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DEALING WITH EMPLOYEES

At Silkin Management Group our surveying department has found that doctors in all professions encounter staff that create problems and slow production. However, due to the confusion caused by these staff, many doctors can't easily identify which staff are the ones causing all the trouble. This article will offer some simple tools to help you see through the confusion and spot which staff you can trust and which are, or will be, causing you headaches and overwork. These are guidelines we teach all of our Silkin Management Group clients as part of their management consulting and training.

Here are some key datums for you to know when dealing with staff:

•With any staff member, the main coin you have to work with is their willingness to work. Without willingness and desire, you’ll be in a constant battle with any staff member and find them telling you all the reasons something can’t be accomplished.

•There are generally 3 classes of employees or potential employees:
a) again, the willing;
b) people who are lazy and try to do the irreducible minimum;
c) people who are insubordinate and unconstructive in their work.

So look for and hire the willing. Do not hire negative types or the lazy. Hire only those who will help you to produce and, by your production as a team, help others. Do this and you will have taken a very giant step in establishing your practice as a model of sanity, expansion and viability.

The next logical question is how do you know who to hire, how do you spot these categories of potential employees and/or what do you do if you have staff who fit into the wrong categories mentioned above?

At Silkin Management Group, we have answers to these questions. There will be more information about this in upcoming Silkin Management Group blog articles

Richard Safft
Silkin Management Group Senior Service Consultant

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com or call Silkin Management Group at 800-695-0257.

GLOBAL WARMING

SOME FASCINATING DATA

PARTS 1 - 4

I ran across an extremely interesting and fascinating article about global warming, climate change, bio-fuels, etc. that I thought I would pass along to readers of the Silkin Management Group blog sites. This is a fairly long article, but worth the read. For ease of reading, Parts 1 through 3 are repeated here with Part 4 following below them. The last section will be posted at silkinmanagementgroup.blogspot.com tomorrow.

What is written here is likely to be taken as either very controversial, a “conspiracy theory” or hogwash by many. I am not taking sides one way or the other on it, but I thought it was interesting and relevant and well documented enough to present it to our readers to take a look at for themselves. I certainly found it eye opening.

Silkin Management Group is a management consulting company that has delivered management consulting and training to thousands of health care practices and small businesses over the last thirty years. Our blogs tend to be about relevant business issues such as marketing, dealing with staff, hiring and training, etc. But, when we run across them, we also like to present big picture items that effect us all. This is one of them.

For more information about Silkin Management Group and its services, visit our website at www.silkinmanagementgroup.com or contact us at info@silkinmanagementgroup.com.

Here are PARTS 1 - 4 of this article, entitled “Anatomy of a Con Job”.

Larry Silver
President, Silkin Management Group

ANATOMY OF A CON JOB

“In times of universal deceit, telling the truth will be a revolutionary act.” —George Orwell

PART 1:

If you look with your understanding, the crimes against humanity are written across the rotting visages of Henry Kissinger and Zbigniew Brzezinski.

Like a couple of aging prostitutes, these leading architects of twentieth-century evil still sell their wares to those with an insatiable lust for the power of the crown.

THE CLUB OF ROME

Birth Mother of the Environmental Movement

The moldy twosome have something else in common. Both have been active members of an international think tank from the dark side of the force called the Club of Rome. Founded at the Rockefeller’s estate in Bellagio, Italy, in 1968, some of the other fraternity brothers and sisters include Al Gore, David Rockefeller, Queen Beatrix of the Netherlands, and Mikhail Gorbachev.

And there is no one better to give you the short version of the Club’s agenda than Gorby himself:

“The threat of environmental crisis will be the ‘internal disaster key’ that will unlock the New World Order.”

Who let this guy out of Lubyanka?

Their more precisely stated goal is population control. The solution? Create an environmental catastrophe like, oh, say, “global warming” and blame it on the planet’s most heinous villain—man himself.

But I should let them tell it:

“In searching for the new enemy to unite us, we came up with the idea that pollution, the threat of global warming, water shortages, famine and the like would fit the bill. . . . But in designating them as the enemy, we fall into the trap about which we have already warned, namely mistaking symptoms for cause. All these dangers are caused by human intervention and it is only through changing attitudes and behaviors that they can be overcome. The real enemy, then, is humanity itself.”

Sounds like a good plan . . . if you’re Darth Vader.

In 1972, the Club took the world stage with the publication of a book they had commissioned to be written by a group of MIT scientists. It was called The Limits to Growth. Examining the planet’s population growth in relation to available resources, the report concluded that the planet would run out of resources sometime in the next 100 years, resulting in a catastrophic decline in population and industrial production.

As one reviewer put it, the authors examine

“. . . the impact of humanity on the world ecology and of steps taken toward remediating the accelerating approach to a train wreck that is mankind’s ill-managed and uncontrolled ‘footprint’ on this planet’s environment.”

Still, these trends and their consequences could be altered, it argued; we had to be less, do less and have less. The brand for this Orwellian path to planetary salvation was sustainable development.

Heavily promoted, the book reached opinion leaders in political, scientific and economic circles as it exploded around the planet like the Harry Potter of environmentalism. It sold 12 million copies in thirty languages despite the fact that the research had all the scientific rigor of a plagiarized term paper for a freshman biology class.

“An error does not become truth by reason of multiplied propagation, nor does truth become error because nobody sees it.” —Mohandas Gandhi

Assailed by top scientists, the research was shoddy in the extreme. Population expert and author Professor Julian Simon said, “The Limits to Growth has been blasted as foolishness or fraud by almost every economist who has read it closely or reviewed it in print.”

Yale economist Henry Wallich reviewed the book saying, “. . . the quantitative content of the model comes from the authors’ imagination, although they never reveal the equations that they used.”

But it is a PR world and with the publication of this book, the modern environmental movement was born. Midwifed to life in a blanket of deceit, it was yet hailed as the savior, not of mankind, but of the planet it claimed was being fried to a crisp by humanity’s toxic binge of carbon dioxide.

The scientific fraud is its own malice, but few were able to see the underlying strategy—that the book would serve as the foundation of a global public relations campaign that would mesmerize legislators, educators, and countless organizations of goodwill and would eventually set the stage for the biggest rip-off in human history. But I am getting ahead of myself.

This then was Con #1: The scientific basis of the book that launched the environmental movement calling for “sustainable development” and a reduction of man’s leper-like carbon footprint on the planet was, and is, a scam, a hoax, a falsehood—environmental snake oil.

“Every violation of truth is not only a sort of suicide in the liar, but is a stab at the health of human society.” —Ralph Waldo Emerson

Which leads us to the second piece of the puzzle, Con #2. Who’d have thought that . . .

OIL

Is Not a Fossil Fuel

PART 2:

The immigration officer at Sheremetyevo took my passport and studied it for some time. He didn’t say anything; he just thumbed through the passport and then looked at a computer screen for a couple of lifetimes before stamping it and grunting me on to customs.

The KGB was still manning the borders the first time I went to Moscow shortly after the fall of Communism. Letting Americans walk freely into Mother Russia without official surveillance was driving the man crazy but he had to keep a lid on it.

In fact, Communism had been officially dead for only a few months when the shock troops of capitalism started storming the gates of opportunity in the former Soviet Union. The ghosts of Marx, Lenin and Stalin stalked the halls of the Politburo in horror as entrepreneurs from the United States, Japan and Western Europe tried to cut deals for every asset in Mother Russia that wasn’t nailed down. Banking, hospitality, timber and precious metals came under assault by peculiar partnerships of western capitalists and thugs from the once mighty KGB. During those early years, when Yeltsin (God love him) and his vodka were in office, it was a free-for-all.

The Oklahoma land rush of the 1890s had nothing on Moscow in 1992.

But even then, the oil industry stayed under control of the state—directly or indirectly. In fact, as recently as 2003, the bare-chested former KGB colonel and current premier—soon to be president of Russia . . . again—Vladimir Putin squashed a buyout deal between Russia’s Yukos and Exxon, the largest company in the world.

To understand the reason for this, we return momentarily to the early days of the Cold War when an isolated Soviet Union tasked their top scientists to identify the actual source of oil. Not a weekend homework assignment. After considerable research, in 1956, Russian scientist Professor Vladimir Porfir’yev announced that “crude oil and natural petroleum gas have no intrinsic connection with biological matter originating near the surface of the earth. They are primordial [originating with the earth’s formation] materials which have been erupted from great depths.”

If your eyeballs didn’t fall out when you read that, you might want to read it again.

He said oil doesn’t come from anything biologic, not, as conventional wisdom dictates, from the fossilized remains of dinosaurs and/or ancient plant matter. It comes from very deep in the earth and is created by a biochemical reaction that subjected hydrocarbons (elements having carbon and hydrogen) to extreme heat and intense pressure during the earth’s formation.

Russians referred to this oil (any oil, really) as “abiotic oil” because it is not created from the decomposition of biological life forms, but rather from the chemical process continually occurring inside the earth.

I know, easy for Porfir’yev to say. But it turns out it was more than just a theory.

Because shortly after the Russians discovered this, they started drilling ultra-deep wells and finding oil at 30,000 and 40,000 feet below the earth’s surface. These are staggering depths, and far below the depth at which organic matter can be found, which is 18,000 feet.

Interesting, eh?

The Russians applied their theory of abiotic deep-drilling technology to the Dnieper-Donets Basin, an area understood for the previous half a century to be barren of oil. Of sixty wells drilled there using abiotic technology, thirty-seven became commercially productive—a 62 percent success rate compared with the roughly 10 percent success rate of a U.S. wildcat driller. The oil found in the basin rivaled Alaska’s North Slope.

Let’s say they had a good hair day.

But it doesn’t stop there, not by a long shot. Since their earlier discoveries, the major Russian oil companies have quietly drilled more than 310 ultra-deep wells and put them into production.

Result? Russia recently overtook Saudi Arabia as the planet’s largest oil producer.

Maybe they are onto something.

Though there were papers written on this early on, almost all were in Russian and few made it to the West. And those that did were laughed at.

No more. With Russia’s rejection of the Exxon-Yukos deal (Putin did not want this technology and their abiotic oil experts exported to the West) and the access to information now available on the Internet, the word has begun to spread rapidly to the West. Still, it hasn’t taken hold yet.

Why not? This is huge. Oil is not a fossil fuel! And it’s renewable! Wow!

There are a couple of factors at play here.

Big oil has a vested interest in pushing the idea that oil is scarce, hard to find, and thus costly to produce—all of which, of course, means increased revenues and profits. This is a story in itself, but not the primary focus here.

More relevant to our story is the fact that a cornerstone of the environmental movement is this: oil is a fossil fuel, a fossil fuel that is scarce, and is in limited and ever decreasing supply. Moreover, its production creates carbon dioxide. Therefore its use, for virtually all productive purposes—agricultural production, real estate construction, auto, truck, train and air transportation, utilities, heating, cooling, communication, ad infinitum (all of them)—must be curtailed.

According to the thirty-year update of the book The Limits to Growth,

“A prime example of a nonrenewable resource is fossil fuels, whose limits should be obvious, although many people, including distinguished economists, are in denial over the elementary fact. More than 80 percent of year 2000 commercial energy use comes from nonrenewable fossil fuels—oil, natural gas, and coal. The underground stocks of fossil fuels are going continuously and inexorably down. . . Peak gas production will certainly occur in the next 50 years, the peak for oil production will occur much sooner, probably within the decade.”

Scary stuff. Frightening. But as false as a hooker’s smile.

Oil is not a fossil fuel.

And it is “renewable.”

While I have never been a fan of Putin the Macho, the Russians have demonstrated the accuracy of their theory in the only place it counts—the oil field. Oil is not only abiotic, it continues to populate fields that were understood to be as dry of petroleum as a desert wind. In fact, some scientists believe it is the centrifugal force of the planet’s rotation that forces abiotic oil toward the planet’s surface on a continuous basis.

“There are some things the general public does not need to know, and shouldn’t. I believe democracy flourishes when the government can take legitimate steps to keep its secrets and when the press can decide whether to print what it knows.” —the late Katherine Graham, owner of the Washington Post

So Con #2 is that oil is a fossil fuel (which it isn’t), that it is scarce and being depleted (which it isn’t), that it is nonrenewable (which it isn’t), and that, as a result, catastrophe looms (which it doesn’t) unless we drastically curtail our use of petroleum.

Lies one and all, which leads us to the granddaddy of con—Con #3:

GLOBAL WARMING—CLIMATE CHANGE

PART 3:

The heart-wrenching icon of a lone polar bear hovering in solitude somewhere in the rapidly disappearing Arctic has become the environmental movement’s most poignant pitchman.

The pitch, however, is bogus. The bears are booming.

According to the Wall Street Journal,

“Nearly everyone agrees that there are more polar bears now than when scientists first started counting: Estimates put the population between 20,000 and 25,000, up from several thousand 50 years ago. In Canada, where two-thirds of the world’s bears live, most populations have grown during the past two or three decades. Arctic residents say they are now bumping into bears wherever they turn.”

The polar bear “debate” cuts to the heart of the foundation on which the environmental movement rests: global warming.

While the Club of Rome’s clarion call for “sustainable development” in The Limits to Growth turned out to be more than a little thin on scientific credibility, and the theory that oil is a scarce and rapidly depleting fossil fuel is untrue, the holy grail of the environmental movement is Global Warming or, as they have renamed it due to the last eleven years of embarrassingly cooler temperatures, Climate Change.

It is the creed upon which the movement is built.

The scripture is as follows: The burning of fossil fuels produces carbon dioxide. This and other “greenhouse” gases create global warming, which will destroy the planet.

To wit, the production of these gases must be “capped.”

Legislation to suppress their use is a first step. Population control, a reduction of the planet’s population, is the real answer because man makes these gases. Fewer people mean less greenhouse gas. Less greenhouse gas means less global warming. Less warming means the earth is saved.

Amen.

Greenhouse gases, by the way, are any of the atmospheric gases, such as water vapor and carbon dioxide, that are said to contribute to the greenhouse effect.

The greenhouse effect is a name for the phenomenon outlined above whereby the earth’s atmosphere traps solar radiation and thereby overheats the planet. According to the theory, these gases in the atmosphere allow sunlight to pass through to the earth, but then absorb the heat radiated back from the planet’s surface.

Shazam! Global warming.

Sounds good. Cut CO2 and you save the world.

A clearly identified evil with an action plan to handle it.

Kind of like the Inquisition—fry the heretics, purify the faith.

Today, global warming heretics are burned in the media not at the stake, but the dogma is no less strident, no less authoritarian, and no less despotic.

SCIENCE SETTLED

Al Gore is the Moses of global warming. He, along with the high priests of the movement, the United Nations’ Intergovernmental Panel on Climate Change (IPCC), has pronounced that the science regarding man-made global warming is “settled.” There’s nothing further to discuss: global warming is real; man-made CO2 is the cause; carbon production must be capped. Done deal.

Al and the IPCC are simpatico on this—which is cool. Harmony in the ranks.

THE OREGON PETITION

But here’s the deal: 31,486 scientists have signed a document called the Oregon Petition lambasting the shoddy research behind global warming, stating quite simply that “. . . any human contribution to climate change has not been demonstrated.”

This is not a gang of political hacks, or George Soros–funded “activists.” No, the signatories include 3,667 atmospheric, environmental and Earth scientists; 4,796 chemists; 2,924 biologists and agricultural scientists; 903 math and computer scientists; and 9,992 in engineering and general science.

Of these, 9,029 have PhDs.

The petition states that there is no convincing scientific evidence that the human release of carbon dioxide or other greenhouse gases is causing or will cause global warming.

It goes on to say that there is substantial scientific evidence demonstrating that atmospheric carbon dioxide produces countless beneficial effects on the plant and animal populations of Earth. (In one of Mother Nature’s most spectacular touches of environmental magic, plants convert carbon dioxide and sunlight into oxygen—you know, the stuff we breathe.)

SENATE COMMITTEE ON THE ENVIRONMENT

In March of 2009 the Senate Committee on Environment and Public Works posted a report of more than 700 international scientists dissenting on the theory of man-made global warming. Several of those joining in on this report were current or former IPCC members.

Several other groups of scientists have issued statements blasting the lack of credible science behind the theory that man-made carbon dioxide and other greenhouse gases in the atmosphere contribute to global warming. Examples include the Statement by Atmospheric Scientists on Greenhouse Warming, the Leipzig Declaration on Global Climate Change, and the Heidelberg Appeal.

THE IPCC COOKS THE BOOKS

You will notice, if you read articles about the environment, that “facts” regarding global warming invariably cite the IPCC as their source

In short, the UN’s Intergovernmental Panel on Climate Change is the planet’s opinion leader on the subject of man-made climate change.

Or at least they were.

On November 19, 2009, one of the largest scientific scandals in history exploded across the international media when thousands of internal e-mails were leaked exposing the organization’s blatant manipulation of climate data. The e-mails revealed that the IPCC had skewed bucketloads of climate information to promote the idea that global warming was a result of an increase in man-made carbon dioxide and other greenhouse gases.

This wasn’t a bunch of stoners in a frat house passing the filched answers to the Geology 101 midterm around. These guys were recognized as the world’s leading “authorities” on climate change, caught red-handed in an intentional plot to mislead environmental groups, governments and the public at large about the current and future state of the planet’s temperature.

This brief excerpt from Canada’s National Post rather tells the story.

“The Climategate Emails describe how a small band of climatologists cooked the books to make the last century seem dangerously warm.

“The emails also describe how the band plotted to rewrite history as well as science, particularly by eliminating the Medieval Warm Period, a 400 year period that began around 1000 AD.

“The Climategate Emails reveal something else, too: the enlistment of the most widely read source of information in the world—Wikipedia—in the wholesale rewriting of this history.”

THE MEDIEVAL WARM PERIOD

Like a cheap Las Vegas lounge act, the pernicious cult of climate change ideologues at the IPCC desperately tried to hide the Medieval Warm Period (MWP)—ditch it, make it disappear. This was the warmest period in modern recorded history and is very well known by climatologists.

Trying a page from Houdini’s playbook, the IPCC created a phony graph of historical temperatures that made the MWP—presto!—vanish.

Cute.

You see, during the MWP temperatures were much warmer than they are today. Agriculture flourished and the Norsemen, taking advantage of the ice-free seas, settled Greenland. There is no evidence of a rise in sea level at that time. None. And ice sheets around Greenland were largely absent. Greenland, get it?

Temperatures soared, but where was the man-made carbon dioxide? Oil had yet to be discovered, factories had not been constructed, and the first Model T was centuries into the future.

There followed a mini ice age, and by 1500 the settlements in Greenland were gone and the Thames froze all the way to London.

There was no “man-made” factor in any of this. These ebbs and flows of the earth’s temperatures were all a product of naturally occurring phenomena, which is discussed in detail below.

But as to the IPCC,

“Research data on climate change do not show that human use of hydrocarbons is harmful. To the contrary, there is good evidence that increased atmospheric carbon dioxide is environmentally helpful.” —The Oregon Petition

FEARMONGERS

In fact, the same mindset that is now promoting the catastrophic consequences of global warming were using the same arguments, almost word for word, to promote the dire consequences of global cooling just a few decades ago.

In 1975, Reid Bryson wrote in Global Ecology:

“The continued rapid cooling of the earth since WWII is in accord with the increase in global air pollution associated with industrialization, mechanization, urbanization and exploding population.”

Yeah, baby! CO2 is causing global cooling.

Or consider Kenneth Watt, writing on Earth Day in 1970:

“If present trends continue, the world will be about four degrees colder for the global mean temperature in 1990, but eleven degrees colder by the year 2000. . . . This is about twice what it would take to put us into an ice age.”

Good call, Ken.

There are more, but you get the idea.

These people, then and now, are fearmongers. They get some kind of perverse joy out of frightening people—in this case, frightening them into acceptance of the greatest con job of all time.

Listen to the climate chaos merchants reviewing a book by a global warming jihadist named James Hansen, who subtitles his book “The truth about the coming climate catastrophe and our last chance to save humanity.”

“Dr. James Hansen is Paul Revere to the foreboding tyranny of climate chaos.” —Robert F. Kennedy, Jr.

“With urgency and authority, Hansen urges readers to speak out—taking to the streets if necessary—to protect the Earth from calamity for the sake of their children and grandchildren.” —Kirkus Reviews

Calamity, chaos and catastrophe: the cocaine of the global warming media extremists.

STATS

The crisis and catastrophe crowd don’t like to talk about the fact that water vapor (not carbon dioxide) accounts for 95% of all greenhouse gases. This is naturally occurring water vapor—99.99% of “greenhouse gas” water vapor is natural. Only .01% (one-hundredth of one percent) of greenhouse water vapor is man-made.

But carbon dioxide is the anointed villain of the piece. It must really pack a punch, because CO2 only makes up 3.6% of greenhouse gases. And here’s the kicker, only 3% of the carbon dioxide—3% of the 3.6%—is man-made. This means .1% (one-tenth of one percent) is man-made CO2.

This, according to the harbingers of climate doom, is what is driving “climate catastrophe.” International conferences are called, governments allocate billions, and corporate PR departments gush over environmental agendas in a universal tsunami of green.

It’s as if someone had turned a programmed cult of global warming druids lose on the planet to shriek the horrors of carbon dioxide to a populace that doesn’t know or can’t confront the blatant lunacy of what they are saying.

In turn, the lapdog media regurgitates the chaos and calamity to millions. Their sole aspiration is to shovel as much death, destruction, filth and depravity into the public’s mind in the shortest possible time. Except somewhere in their collective soul they know . . . and they are sick with shame.

"We allow the most atrocious lies uttered by political and moral prostitutes to go unchallenged. These lies are endlessly recycled in the commercial media until they become ingrained in the public conscience as truth.” —Charles Sullivan, author and philosopher

Can I get an “Amen”?

THE SOLAR CONNECTION

I’m a California boy. I love the sun. During spring break in college, some friends of mine and I would body surf our way down the west coast of Mexico, turning coffee brown in the process, and return to campus as sun-baked bronze gods. The co-eds would swoon. . . . Okay, maybe not swoon, but getting dates was definitely easier.

It never occurred to me in those halcyon days that the sun might play a leading role in an article I would later write about global warming. But it does.

The fact is that Earth has experienced natural warming and cooling cycles all throughout recorded history—cycles that have driven temperatures much higher than anything we are experiencing today.

And what is the source of these fluctuations in the earth’s temperature? Water vapor? No. Carbon dioxide? Eh . . . sorry. Hair spray? You’re joking.

What causes temperature changes on the earth is . . . the sun.

Scientists have discovered that the sun has regular cycles of sunspot activity. Sunspots are regions on the sun’s surface of intense magnetic activity; the more sunspots, the more “active” the sun is.

Sunspots and solar radiation activity virtually parallel temperature changes on Earth. That’s right; it is the sun that is the source of global warming and cooling cycles—not mankind’s “carbon footprint.”

If greenhouse gases were the cause of global warming, how is it that from 1940 to 1975, when there was a dramatic increase in the production and release of CO2, the earth experienced a significant cooling period?

Warming periods on Earth are a direct result of an increase in solar radiation, which prevents cloud formation. Cloud formation has a cooling effect on the planet. This is further borne out by the fact that other planets in our solar system all appear to heat up at the same time. But they’re not driving Chevys on Pluto or burning coal on Mars.

This, then, is Con #3: Global warming is a vast, strategic PR campaign, nothing more. It is not a planetary temperature phenomenon. Sorry, Al.

“Most of the greatest evils that man has inflicted upon man have come through people feeling quite certain about something which, in fact, was false.” —Bertrand Russell

So, what gives? Why all the misleading information and climate change hysteria?

Let me introduce you to Con #4. . . .

END PART 3

BIOFUELS

PART 4

A friend of mine drives around to restaurants late at night and collects used vegetable oil. He uses it in his diesel Mercedes that will qualify for Medicare next year. He has converted the Mercedes to burn vegetable oil as fuel.

One of the solutions to the “carbon crisis” is biofuels.

Biofuels are essentially fuels produced from plants.

There are two basic types of biofuels. Ethanol, which can be used as petrol and is made from corn, sugar cane, beets, wheat and other grains, and biodiesel which is made from oil seeds, tree nuts or waste oil (à la the Medicare Mercedes above).

Biofuels are supposed to be clean, convenient and carbon neutral. But don’t look too closely because the environmental consequences of their use are something out of a Stephen King novel.

DEFORESTATION

The planet’s tropical rain forests are being obliterated as if some frenzied Jolly Green Giant were running an immense weed wacker through the Amazon.

Biofuels are broadly promoted as a solution to the production of carbon dioxide. But a closer examination reveals that they damage the environment on two fronts: the first is massive planetary deforestation.

Tropical forests are the most powerful carbon reservoirs on the planet. In other words, they sequester and store carbon dioxide more effectively than any other resource.

Cutting forests down not only releases massive amounts of carbon dioxide into the atmosphere, it eliminates them as both a carbon reservoir and a generator of oxygen. (Again, for those of you that slept through high school biology, or, like me, never had the guts to take it, plants use carbon dioxide and sunlight to make oxygen.)

But government mandates and corporate greed are pushing the cultivation of biofuels so intently that tropical forests are vanishing from the planet at an appalling rate.

The European Union, for instance, has mandated a 20 percent reduction in carbon emissions by 2020. This is to be partly achieved by mandating that 10 percent of vehicles be powered by biofuel. Financial incentives, which we examine in detail below, have driven global investment in biofuels from $5 billion in 1995 to an estimated $100 billion in 2010. Everyone from George Soros to British Petroleum and Shell Oil are players in this market.

As a result, vast amounts of the Amazon rain forest in Brazil have been destroyed for soybean and sugar cane cultivation. Brazil proudly announced last year that deforestation was on track to double that year.

A report by Friends of the Earth revealed that between 1985 and 2000, the development of palm oil plantations in Malaysia was responsible for the deforestation of 87 percent of the country’s forests. Eighty-seven percent! In fact, palm oil is now referred to as “deforestation diesel.”

In Sumatra and Borneo, 4 million hectares of forest were lost to palm oil farms (9.8 million acres—almost twice the size of the state of New Hampshire).

As an added sucker punch to Mother Nature, biofuel-driven deforestation has also led to Holocaust-like species extinction. The forests in Malaysia and Indonesia are home to the orangutan, Sumatran rhinos, tigers, gibbons, tapirs, proboscis monkeys and thousands of other species, many of which are under serious threat of extinction from habitat loss.

And then there is this troubling little fact: while biofuels generate less carbon emissions than oil, they are doing so by replacing vegetation and soil that suck up even more carbon. In other words, the carbon absorption lost by razing the wilderness to cultivate biofuels is dramatically more than the gains achieved by using the cleaner-burning fuels.

The “inconvenient truth” is that the biofuel craze is destroying nature, and, incidentally, adding to the carbon dioxide on the planet, not decreasing it.

OCEAN POLLUTION AND DEAD ZONES

If you have ever walked by a body of water and noticed an acrid smell, felt your eyes burning or saw that it was blanketed by a thick red, blue or green plant covering, you’ve probably had an unfortunate run-in with an HAB, Harmful Algal Bloom.

In almost all cases, the production of biofuels is accompanied by the use of nitrogen, phosphorous, herbicides, pesticides, insecticides, etc.

Nitrogen, along with other toxic materials, filters downward to the water table and finds its way to rivers, streams and eventually the ocean. There, the nitrogen and, to a lesser degree, the pesticides generate massive, abnormal and very toxic “algal blooms,” which rapidly decay into huge areas of oxygen-sucking dead algae. This is highly destructive of marine life.

Corn cultivation utilizes the greatest application of fertilizers and pesticides. No surprise, then, that the heaviest concentration of these toxins occurs in the U.S. corn belt. The result? Nitrogen and other toxins in the Mississippi River system have mercilessly poured into the Gulf of Mexico creating a dead zone of 22,000 square kilometers (8,492 square miles, an area about the size of New Jersey). It’s not just the Gulf of Mexico. The number of oceanic dead zones has spread around the planet like an environmental cancer.

Since the onset of the biofuel craze in the 1980s, the number of dead zones has increased 450 percent.

But that’s not all.

Species Extinction

There are currently about 405 dead zones on the planet, the largest, 70,000 square kilometers (27,020 square miles—larger than the state of West Virginia), in the Baltic Sea. Species extinction is a direct effect of these zones. In the last ten years, 14,000 dead seals and dolphins have washed up on California’s coast and 650 gray whales have been found beached. In Florida, hundreds of manatees have been killed and 80 percent of the coral reef in the Caribbean has been smothered. Seventy-five percent of California’s fish-rich kelp forest has been ruined and the problem is beginning to affect the availability of seafood for human consumption.

About 1.7 million plant and animal species have been identified on the planet. According to some reports, species extinction is now occurring at the rate of about 20,000 to 30,000 annually. Whatever the number, the endangered species list increased 150 percent last year alone. The single largest reason for this is habitat destruction and pollution, most of which is a result of biofuel production.

Makes you feel warm all over, doesn’t it?

Oxygen Depletion

I don’t know about you, but I’ve grown rather partial to breathing. It brings a certain awareness to life.

So the fact that biofuel production is depleting the planet’s oxygen is more than a little troubling.

Sounds alarmist, doesn’t it? Perhaps even a bit conspiratorial. How could one of the most prolific solutions to global warming be destroying the planet’s supply of oxygen?

The oceans are the planet’s largest carbon sink. (The rain forests are the most effective carbon sinks; oceans are the largest.) It is the algae in the oceans that absorb the bulk of the earth’s CO2. That’s right; the earth’s primary CO2 sponge is the algae in the oceans.

The algae then convert sunlight and the CO2 in the ocean into oxygen.

Seventy to eighty percent (70%–80%) of this planet’s oxygen is produced by the algae in the oceans. Yet the nitrogen, phosphates and other chemicals pouring into the oceans around the world as a result of biofuel production are destroying the very element that produces the bulk of that oxygen—the algae in the oceans.

This is Con #4: Biofuels don’t reduce carbon; they destroy the rain forests and are depleting the very air we breathe. Which begs the question, have these people forgotten to pay their brain bills, are they just plain evil or . . . is there something else at play here?

And that brings us to the last piece of the puzzle and the final con.

END PART 4

© 2010 by John Truman Wolfe. All rights reserved.

For more information about Silkin Management Group and its services, visit our website at www.silkinmanagementgroup.com or contact us at info@silkinmanagementgroup.com

SOME TIPS ON HIRING

The Use of Tests

In two earlier Silkin Management Group blogs, February 10th and February 11th we discussed specific management systems and technology to help you know which staff members are helping the practice, and which ones might be driving it down. The system is based not on emotion, but on statistical interpretation and performance.

Getting a system like this operating is a big first step, and a very important one. But now what do you do if you find, per actual production measurements that, for example, your receptionist is doing a poor job and driving patients away?
You decide that it’s time to show your receptionist the door, but at the same time have trepidation on being able to know that the new person will be any better. You hate to waste more time and money on hiring and training a new person to only find out you have the same situation on your hands. You just aren’t certain.

You contemplate the possibilities: You would love to have your staff problem solved, but what happens once you fire a staff member? You have to find another competent, intelligent person. You have to find one that will be honest, loyal, and good with your patients and clients. You have to find a person that comes to work on time, works hard throughout the day, and generally has a good work ethic. Oh, and how about someone that doesn’t spend time Twittering, Facebooking, gossiping, and calling her boyfriend while she’s on the job?

None-the-less, you know you have to proceed. After you place your ads and dive into your limited personnel pool, you think you have found your Prospect-from-Heaven! Now all you have to do is train her, establish a working relationship, and integrate her into your office and staff.

Again you wonder: Have you chosen correctly? Is this new staff member really as good as she appears? Does she really like to work hard? Has she really never heard of social networking? Does she really know how to balance the books, make the patients feel like family, sterilize the instruments, and act as a crisis counselor in her spare time?

How do you know, or how does anyone know? But you go ahead and hire her. You face the possibility of a failure, resulting in another turnover. This can be very stressful, time-consuming and expensive.

Silkin Management Group clients have a hidden weapon for effective hiring. This weapon is TESTING.

Silkin Management Group offers its clients a full battery of tests which are extremely effective in making the right choices in the hiring game. Although no test is 100% fool proof and guaranteed to always get you the exact right person, good tests increase your odds tremendously.

According to Ken Derouchie, one of the key writers of The Practice Solution (Silkin Management Group’s on line magazine which can be found at: thepracticesolution.net “People are never going to put on their resume that they have a drug problem, are chronically late and don't get along with people well. You must use testing to get something realistic to base your hiring decisions on, rather than just seeing the resume and getting a ‘feel’ for the person."

With good testing the doctor or manager can pick out the best potential employees for a specific job position which gives one the highest chance of success in achieving a valuable, productive staff member.

For more information about what we do at Silkin Management Group, how we help clients with staff and other practice management issues, visit our website at:www.silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

Lyn Ribisi
Silkin Management Group
Appointment Coordinator

SOME UNSOUND ECONOMICS

As a consultant at Silkin Management Group, I’m always looking through various articles in a variety of publications to stay on top of important matters that could effect Silkin Management Group clients. In doing so, I recently read that a well known international economist, Joseph Stiglitz, speaking at the London School of Economics, said that the United States and England should not ever have their bond ratings be anything other than AAA because “all we do is print money to pay it back.” “The notion of a default is so absurd”.

I was a bit amazed at this statement by such an expert, but it also made me realize that this type of thought, promoted by an international expert is part of why the national and international financial scene is in such a mess. Last I heard there were two major countries in Europe that were on the verge of defaulting on loans.

Here’s one way to look at this: if you have to print money to pay your debts, isn’t that a form of defaulting on a loan? I sure wish I could just print some money to pay my house off but, last I heard, I’d get thrown in jail for counterfeiting if I did that.

At Silkin Management Group, we try to teach our clients sound, rational fiscal policies like, “don’t spend more than you make”, “follow a budget”, “pay off debt”, etc. We teach all the obvious, fiscally sound and conservative measures that anyone with any sense agrees with. Why these sound economic principals wouldn’t apply to a government is beyond me. I guess, if I follow the brilliance of the economic policies of most governments in the world, as well as “world renown economists” like Mr. Stiglitz, I should add “print any money you need to pay your bills” to the list too. Hey, great idea Mr. Stilglitz! I’ll do it as long as you cover my jail time.


Gary Crawshaw
Silkin Management Group Consultant

For more information about what we do at Silkin Management Group, how we help clients with financial basics and other practice management issues, visit our website at: silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

Benchmarks Part II

In our Silkin Management Group blog posted February 5th on our blogsite www.silkinmanagementgrp.com we discussed the idea of having and knowing benchmarks for various areas of a health care practice. This is important information for any practice owner to know so that he/she can compare how they are presently doing against basic productivity benchmarks that should be able to be easily achieved. We work with our clients on all of these areas and, where they are falling short of these benchmarks, we help them figure out why and implement the proper actions to achieve them.

In Part 1 we went over benchmarks for Production in a health care office, specifically for dentists, veterinarians and optometrists. In today’s blog we will go over benchmarks for Net and Collections percentages.

Net

Obviously, you don’t want to get your gross production into a higher range and then find out that you aren’t taking home a commensurate amount of money. Producing more without netting more is not the way to go! So, here are the minimal net benchmarks for you to know and what we work with Silkin Management Group clients to minimally achieve.

1. Dentists should be netting 40%


2. Veterinarians’ net should be at least 30-35%


3. Optometrists should be taking home 30-35%

Collections

Collections follow production and result in actual income to your practice. But if you aren’t collecting a very high percentage of your production, you are throwing money away. The basic benchmark for collections percentage is 98% of your production. That can and should be achieved. It is not hard to do.

Many of our new clients aren’t aware of how much money can slip between the cracks. A change of just 2% in your collection rate can equal thousands and thousands of dollars in your pocket (or out of your pocket if the collection rate goes down).
To give you a dollars and cents reality on what this can mean, let’s take a typical example. Say your practice is producing at a $50,000 a month level. Every 1% change in your collection percentage equates to $500. So if your collection percent goes down 1%, you lose $500 and if it goes up 1% you make an extra $500. Simple, right? If you are collecting at a 95% rate, 3% below the benchmark mentioned above, you are losing $1,500 per month. Most doctors feel that 95% is good. But the reality is you are losing $1500 a month which is $18,000 a year, straight out of your pocket. That is net income money as it doesn’t cost you any more to collect that extra 3% as long as you have the proper systems in place and trained staff. What if your collection rate was 93% (which many of our new clients are very happy with when they walk in our door). They are losing $2500 a month or $30,000 a year in net income at a $50,000 a month production level. We all can easily imagine what to do with $30,000. A new car? Pay off some bills? School tuition? Retirement funding?
You can do the math using your collection percentage with your level of production compared to the 98% benchmark. Try it and you might find it eye opening.

Silkin Management Group can provide you with all the tools to increase your gross, net and collections to the benchmarks presented. If you are interested in finding out how, call us at 800-695-0257 or email us at: info@silkinmanagementgroup.com. If you’d like to visit our website, check here: www.silkinmanagementgroup.com

Lyn Ribisi
Appointment Coordinator
Silkin Management Group

WHERE IS MY NET PROFIT?

At Silkin Management Group, we don’t try to just increase the production of your office, we just as importantly want to see a nice increase in net profit for you. Why work on increasing production if you don’t make more money? That would be totally foolish.

You have worked hard all week, the office atmosphere has been snap, crackle, pop; the staff have been getting along with each other; and you are proud of the team spirit they have each shown. In fact, your staff have almost read your mind and anticipated your every need. The patients have all arrived on time for their appointments, and the majority of them have even listened to you and accepted your treatment plans!

Now it’s Friday afternoon, the staff have their paychecks, which include production bonuses because the office has done so well this week. But you look at your bank balance, and you are surprised and seriously disappointed at the lack of funds left over for you.

Where did your net go?

Did you work hard all week to earn less money? The bank balance should be going up, not down!

You wonder if it's worth it. You worked hard all week - only to earn less money. All of that increased production may just have landed you into a higher “office-overhead/higher tax-bracket” situation. It's that frustrating income vortex - the place where despite producing and collecting more, you take home the same or less. And after a few of these "successful" weeks you shake your head and realize that if you have much more of this kind of success, you'll go broke.

A Silkin Management Group consultant would take a look at what might have happened:

• Do your staff work overtime? Do you have systems in place to prevent this without being notified?


• Do you have redundancy in your staff scheduling? Are you scheduling for efficiency? Do you have 5 staff members on duty when 4 staff will do during the slower times of the day?


• Can you consolidate your equipment loans into one loan, thus saving you interest and lowering your payments?


• Can you reduce the amount of inventory the practice holds?


• Are you collecting all you bills? Are your collections at 98% at least?


• Are any staff functions overlapping?


• Do you have an efficient office communication system whereby staff are not interrupting other staff when they are doing their jobs, thus reducing efficiency?


• Do you have any monitoring system to know, factually and statistically who is productive and who isn’t?


• Is there any gossiping going on in the office?


• Are there any problem staff members who aren’t being handled?

These are just some of the areas that Silkin would look into to help you with the management of your practice and figure out any problems with your net income. Your net should be between 35%-55%, depending on your profession, and area. If it’s not, there’s something wrong with the management of your office.

If you would like help with this area of your practice, feel free to contact us at: info@silkinmanagementgroup.com or call 800-695-0257. You can also visit our website: silkinmanagementgroup.com

All the best,
Lyn Ribisi
Appointment Setter, Silkin Management Group

Please visit our other blog at: silkinmanagementgroup.blogspot.com

The Credit Game and You

Part Two

In Part 1 of this article, which you can find at below, I mentioned that FICO, the most widely used credit score determining service, had recently opened its “secret vault”. As part of our normal research for our clients at Silkin Management Group, I ran across this information and thought it would be valuable to share with anyone interested in addition to Silkin clients.

I’m sure you have noticed that it is not uncommon to see credit companies mysteriously lowering credit limits, and many are even closing accounts that have no delinquencies or violations on the part of the consumer.

Why is this?

Some credit companies have just tightened up the amount of credit they are willing and/or able to extend and the consumer can’t do much about it. If this has happened to you, then the best advice is to switch credit companies. With a good credit score, you should be able to procure another line of credit easily enough. Of course be aware of the fine print—check for annual fees, rewards programs and, if you plan to carry a balance month-to- month, then obviously search for a card with the best interest rate.

To help you with this there are many websites that offer information and comparison between individual credit cards. creditcards.com is one of many you can try.

However, there is another reason that you might be getting cut off from your lenders, and that is your FICO score. This is a constantly changing number, and it depends on not only on how promptly you pay your credit card bills (of course that is a primary factor), but also on a number of other spending habits. Here are some examples: If you’ve maxed out a card your score will be reduced. How much? Well that’s another interesting point and depends on where your score was. For example if your score is about 680, it will be reduced anywhere from 10-30 points. However, if your score is about 780, then it will drag it down 25-45 points!

If you are 30 days late on a payment, your score can be reduced 60-90 points if you have a 680 score and for the higher FICO range, it is a 90-110 point reduction!
If you choose to go with a debt settlement service, your score will suffer by 45-65 points for the lower FICO range, and 105-125 points if you start with the higher FICO range.

Foreclosures will cost you 85-105 points low range or 140-160 points in the higher range.

And the worst-case scenario, bankruptcy, will take off 130-150 points in the lower credit-score band. For a higher score, count on losing 220-240 points.

Keep these points in mind when using your credit cards and dealing with credit card companies. As noted above, if you max out one of your cards it can cause a significant change in your score, so think about that before you do something like that.

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com or call Silkin Management Group at 800-695-0257.

Lyn Ribisi
Appointment Coordinator
Silkin Management Group

The Credit Game And You

Part One

You likely have read recently about the ethics of the large banks that were bailed out by you and me…the taxpayers. In fact President Obama is now talking about putting restrictions on the large banks to hopefully prevent this type of catastrophe from occurring again.

Meanwhile, most of our personal credit activities have taken a hit in the last year. You may have experienced this through difficulty in getting a loan or changes in your credit card rules and rates. In fact you might be asking yourself, “What did I do to make my credit card company hate me?” Maybe you’ve had your card limits lowered, or even had some cards canceled for no apparent reason. You have made all your payments on time, and you can’t remember doing anything unusual to have caused such an action against you.

The management team at The Silkin Management Group attempts to watch these activities for its clients in order to offer logical advice. The great majority of Silkin Management Group’s clients are in the health care profession and, as such, their credit ratings are often vital to the operation of their business. Having good credit is vital in getting a lease or loan for new equipment, expanding an existing office or building or buying a new facility.

Unless you’ve been living the last year or so living in an endangered oak tree as a guerilla environmentalist, you are aware that the credit climate in the country has changed. This is not new news. However, it was only recently that FICO, the service most widely used to determine one’s credit-worthiness, has released information about how they arrive at the hallowed number. This is the first time they have opened their secret vault of formulas, calculations, and criteria to the great masses.

Also, Silkin Management Group is a leading vendor for several major lenders to the health care profession. As such we have extensive experience in this field and can help you with understanding this industry and activity as well as aid you in obtaining financing for business needs.

Part 2 of this article will be posted here on January 29th. In Part 2 I’ll go over some of the specifics I’ve found from FICO opening up their secret vault. You’ll find it useful, educational and hopefully helpful in being proactive with your credit rating.

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com

Lyn Ribisi
Appointment Coordinator,
Silkin Management Group

The Key to Patient Appointing

Clients new to Silkin Management Group often experience various problems with patient scheduling. The first thing that we teach our clients at Silkin with regards to scheduling is that the receptionist must be trained to control the flow of patients/clients at all times.

When a patient or client is allowed to determine when he/she is coming in, the receptionist is relinquishing control of the book to the patient.

The result? Unacceptable numbers of cancellations/reschedules, erratic appointing, dead time in the back, open slots, etc.

Patients should be educated from the initial call to come in when the receptionist can get them in – not when it’s convenient for them to arrive. This is not done in any harsh way or in any way other than the person experiencing top notch service from the office. One would always try to fit a patient/client into an appointment slot that as closely approximates what they need and want. But, at the same time, the receptionist controls when the patient/client can best be serviced.

If you have any trouble thinking with this, realize that when a client calls any other professional office for an appointment - attorney’s office, physicians’ practice, bank manager – nearly always the receptionist will state when the client can be seen, not the other way around. Good communication by the person making the appointment will always result in the person feeling serviced while they are scheduled when the office can see them.

There is no difference in your office. The priority of seeing the doctor must be established in the mind of the patient at all times. As a consultant at Silkin Management Group I insure that all my clients all understand this and that proper job descriptions and role playing is introduced into the training of their receptionist so that this can easily be accomplished.

If you’d like to know more about this or want information about any other practice management actions, contact us at: info@silkinmanagementgroup.com or give us a call at 800-695-0257. You can also visit our website at: www.silkinmanagementgroup.com


Bill Hickey
Consultant, Silkin Management Group

METRICS FOR AN OFFICE MANAGER

The various Silkin Management Group blogs have recently been running a theme of how to measure productivity in a health care office. Several examples have been given that are used with Silkin clients to help them manage their office better. So far we have covered possible statistics for a receptionist, collection area and exams. Today I thought I’d cover some ideas on how an Office Manager’s production could be measured.

As previous Silkin blogs have covered, the first thing you need to determine a proper statistic for a job or area is figure out the product that job or area should be producing. Here are some ideas for the product of an Office Manager:

• An office that is expanding and prospering
• A Doctor who only has to wear his/her Doctor and owner hat
• Staff members who know their jobs, are thereby productive, and are operating together as a team.
• Satisfied patients/clients who continue to come in for care and who refer others to the practice.

All of these points could be considered valid products of an Office Manager and all could be used or they could be used collectively.

With these products in mind, one could use the following statistics to measure the overall productivity of the Office Manager:

• Production
• Collections
• New Patients

Silkin Management Group Clients have found the above products and statistics to be very workable in managing their practices. If you are not using some sort of statistical management system, I suggest you start implementing a system using the advice we’ve presented in these blogs.

If you would like help with any of this, please contact us at: info@silkinmanagementgroup.com. You can also visit our website at silkinmanagementgroup.com


Eric Korb
Director of Consultants

Check out our other blogs about managing by statistics at:
Yet More Ideas on Productivity Measurements in a Health Care Office
Here's More Ideas on Measuring Productivity
How Do You Measure Productivity of All Areas of an Office?

A BIGGER PICTURE LOOK AT HEALTH CARE REFORM

If you’ve been reading through some or any of Silkin Management Group’s various blog sites, you’ve seen a variety of articles concerning the health care reform bills being debated and voted upon in the House and Senate. Most of those articles have also referenced writings on the subject by a variety of authors.

Since we at Silkin are attempting to stay on top of this vital issue for our clients, we are continually reading different publications that have information about this legislation. Today I read a very interesting article in the New York Times written by David Brooks. I thought his viewpoint was worth passing on as it gave a bigger picture look at the whole health care reform activity.

As Mr. Brooks says: “But the general view among independent health care economists is that these changes will not fundamentally bend the cost curve. The system after reform will look as it does today, only bigger and more expensive.

As Jeffrey S. Flier, dean of the Harvard Medical School, wrote in The Wall Street Journal last week, “In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it.”

I suggest you read the whole article as it might give you a different perspective on what is going on. I believe we need fundamental health care reform in this nation. What I don’t believe is that the legislation that seems inevitable to be passed will truly accomplish that. Rather it seems that it will add more government costs and regulations rather than fundamentally change our system for the better. Our government is already fiscally insolvent. It seems to me that this legislation won’t help the matter and only add to the problem for our children and grandchildren.

I invite your comments on any of Silkin Management Group’s blog or social media sites:

Silkin Facebook Page
Silkin Twitter Page
Silkin Squidoo Lens

You can also visit Silkin Management Group’s website at:
silkinmanagementgroup.com

or contact us at:
info@silkinmanagementgroup.com


Gary Crawshaw
Consultant
Silkin Management Group

HELP FOR SMALL BUSINESSES OR JUST MORE HOT AIR?

From my job as a consultant at Silkin Management Group, I continue to monitor and read about what is happening with small businesses as part of the economic recession we are experiencing. On November 4th my colleague Bill wrote an article on one of Silkin’s blog sites about how, despite the governments statements to the contrary, small business lending is still not happening.

Here it is, two weeks later and, with even more government pronouncements about how the bailed out banks are suppose to now be helping small businesses, per this article from CNN, very little is still happening. Small Business Loans Evaporate

My clients at Silkin and I discuss this not infrequently. How come, we ask, do these huge banking conglomerates that have made bad business decision after bad business decision and get bailed out by our tax dollars, do nothing to help the small businesses that employ the great majority of people in this country. How come the government who give them all this money does nothing effective to help, despite whatever they may be saying.

I’m not making this up. Per the author of this article, “Eight months after President Obama began prodding the nation's banks to increase their small business lending, the loan numbers continue to move in the opposite direction. The 22 banks that got the most help from the Treasury's bailout programs cut their small business loan balances by a collective $10.5 billion over the past six months, according to a government report released Monday.”

It must be nice to get a lot of money to save your business and do nothing to help other businesses, even though lending money to help businesses is the essence of what you do. I guess I’m just jaded.

If anyone reading this blog has any ideas or comments about this, I’d love to hear it. In the meantime, if you need any help with the management of your business or practice, contact us at Silkin Management Group.

We can be reached by:
Email:info@silkinmanagmentgroup.com
Website:silkinmanagementgroup.com
Blog: silkinmanagementgroup.blogspot.com

Jack Hennessy
Consultant
Silkin Management Group

SOME QUESTIONS TO ASK YOURSELF WHEN YOU ARE HAVING TOO MANY CANCELLED AND/OR RESCHEDULED APPOINTMENTS

As a consultant at Silkin Management Group, one of the management systems we help our clients with concerns various methods for reducing the number of cancelled and/or rescheduled appointments. If a doctor’s office has too much of this going on, it can create havoc with daily production. Normally, when this is going on, it is a sign that the receptionist is not properly trained in scheduling appointments and in how to handle cancels and reschedules.

Here are some questions you can ask yourself regarding cancellations:

• Do you re-appoint a cancelled patient right away?


• When a cancellation happens, do you find out why and keep track of this information for future reference to implement any needed corrections?


• Do you have any patient policy regarding cancellations that is part of your “welcome to the practice” information given to patients/clients?


• If you have such policy, do you enforce it?

Here are some questions we go over with Silkin clients regarding “no shows”.

• What do you do when someone doesn’t show up for an appointment?


• Do you call after a certain amount of time, i.e. 10-15 minutes?


• Do you have any patient policy regarding “no shows” that is part of your “welcome to the practice” information given to patients/clients?


• Is the patient who “no showed” shown the policy the next time they are in?

The clients I deal with at Silkin Management Group are all given these simple questions, plus many more, to review in terms of any problems they are having with cancels, no shows, and reschedules. We closely evaluate the management systems and training they have in place with the staff members involved and then fix and/or implement the proper procedures to reduce the amount of patient loss. This normally leads to increased production for a Silkin client, without any increase in marketing or staff expense. This,of course, leads to greater efficiency and net in an office.

If you would like to find out more about Silkin Management Group, visit our website at www.silkinmanagementgroup.com, email us at info@silkinmanagementgroup.com, and if you are interested in one of our other blogs, please go to: silkinmanagementgroup.blogspot.com

Jack Hennessy
Silkin Management Group Consultant

HELP FOR SMALL BUSINESSES IS GREAT, BUT WHERE DOES THE MONEY COME FROM?

In today’s New York Times, I read the following editorial about needed help for small businesses.Help Small Businesses Hire again.

As a management consultant at Silkin Management Group, I consult our clients with the workable management technology that helps their business grow, even during these tough economic times. Silkin clients are all primarily single doctor owned health care practices such as dentists, veterinarians and optometrists. As such they are all small businesses in the truest sense of the word and anything that affects small businesses affects them. That’s why I found this article interesting.

The author points out those businesses with fewer than 20 employees account for 25 percent of all jobs, and that these same small businesses created 40 percent of the job growth during the 2003 to 2007 economic expansion. I know that our Silkin clients had something to do with that because, as they learned to become effective managers, their productivity grew and the need for more staff increased in order to keep up with the increased productivity. Expansion for our clients is the primary goal of Silkin Management Group and, as consultants, that’s what we are expected to produce. With that viewpoint, I fully back any ideas and methods to help small businesses and that’s why this article caught my attention.

But reading further through the article I found some seriously strange concepts. I thought it was a positive note to promote the concept of making it easier for small business to obtain needed credit, and the author discusses why this is still very difficult, despite the President’s recent statements otherwise. But then the author puts out some concepts that frankly seemed strange including refunds for taxes paid in the past in exchange for higher taxes in the future and work share programs paid for by the government. Interesting ideas, but where does the money come from to pay for all this? He doesn’t say anything about this.

At Silkin Management Group we try to teach our clients fiscal responsibility. This would include the very basic idea of not spending more than you make and running very tight budgetary controls. These are not esoteric management concepts. The Silkin clients who apply these basic principals do well financially. The government, and many economists who write columns such as this one, don’t seem to think that such a basic concept has anything to do with government.

You know as well as I do that if you keep spending more than you make, and you keep borrowing and borrowing money, it will catch up with you and take you out. Why would this be any different for the government, other than the fact that they can print as much money as they want in order to have the money needed? But that activity just leads to inflation. All you have to do is look at the price of any commodity 50 years ago compared to today to see the truth of that.

So, as a management consultant for small business at Silkin Management Group, I appreciate the author’s concern for small business. But I also must express that any help must follow basic and workable management technology and not include more and more borrowing, more and more inflationary activities and less and less fiscal responsibility.

I’d love to hear your opinion about this article and my point of view on it.

For more information about Silkin Management Group, visit our website at: silkinmanagementgroup.com or email us at info@silkinmanagementgroup.com

Bill Hickey
Silkin Management Group Consultant

Visit our other blog at: SilkinManagementGroup.Blogspot.com

Where have all the jobs gone?

As part of our jobs as a consultants at Silkin Management Group, we attempt to stay on top of relevant news that can effect our clients and the management of their business. As part of this I recently read an article that I thought would be interesting, not only to our Silkin clients, but anyone reading this blog. This was an article in Business Week, which, if you are interested, you can access here: A Lost Decade for Jobs

This article points out that private job sector growth has been non existent for a decade! From reading the media over the past year, I had been under the impression that job growth was only a problem in the last year or so, since the economic debacle of a year ago.

This article describes how the only real growth in jobs in the last 10 years or so has been in the government sector which includes jobs controlled and/or sponsored by governments such as education and government sponsored health care. Without this, the article points out, labor growth would have been terrible. After reading this I realized that maybe I’ve been too isolated in viewing what is going on in the business world as I tend to just look at Silkin clients who, for the most part, have been growing and providing more jobs over the last decade.

Here’s a thought…could it be that when the government makes jobs it reduces the potential of the real private sector to provide jobs. Government created jobs have to be paid for by the taxpayers, rather than true productivity in the business market. Given that nearly every state government is experiencing financial meltdowns and the federal government is overspending us into oblivion, maybe we should put more emphasis on private sector productivity and means and methods to help the private sector be more productive. That’s what we try to do at Silkin Management Group.

As a Silkin Management Group consultant, my job is to help our clients, all private business people in the healthcare field, learn and apply effective management systems and technology so that they can be proactive in their approach to living in these very stressful economic times. Most of our Silkin clients are growing, despite the economy, while many other private practice health care providers are declining or barely holding their own. The growth of Silkin clients directly helps provide more jobs in the economy through honest increase in productivity. Activities such as this, helping private sector business people become more proficient in management and thus more productive is, in my opinion, the best method of helping job growth and our economy.

If you’d like to know more about Silkin Management Group, please visit our website at: www.silkinmanagementgroup.com

Jack Hennessy
Consultant for Silkin Management Group

We have another blog at: silkinmanagementgroup.blogspot.com

WHAT TROUBLESOME ECONOMY?!

I’ve been a practice management consultant at Silkin Management Group for over twenty five years. I’ve helped well over 500 different offices during that time and don’t think there is a management problem or situation that I haven’t run into and helped solve at one time or another with a Silkin client.

I get great joy and satisfaction from seeing our clients increase their productivity and decrease their stress by applying the management principles and techniques that we teach and consult at Silkin. Our job is to supply the basic business management education that a doctor rarely, if ever, gets in his or her medical school training.

What we see over and over again is the doctor graduating from school, all bright and shiny and ready to conquer the world and then either starting a new practice or buying an existing practice. In doing so, he or she takes on the rigors of running a business along with the stress of a serious debt load, and doing this with little or no training in business or management. This, to me, is similar a businessman buying a health care office (for example a veterinary clinic) and now having to perform surgery on a dog with little to no training. The success of that surgery would be limited at best! So we at Silkin help our clients learn the business management principles and technology that they didn’t learn in school. As a result, our clients prosper.

The various consultants at Silkin Management Group have been asked to watch the news of the day and write some information for our blogs that would be relevant to what we do at Silkin for both our clients and anyone reading the blog site. We were also asked to write any management information that we thought the readers mind find useful.

To that end, and following the theme I wrote above, I thought I’d relay a very timely article that one of my clients just sent me. I found both the article, and how it was presented in the newspaper, to be extremely interesting in terms of today’s economy and how our clients at Silkin are thriving despite the frequent bad economic news.

My client, Dr. Kathleen Lackey, a veterinarian in Maryland, recently built a beautiful, state of the art facility as one of the results from her great increase in production and income since becoming a client of Silkin Management Group. Additionally, one of the things we taught her was how to get free publicity using her local newspaper. Once her new clinic opened, she took what she learned and got a three quarter page spread about the new office on the front page of the business section of the paper (the October 2, 2009 edition of The Cecil Whig) that has a readership of tens of thousands of people.

The headline of the piece was: “Elk Neck Vet Clinic Thrives With Expansion”, followed by a lengthy article about her growth and the new, state of the art, clinic. What I found both interesting and a bit humorous was the two other headlines right next to her article on the front page of the business section. These headlines were: “Stocks suffer worst drop in 3 months” and “Jobs and manufacturing data suggest slow recovery”.

So, here was my client, growing rapidly and opening up a brand new clinic in the face of the “gloom and doom” economy. And right there, in the front page of the business section were the headlines and articles touting how bad things are right next to the article about her incredible expansion. It goes to show you that, even in tough times, if you know what you are doing in terms of business and practice management, you can not only hold your own, but thrive even during the toughest of times. That is what we are seeing with most of the Silkin Management Group clients.

Dave McKevitt
Silkin Management Group Consultant

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Silkin Management Grp

QUALITY CONTROL

A key administrative division in our company is the Quality Control Division. In actual fact, our company operates on an organizational system that divides up any business into 7 different Divisions. A previous blog article has gone through, in a summary form, what each of those divisions are. In future articles I will detail each of those areas more closely and how they apply and can be used in any health care practice. In any case, as stated above, one of those divisions is the Quality Control Division. Any business, whether a health care office, a restaurant, a car dealership, IBM, etc. must have a Quality Control area of the company that inspects the products that are coming out and determine whether the products meet the quality standard expected and, if not, see that both the product and the product producer are properly corrected. This is a routine activity in our company.

I recently asked one of our quality control staff to summarize a recent client completion and thought I'd pass along this summary report to give any reader any idea of what we do with our clients. I hope you enjoy it.

SUMMARY REPORT ON A RECENT CLIENT COMPLETION
Prior to coming to us, this client was aware of problem areas but he wasn’t confident that he had recognized the actual source of the trouble. The solutions he tried to implement were not resulting in the changes he wanted. He was overloaded with administrative duties, scheduling was inefficient and he was not monitoring his expenses closely which was creating financial problems.

After carefully examining and evaluating information about the practice, his consultant created a step-by-step plan tailored for him. One of the first areas addressed was his recall program. The consultant recognized that there was a “gold mine” that had not been tapped due to inefficiency and staff problems. A recall program was established which yielded results right away.

The second problem that was confronted was the doctor’s lack of case presentation skills. With more patients beginning to come in, it became vital for him to develop skills that would allow him to deliver all the treatment they needed. The consultant had the doctor do a specialized training program which teaches effective treatment plan presentation After working with the consultant for three months the practice’s gross income rose from an average of $50,000 per month to an average of $80,000 per month, with no increase in the amount of time worked.

While these situations were being handled, the doctor had his office manager take part in management training at Silkin. Since the doctor had been overloaded with administrative duties when he originally came to us, the increase in business would have created more work without a trained Office Manager. With training, the Office Manager was able to take over the day-today management of the practice. She implemented job descriptions for each position, got office policies in use, managed staff and ensured the scheduling was done correctly and efficiently. This reduced stress in the practice and greatly facilitated the doctor.

All of this client’s staff members have participated in Silkin training seminars and now perform as a cohesive, efficient team. The statistics of the practice remain in a higher range and the growth pattern has continued. He now spends less time in the practice and enjoys working without the stress he once had.

Based upon quality control interviews with the client and his staff we verified that he is a very, very happy client for the following reasons:

a) his office is now well organized and efficient;

b) he has a well trained Office Manager in place that handles the day to day administrative duties;

c) he is working significantly less hours;

d) has much less stress; and e) his personal income has greatly increased.

We welcome any comments. You can do so by clicking on the "comments" link below.

Larry Silver
President, Silkin Management Group

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Solutions Magazine

The Baucus Healthcare Plan: What Small-Business Owners Need to Know

Every day I get in my email inbox something called the “NFIB Smartbrief”. NFIB is the acronym for National Federation of Independent Businesses. This is the organization that champions small businesses throughout the U.S. and in every single state through extensive lobbying efforts. It is an organization totally dedicated to helping the small business owner.  The NFIB Smartbrief contains links to timely articles concerning any important and relevant news that effect small businesses.  It is a great way to stay on top of news that can effect us all as small business owners.

The clients of Silkin Management Group are all small business owners, and it is therefore important to me to stay abreast of the news about the issues that are most relevant to our clients.  As I’m sure any reader knows, the healthcare legislation that is changing daily while winding its way through Congress will significantly effect small businesses. And, as Silkin clients are both small businesses and health care providers, anything having to do with this legislation is important to stay on top of. Today, while reading the Smartbrief, I found a very good article summarizing the latest potential effects that the legislation, in its existing form, will have on small business. I therefore thought it would be of benefit to our readers to provide that article, published on line by U.S. News and World Reports and written by Mathew Bandyk.  The article is reproduced below or you can link to it by clicking here: The Baucus Healthcare Plan.


I hope this article helps you see the latest that is going on with the healthcare legislation.  Comments on this are welcomed by clicking on the comments link at the end of this blog.

Larry Silver
President, Silkin Management Group

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The Baucus Healthcare Plan: What Small-Business Owners Need to Know

What business owners should look out for as healthcare reform moves ahead

By Matthew Bandyk

In the battle to pass some form of healthcare reform, small business is a major player.  Earlier this year, Congress proposed reform bills that would put in place heavy fines on businesses that fail to provide healthcare for their employees, with the exception of those that have just a few employees. Small-business political associations in Washington quickly denounced these provisions as too burdensome for too many businesses. Now, what's on the table for healthcare reform has changed. In early September, the SenateFinance Committee put forth a new healthcare bill that removes those penalties on businesses. Instead, it offers carrots to employers that provide healthcare, while keeping a few sticks. The bill, associated with its main sponsor, Democratic Sen. Max Baucus of Montana, seeks to expand insurance coverage through the creation of nonprofit insurance exchanges at the state level. These exchanges, under recent amendments Baucus accepted, will be open to small businesses with up to 100 employees.

Although the Senate is currently debating numerous amendments to the bill, many of the most relevant pieces that apply to small business don't seem to be points of contention. One thing is for sure: Many elements of the bill will have a profound impact on how employers seek out and pay for insurance for their employees.  4 Conundrums That Impede HealthcareReform.

Here are, from the perspective of small-business owners, some of the most important pieces of the current plan to reform healthcare.

Tax credits.

The new carrots in the bill are in the form of tax credits for employers that provide their employees health insurance. But not every employer can cash in on these incentives. Only businesses with 25 or fewer employees would qualify. However, about 92 percent of small businesses with employees fall into this category, according to the SBA. There's one further qualification: The average wage of all of the business's employees must be no greater than $40,000. Most business owners will want to pay attention to how much these credits could save them, and when. In 2011 and 2012, the bill would allow employers to deduct from their taxes an amount equal to the dollar amount the employer contributes for each employee's coverage, multiplied by a certain percentage. This percentage would be based on the amount of the employee's total premium contributed by the employer, or the average premium in the employer's state.

Starting in 2013, the state insurance exchanges kick in, and the credit applies only to businesses that purchase insurance through those exchanges. So would these write-offs revolutionize the way small businesses provide employee healthcare? Bill Rys, tax counsel for the National Federation of Independent Businesses, says expectations shouldn't be too high. The size and length of the credit—just four years—aren't high enough for businesses that are strapped for cash to suddenly consider buying healthcare. But the credit could make a difference for business owners "on the cusp"—those unsure if they can afford employee coverage. "It does provide some immediate cost relief," he says. The relief is especially large for the smallest businesses.

Businesses with fewer than 10 employees and less than $20,000 in average wages get to keep the tax credit in full. For larger businesses, it begins to phase out starting in 2013.  But there are also some potential problems. If a business owner starts paying employees more and the average wage surpasses the $40,000 mark, the business could no longer be eligible for the credit. That wage requirement could make employers reluctant to give out raises. Rys says that this is a real concern, but he's not too worried. There isn't much incentive for employers to keep average wages down for the same reason that the tax credits won't have small businesses rushing out to buy health insurance. The length of the credits is just too short. "The concern would be greater if the credit were longer, but the credit is for only two years before the exchange starts," Rys says.

Tax penalties.

Although no employer will be automatically punished for not providing coverage, there are still some fines in the bill that apply to firms with 50 or more employees—only 4 percent of all businesses that hire. But for businesses included in that 4 percent, the tax penalties can be hefty. That's because the bill provides subsidies for individuals and families who make up to 300 percent of the federal poverty level to help them buy insurance through the state health exchanges. Employers that don't provide coverage will have to pay a tax penalty for each employee who receives these subsidies. This has been dubbed the "free rider" provision because it is intended to deter employers from "free riding" off the new health insurance exchanges. The penalty is either the average cost of subsidies that year multiplied by the number of employees receiving subsidies or $400 per employee—whichever number is lower. But business owners won't be told what they owe. They'll have to crunch the numbers themselves to determine if they owe the full amount or the minimum, says Judith Solomon, senior fellow at the Center on Budget and Policy Priorities. There are many administrative burdens that could come with this provision. For example, a business owner would have to keep track of which employees qualify for subsidies, if they suddenly become qualified, or if they drop out of the exchange altogether. Some business that want to avoid the penalty can expect disputes with the tax man—it will be up to them to inform the IRS that some former  employees who received health insurance subsidies were laid off or no longer work there, says Solomon.

Another complicating factor of the "free rider" provision for employers is that it might make them think twice about whom they hire. "It does distort the hiring decisions in the direction of employers who don't need coverage," says Solomon. A business owner might be inclined to look for potential employees who already get health insurance through their spouse, for example, in order to avoid dealing with the tax penalty. Choosing to hire or not hire someone on that basis could land a business owner in legal trouble.

Insurance taxes.

One of the most controversial aspects of the Baucus bill is that, if passed, it would be partially funded by an excise tax on health insurance companies. In 2013, a 35 percent tax would kick in on insurance policies in which premiums are above $8,000 for single people and above $21,000 for families. It might not seem as if a tax on insurance companies would have much to do with small businesses, especially considering that few small businesses have the type of gold-plated, "Cadillac" health insurance plans to which the tax applies. But Keith Ashmus, the chair of the National Small Business Association, says these taxes could be passed down to all employer health insurance plans—not just the gold-plated ones—in the form of higher premiums. "The tax will be part of the entire cost structure of the insurer," he says. "[So] the trigger will be a high-cost plan by company Y, but the impact will be felt by everyone." The good news is that as the Senate has negotiated aspects of the bill this week, Baucus appears to be willing to ease the impact of the excise tax—but not eliminate it.