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December 25, 2018
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As 2018 winds down next week, we will be reminded about what a terrible year this has been. To recap, we witnessed:

  1. Catastrophic hurricanes in North Carolina and Florida, and deadly wildfires in California
  2. Mass shootings in Parkland FL, Santa Fe TX, Pittsburgh PA, and Thousand Oaks CA
  3. A growing refugee crisis on our southern border
  4. Numerous government scandals, indictments, resignations, and now a shutdown
  5. And most recently, a stock market that has fallen nearly 20% (so far)

Tragic events have also hit close to home, as some of my closest friends are dealing with serious illnesses. It is easy to get despondent, but it’s Christmas Day, when we should all look for a glimmer of hope and optimism. Like many of you, I spent this morning enjoying the look on my kids’ faces when they opened their Christmas presents. Not being satisfied, I played old tapes of past Christmases, when they were even more joyful! I can’t say that most of those toys lasted a year before they were broken or forgotten, but the memories of being together at Christmas will last a lifetime!

Like many of you, at Greater Austin Urology, we’ve also seen our ups and downs this year, but I remain focused on True North, and what it will take to get us there. Everything else is just a detractor and a temporary road-bump. I can’t help but think of the words of the late comedian George Carlin, who said it best: “Don’t sweat the petty things…and don’t pet the sweaty things!”

May the blessings of the Holiday Season be with you and your family. Merry Christmas, everybody, and best wishes for a healthy and prosperous 2019!

October 31, 2018
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Howdy folks! I know it’s been far too long since I last wrote on my blog, but it’s Halloween, and the holidays (even Pagan ones) have a way of inspiring me to reflect on the past and write about it.

October has been a truly historic month for Greater Austin Urology. We saw a record number of patients and made a little money accordingly, which is always nice when you’re starting out. I performed my first robotic prostatectomy (with the expert assistance of my good friend, Dr. Sandeep Mistry). And we launched an innovative treatment for prostate cancer, HIFU (which stands for high-intensity focused ultrasound). Our first 2 patients were already out dancing and jogging less than a week after their surgery. If it’s as good as advertised from a cancer-cure standpoint, it will truly be a game-changer!

Most importantly, we have an entirely new team, with some familiar faces. Stacey Hardt is our new office manager. She worked with me in a similar capacity at my previous job, and for some strange reason, she was willing to take the plunge and do it again! Joining Stacey is my new nurse, Benny Reeve. He was my very first nurse at my previous job, and I watched him climb the ranks to become an RN. He has a regular job, but luckily for us, he was willing to help us out in clinic a couple of days a week.

Finally, this month was historic for others as well. Speaking of my previous employer, on the first day of this month, they announced plans for a $14 billion merger with the largest hospital system in the Houston area. Or was it an acquisition, in which case, who bought whom? Doesn’t matter. 14 years ago, another relic from the 19th century, K-mart, bought/merged with Sears in an $11 billion merger. And, wouldn’t you know it, this month they also made history, only this time it was by declaring bankruptcy. I guess bigger isn’t always better, especially when you don’t adapt to changes in your industry and take your employees and customers for granted, while your competitors and new industry disruptors continue to crush you on service and price.

Now that’s spooky scary- time to go trick-or-treating! Happy Halloween, everybody!

April 26, 2018
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Howdy folks! I know, it's been a while since my last Blog, but I've been busy trying to Make Urology Greater Again. Plus, I've been searching for something meaningful and positive to say, since my mom thinks my past blogs sounded a little bitter. What do you think?

Overall, I'm alive and well in the great city of Austin, TX, so life is good. Greater Austin Urology is gradually filling up with patients, both old and new. I have performed my first 2 robotic cases, and they went well. And on April 12, we celebrated our second month in business with a Grand Opening/Open House at the office. Many thanks to everybody who pitched in to make it successful: Glen Dyson and Lance Gay from Cogentix, Britney Blankenship from Touchstone Imaging, Danny Williamson from 180 Medical, Landon Groff from J&R Medical, and last but not least, my parents Nick and Vasso Jacomides, for coming all the way from Houston to bring baklava!

Of course, there have been some down moments too. Starting and running a business, especially a medical practice, is not easy. There are serious headwinds that eventually force many of the small fish in the ocean to seek power in numbers, whether it be with big hospital systems, big multi-specialty clinics, or big single-specialty practices. I really think there are a lot of people out there who want to see me and others like me fail, but I keep looking for allies to help me win the battle. Unfortunately, while attending one of those meetings yesterday, my car got broken into and my laptop was stolen. Don't worry- all of my data is password-encrypted, but it still sucks nonetheless. I feel like the only doctor who had a worse week than me was Ronny Jackson, Trump's doctor and failed pick for VA Secretary!

It's easy to get despondent, but lately whenever I start to feel this way, for some strange reason (for which I'm sure I will catch a little grief), I think of the words to the song "Roar" by pop diva Katy Perry:

"You held me down, but I got up. Get ready 'cause I had enough. I see it all, I see it now. I got the eye of the tiger, a fighter, dancing though the fire, 'cause I am a champion, and you're going to hear me roar, louder, louder than a lion, 'cause I am a champion, and you're going to hear me roar!"

I know, make fun of me all you want, but the best days of Greater Austin Urology are ahead of us. I won't go down without a fight, and it's going to take a lot more than petty larceny to get me down. So time to jump on the bandwagon, everybody, because I am a champion, and you're going to hear me roar!

Lately, whenever I think about corporate medicine (or corporate anything, for that matter), I cannot help but think of that song from The Lego Movie.  “Everything is awesome! Everything is cool when you’re part of a team.”  As long as you go to work, do your job exactly like everyone else, and follow the instructions without questioning authority, everyone wins.  The only problem is that behind that perfect façade, “Lord Business” is plotting to unleash the “Kragle” on Taco Tuesday, but everyone is too focused on mindlessly doing their job during the day and watching “Where Are My Pants?” at night to see it coming.  At that point, your only hope is that “The Special” will come along with “The Piece of Resistance” to stop the Kragle and save the world.

 

Like all other underdogs, I completely identified with the protagonist Emmet- not because I’m “special”, but because like Emmet, I think differently than most people.  While everyone else is busy building practical things, I think about building the next double-decker couch, because to me it seems practical, and in the right setting, it can come in handy.  I have also never backed down from questioning authority whenever I didn’t think something was right.  So, despite my initial feelings to the contrary, maybe being at the top of the corporate ladder wasn’t the right place for me, because I didn’t like pretending and telling everyone below that everything was awesome, when I knew deep-down it really wasn’t.

 

That is not to say that I cannot be an effective leader.  A lot of the most successful organizations in the world (Apple, Amazon, Facebook, Google, Netflix, Southwest Airlines, Tesla, to name a few) were led by forward-thinking leaders who thought differently than their competitors, and because of that they completely revolutionized their respective industries.  The key is to pick an industry in which there is an inherent problem that merits disruption, and lucky for me, the Healthcare Industry happens to be one of them.

 

So, if you will excuse me, I’ll be on the lookout for a group of similarly-minded “Master Builders” who will help me find “The Piece of Resistance” so that we can save our profession from “Lord Business.”  But first, I must find my pants. Until then, Happy Taco Tuesday, everyone!

After spending most of the past 2 months getting the new office ready for business, it was great to finally get back to doing what I normally do this week. Along the way, I have learned many valuable lessons that I want to share with anyone thinking about starting their own business:

  1. No one is on the same timeline as you. Granted, the holiday season is not the best time to start a new business, but no matter how quickly you want to get going, the rest of the world will move at its usual glacial pace. It doesn’t matter if you are an insurance company or medical staff coordinator in charge of credentialing new doctors, a web design team in charge of building your website, or a previous tenant packing up to move out of your future office space, no one is in as big a hurry as you.

 

  1. You cannot do this alone. There is no shortage of people wanting to cash in on you (e.g., passing themselves as “working with Google” to increase your business). However, there is way too much to do, so as with all things in life, it is imperative to surround yourself with good people that you trust. I could not have done this without the help of my team, too many to list here. Special shoutouts go out to Yvonne Mounkhoune at TMA, Nick Albino at Independent Bank, Jenny Frix at AthenaHealth, Josh Johnson at McKesson, and Caroline Domin, who connected me with several of these folks and was an invaluable source of help and inspiration along the way. And finally, my wife and family, who continue to tolerate and support me, no matter what I do.

 

  1. At some point, (almost) everyone should do this. I get so tired of listening to doctors constantly complain about how medicine has changed, and how they are powerless to do anything to change it. Well, I am living proof that you can do something about it. Call it what you want (boredom, burnout, midlife crisis, or a combination of the above), but I left a very successful practice with a load of administrative responsibilities largely because I was miserable. I was too busy to realize it myself, so it took the people who knew me the best to tell me so. Now, I am a changed man. Having your finger on the pulse of your practice is empowering and uplifting. When you own your own practice and become your own boss, almost every decision begins and ends with you, and there is no better way to control rising health care costs than when you are the one cutting the checks.

 

Feel free to comment and pass along to whomever you wish. I plan to revisit this topic a year from now, if not sooner. Until then, I will continue to periodically share my thoughts with you on various topics, on business, medicine, or whatever. I will try my best to keep it funny and interesting. If you have any specific topics you want me to discuss, please reach out to me.



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