Author Archives: dmacdonald

Going to the Dr.? Forget Insurance. Bring Cash.

Cash based healthcare service is a rapidly growing trend that you can see in a variety of settings, such as micro practices and concierge medicine. The driving force is the shift we’re seeing in the healthcare delivery model, where all stakeholders are being negatively affected by the current status quo.

Doctors and Patients alike believe the current bureaucratic insurance system is too costly, inefficient and is impinging upon traditional liberties. As the cost of insurance has risen dramatically, the value has actually diminished. Patients are waiting longer to schedule appointments, longer in the waiting room, and most importantly receiving watered down health services by paraprofessionals as opposed to physicians.

On the physician side, it is extremely complex to operate a private healthcare business with all of the compliance, rules, regulations, process and forms in order to see a patient, and HOPE you get paid in 45 to 60 days.

Enter “CASH ONLY.”

This solution makes a lot of sense from a value proposition. This is not to say that people should not insure for catastrophic illnesses or accidents such as cancer or car accidents, however, everyday healthcare maintenance fits well into the cash based model.

The benefits to the practitioner is that they will be treating patients who truly value their health and a doctors expertise, while reducing cost and administrative burden of working through the insurance based system. The model has shifted to a consumerism based model – the more you pay, the more you expect. This is not necessarily the case with healthcare delivery today. The downside to this approach for physicians would be limiting their market share because it will only appeal to a certain sector of the market place, much like higher end goods or services.

In the right geography, cash-only practices could be an effective business model, but site selection and targeted demographics are key. This must be researched to understand where the people are spending their money, what do they value, and what do they expect. A professional or a busy mom does not have the time to sit in a waiting room for an extra hour because their doctor is running behind schedule. What it says from a service perspective is that you are not a priority, which is something that the private market and a cash based business would correct immediately.

The rest of the countdown…Happy Holidays!

I thought posting these daily would be a cinch, yet here I am with only 3 days left until Christmas and I’m 4 traits behind (and noticing that Day #9 got lost somewhere in the WordPress black hole!  Need to find that one!)

So, I’m wrapping up (pun intended!) this Top Ten list of Leadership Traits below and looking forward to continuing our dialogue in 2012!

7.      Transparency

It’s not always easy to be open and accessible, particularly with difficult issues or tough solutions, but a good leader needs to be transparent with his teams and speak clearly and openly about pressing issues.

 6.      Visionary

The ability to look and plan ahead is paramount for any good leader.  It’s important to set a vision and solidify support from key stakeholders who will help execute your vision.

5.      Decision Making Ability

Healthcare organizations can have very complex political environments that demand comprehensive, deliberate and sound decision making.

4.      Innovative

You cannot be afraid of technology! Embracing IT and new technology advancements for the betterment of Patients, Partners and Employees is a must.

3.      Communication Skills

Sounds simple, but good communication skills can’t be underscored enough.  Leaders need their constituents to understand their vision and expectations.  There is no room for ambiguity.

2.      Inspirational

People genuinely want to be led and to believe in their leader.  A fancy title is not leadership.  It’s having the ability to motivate and inspire people to follow you.

1.      Visible

You must be present! A corner office with a closed door won’t get you anywhere.  To be a good leader you must know your people, your patients and your community.


8 Days Til Christmas

8 Days.. Trait #8… A good leader must possess…


A good leader ensures that people and systems are measured and held to standards, because without benchmarks there is no way to demonstrate progress and success. Ensuring your team has ownership of its ideas and is held responsible for their results.  At the same time, a good leader must holding himself/herself to that same standard.


10 Days ‘Til Christmas

Today officially marks the 10 day countdown to Christmas! To commemorate the occasion, I’m going to do a Top 10 myself – Top 10 Traits for Healthcare Leaders!

As we look to start a New Year, healthcare executives should be thinking about how they can make 2012 more successful – for their employees, partners and patients! Each day, I’ll reveal a new trait.

Today’s Trait:
#10 – Clarity of Purpose
A strong leader must truly understand the reason for an organizations existence as well as its goals. Once you know what the organization wants to accomplish, you must be able to balance those priorities with the economic realities.

Sounds so simple. Yet, I’ve met many executives throughout the years who have lost focus on their mission. When it comes to purpose, fuzzy won’t cut it; clarity is critical.