Reflections on the NORM 2013 Annual Conference

Jay Salliotte
Managing Director
Advanced Rheumatology
Lansing, MI

Long Beach, CA—As I was packing up my bags to return home from the National Or­ganization of Rheu­­ma­tology Mana­gers (NORM) 8th Annual Conference, I had the television on in the background. I overheard part of a poem that I later learned was written by Wendell Berry. The poem is entitled, “In A Country Once Forested,” and the lines that most struck me were:

“...and the soil under the grass is dreaming of a young forest/and under the pavement the soil is dreaming of grass.”

As tired and travel-weary as I was, my mind was still in sponge-mode—ready to soak up anything useful, actionable, and inspiring. Knowing neither this author nor the context of the poem, I pondered. Surely he was not referring to practice management or the state of healthcare, but still the words resonated. Then it hit me. For me, this poem is about us and our roles as leaders in our organizations. We are the stewards of the soil (our practices) and what grows from that soil, if anything, is a direct result of the care we provide.

Do we nurture our soil? Do we water it, weed it, fertilize it, and plant in it? Or do we pave over it for the sake of consistency and convenience? How do our patients experience our soil? Are we a hard, dull, paved lot, void of life? Are we a paved lot overgrown with weeds and riddled with dangerous cracks and potholes? Or are we a colorful field of grass and flora? Perhaps we are a young forest growing and reaching for the stars? These are the questions we should be asking about our practices.

If you are the caretaker of a practice that is like a breathtaking forest of Sequoia trees, you can stop reading now. But, if you are like me, we know there is always more to do. We can always grow taller, and we never stop reaching toward the sky.

Helping us to move forward in our cultivation of employees and the work environment were several great sessions at the NORM conference. Some of the excellent sessions are covered in this issue. Dr Sean Limon’s breakout session on performance feedback was very helpful. Not only did he address the common problems with performance feedback, he set some great guidelines for doing it effectively with positive impact. Dr Limon’s general session presentation on leadership was also very helpful for evaluating our practices and the leadership style of our colleagues. I also really appreciated Dr Paul Caldron’s breakout session on building the practice culture. Had time allowed, Dr Caldron probably could have easily expanded his presentation for several more hours, because he touched on some absolutely essential topics. Topics included working in a service business, setting and meeting expectations for our customers, and defining what workplace culture is and why we should pay attention to it. These are the building blocks for a foundation and framework within which a good practice can thrive and weather any storm.

Of course, as practice managers, we are the people who are ultimately accountable for billing, compliance, information technology, marketing, contracts, credentialing, customer service, and the financial health of the practice. All of these things are extremely important, and they are not small tasks. But, we should feel equally responsible for the growth and development of our practice and our staff. I believe we should cultivate our practice and employees through leadership and inspiration rather than pave over them with an overabundance of rules and mistrust. We need to define our work environments, build and modify its framework, and set the tone before someone else does it for us, because we all know where that story ends.

How will you set aside time to cultivate your soil? What will you plant? What tools do you need? What positive changes can you commit to before NORM meets again next year in Louisville, Kentucky?

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