For a child, FAIL is nothing more than the “First Attempt In Learning.” As her father, it’s my responsibility to help her grow comfortable with failing so she can be the best version of herself.

Likewise, in business, one of the biggest mistakes I see talented people make in their careers is being afraid to fail. The prospect of failing is so intimidating, they pursue goals they are guaranteed to achieve rather than aim for more ambitious outcomes they could miss. They are so motivated to avoid error, they shortchange themselves and their colleagues, sacrificing creativity and ingenuity for the safety of the status quo.

To make any decision is to take a risk. Some percentage of our decisions will fail. According to JP Morgan’s Chief Marketing Officer, , “If you’re not failing, then you’re not learning.”

One of the best ways people can get comfortable making fast decisions is to focus on “two-way door” decisions making, rather than “one-way door” decision making. Jeff Wilke, Senior Vice President of Consumer Business at Amazon, does a great job the critical difference between these two: “A one-way door is a place with a decision if you walk through, and if you don’t like what you see on the other side, you can’t get back. You can’t get back to the initial state. A two-way door, you can walk through and can see what you find, and if you don’t like it, you can walk right back through the door and return to the state you had before.”

Two-way door decisions are reversible and therefore require less vetting. As Wilkes says, “Why would we need anything more than the lightest weight approval process for those two-way doors?” What applies for Amazon as an organization applies to people as well. Why worry too much if you can walk it back?

As a CEO, I encourage my employees to make two-way door decisions. This may take the form of releasing a software enhancement that can be rolled back, or piloting a program within a single department before implementing company-wide.

One-way door decisions require more thought and buy-in since they cannot be undone. Both decision types have the potential to yield great results, but one-way decisions risk greater repercussions if they are wrong and take greater care and vetting.

If fear of failure is hindering your organization’s ability to innovate or your personal ability to take risk in your life, consider using the concept of two-way door decision making. It is a safe, simple, smart way to open up your employees or yourself to the risk of failure, and, more importantly – the risk of success.

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Many providers contend the shift is the result of sicker patients coupled with the widespread implementation of electronic medical records, as treatment and documentation of more complex cases requires greater time and effort. But the persistent increase in costlier codes has made pursuing potential billing abuse a Justice Department priority.

One area of focus for federal investigators has been upcoding, the practice of deliberately billing for more extensive and costly services than were actually performed.

In February 2017, nationwide hospital staffing provider TeamHealth Holdings agreed to plus interest to settle allegations that its hospitalist group practice, IPC Healthcare, submitted upcoded bills to Medicare, Medicaid, the Defense Health Agency, and the Federal Employee Health Benefits Program.

In June 2017, Carolinas Healthcare System agreed to to resolve allegations that it billed federal health care programs for “high complexity” urine drug tests when the tests conducted were only of “moderate complexity.” According to court documents, this upcoding persisted for four years and cost the government an extra $80 per test.

In October 2017, multi-location New York Spine & Wellness Center agreed to to resolve improper billing claims after a federal inquiry determined the practice routinely billed for moderate sedation services – which require physicians spend at least 16 minutes with patients – despite its doctors not meeting the minimum time criteria.

But upcoding is not exclusive to tax-payer funded health care. In the case of New York Spine & Wellness Center, for example, a private insurer first detected the Center’s sedation upcoding in January 2015, initially rejecting two claims that fell short of the 16-minute rule. A subsequent audit by the same insurer resulted in more rejections, but the Center continued its upcoding abuse for two more years until the U.S. Attorney’s Office intervened, seeking to recover overpayments by the state’s Medicaid program. Indeed, of the $1.9 million settlement, more than $660,000 will be returned to the New York Medicaid coffers.

Outcomes such as these are terrific news for taxpayers, but such retrospective vigilance by the Feds has little to no impact on private insurers, employee organizations, and individual payers.

While the government concentrates on recouping federal dollars post-payment, medical cost containment firms must protect private payer clients from overpaying upfront. For example, 911�Թ� uses tools such as in-depth bill review by certified coders and nurse auditors and pre-negotiated, bundled rates to wean out upcoding and other billing abuses on a transactional level. Such proactive approaches are a key core competency of medical cost management, and continue to be as important today as they have been historically.

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To help combat this crisis, organizations such as the Official Disability Institute (ODG) and The American College of Occupational and Environmental Medicine (ACOEM) have released guidelines for prescribers in the appropriate use of opioids for treating pain specific to workplace injuries.

In a published in a recent edition of the Journal of Occupational and Environmental Medicine, researchers at the ReedGroup and Kaiser Permanente retroactively applied ACOEM’s April 2017 guidelines to 7,840 patients who underwent carpal tunnel release (CTR) surgery from 2007 to 2014. Of the 70 percent of cases prescribed an opioid, 29 percent were contrary to the guidelines, which recommend no more than a five-day supply of short-acting opioids for acute postoperative pain for new users. Patients given greater dosages averaged disability durations 1.9 days longer and medical costs $422 higher than their ACOEM-compliant counterparts.

While these cases were not exclusively workers’ compensation related, given the volume of injured workers who require CTR surgery annually, it’s easy to see how following the guidelines could substantially benefit payers and patients. The study estimates if 29 percent of the 577,000 CTR procedures performed annually were prescribed an opioid according to ACOEM’s guidelines, the potential medical cost savings is $71 million per year with a reduction in disability durations by 124,000 days. Incredible.

Clinicians at the Center for Surgery and Public Health at Brigham and Women’s Hospital took guideline research a step further by analyzing more than 200,000 postoperative opioid prescribing patterns to define the ideal prescription length by procedure type. Their , published by JAMA Surgery, determined the optimal length of opiate prescription was four to nine days for general surgery procedures, four to 13 days for women’s health procedures, and six to 15 days for musculoskeletal procedures.

While it’s too soon to know the time and monetary impact these guidelines could yield if implemented, it’s heartening to see that the risk of prescription opioid misuse is being considered when looking to alleviate temporary acute pain. We must all be mindful of what is in the patient’s long-term best interests and limiting opioid prescription duration is a critical step in that process.

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At Kaiser Permanente, virtual patient encounters now outnumber in-person visits. , his health system saw more than 110 million people last year, with some 59 million connecting through online portals, virtual visits or the health system’s apps. That figure represents more than half of the organization’s total 2016 visits.

“We are going through a major transformation in healthcare,” said Tyson.

At (NYP), their suite of telemedicine services includes adult and pediatric emergency and urgent care, virtual follow-up visits for surgical and psychiatric patients, and a second opinion program.  Such telehealth adoption has yielded dramatic results. In the ER, for example, low-acuity patients are now seen virtually by an ER physician elsewhere in the health system, reducing average wait times from 2.5 hours to 31 minutes.

Moving forward, NYP aims to make 20 percent of all patient visits virtual, a goal that seems readily attainable given its volume of virtual visits has increased 100 percent every month since it began piloting telehealth services in 2015.

Although telemedicine has yet to significantly impact workers’ compensation or auto, its day is coming. Workplace health clinics, such as the kind operated by , are now augmenting onsite occupational care with telemedicine services. Consider the case of a California factory worker with a blistery hand rash who had her condition treated via a teledermatology visit at her employer-sponsored clinic. It’s only a matter of time before onsite injury assessments, follow-up status calls, and prescription management are conducted virtually, with great cost, comfort and convenience benefits for all parties involved.

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However, sometimes organizations can get bogged down with too many key performance indicators (KPIs), copious desirable employee traits and overly complex review processes, so it’s nice to have a quick, “back-of-the-napkin” measure of employee value.

According to businessman Mark Cuban, the secret to career longevity in his billion-dollar empire is the ability to lower his stress level.

In a recent with Money magazine, Cuban shared, ‘’Anybody who reduces my stress becomes invaluable to me.  I never want to get rid of them.’”

Cuban’s approach really resonated with me. It’s a seemingly simple litmus test that easily encapsulates so many desirable workplace traits:

• Reliability
• Accountability
• Resourcefulness
• Team Player
• Skilled Communicator
• Solution-Oriented
• Conflict Resolver

As any manager can attest, leading teams and organizational functions is often stressful. With so many responsibilities to juggle, it makes perfect sense that an employee who minimizes disruption and spares you headaches is an invaluable asset.

So, the next time I’m considering an employee for a promotion, conducting a review or assessing performance coaching opportunities, I’ll be keeping Cuban’s insight in mind. Asking myself, “Does this person reduce my stress?” is a wise way to gauge an employee’s current worth and potential coaching needs.

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This Harvard Business Review about WD-40 – yes, the stuff you use for squeaky hinges – illustrates just how important continued learning is for company growth and, in this case, reinvigorating a tired brand.

WD-40 was an old “one-trick pony” when Garry Ridge took over as CEO. Ridge broke the company out of its rut by creating a learning-obsessed culture unafraid to take risks.  Since 2009, WD-40 has expanded to 176 countries, added many brands and products, and nearly tripled its overall value as an organization.

The pledge required of all employees is one of the most brilliant things I have ever read.  Ridge calls it the “WD-40 Maniac Pledge,” a solemn vow to become, in his words, a “learning maniac.”

“I am responsible for taking action, asking questions, getting answers, and making decisions. I won’t wait for someone to tell me. If I need to know, I’m responsible for asking. I have no right to be offended that I didn’t ‘get this sooner.’ If I’m doing something others should know about, I’m responsible for telling them.”

What about this pledge do I love so much? It demands that teams keep learning. Learning offsets the “paradox of expertise” and prevents people and businesses from becoming stagnant.  What an industry did five years ago may seem to be the “gold standard” in a team’s mind, when the world has actually evolved considerably during that timeframe.

Additionally, this pledge requires people to take responsibility when something goes wrong instead of placing blame elsewhere. Being fully accountable for one’s actions encourages resourcefulness, removes unnecessary drama, and eliminates the need for micromanagement. A workforce rich in their ability to find and create solutions independently is a strength in any industry.

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Expertise and experience should be a competitive advantage when it comes to innovation. Yet, the most experienced people are oftentimes blind to new opportunities.

It’s called the “paradox of expertise​” – the more closely a person is immersed in an industry, the more successful they’ve been in a company or a profession, the harder it can be to see new patterns, prospects, and possibilities.

In fact, show “experts” are no better at predicting their industry’s future than actuarial tables.

One way to avoid the paradox of expertise is to cultivate new knowledge, drawing inspiration from other industries and collective insights. Leaders who neglect to be learners plateau. The best leaders are almost always insatiable learners.

“” is a question I put to myself daily and one I encourage all leaders, wherever they are in an organization, to ask themselves too.

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Probably the most common and damaging threat to a healthy relationship is the need to be right. This represents the Ego, one of the three “Evil E’s”– Ego, Envy, and Entitlement – that I’ve written about previously. When someone always needs to be right, by definition, there is someone that always needs to be wrong. This may not seem to be of any great importance, until you realize that the person that is “wrong” also has their self-esteem damaged in many instances. The need to be right does far more than provoke arguments. The need to be right eats away at loyalty, trust, intimacy and eventually destroys relationships and teams.

Most divorces result from small insults to the ego that build up over time. Indeed, most fights between strangers result from the very same thing. It is the small blows to our self-esteem, the indignities, and the little insults to our vanity, that cause a lot of the pain in the world.

To me, the most annoying people to be around are the “know-it-alls.”  It is sad at times, because the “know-it-alls” often have decent knowledge on many subjects, but no one wants to listen to someone preach at them on every topic.  I can’t help but think that they could just sit in a room with a mirror and they would get the same social interaction.

So what does this mean?

Fight the need to be “right.”  It is unimportant.  Focus on the outcome that you want to achieve. Listen to other people as much as you speak.  You may find there are things you had not thought of before. Changing someone’s opinion does not happen like a car slamming into a wall.  It happens like a car taking a gentle turn in a new direction.

“Those who never retract their opinions love themselves more than they love truth.”
―

“It’s as simple as this. When people don’t unload their opinions and feel like they’ve been listened to, they won’t really get on board.”
― ,

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