Physician Revenue Declines

As you know, all things physician have been my passion for ages. I follow all their trials and tribulations. Here is documentation about how these economic times have been making an impact in the physician space....

A Jobless Recovery Will Prolong Physician Financial Woes

by Elyas Bakhtiari, for HealthLeaders Media, October 8, 2009

If your revenue increased or even stayed the same during the beginning of the recession, then you're doing better than many physicians. The median total revenue in medical practices declined—for the first time in years—by 1.9% in 2008, according to MGMA's latest cost survey.

And revenue wasn't all that dropped. The median number of patients visiting medical groups fell by nearly 10%, and the overall number of procedures declined 11.6% between 2006 and 2008. During that same period, bad debt from fee-for-service charges jumped roughly 13%.

This new information offers some statistical validation for trends that many in the healthcare field have already witnessed firsthand. Patients are cutting back on elective procedures in hard times. In some cases, they're forgoing necessary medical care because they are newly uninsured after a job loss. Or they're struggling to pay their bills after a visit, leading to that increase in bad debt.

The publicly-funded safety net is becoming increasingly strained, as well. In many states, Medicaid rolls are higher than they've ever been—Medicaid covered about 42.6 million people in 2008, up 7.6% from 39.6 million in 2007—and governments are starting to cut reimbursements to physicians in order to ease the pressure on budgets.

Physicians seem to be surviving the way most businesses keep going when revenues disappear—they're cutting operating costs. According to MGMA data, practices reduced overhead expenses in 2008 by about 1.5%, and much of that came from support staff, which dropped in the survey for the first time in a while.

Overall, staffing levels stayed about the same in aggregate, which may indicate that some groups hired while others laid off workers, and it has evened out in the wash. It's also likely that healthcare workers, like employees in almost every sector, are forgoing raises or even taking pay cuts for the time being.

Keep in mind, this data is from 2008. Fresher data from 2009 will likely show an even drearier financial situation for medical groups, as many of the indicators have gotten worse this year.

When the healthcare economy will turnaround is tough to predict. There are already a few green shoots that suggest the U.S. economy has at least bottomed out—the stock market has been on a tear since March and the latest GDP estimates have been better than initially predicted.

But an improving economy doesn't mean physician financial woes will end soon. The underlying factors that have hurt medical groups are unemployment and strains on safety net programs, and those may actually get worse as the rest of the economy improves. Economists are predicting a jobless recovery initially; unemployment may climb past 10% while the rest of the economy rebounds. That means more patients losing their insurance or migrating to already bloated Medicaid rolls, and possibly further reimbursement cuts. And it means more revenue struggles for medical groups.
The old conventional wisdom that said healthcare is recession proof has been soundly dispelled by the current downturn. The new conventional wisdom is that healthcare is one of the last sectors to be affected by a recession, but also one of the last to recover.

It's still too early to tell if there's any wisdom in that.

I'm thinking the article gives us all pause.

Happy and healthy hiring. Success by design - one career and new hire at a time.

Lynden

Success by design. One great candidate and client at a time.

Happy and Healthy Hiring.

Lynden
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The Average American and Healthcare Reform

Here is an interesting piece about what the average person thinks about Healthcare Reform. Interesting. As a part of the system, what do you think? Can we afford to do this? Can we not?

 

Most Americans Don't Believe Health Reform Will Pass This Year

John Commins, for HealthLeaders Media, September 18, 2009

Fifty-four percent of U.S. adults don't believe healthcare reform will pass this year, compared to 41% who do, according to a national telephone survey commissioned by the Deloitte Center for Health Solutions.

"Consumers are at a crossroads," says Paul Keckley, executive director of the Deloitte Center for Health Solutions. "While the majority of Americans surveyed (84%) believe some form of change is needed, many are confused by the complexity of the system and often default to their own personal experience with the system rather than look at the functionality of the entire system."

Harris Interactive conducted the national telephone survey of 1,010 adults 18 years old and older from Sept. 10-13 to gauge opinions about healthcare reform following President Barack Obama's address to the nation on Sept. 9. The survey has a sampling error of plus or minus 3.1%.

While most doubt legislation will pass, the 44% of those surveyed who watched Obama's address last week (55% did not watch) were inclined to agree (68%) versus disagree (30%) with Obama's reform plan.

"Interestingly, respondents said they trust physicians and healthcare providers (37%) the most when it comes to reforming the healthcare system, followed by the White House (21%), Congress (13%), employers (11%), and health insurance companies (7%)," Keckley says.

Concern over the government running healthcare was a common theme throughout the survey results. Sixty-one percent of respondents believe that Congress is likely to make the healthcare situation worse than better, and 55% thought government solutions to healthcare will ultimately cost more and deliver less compared to private sector solutions. Additionally, while the economy is still a major concern, 51% believe that health reform should not wait until the economy is better compared to 47% who thought it should wait.

Top concerns expressed by consumers surveyed include:

• 37% do not want the government to run healthcare
  
• 20% do not want their taxes to increase to cover healthcare for others
  
• 13% were concerned that they did not understand the proposals
  
• 12% thought they might have to wait too long to see a doctor if the public option is passed
  
• 5% were concerned about issues related to end-of-life care
  

"Our survey results indicate that while the majority believe the healthcare system needs to change, 48% want improvements, but not a major overhaul of the system. This supports the idea that a more moderate, incremental approach may be the answer," Keckley says.

Additional findings from the survey include:

• 73% of respondents believe it is important for every American to have health insurance
  
• Uninsured (60%) and underinsured (55%) respondents were more likely to believe a major overhaul of the U.S. healthcare system is needed
  
• 57% of respondents believe Town Hall meetings have been an effective forum for gaining feedback from the public compared to 35% who disagree with that statement
  
• Respondents were split when it came to ranking the U.S. healthcare system, with 48% agreeing that the U.S. healthcare system is the best system in the world compared to 48% who disagreed
  
• 55% of respondents do not believe coverage for the uninsured should be the sole focus of the debate
  
• Respondents were most familiar with terms such as the public option (46%), healthcare co-ops (34%), and health insurance exchanges (28%), compared with terms such as comparative effectiveness research (20%) and the medical home (19%)
  

 

John Commins is an editor with
HealthLeaders Media. He can be reached at
jcommins@healthleadersmedia.com.

I'd love to hear your comments. Please post.

 

Success by design. One great candidate and client at a time.

Happy and Healthy Hiring.

Lynden

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Sermo vs the AMA and Healthcare Reform

Like many of you, I'm avidly watching the healthcare reform debate. Like my clients and candidates, reform is ideal and necessary; but the task is overwhelming. So, how does reform really happen?

If you'll indulge me for a moment, healthcare is a healthy industry. There is growth in the sector – new treatments, new drugs, new outcomes; there is significant job creation and shortages. And then, there is the human benefit in caring for the health of others for communities and our nation. So, why is reform such a challenge? For me the issue has been that the big players weren't at the table – those with significant skin in the game. However, yesterday the AMA endorsed the US House of Representatives' Sponsored Healthcare Reform Bill. Ok, I thought. Finally, the physician lead organization has come to the table – I hoped their support of reform was serious. I assumed that their participation was good.

However, today I read a post by the founder and President of Sermo that gave me pause. Sermo is an online community for physicians with more than 100,000 members. In the Sermo Blog Post there is concern raised that perhaps the AMA isn't the best representative of the physician population.

Since most of my adult life has been in service to supporting physicians, this gave me pause. What if the AMA isn't the best voice for physicians? What if there are a significant number of physician voices that aren't being heard in this debate. I'm curious what you think? Please share. I will share the results in subsequent post.

 

Success by design. One great candidate and client at a time.

Happy and Healthy Hiring.

Lynden

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AZ - ENT

Sonoran Desert - 1 BE/BC Otorhinolaryngologist

Seeking ENT Talent. This hospital has received the 2007 Excellence Through Insight Award from HealthStream Research for its high community perception of quality. This 144 bed (all private) facility is a regionally recognized leader in healthcare.

1 BE/BC Otorhinolaryngology (prefer candidate with 2 years post resident experience) to join a 3 physician single specialty group. This new need is due to the growing community population. The group has been established for 5 years and consists of 3 ENT's. Currently the call coverage is 1:3. This group typically is able to cover 20-22 days a month. The group offers a partnership track.

Near perfect location offers:
• 300 days of sunshine
• 4 majestic mountain ranges in beautiful Sonoran Desert
• World class golf courses
• 100 of miles of hiking and biking
• Historic Spanish Missions
• Old western towns
• Nationally known schools and universities
• Lots more.....

Curious about Comp? Well it may include:
• Compensation amount determined by group
• CME
• Relocation
• Potential medical education debt assistance
• Potential commencement bonus
• More....Call ME!

Success by design. One talented physician and client at a time.

Happy and healthy hiring.

Lynden
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AZ - Radiologist

Here is a hot physician job lead for a radiologist:

This 300 bed regionally and nationally recognized leader in healthcare:

Needs a Radiologist - Womens Imaging/ Mammography - only. Physician will be employed by the hospital and work in a freestanding Women's center which is a hospital department. This candidate must have a Fellowship in Mammography / Women's Imaging and have previous experience and be either board certified or board eligible.

This ideal location offers:
300 days of sunshine
4 majestic mountain ranges in beautiful Sonoran Desert
46 World class golf courses
100 of miles of hiking and biking trails
Historic Spanish Missions
Old western towns
Nationally known schools and universities
Lots more.....


Great recruitment package may include:
Competitive salary
CME
Relocation
Potential medical education debt assistance
Potential commencement bonus
More....

If you want more info - contact me today! :)

Success by design. One great candidate and client at a time.

Happy and healthy hiring.

Lynden
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How Talented Are You – How Big Are Your Questions?

As a recruiter, I am constantly interviewing people. As you know, we humans come in all sizes. People do reveal themselves in interviews – of course I also ask good questions. However, I'm always asking myself "how does this person show their spirit, their leadership, how do they 'show up' and make their contribution or mark in the corporate culture?" Since most of my clients are healthcare companies, private practices or hospitals, hiring people who 'get it' and who contribute at the top of their game is crucial.

Today, as a talent management professional and a trusted advisor to great clients, I have to share this quote. This is one of my favs of all time:

Our deepest fear is not that we are inadequate.

Our deepest fear is that we are powerful beyond measure.

It is our light, not our darkness, that most frightens us.

We ask ourselves, "Who am I to be brilliant, gorgeous, talented and fabulous?"

Actually, who are you not to be?

You are a child of God.

Your playing small doesn't serve the world.

There is nothing enlightened about shrinking so that other people won't feel insecure around you.

We are born to manifest the glory of God that is within us.

It's not just in some of us, it's in everyone.

And as we let our own light shine,

We unconsciously give other people permission to do the same.

As we are liberated from our own fear,

Our presence automatically liberates others.

----Marianne Williamson in "A Return to Love"

My reason for sharing this is that at all levels of hiring, we are seeking those who can "connect". We seek talent that enables our healthcare system to provide healing.

If you are hiring what are you looking for? If you are a job seeker – why should we hire you?

Think about it.

Success by design. One career and client at a time.

Happy and healthy hiring.

Lynden

Lynden

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How to Find a Job When You’re a Phlebotomist

I have invited a guest blogger to share info with you all today. This article is written by Kat Sanders, who regularly blogs on the topic of phlebotomy tech salary at her blog Health Zone Blog. She welcomes your comments and questions at her email address: katsanders25@gmail.com.

If you're a phlebotomist and looking for a job, well, you're in luck. Your profession is one that is actually recession-proof because trained and skilled phlebotomists are in demand in various kinds of healthcare settings. Better still, if you're able to manage your time and your schedule well, you could work part-time in two or even three healthcare facilities and make the most of your time and income. If you're wondering how you can kick off your job search as a phlebotomist, read on to find out:

• Check out local hospitals, private physician practices and other healthcare facilities to see if they have any openings or if they can recommend you to someone who does need a good phlebotomist. Put out the word that you're looking for a job even before you graduate so that people know they can contact you if they find themselves short of a good phlebotomist.
  
• Register yourself with online recruitment agencies where prospective employers can contact you if they have anything that suits your skills and qualification. You need to have a resume prepared and uploaded and keep your eyes open for a listing that you think is suited to you.
  
• Check for job postings on online forums, websites, local newspapers and magazines and in flyers posted in public places.
  
• Ask your friends and family members to keep their eyes and ears open if hospitals and other healthcare facilities are in need of a phlebotomist and to give you a call if they do.
  

Most phlebotomists are also expected to handle administrative duties, especially if they're working at a private practice. So it helps your job search if you have secretarial abilities and are able to organize and manage records well. Besides this, experience will come in handy in your hunt for a job, so even if the first job you get does not pay as much as you thought it would, accept the offer and gain some experience before you think of bargaining for more. Your people skills will also stand you in good stead in an interview because phlebotomists have to be good at putting people, especially young children at ease, before and when they draw blood.

It's not too hard to find an opening in the phlebotomist industry because you don't require much training and job openings are aplenty. Since the training period is comparatively less, you can start earning much earlier than others who choose to enter the medical field.

If you're looking to move up the career ladder in phlebotomy, you could earn more and take on more responsibility as a donor phlebotomy technician (DPT) with the necessary certification, or you could graduate to a supervisory position with a few years of experience and dedication.

Again, check out Kat's blog about salaries at phlebotomy tech salary at her blog Health Zone Blog a blogosphere for health professionals. She welcomes your comments and questions at her email address: katsanders25@gmail.com

Happy and healthy hiring, one candidate at a time.

Success by design. Careers by design. Captivating careers.

Lynden

Websites http://www.nextiteration.net/

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Annals of Medicine: The Cost Conundrum: newyorker.com

This is one of the most insightful articles I've seen recently about the thorny issues in healthcare. I can't say enough that I think this is must reading.

Annals of Medicine: The Cost Conundrum: newyorker.com

Shared via AddThis

Success by Design
Happy and Healthy Hiring - One talented person at a time

Lynden

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PRC – Physician Recruiter Credential

I recently studied for and then sat for an exam about recruiting physicians. Since I have been in the business of recruiting for a long time and since I have been recruiting physicians even longer, I have a passion for hooking them up with "just the right thing."

Getting the credential by passing the certification exam was a significant milestone. Physicians are used to thinking in terms of certifications – especially board certifications. Being board certified myself then made sense. So, now on equal footing at least in this one detail. If you want to know more about the PRC – Physician Recruiting Certification let me know. Email Lynden I will be happy to connect you (if you are a physician recruiting colleague) to the resources.

Also, I'd like to share a brief thought:

Vision helps us see the possibilities of tomorrow within the realities of today, and motivates us to do what needs to be done.

Dreams are extremely important. You can't do it unless you can imagine it. ---George Lucas.

Happy and healthy hiring and job searching.

Success by Design – one talented professional at a time.

Lynden

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When Good People Get Bad News – Healthcare Job Growth Declines

According to an article by John Cummins at HealthLeaders Media on April 27th, 2009 we may be seeing a blip on our radar in the healthcare market place.

The article below indicates that there seems to be a trend downward in job creation and demand in healthcare.

Hospital job growth, until recently one of the few bright spots for a nation deep in recession and high unemployment, has all but flat-lined so far this year, Bureau of Labor Statistics show.

For the first quarter of 2009, preliminary BLS figures show that the hospital sector created slightly less than 6,200 jobs nationwide. In the first three months of 2008, the hospital sector created 32,500 new jobs.

BLS reports that there were more than 4.7 million hospital jobs nationwide through the end of March 2009. "It's a response to the fact that volumes are weak and hospitals are adapting their staffing to adjust to that," says David Bachman, an analyst with Longbow Research in Cleveland. "Employee expense is a huge cost center for hospitals, so the extent that they can manage that appropriately that is one of the few levers they have to try to keep margins from deteriorating too much in this environment."

If hospital job creation continues at this pace, fewer than 25,000 new jobs will be created in 2009, as compared with 137,100 new hospital jobs in 2008; 105,700 new jobs in 2007; and 81,400 new jobs in 2006, according to BLS data.

"We are going to see subdued job growth throughout the remainder of this year," Bachman says. "The sentiment among hospital leaders could be we are not going to see a big upswing in patient volumes and margins are so tight, or negative, so they are going to try to continue to do more with less. Essentially, there is no real employment growth in the hospital space over the course of the year, which is very different from what we've seen recently."

The stagnant job growth in the hospital sector comes as the American Hospital Association today released a nationwide survey of more than 1,000 hospitals, nearly half of which report layoffs.

"The fact that hospitals are cutting staff challenges the notion that hospitals are recession-proof," says AHA President and CEO Rich Umbdenstock.

The job growth is also adversely affected by reduced patient volumes, which are being reported by hospitals across the nation.

It's not all bad news. The slowdown in job growth and the weak economy have helped hospitals—at least temporarily—quell an acute shortage of nurses and other clinical staff. Hospitals are reporting that turnover has declined, and that many former nurses have returned to the workforce for any number of pocketbook reasons.

Bachman says the recession has created a "bunker mentality" among nurses and other healthcare workers. BLS data show that—like everyone else—nurses and other healthcare workers are digging in, putting their heads down, and staying put until the economy improves.

Historic trends have shown an uptick in hospital hiring in the second quarter of each year, as hospitals get a better idea of their patient volume projections and they look to graduating nurses and other clinicians to fill jobs. "You start to get some pickup again in March, based on what we've seen historically," Bachman says. "Probably if you look out over April, May, and June, those are a good test to see what is going on here."

Ouch. We know that spending on elective medical procedures has dropped. Hospitals are scrambling in the credit markets like other industries too.

It isn't too surprising to see that hiring has dropped. The surprising thing is the forecast for when it will pick up again.

Basically, as the Baby Boom generation continues to age we know that there will be high demand on the healthcare market, but how are hospitals going to cope with chronic shortages?

Well, they will work smarter and they will be smarter about keeping their best in class talent from physicians to paraprofessionals who "extend" the reach of the physicians and nurses.

There is also a lot of jitteriness about what types of reforms to expect from the Obama administration. However, healthcare has been a target for a long time. There was much discussion about reform out of the Clinton Administration too…and yet very little changed.

I look forward to seeing how the best and the brightest of this industry embrace their challenges.

It will require even more strategy on the part of hospitals and medical practices to be creative in their leadership and staffing development plans.

That means being sure you have solid loyalty programs, referral programs and individual professional development as a high priority. Even though there appears to be a shortage, there is always a call for best in class talent.

If you are best in class talent or a best in class employer – we've got all sorts of ideas to share. Just let us know.

Happy and healthy hiring and job searching.

Success by Design – one great employer and employee at a time.

Lynden Next Iteration; NI Health Jobs

http://www.linkedin.com/in/lyndenkidd

Smart and Sassy Can’t Say Practical

I don't usually talk about my candidates. As a matter of fact, I make it a point to NOT talk about them to preserve and protect their confidentiality. However, I have to break my rule this once.

As you may know, I work with physicians usually. They come in all shapes and sizes. They are super smart and uber smart. There is a shortage of them in the US. Some work with recruiters to help them find jobs. Some have a hard time working with anyone. By that I mean, we have done such an awesome job of teaching physicians to rely on their own judgment, to trust their instincts and to reluctantly rely on others (beside a physician colleague) that they have a hard time delegating any part of their job search to someone else.

Now, just for a second, to intensify the pitch of my whine that makes them tough cookies to work with as a recruiter. Docs don't listen to your advice and they go off wandering alone – much like my seven year old. The real issue is that the recruiter is an asset to the physician. Recruiters have experience in that in which docs don't – finding jobs.

So, here is my rant. I've been working with a doc who has an offer in hand. He is interested in joining this great practice with people he is confident will be good to work with for a long time. He is and has been seeking attorney review of his offer. I applaud his desire to have attorney review. I believe that is a step every physician candidate should take. However, please know that it always: 1) adds time to the negotiation process; 2) adds expense; and 3) I've yet to see anyone go to an attorney and say, "I want you to find only the things that are right about this so we can move forward quickly." By definition, adding an attorney adds a layer of complexity to the process. Attorney's (I am one by training so I can say this with an insider's navel-lint-picking-perspective) HAVE to find something to correct. You'd be mad if you paid someone $500 or so dollars to have them come back and say, "everything is fine."

So, I've got this candidate with a job offer and the first attorney, one he selected, takes FOREVER to get back to him. Doc starts calling attorney and attorney has excuses about why he hasn't had a chance to review the offer letter agreement. Eventually, attorney stops returning calls. Doc is desperate. Super Recruiter (me) steps in and says, "lookie here are the names of well respected firms that I know 1) do this work on a regular basis, 2) guarantee that they will produce an answer promptly." Viola, a win-win for everyone. Doc even sends Super Recruiter a note saying thanks for the suggestions.

Next, what do I learn? Well, Doc has hired a new attorney. Yeah. However, it isn't one of the ones recommended by me, it is some other guy….so we are still waiting on the results of "attorney" review. Just for the record…it has been over a month. I'm sure that Doc will come back with feedback about the offer for my client soon. I'm sure eventually we will get to an acceptable arrangement between the two. I'm also sure that like my seven year old, I'll forgive him for this interminable delay and send him happily on his way to his new job. But, just for the record, if he had listened to me, sought my advice and allowed me to be a true partner to his process the offer negotiations would have been over at least two weeks ago and he would be working with the relocation specialist by now rather than still being up in the air.

Ok. I'm done. I just think that sometimes we "do what we think we need to do" without thinking about the consequences. In this case his prospective employer is learning something about this Doc and what it is like to work with him. Not all these impressions are good. Wish it was different, but in this instance the Doc choose to do his own thing and I will support him to the finish – cleaning up behind. Food for thought.

Happy and healthy hiring and job searching.

Success by design. One candidate, good advice and retention tips at a time.

Lynden Kidd
http://www.nextteration.net and www.nihealthjobs.comhttp://www.linkedin.com/in/lyndenkidd

Healthcare Sheepwalking and the American Investment & Recovery Act

I’m a huge fan of Seth Godin the marketing guru. Recently I’ve been enjoying his book about Tribes where he talks about a concept called “sheepwalking”. He refers to employees who are shuffling around on their jobs; doing what is asked but not being inspired and not giving their all. I appreciated the thought about how when one does a job that doesn’t inspire even the best employees morph into a herd mentality. There is a mindlessness about work in that context which when viewed from the healthcare perch is frightening.

Also, as the economy continues to befuddle economists, the government, the world’s stock markets and employees/employers alike, the challenge becomes how to create a culture that keeps healthcare employees engaged and not simply shuffling around in fear of losing their jobs.

Here are the allocations in the financial stimulus plan for healthcare and education in the US.

Department of Health and Human Services: $19.57 Billion

o National Institutes of Health: $9.7 Billion
Additional scientific research and capital improvement projects
o Office of the Secretary: $3 Billion
Includes funds for computerizing health records and prep for possible flu pandemic

o Administration for Children and Families: $3.1 Billion
Includes funding for childcare assistance for low-income families
o Health Resources and Services Administration: $1.958 Billion
Building and renovation of headquarters building and other health centers
o Agency for Healthcare Research and Quality: $1.3 Billion
Conduct research on effectiveness of healthcare treatments and strategies
o Centers for Disease Control and Prevention: $412 Million
Purchase of property and equipment and renovation of laboratories and other facilities
o Administration on Aging: $100 Million

So what can we expect from the stimulus? Karen Sampson blogs on Masters In Healthcare about how it is to play out and how it might affect the care we receive. But, I'm asking what about what it might do for the healthcare employee? I suggest we need to think about the culture we are creating for those who touch us in a very personal way at the intersection of our health – in healthcare services, medical care or in the life sciences. I’m curious what you think it means to you?

My clients are healthcare companies, medical practices or life science companies. I’m curious about when everything and everyone contracts and squeezes the healthcare professional or scientist in the middle? How do we keep them from “sheepwalking” just to keep their jobs? How to we keep them “stimulated” not from anxiety about their fears of the future, but of the gift and promise of the future?
Answer: I don’t know. I don’t know. But, I do promise to stay active in the dialogue. Contributing my two cents and advocating to those who are hiring, and to those companies who have hiring on hold – our biggest challenge is creating captivating cultures of excellence that stimulate employees to do their best; to care, to innovate, to offer quality in all they do.

Success by design – one employee at a time.

What career is captivating you? What employee are you inspiring?

Lynden Kidd
www.nextiteration.net and www.nihealthjobs.com
http://www.linkedin.com/in/lyndenkidd

Focusing the Mind – The Career Search Paradox

"Nothing focuses the mind like a gun to the head" - Winston Churchill

This quote captured my attention like a laser. The economy is the proverbial gun to our heads. The challenge of the current economy, the struggle of companies hiring and those who are letting people go and the swirl of fear for so many. For the individual wage earner, the prospect of being let go in an economy as rough as ours is right now is chilling. The headlines in our newspapers tell stories of people pushed to the brink - a recently unemployed couple where the husband massacred the whole family. How tragic. How sad. Such a crazy outcome borne out of helplessness.

I would like to challenge all among us to creatively push back against the fear of “losing a job” and instead to hold fast to the knowledge that "we can and do make a difference." While there is always the chance we can become paralyzed by our fears temporarily; personal success and corporate success is going to come from continuing to be bold and to not shrink in these scary times but to push through.

Happy and Healthy Hiring.

Success by design, one step at a time.

Lynden
www.nextiteration.net and www.nihealthjobs.com