Thursday, February 6, 2014

Reflections: Director's Completion

For those of you who have been following me, you know my most recent service as that of Rehabilitation Director of a high-end, continuing care retirement community in San Diego. I've held this post for the last year. I was given charge of a skilled rehab department, an outpatient department, and a home-health program - a contrast to my former work in acute care physical therapy, wellness, kettlebells, national public relations/outreach, and marketing.

There are many who have asked me, "Why are you leaving?! You got to director in record time. Aren't you going to miss it?" - I can give you my very honest reasons: 

Life is made of phases; these phases are comprised of layers of experiences - I got my early start into healthcare management, at a director's level no lesse. I like it. Actually, I love it! Moreover, I've demonstrated sharp acumen for high performance from a business standpoint. However, being that this phase of life circulates around a new-born-son and beloved wife, it is time for me to refocus on things which time and money simply cannot replace. For this reason, I've decided to step down from my post to spend more time with my family.

I have nothing but the very best regards for those that have partnered with me, and, for the mentors that have taught me so very much to bring me to this point. It is now that I find the most meaningful reflections, and, a new direction that allows me to redouble my efforts in didactic enrichment, consulting work, hobbies, and of course, connecting with you.

These are my reflections upon completion of my first directorship.

Reflections: Director's Completion
A Forward: I've observed that each turn of management holds specific purposes; mine was business restructuring, organizational culture, and networking. In my time as director, there were a lot of changes; changes in staff, in operational structure, in the community itself, and in healthcare. Below, I will reflect on some of my experience. Where I would love to talk numbers, I must for now, withhold for reasons that the company for which I was formerly employed is publically traded. We'll simply use some non-specific descriptors and leave it as that, savvy? Okay! Here we go!

Business Restructuring
Restructuring is a tough business. For most who are hiring into management to perform this duty, burn out is quick and maintaining what was built is quite difficult. Typically, restructuring occurs due to a combination of people problems and professional misperceptions. My experience lead me to a place where I had to make decisions of business viability.

In the end, I was able to astronomically increase profit margins as well as increase departmental productivity by a handsome edge. The cost? Staff turnover. In the end, when a company runs practice as a profit driven business, the question is risen: Is hiring new staff and starting over, amputating old poisons before they reach the core, worth it? If so, then it must be done. And, so it was. The good that did come from this was the hand-picked-construction of a much more cohesive team than that which was inherited.

Additionally, the daily flow of work, scheduling, and service delivery required much review as the revenue generated was severely lacking as compared to the earning potential of the program. In general, service was under-delivered which also yielded outcomes much to be improved upon. On a quick side for those of you in the SNF/geriatric settings, the informal data I was able to analyze across the systems yielded that for the most part, residents that found their way to skilled rehab generally increased by 50% from their level of function upon admission until discharge.

Finally, I found myself realizing the lesson that despite my personal management style being of a collaborative, agile process operator - when a company has its own corporate structure & culture, all levels of management must jive with the same groove. This was an area which I was not able to restructure, despite my best intentions out of respect for the command structure already present.

Organizational Culture
There were many hard human resource lessons to learn in my first directorship. Much if it circulated around the fact that: If you want the "grown-up-job", you will need to live with the hard decisions - this of course, includes the hiring, firing, disciplinary actions, and keeping secrets. Also, part of serving as management is being disliked - hated even. You need to develop thick skin. The other aspect of being in management is learning to be a leader. Empowering your employees within the given structure of firm is a balancing act that requires careful planning and execution. This is perhaps, the most frustrating part of management - you cannot run as if it were your own business. The business belongs to others, many times to public trade. Therefore, you must act within the parameters given.

That said, I was once again given the opportunity to forge a culture of service, caring, and cooperation. Being that I was part of such initiatives in my former line of work, growing an expanded culture came quite naturally. Much of this is leading by example. Watching management take the time to clean tables, pick up random bits of paper, and spending extra time with customer concerns are an essential function of creating a culture by which staff are willing and empowered to do the same.

The other aspect of organization culture change is creating cohesion. Many times, departments are filled with individuals that work together. The goal is to transform the department into a team that finds it hard to work separately. Aspects of attaining this can be organic and thus unpredictable; the other aspects are a combination of strong leadership - and - unfortunately at times, letting go of people who resist the direction of the team as a whole.

Business is a human behavior of connecting with people; of communicating in hopes of reaching agreements upon perceived mutually beneficial arrangements of trade in products, services, information, and other forms of exchange. The skilled rehab setting is a delicate game of satisfying customers on all side. Typically, the facility wants to keep people as long as people. The residents want to go home as soon as possible. The rehab staff wants the residents to be a safe as possible. All these desires usually go in very different directions. For more, Management Tips (and Commentary): Skilled Nursing Rehab - may be of interest to you.

As much of the business in SNF's relies upon flow, it was incumbent to me, by my former work and connections, to develop and cultivate the relationships from the hospital & health systems for which I was familiar with to deepen the connection that was established in historical contexts. The results, an increased awareness regarding the quality of the program I was given charge of by three major health system & managed care organization by which several major hospitals found their options increasingly open for discharge disposition. Realistically, this means increased referral rates by which a SNF rehab program can add value to the facility at large.

Networking also meant that certain expectations set by the referral sources needed to be met. In preparation for accountable care organizations, I was given the opportunity to learn of the new metrics by which much of healthcare's future would be held accountable to. Discharge time frames, cost analysis, and expectant trends for the continuum of care were lessons learned from networking that I never could have learned from a course, seminar, or break-out session. As for the specifics of these lessons, I'll have to share at a later time when I am freed to convey such news - in so far, I can say that physical therapists are well poised to add value to the future of healthcare.

Some Closing Thoughts:
My first experience with directorship? I loved it! Unfortunately, the timing was poor. In the midst of finishing an Masters of Business Administration program in marketing and becoming a new dad - the combination just wasn't quite right. Nevertheless, through the experience, I found myself in high performance in regards to operations optimization, cost containment, and thus maximizing profit margins. I also learned that growing thick skin, and perhaps, time & exposure to tough HR issues is something that all managers will continually appreciate - though - not exactly wish upon. Such struggles are part of the management business.

Finally, I found that I'm quite talented in consulting business models; I am skilled at making something from good to awesome. However, I don't have the best personality for maintaining the flow. To be honest, I simply lose interest. I'm a problem solver by nature. It is best for me to enter into situations where solutions are needed; to create, implement, and successfully execute said solutions - and finally, to create an exit strategy for smooth transition and continuance of high octane performance.

I look forward to completing the MBA program and pursuing some other ventures. I also look forward to spending much more time with family, and, perhaps earning a belt promotion in Brazilian Jiu Jitsu.

As I said, I see life as that made of many phases... experiences. I've demonstrated high levels of performance in management. Now, it's time for me to refocus my experiences on some of things that simply matter more - the things that time and money can't buy.

Until Next Time, I Remain Humbly Yours,
-Ben Fung


  1. Ben, that's a decision that I made last year to work less and spend more time with my family. It's time you'd never get back and so worth it. Best of luck!

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