the check is in the mail August 29, 2008

Today was a really exciting day.  Who knew getting the mail could be this exciting!  There was no Ed McMahon there to hand me the Publisher’s Clearing House Sweepstakes check (which I was absolutely convinced I would win every single year), but there was something almost as exciting….my first check from an insurance company!  For 15 years I have been a pediatrician and undoubtedly I have been receiving these sorts of checks every week for the entire time but this was the first time that I could hold the check in my hand.  You see in most practices, the billing staff gets the checks and posts the amounts to the patient accounts and then the check gets deposited in the bank.  Sure when I would see the practice bank account I knew that this represented the fruit of my labor and the labor of my partners but honestly I never held a check!  It was a thrilling experience see the checks today and even though the amount was small, it is the beginning of the new cash flow that will pay the rent and my staff and my bills and me (if I am lucky). 

Today was also the first pay day for my employees so the timing was perfect!  We all felt the financial reward of our work. 

In the excitement of the day, I also realized that I am by no means a professional biller….there were a ton of rejections and I can see that several of the claims that were paid will need to be appealed or some info resubmitted since they weren’t paid in full.  Good thing I have my on site e-MDs folks coming out next week!  Of course that means I have to clean the office…..

Enjoy the weather, the long weekend and the fruits of your labor and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  248 816 2558

www.birminghampediatrics.com

Not every day can be your best August 27, 2008

Ok I admit it, I am a polly anna.  I like to see life’s hassles as opportunities and life’s crap as a small price to pay for the great stuff every day.  So tonight as I sit here with a glass of wine and 40 charts to sign off I have to admit a little feeling of defeat creeping in. 

This morning I walked into the office 30 minutes late due to an early meeting that took longer than expected only to find nine (count em 9!!) patients either in rooms or doing paperwork in the lobby.  YIKES!  I knew there were three on the schedule from 9-930 and I had told one child to come in but since I hadn’t mentioned this fact (or my meeting) to my staff they went ahead and told others to come on over that needed to be seen.  Meanwhile, as I stroll into the lab to fire up my computer, who is standing there but Frank, my architect, whom I adore but honestly couldn’t even spare a minute to say hello to.  He was there to show me my final build out bill (and presumably get paid) but I couldn’t even give him the time of day let alone a check!  He said he would wait, which I discouraged knowing what nine (count em 9!!) people already waiting meant for my morning flow.  But he waited, undeterred as I scrambled in and out of rooms, trying not to seem as rushed as I felt, trying really hard to give each patient the time and attention she needed but I must say, there weren’t too many smiling faces leaving the office until around noon when I had finally almost gotten caught up.  Discouraging…..Frank left at some point (poor guy, literally and figuratively) and Maria was convinced she would get no lunch.  Lucky for me she remained chipper and kept a smile on her face. 

By lunch I had dug myself out of the hole and then came the afternoon onslaught.  It was a very busy afternoon too but the flow was much better starting out on time. 

When I started this new venture, one of my main goals was to stay on time and have truth in scheduling.  I have been pretty good on the time thing until this morning but the scheduling needs some tweaking which I will work on in September when things will be a bit calmer.  I am on the right track but not there yet.  Hang in there with me on days like today and know that I learn from my experiences and with good efforts the same bad day won’t happen twice!

Who knew that the Total Quality Improvement or Six Sigma or whatever it is called nowadays actually lives and breathes!

Change, adapt and keep the faith and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248 816 2558

www.birminghampediatrics.com

a new beginning August 26, 2008

Life gives us opportunities, risks, and choices.  I am so glad that I took the opportunity and the risk and made the choice to start my own practice.  The hours are very long (I am doing billing until after 11 pm most nights) and the learning curve still amazingly steep but I am happy.  I am content.  I feel for the first time in my life that I am just where I should be.  There have been bumps along the way and sometimes facing reality is really hard but I have learned that it can be cleansing too and can be the start of a new understanding of myself.  

I have now completed three full weeks in practice and since I have soooo much experience, I can say that this is a resounding success.  I am just as busy as I would have been at my old office and yet much happier than I have ever been.  Sure I am on call every night, but everyone respects my time and uses their book as a resource before calling.  Sure I am answering emails and fielding a lot of phone calls but I feel a sense of peace and pride I have never felt before in my work life.  I have always loved my work; loved the kids and their parents and the challenges they present, but now I feel a greater sense of satisfaction and excitement and pride.  I have always taken the time to really know my patients but with the smaller setting, everyone I see is my patient and I like that intimacy.

It is a rare thing in life to get a second chance at something and I am lucky to have it.  I am lucky to have people who are willing to share this experience with me and although I know I will make mistakes it is comforting to know that I am in a place of peace and happiness with supportive people all around me.  Have I mentioned lately how much I cherish my brothers and the opportunity to have them near me every day?  Have I mentioned that my relationship with my mom even as her boss is going better than I could have ever hoped?  Have I mentioned that Pat is a joy to work with?  Have I mentioned that Paula is fantastic and Maria and Jeni are great to have on the team?  Who could ask for a better crew!

Most importantly though, this is a new beginning for my kids and my husband too.  The past few months have been trying in many ways and exciting in others and we have weathered the good and the bad and now that the dust is settling and the routine of life is starting to make itself more clear, I am sooo glad to have an incredible family and husband to share this with.  

I always loved September, the beginning of the school year with its school supplies and new clothes and renewed friendships and the promise of a neat locker and no more procrastinating.  By October the locker was a mess and I was up late doing homework assignments that I had weeks to do but didn’t but I still loved the start of the school year.  A new beginning.  What a gift.

Try something new, love your family, and apologize for your mistakes and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248-816-2558

www.birminghampediatrics.com

‘We Sing, We Dance, We Steal Things’ my new music obsession August 20, 2008

AAAHHHHH Mackinac Island.  For those of you who haven’t been there I have just one word for you: GO!  We stayed for a few nights at the Grand Hotel and it was fantastic.  Between the 5 course gourmet meals, the ice cream socials and the Irish oatmeal and croissants at breakfast I gained some weight but thoroughly enjoyed every morsel.  We were there to celebrate my in-laws’ 50th wedding anniversary and Kevin’s brother and his wife and kids came in from New York for the event as well.  It has been years since we have seen them and the kids are actually practically adults now.  The oldest is in college, the middle one is a senior in high school and the youngest is a sophomore.  What was most amazing was to watch the cousins together.  They have met only a couple of times and the last time was several years ago.  The boys idolized their cousin Eamonn who is an amazing LaCrosse player and despite his adolescent age of 15, couldn’t have been nicer to the boys.  He hung out with them, took them swimming, taught them how to play LaCrosse, sat with them at dinner and generally was a dream.  I hope that my boys will end up like him….not a surly, self-centered 15 year old but young men who are comfortable enough with themselves that they can enjoy and entertain the younger kids voluntarily.  NICE! 

On the way up, I picked up Mairen from camp (HOORAY!) and she chatted and chatted the whole 4 hour drive up to Mackinac.  She loved camp and made a ton of friends and although she was so tired she could hardly see straight she was aglow from the experience and noticably more mature and content in her own skin.  What a great experience!  I went to camp once as a middle schooler and HATED it.   I am sooo happy she loved it.  I think going away like this is a huge and important experience for kids.  It provides them an opportunity to be independent and stretch themselves in ways that are both comfortable and painful but encourage a sense of knowing themselves in a way little else can do.  Having caring counselors makes this all possible and Blue Lake seems to have gotten it right!  I am thrilled for Mairen!

On the way home from Mackinac, I was listening to an amazing album (yeah I know, not an album a cd) by Jason Mraz called ‘we sing, we dance, we steal things.’  It is melodic and soulful and his musicianship rocks.  He writes the lyrics and the music and has an amazing voice.  Take a listen…..

http://http://www.youtube.com/watch?v=EkHTsc9PU2A

Today I was back at the office and things are really running smoothly now.  Jeni had her first day alone with me and did an amazing job!  We were largely on time and I even had a chance to do the revisions to the cash flow budget that I needed to.  If things keep going so well, I will have to actually start using the treadmill and elliptical at lunch as I had originally planned (YIKES!).

I must say that I am loving my life these days….the time on Mackinac with the family was amazing with great weather, a long bike ride, great food and reuniting with the New York O’Sheas.  Work is really going well and each day I meet new families and get to hear about summer vacations and plans for school this fall.  Of course work is great for me since Jeni or Pat or Maria gives all the shots!

Jam to Jason Mraz, read ‘The Hakawati’ and eat some fudge and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248-816-2558

www.birminghampediatrics.com

Dating myself August 16, 2008

This was a marvelous second week in practice.  I have come to see that what makes work fun isn’t just the kids and their parents, not just my brothers and staff, nooo not by a long shot.  What makes work fun is jamming to the late 70s and early 80s music in the lab while we get ready in the morning and wind down at night.  There is nothing like a good song from Queen or the Who or ELO or even James Taylor to keep me moving and shaking.  Throw a little Madonna in the mix a cookie or two, some milk chocolate and you got yourself a version of Woodstock that was made for a women in her 40s.  You can just picture it….(cue the cheesy montage music and wildly happy synchronous singing and dancing a la Mamma Mia)….tapping out the notes on the laptop, singing along….what could be better!  Gimme a diet Pepsi, some Mini-Wheats, one little piece of chocolate every day and with the soundtrack goin in the background I can’t help but have a smile on my face.

I met a real live celebrity this week too….a little girl who is won a magazine cover photo contest at the tender age of 1 year old!  It was a thrill to see Frankie again this week.  Her parents rock and are incredibly fun to be with and even brought delicious cookies to congratulate me on the new opening.  Frankie was adopted from China and since she came home in the late spring, this girl has blossomed.  She is talking and walking and has such a winning personality you can’t help but smile when you are in the same room with her.  Her mom is an amazing writer and I love reading her blog about life with Frankie (www.codenbaby.blogspot.com) and practically fall off the couch laughing whenever I read an installment.  I feel like Frankie and her parents are old friends even though we have only seen each other a few times since I dutifully read her blog and knowing that her mom likes both Eminem and m & m’s makes us soul sisters.  Fun!  

Tomorrow I head to Blue Lake to pick up Mairen (soooo glad she’s coming home!) and then I am driving with her up to Mackinac Island to celebrate my in-laws 50th anniversary with Kevin’s family including his brother, sister in law and their kids who we haven’t seen in years.  I will be back on Tuesday night but am available by phone and the staff is in the office on Monday and Tuesday to help.  I had lined up a pediatrician to be in the office for a half day Monday and Tuesday and the person called and there was a death in her family and she had to go out of town too.  I was unable to get anyone else at the late date so I will handle as many of the sick issues as I can from afar.  I am working harder now on getting a deeper fill-in bench for me and with the way business is going, I may even be able to have another person in the office regularly anyway.  

I have actually sent claims out to the insurance companies (with more ready to go out on Monday) so there is a good chance I will not only make payroll but may even be able to buy a better sound system for the lab in the coming months…..soooo send me your favorite playlists!  I am interested in broadening my musical palate!

Happy weekend!

Find your personal soundtrack and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248-816-2558

www.birminghampediatrics.com

Going out on a limb here…. August 14, 2008

Ok here’s the personal ad:

Cute, happy 2 year old seeks nanny/babysitter for 3 days a week starting just after Labor Day.  Must have a good sense of humor and enjoy playing music and chasing me as I climb on the couch.  I have some special feeding requirements and am not a big talker yet but my personality will win you over.  Watch out though, I am pretty smart and like to solve problems like wiggling out the stroller. 

Ok for real now, I do have a terrific 2 year old boy in the practice who would love to hang out with a nanny/babysitter while his parents work.  He does get fed through a G-Tube and it is really easy to do (and a lot less messy than a 2 year old in a high chair!).  He has a ton of personality and is an incredibly happy child who only has a few words so far so he lets you know what he needs by smiling and giggling and showing you.  If anyone is able/interested/knows someone who would like to meet this little guy, email me at drmolly@birminghampediatrics.com and I will get you in touch with his mom.

Thanks!

Molly O’Shea, MD

Meet the doctor August 14, 2008

Over the last two weeks, I have had six Meet the Doctor appointments.  These are set up to allow couples who are expecting a baby to come into the office and talk to me about everything from breast feeding and scheduling to vaccines and car seats.  Many times the questions asked by the folks coming to meet me are the same and of course my answers are the same and yet each one is a little gem of a visit.  So much joy and hope and anxious anticipation is clear on the faces of the couples that I can’t help but be excited with and for them. 

It is getting to know the parents and later the children that brings me such joy in my practice life.  A lot of the time my everyday practice life is a series of similar problems with similar solutions.  Of course there is the occasional diagnostic dilemma to keep things spicy but it is the fact that so many of the visits are ‘the same’ that makes the focus on the child rather than the illness so wonderful.  I know a lot of doctors who have found that they are bored by their work or who are so frustrated by the sheer number of patients that need their help that they burn out.  I find the busy days are oddly energizing.  I feel a huge sense of accomplishment and gain a ton of happy energy from my interactions with my patients and their parents.  So this is why at the end of a very long and busy day, the Meet the Doctor appointments are wonderful.  They remind me of the unfettered joy and naive excitement that life can bring.  Just as I enjoy seeing the world through the eyes of my own children, I enjoy seeing the world of parenting through the eyes of soon-to-be moms and dads.

Congratulations to the new families to be and to the people that will help them as they realize their dreams and visions will have to adapt to the fact that the baby will have a say in the reality of life too!

Sleep, eat miniwheats and have an epidural and your labor day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248-816-2558

www.birminghampediatrics.com

Thanks! August 12, 2008

I am getting in the groove at the office.  Pat and I are a great team and between the two of us we are measuring and drawing blood and doing vision screens on 27-32 patients every day!  We still have some start up snags, mostly because we are all new at this new thing, and so I am not quite as on schedule as I would like to be by the late morning and late afternoon.  I am still no more than 30 minutes off the time but my goal is to be better than that.  My brother Tom is doing a bang up job getting the billing under control but even with him doing a lot of it, there is still a steep learning curve for both of us.  We had hoped to send out our first batch of claims today but it will have to be tomorrow due to a problem with the printer.  I can’t wait until all of this is electronically filed (about 2-3 weeks from now)…..then we will not only bill electronically but the posting of the payment will happen electronically and I might even be able to make payroll! 

I really appreciate all the well wishers and the many folks who have brought gifts of food and wine and wonderful flowers and plants.  I also appreciate all of my friends who have been hanging in there despite my lack of returning phone calls or having any availability to see them.  I appreciate my staff, who are working so well together and seem (at least most of the time) to be enjoying life at work.  I appreciate my brothers, Tom who is a great biller already, and Chuck who sits down on my lunch break with me every day and reminds me that there is life outside of the office and keeps me grounded.  I appreciate my mom who finally was able to take a well earned day off and has set a tone for the office that is warm and efficient at the same time.  I appreciate Paula who is quickly becoming a member of the ‘family’ too.  Mostly though I appreciate my husband and kids who are putting up with my new longer hours and constant attention to the details of work.  Thanks to all of you!

Go Michael Phelps!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center  Phone: 248-816-2558

www.birminghampediatrics.com

An amazing first week August 9, 2008

What a great first week!  Although Monday was chaotic, by yesterday we were a finely oiled machine able to accommodate the 25 patients on the schedule with ease and friendly efficiency.  I can’t begin to tell you how much fun this week has been!  The group of folks I have around me makes each day better than the last and the vistas out the windows from up on the fourth floor are stunning.  Did you know that on the clear days you can see the Renaissance Center?!  

There were a few glitches, of course, including the fax server not working at all despite an all day attempt by my IT folks to remedy it and the lack of paper towels for the dispensers until Thursday (we used rolls of paper towels instead) and the fact that I completely forgot to order one vaccine (Prevnar) so we had none for the first week in action!  But the great stuff far outweighed the glitches and between my awesome e-MDs medical record, my fantastic new space that is cheerful and sunny and my staff who are genuinely working amazingly hard and well to ensure a great launch this has been a landmark week for me.  Even with the long hours, the chaos of Monday and the busy-ness of the week with appointments, I have never been so happy in my work life!

This amazing week was also punctuated with another big milestone.  Mairen left for camp early Wednesday morning and it was truly bittersweet for me.  I have never been the sort of mom that felt a loss or a wistful sadness when the kids marched off to school at any time.  I travel a fair amount and although I miss the kids when I am gone, I have never felt the sense of loss that I felt that morning.  She is going into 8th grade this fall and has been really excited about heading to Blue Lake for camp this summer and I have been really excited for her.  She was packed and ready to go in her uniform for camp when I came down to kiss her good-bye and wish her well….it hit me like a ton of bricks….she was so grown up all of a sudden….and for the first time I realized what most parents realize over and over again throughout their children’s lives: she won’t be with me forever.  At least not in this way, still pretty innocent, still wanting me near her (at times at least), still under my spell as her mother…..and I cried and cried after she walked out the door.  She didn’t see my tears, I guess I was embarrassed and I didn’t want her to have any mixed feelings about her first flight from the familial nest but I cried nonetheless!  Kevin drove her to camp, just north of Muskegon and got her settled in and was kind enough to call me in the afternoon to tell me how happy, excited and comfortable she was and the tears returned.  Isn’t this what we work toward as parents, independent kids who we trust will make good choices most of the time and are confident on their own?  I know it is and yet part of me still wanted her to need me in a way she doesn’t anymore.  Part of me wanted her to call and be just the slightest bit homesick.  The rest of me though is happy that she is happy, proud of her confidence and strength, and thrilled that she has begun to negotiate the world on her own.  

The boys kept me company this week with visits to the office almost every day to work as my janitors and did a bang up job which softened the blow of Mairen’s departure and we spent the day today taking a 5 mile walk, going horseback riding, and then shopping for some dress clothes for our trip next weekend to Mackinac Island.  Nice!

Tonight brings Declan’s movie night (High School Musical—which, believe it or not, none of us has seen yet) and the stunning awe of the Olympics.  For those of you who missed the opening ceremonies, go to NBC.com and watch some of it….it was remarkable and beautiful and decidedly human.  

Walk, eat pizza and watch the Olympics and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center    Phone: 248-816-2558

www.birminghampediatrics.com

soooo how do i get paid for this??? August 7, 2008

Now that the hurdles of getting the emr down pat are done (in a record breaking 4 days), I have to figure out how to actually submit claims to the insurers….my forms arrived today and I am beginning to build my fee schedule and then I can build my claims.  By the end of the week I will have seen 110 people and I am thrilled that I will be able to pay the rent and my employees!  Woo hoo!

Lucky for me, I have great support from e-MDs and on Monday I am going to have a conference call to drop my first set of claims to paper to mail off for payment…..keep your fingers crossed that there aren’t a million rejections! 

Two other exciting things happened today….my permanent signs were installed (pictures tomorrow) and I was notified of the first newborn that will be a patient at my practice.  I will head off to Beaumont tomorrow to see the little guy and welcome him into the world.  What a joy my job is. 

Thanks to all the families that have brought gifts of fruit and chocolate and plants and planters….my staff and I are LOVING all of them!  I really love the community we are building together.

Eat chocolate, drink a glass of wine and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics + Wellness Center   248-816-2558

www.birminghampediatrics.com