HEALTH & LIFE’S BEST PRACTICE NEWS ALERT CURRENT CIRCULATION: 7468 DATE: 14th January 2008 ISSUE NO: 154 Welcome to Health & Life’s free email newsletter service. Tell a friend that we would be happy to add their email address to the distribution list. This service is to provide Health and Life’s clients and those who attended our presentations with up to date information on key financial and practice management issues that may affect your practice. Please do not use this as a substitute to seeking professional advice. Writer in charge: Mr David Dahm BA.Acc, CPA, FTIA, Ffin, FAAPM, GLFG.

Life Begins at 40!

I hope all of you had a great Xmas break and are well rested for the new year. Happy New Year to you. This year has already been an important one for me. On the 4

th January I had hit

the magic milestone age of 40. I have been in private practice for 18 years. A lot of you may have hit this mark or are headed in my direction. For me it has been a time for reflection on how I have spent the first half of my life and where the next 40 are going to take me. Statistically we are all supposed to leave this wonderful planet when we are 80! This edition is my recollection of the ups and downs and my life’s lessons learnt about the business of healthcare and life in general that you may find of interest. Most importantly this is also an opportunity to thanks those people that have generously helped me in my first 40 years of life. In this edition we cover:

1. The first forty ++!

• My car accident was a life changing experience*

• Making mistakes is a good thing – just don’t take it personally?

2. The next forty? 3. Lessons Learnt

• About business

• About Life

4. A Word of Thanks to You!

5. So What Really Matters?

6. Where to from here?

Life Begins at 40!

1. The first forty ��!

For me the first 40 have been about principally learning and not so much about earning. My car accident was a life changing experience* A lot of you may not be aware, that if it was not for my car accident in the late eighties and nine operations later, I probably would not have entered the health care industry. Unfortunately as a young and enthusiastic graduate accountant, working 24 hours straight without a break I fell asleep at the wheel and crashed into a tree 5 minutes from my place of employment. A senior journalist once said to me: “David you hit a tree and we are all headed for the same one it is just you got there earlier than the rest of us”. I guess this was my first lesson in life. All the money in the world can’t make you happy if you are not alive to enjoy it. Your health is the most important thing you have and don’t abuse it. I guess work life balance was a concept that was introduced earlier in my life. Some of you may say I still have not learnt. I can assure you I am conscious of this but owning and running a practice is like being pregnant. There is no such thing as being “half pregnant” it is still a full time job but at least now I am really enjoying my work because it is at my pace. In my 30’s it have been more about making a stand. There has been a lot of changes I would have like to have seen in the healthcare system. Sadly I feel in particular the standards in the public health system have dramatically deteriorated despite the hard working commitment of our doctors, nurses and staff. Not much will change unless there is a radical change in how consumers look after themselves and how providers and the government educate and support those that are really in need. Making mistakes is a good thing – just don’t take it personally? Professionally there have been many great experiences and in some cases equally as many sobering disappointments but today I feel the best things that have happened to me were when things went wrong. The greater the risk the bigger mistakes the more I have learned and the more confidence I have gathered. This not only from my own eyes but also through my clients and your own. The reality is it is more important how you recover from such set back that makes the difference rather than whether who was right or wrong. At 40 I am left with a lot less self doubt but will never stop learning. No matter how old you are I think we are all kidding ourselves if we think we know it all. In a sense I have a better understanding of my purpose which I wish I had when I was in my 20’s. Many people have shown me this way which I appreciate. Unfortunately you can’t learn about life from a text book any more than you can learn how to drive a car by reading the manual. For me a fulfilled life is an experiential process. It is about giving it a go and having no real regrets and reaching your full potential no matter what that is. It is only for you to decide and judge for yourself whether you are being true to yourself.

2. The next forty? Personally, life has dealt its harsh lessons and the truth does hurt but it is character building if you can take it the right way and turn it into a positive experience. Right now I know who I am and what I want. I have a young family and am becoming more pre-occupied with what kind of world I will leave my kids and how do you shape a less materialistic and more caring society. Despite my strong sense of self confidence there is also a strong need for security. I continue to have excellent health “touch wood”. However after meeting the 40+ generation the potential for one to suffer from fallen arches, rheumatism, faulty eyesight, and the tendency to tell a story to the same person, three or four times does not escape me �. All said and done it is a comfortable age to reach so long as the school fees and raising 3 beautiful kids doesn’t sink me first☺! 3. Lessons learnt+.? Over the years there are many lessons learnt and these are just a few that come to mind: About Business

• Passion and a significant purpose is the fuel that drives excellence and commitment, don’t compromise;

• Believe in yourself and surround yourself with people who share the same vision and passion as you – you don’t have to micro manage as much;

• If people say it can’t be done just do it – humility teaches - you have nothing more to lose and even more to gain;

• What goes around eventually (if you can persist and can afford to wait that long!) does come around;

• Any significant and sustainable achievement requires an enormous personal commitment and financial sacrifice there is no room for short cuts.

• When it matters, you know when to really believe somebody when they understand the decision and are ultimately responsible for it. If they put their own reputation and the family home on the line you have no need to doubt their word.

• Use mistakes as a way to lead you to the truth and as an opportunity to fix things.

• Self pride is the greatest barrier to achieving your full potential. If you have the courage to listen, understand and address your critics this will become your greatest strength. If you are right, they will become your greatest advocates.

About Life

• People who keep in touch show they care about you;

• We all need each other, it just that some of us don’t know it yet;

• Never place expectations on people, then you will never feel disappointed;

• Perception is reality. Envy lends itself to the truth being frequently distorted.

• Personal success and happiness is about how you feel about yourself and not about “buying” your way into social acceptance – your family and few appreciative friends is enough to keep most of us content;

• The real missed opportunity is about making a sustainable difference in society and not the endless pursuit of money;

• Many people have forgotten the word “thank you”. 4. A Word of Thanks to You! True to my word, I would like to give a word of thanks to those that have put their reputations on the line to help me build mine. When was the last time you have said thank you to people who have made a real difference to your life? These people can range from your mentors or sometimes to important moments where people have just been there at the right moment in time. Making a list of names like this is usually reserved for one’s 60

th birthday however I say why

wait when these special people may not be alive if and when I turn 60. ☺ So please bear with me for this very public thank you and if I missed your name you know who you are. If you are on the list I hope I have not embarrassed you. The early 80’s

• The late Mr Jack Connelly Senior School Teacher– “always provide positive support”

Mr Connelly My year 8 commerce teacher who taught me there was more to life than reading, writing and arithmetic. Clearly I was destined for accounting my physics and chemistry was a bit wanting. He tirelessly supported me in and saved me from what most kids thought was a dumb subject called Latin.

The early 90’s

• Dr Peter Heysen General Practitioner – “always look beyond your own back garden”. Peter is the grandson of the famous Australian painter Sir Hans Heysen. Peter acted as my mentor and introduced me into the world of practice management in general practice. For seven years he supported me at the Royal Australian College of General Practice SA practice management committee. His flagship practice in Adelaide was one of my first clients in Australia. He and his partners led by Dr Alex Burridge allowed me to help run their 22 doctor multi-disciplinary general practice. Peter would often share many fascinating quotes with me. The most telling was about his grandfather who said “unless you see how they paint in France where the world’s best painters displayed their work you cannot learn how to improve your own work”. This is the main reason why I visit many practices and the best practices I can.

The mid 90’s

• Brigadier Mr Robert Atkinson – orthopaedic surgeon – Ethos Pathos Logos

Robert and his group introduced and mentored me through the challenging world of public hospitals and specialists in both the private and public sector. We all experienced the unchartered waters of negotiating with a listed company for the provision of public on call, clinical operating and out patient services for several years.

Dr Atkinson would often quote Aristotle. Perhaps the most famous arguer, described three routes to change the mind of the other person. Ethos uses trust, and focuses on reputation and credibility. Pathos appeal to the emotions of the listener, seeking to excite them or otherwise arouse their interest. Logos focuses first on the argument, using cool logic and rational explanation, as well as demonstrable evidence. When it came to the public hospital system everyday we turned to Aristotle for strength but achieved results envied by their own peers which made it worth it in the end.

• Ms Cathy Drummond - former AMA SA Secretariat – be efficient and use the power of the pen to persuade others Prior to joining Health and Life, Cathy had worked for the AMA in SA for 10 years as well as a long stint with the Australian Embassy in Hong Kong working with diplomats. She is a natural wordsmith and helped me in improving my writing skills and coined one of Health and Life’s key missions: “Creating a sustainable and socially responsible healthcare system” Cathy took our practice from a home office environment into professional offices with efficient systems and procedures. She developed many timeless consulting templates and presentations that we still use today. Like me she had a real understanding and respect for the medical profession and her professionalism remains second to none.

Late 1990’s

• Ms Anna (nee Whiteread) Fisher former Employee and Director – share your knowledge and let people know who you are and your motives Anna is a CPA. She started as a receptionist with us and completed most of her professional training with Health and Life. She is currently raising a new family – congratulations. In the early days when I presented seminars I was brought up not to share my “trade secrets” with anyone out of fear people would copy my work. At first this may have seemed like a good idea but it did not generate many new clients and often left audiences frustrated. Anna did notice what I did know. One day she suggested for once and for all to start telling people what I really know. Much to my surprise it generated a lot of new clients and has built a strong rapport with my audience and with readers to this very day. The reality is people are more likely to respect and have confidence in you if you are honest about who you are and what motivates you. Furthermore real education is about effective communication without all the misinformation that can arise from professionals using complicated jargon and being overprotective about their intellectual property. Anna taught me openness encourages mutual respect and promotes ones credibility. This has been an important piece of advice I will never forget. There is a natural tendency to make ourselves indispensable but this actually inhibits our real opportunities to grow and develop instead of enhancing them. In addition to being there in some of my most challenging times, most importantly she has helped me create and articulate the most compelling and enduring vision for the Health and Life Group. This very vision was set in 2002 and it precisely echo’s current healthcare reform policy. I will be forever grateful for her long hours and self sacrifice and her continued personal belief and support of me. This very vision is beginning to materialise as I write.

Today - 2008

• The Media and Organisations The media have been a great support since 1997, especially Deana Henn and Kellie Bisset the co-editors of Medical Observer who ran my very first media story on Managed Care and corporatisation. Each year they continue to invite me to catch up for a chat and have supported some of our most important stories in the industry. Together with other media outlets such as Australian Doctor, GP Business Essentials, BRW, Money in Practice, The Australian, The Advertiser, In the Black and the Australian Financial Review it has been a real privilege to work with so many professional journalists and editors who have given me the opportunity to air my views and have reported them accurately to the letter. This support extends to the Australian Association of Practice Managers, Divisions of General Practice, the AMA, the National Primary Care Collaboratives and the Royal Australian College of General Practice where they have hosted many of my events and/or have involved me in key consultancies that have had a significant impact on the industry. It has been an honour to serve you all.

• Our Staff and Directors To all of our 90 nationally based staff and to my directors (and soon to be appointed directors), I thank you for you tireless support and commitment to Health and Life. Without you, I would not be here to lead this wonderful organisation. It is a great honour to have this opportunity.

• Our Clients and You Our valuable clients that have used us for consultancy work and our present accounting clients thank you for all your past and future support. You are the main reason for our very existence and we don’t take for granted each of you have made a valuable contribution to my own personal growth and experience. This also extends to my readers and those who provide me feedback and more food for thought.

• My Family and Friends Finally to my beautiful wife and kids, our family and friends that have endured this long and at times very challenging journey. Thanks for all your unconditional support. The best days are ahead of us.

5. So What Really Matters? Spending a quiet 40

th birthday with my happy and healthy wife and 3 kids and sharing a big

lobster with Jai my 6 year old son is my greatest achievement. The other is having the honour of being a part of your life and our clients and watching you make a success of it. The bottom line L. Happiness is about finding and achieving your passion and purpose and believing in what you do. It is going to be an exciting year for us and I hope it is going to be an equally great year for you. I truly believe life has already begun at 40 for me (albeit it is a work in progress!). I hope it has or will be the same for you. Good luck to all of you in 2008 have a safe and happy and prosperous new year.

David Dahm *I do not recommend crashing your car or hurting yourself as a substitute to professionally sound advice!! PS: Those of you in the East Coast that have been experiencing the floods and bad weather please take care our thoughts are with you. PSS: If you have money in the share market please consult your financial planner or ours Maurice Nistico on 1800 077 222 about reducing your exposure to the US and possible world recession. At least you can sleep easy knowing the healthcare industry is a recession proof industry.

6. Where to from here?

1. Consult your professional adviser in relation to any advice suggested;

2. If you are not sure about any issues raised in this broadcast contact David

Dahm on 1800 077 222 for an initial free no obligation consult, or email us at pa@healthandlife.com.au. Health and Life provides comprehensive practice consulting, accounting, taxation and financial planning advice for group practices and individuals.

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