July 2009

I just got back from an 18-day trip to Svalbard Island, deep in the Arctic Circle and halfway between Norway and the North Pole. We started in Copenhagen and finished in Oslo. The best part of the trip was spent spotting polar bears and other Arctic wildlife at Svalbard Island.

Let’s get the facts out of the way. Even at 79° North, life abounds. The frigid waters surrounding the Svalbard archipelago contain Atlantic walruses, five different species of seals and 12 different types of whales as well as cod, plankton (for the whales) and other sea life. The air is host to 27 species of migrating, and one resident species of, birds numbering in excess of three million (who counts these?) during the short summer. The island, really islands, host reindeer and Arctic foxes and, one of the main reasons for my trip, about 1,500 polar bears.

I attribute a lot of my success with Vickie Milazzo Institute over the past 27 years to my morning and evening renewal rituals and to my sabbaticals. Just like you don’t expect a battery to keep going forever without recharging you can’t expect it of yourself as a legal nurse consultant. Revitalize your mind, body, emotions and spirit frequently, and you’ll find the energy abundantly available when you need it for your attorney-clients and your CLNC^® business. But there’s more to renewal than two cups of healthy green tea and a good soak in a candlelit tub (although that does work for the short-term).

I take 12 weeks off a year and at least 2-3 times a year those weeks are a true sabbatical from work, business, email, staff and all the associated stressors. This 18-day Arctic Circle trip was one of my sabbaticals – the kind of remote place where I can completely disconnect.

As you can imagine, getting off the grid is not always an easy thing to do (you don’t just hop onto the 5:15 train to Bhutan). I have to plan for renewing my energy in the same systematic way I plan to manage and grow my legal nurse consulting education company. I set my renewal goals and strategies and formulate action steps (can you tell I’m a Pisces?). I schedule my vacations and other Vickie-enhancing activities far in advance to guarantee that no one (including me) overbooks my calendar or schedules a last-minute emergency that will completely wreck all those hours of planning (although it has happened and when it does, I adapt).

My goal is to get far away, into something so different that it forces me out of my regular relaxation routine into one that helps stretch me in different ways. So, for 18 days I was completely disconnected from my normal, day-to-day life and I allowed myself to completely relax and renew. Nature and wildlife provide two of the most powerful tools for relaxation that I’ve ever found and the combination of Arctic ice packs, mountains, glaciers and sea water was incredibly renewing. Sea kayaking, hiking, riding a zodiac raft, seeing a blue whale and worrying about nothing more than getting too close to the business ends of large, hungry, white-furred mammals renewed me in ways that a massage just cannot. Studies show that being exposed to nature may improve your memory as well as your well-being. I know it makes me feel better all over.

I’m now back at my desk and I have the energy for whatever madness life and business throw at me. My mind is clear, I’m calm (relatively) but more important, renewed. My batteries are fully topped-off and I have the energy to accomplish my Big Things and juggle my daily demands yet feel centered, even in the unrest. Renewal lightens my load, and while the world around me may be (and often is) in chaos, I can remain solid in the midst of it.

You don’t have to travel 4,500 miles or 49 degrees of latitude to renew. Find what works best for you – it may be a three-day weekend, working in your garden or lying on a beach. Whatever it is, plan it and do it. You owe it to yourself, your family and your legal nurse consulting business. In the meantime, I’d like to share some small parts of my trip with you. (The one where the bear chases Tom is really funny.)

Rested, renewed and ready for anything.

Success Is Inside!

Every CLNC^® consultant worries endlessly, and to some extent needlessly, about privacy. Without getting into a discussion, let’s talk first about the hippo in the room – HIPAA. It’s been said that law firms are not covered entities under HIPAA (hooray).

That being said, in my humble opinion (which was wrong once back in 1977 – a really bad haircut), a legal nurse consultant working for the defense would be considered a business associate of the defense attorney who would be a business associate of the hospital, other facility or other defendant who is covered by HIPAA. On the plaintiff side, HIPAA regs don’t apply because you’re looking at the records with the plaintiff’s, or potential plaintiff’s permission. But to be safe, keep your CLNC^® subcontractors under contracts with confidentiality provisions and you should be in good shape. Once the suit has been filed, the plaintiff’s medical records are pretty much fair game as they’ll become public records. Here’s a Medscape article on the subject if you want to read more, but the best way to stay in compliance is to discuss any privacy expectations with your attorney-client first.

Enough of HIPAA – let’s talk tech! More and more Certified Legal Nurse Consultants are buying laptops, which means you’re working in places where other people can see your laptop’s screen. I know that every time I walk through a Starbucks^® or to the airplane’s restroom from my seat in steerage I look at what people are doing on their computers (most of them are watching movies but you see the occasional worker bee crunching away on a spreadsheet). Sometimes I get dirty looks but I really don’t see much. It’s the person sitting next to you for a period of time at a table or on a three-hour flight who is the danger.

If you’re worried about people seeing your work product, or lack thereof, consider buying a frameless privacy filter for your laptop. You’ll have to mess around with the installation and make sure your laptop will close with the screen installed, but the filter will hide your data from prying eyes. 3M makes some highly rated filters. They’re a bit pricy, none is perfect (some can be viewed from above) and all can be seen from behind you (otherwise you couldn’t see through them). The good news is that it works on all laptops, after you figure out how to install it. If you think you need one go ahead and buy it. I’m thinking about getting one to keep Vickie from looking over at my laptop to see my flight simulator score on those long “working” flights. But if people seeing your work (or play) isn’t a concern for you, save your money and put it into your marketing materials.

Another privacy concern is with getting your work product to an attorney via email. There are ways to encrypt your email but they can be pretty complicated to set up and not every attorney understands “public key encryption” like you do. So, for legal nurse consultants who want to keep their documents private, buy a copy of WinZip^®. It will allow you to compress your reports, into password-protected “zip” files, which you can then send to your attorney-client. Simply set up a different agreed-upon password with each attorney-client and then send them the password-protected zip files. If anyone intercepts your email or it goes to the wrong address, they won’t be able to read it (easily).

In an earlier blog I discussed another way to secure your work product by sending your attorney-clients your work product in portable document format (PDF). If you have the free Bullzip PDF Printer or a full version of Adobe^® Acrobat^® you can password protect your PDF documents too. Once you get Adobe, it will integrate into your Microsoft^® Word software so you can print PDF files straight from Word. The “save PDF” add-in from Microsoft will let you create PDFs but will not let you add security so you really need either Bullzip PDF Printer or Acrobat (Bullzip is a lot cheaper…free). Then you can simply email your new password-protected PDF documents to your attorney-client (just make sure he’s got the password).

You should keep in mind that it’s pretty unlikely that someone will intercept your email. It’s more likely that you’ll send it to the wrong address and password-protecting your work is a great way to keep it private.

This post should help allay some of your privacy fears but, remember, even paranoids have real enemies!

Keep on techin’,

Tom

One thing every Certified Legal Nurse Consultant knows is that a simple apology by a healthcare provider often goes a long way in disarming anger in patients. But what if a doctor or representative of a healthcare facility were to apologize to a victim of medical malpractice? Do you think that might reduce the number of lawsuits and the associated costs of litigation? It actually does (and that saves us all money)!

“Sorry Works!,” a self-professed “advocacy organization for disclosure, apology (when appropriate) and upfront compensation (when necessary) after adverse medical events” has been successfully implementing laws in 34 states which allow doctors and/or facilities and their representatives to make apologies for medical errors. Those same laws make those apology statements inadmissible in court in order to encourage settlements. Admitting a mistake to keep someone from suing you seems a little odd, but experience and research proves it actually works.

Providers disclosing medical errors to patients and, at the same or a later time, offering a sincere apology, and often compensation, results in decreased numbers of lawsuits. The New York Times reported that as little as thirty percent of medical errors are disclosed to the patients (or their survivors). It is often the concealment of the error and an accompanying unrepentant attitude that feeds the injured party’s anger and results in the filing of lawsuits.

The “apology” program proved successful at the University of Michigan Health System – lawsuits were reduced 68% over the period tracked and at the University of Illinois – lawsuits were reduced almost 50%. Both facilities also experienced drops in legal-related expenses (including settlements). The National Quality Forum in 2009 published an updated practice statement of safe practices that included standards for disclosure of unanticipated outcomes. In a terrific review article, the New England Journal of Medicine has discussed the effectiveness of such disclosures and even the Joint Commission, as far back as 2001 (when they were still JCAHO) adopted the first standards for disclosure. Since then, similar standards and guidelines have been adopted by organizations and facilities across the country. (Here’s a bibliography of articles on disclosure from the Joint Commission.)

So why aren’t more facilities allowing doctors to apologize in order to deter litigation? Part of it is reticence. Would it surprise you to know that according to the Journal of the American Medical Association doctors are either unwilling or afraid to apologize? Insurance companies and facilities still prefer to “deny and defend.” Also defense law firms, whose livelihoods depend on continued and protracted litigation, have no incentive to quickly settle a potential lawsuit.

As a legal nurse consultant working with a case involving an injured plaintiff you will want to discover whether a defendant facility had a disclosure policy in place and whether or not that policy was followed. As a defense CLNC^® consultant you may wish to do the same. It may also be time to involve your facility in this type of program as a cost-savings measure.

Here’s an interesting thought, if these types of programs work so well in medical-related cases, what other types of cases might be able to use an apology system? Perhaps you might see this in toxic torts (chemical spills) or products liability (medical-device) cases? How about simple personal injury cases? The possibilities are endless.

Success Is Inside!

P.S. Comment and share your opinion on “Sorry Works.”

I met Sandy Lawrence of Perceptive Marketing at an Inside Every Woman book signing I did for Houston Woman Magazine. After talking with Sandy, I invited her to join me to discuss marketing your legal nurse consulting business and yourself. When you are launching your legal nurse consulting business, taking one action step a day toward the vision for your CLNC^® business is imperative. To accomplish the goal of taking action day after day after day; plain ole, old fashioned perseverance is the key. Listen to Sandy describe why she’s having her best year ever.

Success Is Inside!

I’m not a pack-rat, but I’ll admit a couple of bookshelves in the business section of my “library” are a bit overrun by books I’ve read, plan to read and some books I will probably never read. The other day Tom was doing some unsolicited (and unwanted) Spring cleaning and ran across a book given to me by the marketing guru Seth Godin. Tom looked at the cover and asked me “Vickie, what the #&%* is a meatball sundae?” He held the book up and I laughed because it does indeed have a photograph of a pretty unappealing meatball sundae (as well as a funny shot of Seth in a chef’s cap).

Still laughing I explained that, according to Seth, a meatball sundae is what results from a disconnect between your marketing and your message. In other words they are totally out of sync – you get a meatball sundae when you mix together two good ideas, like meatballs and sundaes, and the combination results in one bad idea. In my 27 years of managing Vickie Milazzo Institute, as well as teaching and certifying legal nurse consultants, I’ve seen a lot of meatball sundaes cross my desk. Some were my own (or at least my marketing department’s), others came from legal nurse consultants I was mentoring.

Here’s a great legal nurse consulting example. You’ve done your research on the Internet, browsed the attorney-prospect’s website pretty closely and are ready to send your first batch of marketing materials. Instead of positioning yourself properly and marketing to the attorney-prospect’s strengths and core business (personal injury cases), you send materials including and discussing medical malpractice cases; you also emphasize your experience in the ED without explaining its relevancy to the attorney. You just sent the attorney-prospect a meatball sundae, a perfect serving of a mix of bad ideas. Not only did you send the wrong materials to the attorney-prospect, you blew any chance of appearing to be savvy and sophisticated by sending him materials that won’t interest him from the beginning and will put him off from reading the rest of your promotional packet. So, no matter how appealing (and tasty) your promotional materials are, if the attorney-prospect doesn’t have the appetite for the meatball sundae you just served him, you’re not going to get his business.

As a Certified Legal Nurse Consultant you’ve been trained by the Institute not to send meatball sundaes to your attorney-prospects. We’ve taught you how to research attorneys, their practices and their firms to be sure you’re properly targeting your market. We’ve taught you positioning strategies that keep you in the mind of the attorney-prospect. We even mentor you on the proper responses for the interview questions you’re likely to be asked.

I can’t be there to stop you from stuffing a meatball sundae into an envelope and addressing it to an attorney-prospect or heading into the attorney-prospect’s office for an interview and dropping a meatball sundae on her desk during the interview. So I thought today is a good day to remind you to get out there, get cooking on your marketing and make sure you know what you’re serving to attorneys.

Personally, I prefer my meatballs with spaghetti and my sundaes with hot caramel.

Success Is Inside!

P.S. Comment and share how you avoid sending attorneys meatball sundaes.

Have you ever tried to figure out how to disprove or validate those rumors that go around the Internet? These are the ones about computer viruses in messages from political figures, whether the IRS really wants to share unclaimed income tax refunds with you or absolutely anything that comes in an email from your parents. If you’re like me, sometimes you need to find out what’s true and what’s not – especially if you’re a legal nurse consultant trying to construct security rules for your office network. Well, look no farther than Snopes.com. This is an advertising-supported site that researches and debunks just about every urban legend out there.

For accurate computer virus information nothing beats Symantec’s Security Response Website. There you’ll find all sorts of information on viruses, spam, malware and other threats to your computer’s well-being. Believe me, between the Symantec.com website and Snopes.com, Certified Legal Nurse Consultants will find everything they need to know about computer viruses (and emergency celebrity gerbilectomies).

Keep on Techin’,

Tom

In 1982 nurses weren’t starting businesses in droves. And the term legal nurse consultant didn’t yet exist. What possibly made me think I could do something no other nurse had done before? That’s Promise 5 – believing as a nurse I really could do anything. Believing you can do it is 90 percent of the win.

I still remember vividly my first interview with an attorney. I was sitting in the attorney’s office to promote my brand new legal nurse consulting business. He was sitting behind a big desk and I was so nervous my legs were shaking and I worried that if I had to stand suddenly I might faint. What got me through that first interview was remembering who I was – a registered nurse.

I thought if that attorney was in a hospital gown with his backside showing I would have no problem introducing myself and inserting a Foley catheter. During my 27 years of owning Vickie Milazzo Institute, I always remember I’m an RN whenever I hesitate to go for what I want.

We Are Nurses and We Can Do Anything!^® How many of you handle emergencies as easily as making the bed? How many of you make split second decisions that are the difference between life and death for your patients? And how many of you do so in the middle of the night when there are no doctors to be found (and even if they were – they’d just get in your way)? If we can do all that, for sure we can do something as straightforward as talk to an attorney and analyze a medical record.

Any time you’re not grabbing the opportunity, tell yourself, “I am a nurse and I can do anything!” Believe and you will achieve all that you desire for your CLNC^® business.

Promise big and promise now!

Success Is Inside!

P.S. Comment and share what you will do to believe you can achieve it.

All great athletes and performers practice every day. Even after they achieve a level of success, they continue to practice and take instruction from their coaches, learning new ways to reach higher levels. They are lifetime students.

Success breeds success. Becoming a legal nurse consulting success student for life is about practicing being successful. What’s hard today is easy tomorrow – with practice.

A woman who started her CLNC^® business after completing Vickie Milazzo Institute’s CLNC^® Certification Program told me, “I think I can do this.” A few weeks later, when the demands of the business world had her spinning in circles, she called and told me, “No way I can do this.” We talked through some of the strategies she had learned in class, and she kept taking action steps. When she accomplished her first big business goal, she called me again. This time she said, “I know I can do this.”

It is a myth to think you can launch a successful legal nurse consulting business or succeed in any life goal without learning. The most successful Certified Legal Nurse Consultants respect the complexity of consulting with attorneys on medical-related cases and become students for life.

I’ve owned my own legal nurse consulting business for almost three decades, and I still learn every day – from my CLNC^® students, staff members, favorite writers, speakers and business experts. No matter what the subject, there is always more to learn.

There are two ways you can learn:

• The hard way – through trial and error, making lots of mistakes. We’re going to do some of that anyway, but this is a slow, expensive path to success.

• The easier way – through the experience of others who have already successfully overcome the problems and discovered the answers. This is the quick and sure path to success. Just about any problem you will encounter, the right mentor has already successfully managed.

As a committed lifetime student, I choose to listen and learn from mentors who are far more successful than I am. I attribute much of my success to choosing my mentors wisely.

Commit now to being a legal nurse consulting success student for life and to learning not only from your own mistakes and accomplishments but also from successful mentors. When you do so, “I think I can” becomes “I know I can,” squelching any thoughts of “No way I can.”

Success Is Inside!

P.S. Comment and share how being a legal nurse consulting success student has helped you launch or grow your CLNC^® business.

Windows^® XP comes with a nifty indexing service that was designed to help speed up your searches for documents, folders and other files. Unfortunately it doesn’t work as well or as fast as it was designed. It actually slows your computer’s performance. Microsoft^® fixed the issue in Windows Vista^® but for those Certified Legal Nurse Consultants and people like me who are still using XP, you’ll have to take matters into your own hands to nix the index.

Here’s how you do it. First, open up your Control Panel and once it populates (geek-speak for the process of displaying all the icons) double-click Administrative Tools. Once that’s open double-click Services. It will open a new window called Services (Local). Expand that window to full screen so you can locate Indexing Services and double-click it. Change the drop-down next to Startup type from Automatic or Manual to Disabled. Click OK and then close all the windows. You might not notice it, but there will be an increase in your computer’s speed which means you’ll get more legal nurse consulting work product done faster – trust me on this one.

Keep on Techin’,

Tom