An MD With an MBA
Teaches Fellow Physicians
the Business of Medicine

After surviving 11 hurricanes, fate finally caught up with Dr. Asa Lockhart's boat, the GCCeas. In September of 2009, Hurricane Ike roared through Galveston Bay coming ashore in Seabrook, Texas bringing with it a 10-foot wall of water.

When the water subsided, the GCCeas—still tied to the dock—was underwater, where she lay until the insurance company raised her three weeks later.

Hurricane Ike is a fitting analogy for what is going on in health care today. In the midst of a sea of changes, Dr. Lockhart believes physicians need to learn the business aspects of medicine in order to survive.

"Healing is an art, medicine is a science, and health care is a business," says Lockhart. "Physicians have a command of healing and science, but the business aspect is another story."

In the past, the business of medicine was ignored, even vilified, in the medical community. But in light of the political environment and the national health care reform discussions, Dr. Lockhart believes that it is crucial for physicians to have business knowledge in order to survive in the health care arena.

"Physicians must be involved in the health care reform process to assure that their patient relationships continue. Additionally, many physicians feel that health care reform should include tort reform, cost containment strategies, and affordable health care—all of which are included in the business side of medicine."

Dr. Lockhart considered careers in architecture and the Coast Guard before he settled on medicine. "I didn't grow up in a medical family so I didn't have an intimate knowledge of the field," he says. "But Dr. Norman Halbrooks, an anesthesiologist in Tyler, convinced me that I would excel in medicine."

In 1973, Dr. Lockhart graduated from the University of Texas Medical School at Houston in its first graduating class. He completed his anesthesiology residency at Emory University School of Medicine in Atlanta, Georgia, and moved back to his hometown of Tyler where he continues to practice one week a month and is a member of East Texas Anesthesiology Associates.

After earning an MBA from the University of Houston at Clear Lake in 1999, he developed the 100-hour Certificate of Business Administration (CBA) course for the American Society of Anesthesiologists (ASA) that teaches business fundamentals to physicians. He also serves as the Course Director.

The program is designed to teach physicians leadership and management skills, accounting, financial analysis for health care organizations, legal aspects of health care, management of human resources, marketing, strategic analysis and planning, and integrated delivery systems.

Dr. Lockhart and his wife, Joy, own Golden Caduceus Consultants (GCC). They've worked with approximately 130 hospitals and anesthesia groups all over the country. Their goal is to have a fiduciary responsibility to both parties while developing crisis management strategies that deal with the shortage of anesthesiologists. "In the past, patients went to the hospital to have surgery," Lockhart says. "Now patients requiring anesthesia services can go to ambulatory surgery centers, doctors' offices, and short-stay facilities," which has caused an explosion of anesthetizing sites.

"A lot of our clients have trouble recruiting anesthesiologists, general surgeons, and registered nurses," Lockhart says. "We offer strategies so that hospitals can improve perioperative flow, which affects all surgical specialties and services from scheduling through the PACU. Efficiently-run services require fewer anesthesiologists and hospital personnel."

Improved perioperative flow is just one example of how hospitals and medical practices can benefit from smart operational changes that lead to better business results and improved patient satisfaction.

Practicing medicine, running a consulting business, being active in the Texas Medical Association and Texas Society of Anesthesiologists, speaking engagements, and directing ASA's business program keeps Lockhart busy. When he is not working, he enjoys spending time with his family on their new GCCeas. "Boating means relaxing and enjoying the scenery," he says. "It's tranquil—except when the grandkids are aboard!"

The new boat, a Hatteras cockpit motor yacht, replaced the one that foundered during Hurricane Ike. After raising the sunken boat, the insurance company sold it on eBay, and the new owner is in the process of restoring it. Which begs another analogy: If a boat can survive the devastating effects of a storm, maybe our health care system can, too.

You can reach Dr. Lockhart at ACLHart@aol.com.

Be Smart About Maternity Coverage

"An important thing for young families to think about when it comes to medical insurance is whether or not your plan has maternity coverage," says Edward VanWisse, an insurance advisor at TMAIT.

However, maternity coverage is not always easy to come by, especially if you try to buy an individual insurance policy. Only 14 states require maternity coverage in policies sold on the individual market—and Texas is not one of them.

A report last fall by the National Women's Law Center found that nationwide, only 12 percent of 3,500 individual insurance policies included comprehensive maternity coverage. Another 20 percent offered it with a rider that costs as much as $1,100 a month. Others required a two-year waiting period.¹

You may have better luck getting maternity coverage through an employer-sponsored medical plan or an association-group plan. Most of these policies offer maternity coverage. However, make sure you have coverage before you get pregnant, because you could be denied an insurance policy if you apply for an association-group plan while pregnant.

With an employer-sponsored group plan, you cannot be denied insurance coverage because of a pre-existing condition. However, you may be denied coverage for a specific pre-existing condition if you've had a lapse in insurance coverage for over 63 days. In that case, you may have a waiting period for up to a year before coverage for that condition kicks in.

¹ "Nowhere to Turn: How the Individual Health Insurance Market Fails Women," National Women's Law Center, September, 2008
http://action.nwlc.org/site/PageNavigator/nowheretoturn_Report

How Does Marriage and Family Impact Your Career?

October 17 is your last chance to attend Family Systems: The Impact of Marriage and Family on Physicians workshop offered by TMA.

The workshop, which has previously been presented in Beaumont, Corpus Christi, and Austin, will be held at the Cooper Guest Lodge Hotel, Spa and Conference Center in Dallas.

The workshop covers:

• Differences between healthy family systems and families in distress
• Assessment of your family of origin, contrasted with your current family system
• The impact that your marital relationship has on the well-being of each family member
• How your family system and marital relationship affects your performance as a physician
• Steps that may be taken to improve your family relationships and strengthen professional performance

To register online for this workshop, visit TMA's website at www.texmed.org/public/events/viewseminars.aspx or call
1-800-880-7955.