Enter Guns A-Blazing

It’s true. I used to make my living as a gunslinger. No silly, not that kind of gunslinger. I made my living as a medical practice turnaround specialist. That kind of gunslinger.

I was a ‘hired gun’ brought in by doctors and their accountants to do ‘whatever is necessary’ and get their business and clinical operations efficient again.

And boy, did I ever take my job seriously! (Rolling my eyes in self-mockery.)


Day 1 ~ The Eagle Has Landed

On the date stated in the engagement later, I would arrive at the appointed practice like Mary Poppins—slowly drifting down wearing my black kevlar business suit—tastefully accessorized with an asbestos shield and a full array of tactical gear.

With a snappy salute and a perfunctory clicking of the heels of my sensible-yet-stylish dress pumps, I spun around and promptly set about ‘getting things done’—in textbook David Allen fashion.

As I detail in other posts, I gravitated to doing this kind of work, partially because I couldn’t say no, and partially because I was trying to prove my relevancy in the world to someone (pretty much anyone!) at that point in time. Oh pleeeze.

And boy, did I trip the light fantastic to please.


Metrics Busting Was My Thing

At the end of each stint as an interim CEO, I loved delivering my “Here’s what your practice looked was when I got here and here’s what it looks like now” presentations to the Board.

To increase the wow factor and further emphasize the improvements that I’d made, I presented my metrics using colorful charts, graphics, and bold revenue numbers.

There’s just no other way to put it—I was on an ego trip—a pretty big one.

Now some would suggest that it’s not bragging when what you’re crowing about is factual—and my presentations were always factual. My claims of improvement were always firmly supported by accountant-sanctioned financial statements and best of all—validated bank deposits. Woo hoo!

Trust me boys and girls, nothing turns on the happy in a room full of doctors like the color green. Green that drops ‘below the line’ (accountant-speak), therefore now available for distribution to the physicians as W2 income.


Doctors’ wives love it when this happens. And when already-happy doctors make their wives at home happy by bringing home more bacon, the work environment becomes even jollier. We all know that old saying ‘When Mama ain’t happy’ … Well, you know the rest. LOL

Stepping Up

While dispatched to temporary duty as Mary Poppins/Annie Oakley, I didn’t just work my magic on the financial side of the house.

No, I handled hot-potato personnel and performance issues that derelict predecessors allowed to languish unattended—sometimes for years—prior to my arrival.

I dutifully stood in the blast furnace—taking the heat for the physicians. Channeling Wonder Woman, I caught bullets with my teeth for them.

My role required me to make wholesale (and often very unpopular!) changes to the status quo. All the changes I made were directed and overseen by The Physician Board—who afterward, often hid under my skirt acting as if they had no prior knowledge of any part of the action plan. This was annoying, but it was my job—part and parcel of why they paid me so handsomely.

Yeah, Whatever

The doctors often referred to my management style as one of “approachable gravitas”. [Second eye roll.]

Yeah well, that’s just Yale-speak—a codified way of blowing smoke up my skirt. A way of saying that I always stepped up and did whatever had to be done and that generally, the surviving staff members weren’t too afraid to walk past my door. At least most days. LOL

Obviously, I’m being intentionally flippant here for comedic emphasis, but the reality was that everyone had a pretty good time. The staff enjoyed esprit de corps. We maintained a culture where everyone felt comfortable laughing and joking—as long as they kept on working, and no one wasted time.

We Hold These Truths To Be Self-Evident

By cleaning up their business operations, the doctors got paid every cent they were due from the insurance companies, on a consistent and timely basis. By streamlining their clinical and front end intake processes, they were able to see more patient each day—therefore being able to bill more.

By billing for the services of all those extra patients, and doing it accurately without delay, insurance denial were rare, and revenue increased.

Increase revenue complimented by lower expenses increased net revenue. Bring on the party favors and confetti.

I would generally spend a couple of years or more embedded in each practice. As a result, every practice under my oversight became what the health care industry designates to be ‘better performers’—groups who significantly perform better than the national benchmarks for efficiency and revenue.

Long story short … The doctors made more money … They paid me well … And a good time was had by all.

Mary Poppins Meet Ricky Gervais

That was then and this is now. Since that time, I’ve been through a Nightmare On Elm Street with my husband’s ghosting and that whole twisted ordeal. Frankly, it’s taken a toll on me—in that my filter, my energy, and patience have all worn paper thin.

No longer do I have any desire to catch bullets with my teeth. I haven’t the time or the inclination to continue playing gunslinger—nor do I want to play one on TV.  Never again would I tolerate grown men and women [licensed professionals!] hiding under my  petticoats. And that human shield thing? Fuggettaboutit!

Bummer. Try as I might, I just can’t seem to revive Mary Poppins. Maybe she ran away with my ex husband too, who knows? (Better yet, who cares?) All I know for certain is that my ‘appropriate gravitas’ seems to be morphing into something remarkably similar to Ricky Gervias’ monologue on The 2020 Golden Globes. We all remember what that looked like when he knew it was his last gig. Oy vey!


Exit Stage Right

So for everyone’s benefit, I’ve decided to permanently quarantine myself from the health care management space and permanently close up shop—no more consulting gigs. Really, it’s for best … I know too much … I know way too much … I know where all the bodies are buried … I know where all the incomplete patient charts are …. Medicare, are you listening? Oops, did I say that out loud? Shame on me! LOL

Everyone take your seats, there’s no need to panic. Why are you so jittery? 

Relax! … I’m retired. But what you might want to do is pause for a moment of silence and thank your lucky stars. Be grateful that I write anonymously. I always have. I always will. My Mama didn’t raise no fool. LOL  

I even deleted my LinkedIn account, so chill.

And There You Have It

Snap to it! Ya’ll stop standing around! Get back to work! Chop, chop! You’ve got patients to see, and insurance to bill! Ya hear me?!

Patients, and billing, and copays, oh my!