Friday, November 8, 2013

“That” Person

A People Game
EMS is a people game.

Be it fellow first responders, patients, facility staff, the “town fathers”, the media or whomever we encounter; part of being a really good EMS provider is learning how to effectively deal with other people.

For the most part, those who remain in EMS for a good amount of time fine tune their people skills. The EMS provider, who doesn’t learn the art of dealing with people, usually ends up finding another interest or occupation.

But then again…
But then again, we all know that each department has at least one person that somehow made it under the wire and even though he/she lacks effective people skills and frankly is downright obstinate in many ways… they remain on the job.

You know him/her…. For our purposes today call ‘em “that” person.

That one person can negatively affect your entire staff and set back your entire organization.

Right now, if we asked, we know you could tell us the name of “that” person in your organization that fits the profile. You see him/her in your mind. Typically “that” person is difficult to interact with; but no one, including supervisory and administrative staff does much about him/her because frankly they don’t know what to do with the person. He/she has probably been around just long enough (or too long) to be entrenched and is grouchy enough to be untouchable.

Like a junkyard dog, we stay away and don’t poke because we don’t want to get bit… right?

Billing Application
From the billing office's perspective, we find these people to be unwilling to do the basics. Many times, we have learned that these types of people tend to be lacking in some basic skill sets. They tend to be marginal patient care providers unsure of their own personal abilities, think they know everything about EMS and actually believe in their mind that they created modern EMS.

Only they know how to do things the right way and the rest of us are idiots. Quite frankly, we all know that this is many times a façade to cover their own fears about not measuring up.

They are resistant to change and because they have marginal skill sets of all types, they are many times woefully deficient with their documentation skills too.

These people don’t get that things change. In fact they deflect their own shortcomings and lack of knowledge and understanding of new things by blaming everyone else if things don’t go right.
“What do you mean I have to write a narrative in my PCR? That billing office has no clue. We never used to worry about stuff like that. They’ll have to settle for whatever I write and I’m not going to change the way I document for anything. That’s the billing company’s problem. I’m here for patient care.
I’ve heard it and so have you. And… how about these examples? Sound familiar?
“I don’t have time to get the patient’s insurance information.” “The billing company will collect the patient’s signature, why should I bother.” “Medicare always used to pay for these trips. If they call, we’ll haul and let the billing office worry about whether or not it gets paid. I’m just here to do my job and go home.”
Or I love the ones that hide behind the patient in making excuses.
“The patient can’t be bothered by a lot of questions. They’re sick or in pain. What gives me the right to ask them for information or to ask them to sign something? If you keep this up patients aren’t going to call 9-1-1 and they’ll die. If the department gets paid, they get paid if they don’t, then they don’t. It’s someone else’s problem to worry about. I’m just here to do my thing.”
Are you “that” person?
So join me in this exercise. Take a break from reading this blog for just a minute or two.

Walk to wherever the nearest mirror is and stand in front of it. While looking at the mirror image of yourself, verbally ask yourself these two questions out loud…
“Am I the one person in my department that everyone would love to avoid? Am I so negative that I am standing in the way of progress and change?
If you are “that” person, think about how your persona affects everyone else in your organization and then do something positive about it.

Most likely, in the past month, you have had a confrontation with someone in the office, had to defend marginal work (either in the field, related to charting or something related to your not following directions from the top down.)

Set your mind right now to change because, if so; you’re killing your organization little by little each and every day.

We’re not saying that you’re not dedicated or committed to the cause of EMS. You wouldn’t have stuck around if you weren’t dedicated. But, you’ve just dug yourself into a hole of believing that you are the only one that cares and by extension you truly believe in your mind that you are the only one that has a clue what’s going on and everyone else is just in your way.

It’s time to hit the reset button!

Change is Coming- Get used to it!
Because EMS is a people game, we- the people of EMS- are going to be forced to embrace change if we are going to continue to operate as a discipline of the healthcare industry.

Get used to it.

Will your administrators ask you to embrace new ideas? You bet they will because they don’t have a choice.

Expect big changes over the next five years, for sure due to mandates from the Federal and State governments. Obamacare (the Affordable Health Care Act) will usher in the most sweeping paradigm shift in American healthcare that this Country has seen possibly since the days following World War II.

EMS is a healthcare component. We will be affected just like everyone else.

The health insurance crisis and ambiguity we are experiencing today will only compound matters as people lose their current coverage, pick-up new coverage, experience higher out-of-pocket expenses or even, in some cases, gain healthcare insurance coverage for the first time (albeit with lower payments to providers of service… ie. EMS agencies.)

Healthcare facilities are merging, being sold, being closed. You’ll be working with new players, fewer choices and new rules. EMS organizations are being forced to re-invent their processes given tightening budgets from risings costs coupled with shrinking reimbursement windows.

You may be asked to leave the comfort of your station to do community paramedicine in the field in-between 9-1-1 runs. You may find that patients who previously were considered medically necessary now no longer fit the definitions when Medicare, Medicaid and managed care organizations change the rules so you’ll have to adjust your SOP’s and call intake procedures.

You’re going to have to learn new skills. Things aren’t going to be done the same way anymore.

You’ll probably have more to do and maybe have fewer resources to do it with. Or maybe you’ll be presented with new equipment such as I-Pads and mobile computer devices to capture patient information in the field.

Are you ready to treat a patient while protocols flash in front of your eyes suggesting treatment options using your department-issued Google Glass hardware?

Instead of scolding or shunning your billing office, supervisory and admin people who are simply doing their best to adapt to those rule changes and help you keep your position, learn to understand their world just like they have to understand yours and help find solutions to meet the challenges ahead.

Take a class. Read a book. Educate yourself and learn a new skill.

When administration makes a big change, think about how you can adapt to help them make it work rather than inciting a mutiny amongst the troops because you just can’t accept change.

Not you? Dealing with “that” person…  
So having read up until now, you’ve determined you are NOT “that” person. Good for you!

Now what can you do to offset the negative energy radiated by “that” person?

First, work with admin to offset the effects of “that” person.

Next, encourage “that” person to chill. Sometimes the most effective way of dealing with rogue fellow providers is to apply peer pressure. Point out to “that” person that he/she is dragging everyone down and they need to find a way to go with the flow.

Now do the best you can to demonstrate to “that” person how he/she may actually benefit from change. Remind “that” person that he/she is part of a team and you would appreciate it if he/she would not be so negative and help you make things flow better for you and everyone else.

If you are in a supervisory or admin role and you’ve done everything to help “that” person move forward and he/she just will not budge… then maybe it’s time to apply some justifiable pressure that may include workplace sanctions or even dismissal. Sometimes all it takes is to remove one negative person from the team to propel an EMS organization into a flood of positive outcomes when person’s negativity is finally out of the picture.

We do our best…  
At Enhanced we do our best to communicate change and provide coaching on how to properly adapt to billing-related changes.

This blog is one example of our ongoing educational efforts to the benefit of all of our clients. We offer training and cutting-edge communication and interaction tools that your organization can use to work together with us on a daily basis.

We encourage clients to talk with us. Tell us your needs. Let us know how we can help minimize the effects of “that” person. Our staff is expertly trained and ready to communicate with our clients regarding every angle of their billing program.

If you haven’t connected yet with Enhanced; now’s the time to explore how we can work with you to navigate the changes that are sweeping the EMS industry. Connect today with Chuck Humphrey at chumphrey@enhancedms.com or by phone (800) 369-7544, Extension 108.

Together we’ll work with you to take the fuel from “that” person’s fire!
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