duplicate.
  3. Don’t be afraid to use the “local card” when marketing.  Examples include:
  • We are part of your community…
  • We know you and your family…
  • We share the same values…
  • We only care about you…
  • We are friendly, familiar, and part of your community…

Many consumers still respond positively to supporting community and locally-focused providers even at the expense of flying in the face of the old adage that the true experts are at least a 50 mile drive from home.

A giant is at the door of your hospital, what do you do?

Annual Performance Evaluations

19 Saturday Nov 2011

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annual evaluations, business advice, business management, how to conduct an annual performance evaluation, leadership, management, performance evaluation

No one enjoys annual performance evaluations.

Essentially, if you are doing your job right as a manager, these annual exercises are redundant, at best.  Therefore, when you subject you and your employee to these exercises, there should never be any surprises in this formal sit-down.

Measuring performance is an on-going process.  Your staff should know your expectations and if these expectations should change in the course of the year, as they will often do, you two have already met and created new goals and action steps.  If an employee’s performance begins to tip downward, you both should realize it at the same time and talk now.  Immediate dialogue about shared goals avoids the “blame game”, shows mutual respect, and builds a team.

Annual performance evaluations, on the other hand, can be intimidating.  By design, these evaluations are not a meeting of equals and are potentially weirdly timed monologues covering issues that may have occurred 11 months ago.

If there is no way to avoid them, because they are mandated by your employer, annual performance evaluations, like reading and analyzing data from financial reports or marketing studies, should tell a story.  This story incorporates objective data, an assessment of the situation(s), and goals/plans that reflect the desires of your company with the skills (actual and/or desired) of the employee.  This process is less intimidating and more collaborative.

As managers we may not have a choice about performing annual performance evaluations, but we can choose to evaluate and lead our staff daily and not manage them annually.

Communication – Face-to-Face

01 Tuesday Nov 2011

Posted by Scott Southard in business communication

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business management, business solutions, communication, hospital management, leadership, Scott Southard

I love my Iphone and all the things it can do.  E-mails and text messaging have made it possible for me to stay in touch daily with staff in eight different locations, not to mention with my fellow managers, and other valued contacts at the hospital and in the community.

I have found, however, that this technology is no valid substitute for meaningful dialogue with clear understanding of what was discussed and what actions are needed.  With e-mails, and even more so with text messages, attempts of cleverness or neglect to proof read may leave your client reading between the lines.  Inevitably, this will lead to confusion and, sometimes, hard feelings.  These hard feelings have a tendency to morph in some pretty strange ways you will have little control over.  The results are predictably bad for everyone involved.

In spite of its inconvenience in time, mileage on your car, and schedule strain, I have found it is more than worth all this extra work to schedule a face-to-face meeting.  I would go as far as advocate including a written agenda that both of you approve.  In cases of new customers, customers at risk, contacts that could influence how you perform your job, schedule the face-to face meeting.  Your staff will also appreciate you making the effort to spend time with them versus an e-mail response, or worse, not receiving any response.

When in doubt, arrange the face-to-face and come prepared.  The payoff is a real dialogue that will foster a healthier relationship and mutual respect.

Recent Posts

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  • It’s the Same Old Story – Everywhere You Go
  • Digging For Answers
  • That Eohippus Blog Post
  • Healthcare Leadership in a Time of Change

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