Rules for Home Based Business Success


Guest post by: graylin sanders

Here we are the online entrepreneur building a small business which we work from home. With full intent to build a Successful Home Based Business so our work at home will lead to bigger and better business opportunities. Business ideas are at the core of success for a home business whether you are involved in a franchise business or are in a work from home type business in either case we are all in the pursuit of success for our businesses whether they be franchise business or a work at home type of business we are striving for success in those businesses so here are some rules for Home Based Business Success

Rule 1 it ain’t nearly as bad as it seems right now, it will look better tomorrow

There is a single thread that binds all of us that are doing business in work from home, small business and that is at times. It can seem like you are at standstill frustration and panic are setting in and you have had it with the Internet and Home Based Business. Unfortunately this is where to many entrepreneurs give up the ghost right when they are on the brink of success. Remind yourself that tomorrow is a new day and a new start.

Rule 2 Get Angry, then get over yourself

This is not just for home based business it applies across the board. Resentment and anger just for the sake of being angry will solve nothing. Only effects you the entrepreneur rob you completely of your focus on your business opportunity. So feel your anger get it off your chest (intelligently) and get back to your successful home based business.

Rule 3 Don’t allow your ego to stop you from growing beyond more than an entrepreneur who is consumer by his business opportunity.

In the time I have been a successful home based business owner I have seen more than one case of an entrepreneur who has allowed for their ego to make them obsessive about their work at home small business to where they have no objectivity. And are completely into themselves and their home based business. No longer being able to see the value in others or how by simple interaction so much more could be rediscovered about who they can be

Rule 4 Yes! It can be done

Don’t allow yourself to become short sighted and put limitations on how you think. You need to be surrounding yourself with great people. Stoking the fires of your creativity and fueling your mindset and tapping into that inner you. Who is capable of achieving get things but for that to happen you have to believe that it can. So becoming a more disciplined person daily is your goals as an entrepreneur and owner of a successful home based business you can do anything.

Rule 5 Be careful of what you wish for, you may wind up getting just that

As a successful home based business you know how important goal setting is in your business opportunity if you remained focused on the goals that you’ve set they will have happen keep those business ideas at the forefront and success will be yours.

Rule 6 If you make a good decision or come to a good decision through interaction with others then you should stand behind the decision that you made

The number one enemy standing between you and your goals are distractions. So it is up to you to defend yourself from adverse influences. Things going on outside of your business can not be allowed to distract you from your accountability to your home based business. As an entrepreneur your mind needs to be clear to focus on business marketing, business ideas and business opportunities which together can take your work at home business to the next level. There is going to be competitors in your same business niche but that should only boost you to be even more into your successful home based business

Rule 7 No one is going to allow you to make their choices so you should not stand for anyone thinking that it is alright for them to make decisions for you

We should all be familiar with how family and friends can be discouraging of your efforts to break away from the pack and have a moment of clarity where you can truly see what is possible. For you with your home based business so what people think does matter it just doesn’t matter that much your work at home small business is what matters you having the courage to pursue it matters. So just stay focused and believes in yourself and your successful home based business.

Rule 8 the small things matter most

This is about paying attention to details like checking all of your copy and content for errors in spelling and grammatical corrections. It is paying attention to the fine details of your home based business. Which will demonstrate to people that you are a serious entrepreneur that is carefully building their work from home business opportunity?

Rule 9 You cannot and will not be successful on your own, so make certain that you recognize the people who have helped you

None of us can become successful in life without the input and positive influence of other people so we can’t afford to not recognize those people because each of them has given you little of their experience in small business, how to be a better leader and manager of you business opportunity

Rule 10 be clear, calm and careful

Flying off the handle and going into frenzy over when things don’t go as you have expected them to this home based business. And there are going to be a never ending stream of different kinds of adversity is you build your business opportunity. So just take it easy and give things the time they need to get worked out the key is being slow steady and careful

Rule 11 Seeing the big picture/ and go after it

The vision that you have for yourself is very important because how you see the vision for your home based business. Is how you will pursue it you need to very a huge vision so that you will be driven by the size of that vision this will set the stage for you knowing what it is going to take from you to get your work from home business aligned with your vision.

*Rule 12 don’t listen to your fears or people who don’t share your vision

You cannot be an entrepreneur or a human being for that matter without having periods of self-doubt and just plain old fear you are growing into this so you can’t expect yourself to know about it. Pursuing your goals is going to bring on a lot of different emotions anxiety, nervousness. These are your emotions feel them learn from them and move on to growing your business opportunity.

Rule 13 your optimism is one of your greatest assets

This rule is along the line with rule 1 you believing in yourself and what you are doing is imperative to your success. If you have one of those days as we all do where nothing seems to go right in your business opportunity. You must remember that this day is going to end and when I wake up tomorrow I will have a new day to look forward to for possibilities in my work from home business opportunity. Having an indomitable optimism will serve as your magnet attracting success to you.

*Rule 14 you can’t be a responsible entrepreneur without ticking someone off

It is not possible for you to be all things to everyone so don’t do it. People close to you are going to have resentments of you spending more time on your work at home business opportunity that you are with them. Your business opportunity is number one along with yourself success is a selfish pursuit at times and this is just one of the things that go along with it. You may have to go as far as putting some people on the shelf because they won’t accept what you are doing.

Rule 15 The only way you will know if something can be done, is to do it

Being an entrepreneur is always reaching out for something that includes is reachable and teachable you are always looking for that break through. Opportunity if it comes along takes it because it may never come again. You as a home based business entrepreneur are waiting for the moment and the situation that you can get ahead. If there is a situation of confusion and people are bantering about you remain calm and seize the moment. These rules are to assist you in your entrepreneur’s method of operation for how you show see things and how you can make them work for you.

It is getting a lot harder to do this’: Doctor shortage strains practices

It’s a national health care crisis. There just aren’t enough doctors in our country. The shortage has hit rural America especially hard, but there may be some solutions. NBC’s chief medical editor Dr. Nancy Snyderman reports.

Tucked among the cornfields, windmills and water towers of Littlefield, in west Texas, Dr. Isabel Molina treats one patient after the next at Lamb Healthcare Center.

Littlefield is a small, dusty town of about 6,500 people, but Molina’s two-doctor practice draws from a much larger area. She and her partner serve a total population of about 15,000, she estimates. To keep up with her patient load, Molina regularly works 13-hour days without stopping to eat.

“I usually eat breakfast over charts. I usually eat lunch over charts while I call patients back and take care of my dictations,” says Molina, 38. “I do love what I do, but it is getting a lot harder to do this.”

A nationwide doctor shortage is expected to worsen over the next decade, according to the Association of American Medical Colleges. Medical schools, like Texas Tech University Health Sciences Center are coming up with innovative ways to get young doctors practicing with fewer years in medical school. Dr. Steven Berk, TTUHSC Dean on the crisis and their efforts to help.

Molina is just one of thousands of primary care doctors nationwide working in an area designated as having too few health professions to meet the needs of the population.

The Association of American Medical Colleges (AAMC) estimates that there is a shortage of up to 20,000 physicians and that the deficit will grow to 100,000 physicians in the next decade. An aging population – and an aging population of physicians themselves – will make matters worse as health needs become more severe and as doctors retire without enough new ones to replace them. And, millions more Americans will rely on our existing physicians when the Affordable Care Act fully kicks in next year.

“We are very concerned that we’re going to hand insurance cards to 30 million people and we won’t have the doctors to treat them,” says Dr. Atul Grover, the chief public policy officer at the AAMC.

West Texas is one pocket of the country where entire counties lack even a single health care provider. The dire need inspired an innovative program at Texas Tech University Health Sciences Center in Lubbock, Texas.

“We felt at Texas Tech that it was very important to help solve the primary care crisis as best we could and one of the ways of doing that was to try to make sure we get enough students into primary care and into family medicine,” says Dr. Steven Berk, the dean of the School of Medicine at Texas Tech University Health Sciences Center.

From that concern, the Family Medicine Accelerated Track (FMAT) was born at Texas Tech. The program teaches the competencies of four years of medical school in only three years and offers a scholarship to all students in their first year.

Keeley Ewing-Bramblett is a third-year medical student at Texas Tech who grew up in the rural, one-physician town of Post, Texas, and saw firsthand how overloaded the town’s only doctor was.

“I really just want to go back to a place where I know I’m going to be making an impact and where I’m going to get to see kind of the fruits of that impact,” says Ewing-Bramblett, 24. She signed up for the FMAT program the day she heard about it, and hasn’t looked back.

Medical students nationwide are struggling to find residency positions – a crucial stage in their process of becoming a doctor.  But, a unique program at Texas Tech University Health Sciences Center School of Medicine guarantees residency spots for Keeley Ewing-Bramblett and her fellow students. It will allow her to stay in a rural area where, “I know I’m going to be making an impact.”

“When they offered an accelerated track where I could get out and be doing what I love essentially a year sooner and also for half the amount of debt that would have otherwise been incurred, for me it was kind of a no-brainer,” recalls Ewing-Bramblett.

To curb the physician shortage, medical schools across the country have boosted their enrollment by 16.6 percent since 2000. Five-thousand more students are expected to graduate per year by 2019, according to the AAMC.

But just graduating more students won’t reverse the physician shortage.

There has been a bottleneck to getting more young doctors into residency programs: the stage in medical training that follows graduation from medical school and takes place under the supervision of licensed physicians. The number of federally funded residencies has been frozen since 1997 when Congress passed the Balanced Budget Act.

“A lot of the benefit of increasing those class sizes and building those new medical schools – a lot of those benefits won’t be realized unless there’s additional residency positions,” admits Berk.

Of almost 22,000 U.S. medical school graduates who wanted to be “matched” to a residency position this year, 1,600 applicants did not find one, according to the National Resident Matching Program that places residents.

That’s one more reason why lawmakers are stepping in. Congressman Aaron Schock (R-IL) and Congresswoman Allyson Schwartz (D-PA) introduced the “Training Tomorrow’s Doctors Today Act” in March that would create 15,000 new Graduate Medical Education slots over the next five years.

In an interview, Schock stressed that, “We know that a crisis is coming where there are more and more Americans who need doctors that are going to go without if we don’t get them trained and in the field.”

Even if the bill passes – no easy task in an era of squeezed budgets – there is no guarantee that new doctors will practice in the areas where they are needed most.

“Physicians cluster in urban centers where they can work with each other efficiently and leave the rural areas and some other areas underserved in the process,” explained Dr. Richard “Buz” Cooper, director of the New York Institute of Technology’s Center for the Future of the Healthcare Workforce.

Back in Littlefield, Molina bounds from one appointment to the next. “When you’re this short-staffed, it becomes something that is at the cost of everything else. Missing things with my kid, missing things with my family,” she admits.

As she leaves one exam room, files the necessary stack of papers and steps into another room to asses a patient, , she smiles all the while. “Once I actually have help, I think then I’ll be able to relax and see what a real life feels like again.”

Dr. Michael Johns, a professor in the Schools of Medicine and Public Health at Emory University, says it will take wider reform to get doctors the help they need. “Just having more doctors is not going to fix this.” he says. “For one, we need a team-based approach that will get nurses, and other members of the healthcare team more involved with more responsibility.”

And, while the Family Medicine Accelerated Track will graduate more family care doctors, it does nothing to increase the number of specialty physicians nationwide.

“What everyone is missing is that a little over half of the shortage is in specialty medicine,” argues Johns. “The battle shouldn’t be about having a 30-to-70 ratio of specialists to primary care doctors, it should be about how we have a shortage of both.”

The slow pace of reform is frustrating for medical students like Ewing-Bramblett who chose  primary care medicine because her mother suffers from chronic illness and a primary care physician made an outstanding difference in her care.

“It hurts me on a few levels,” said Ewing-Bramblett. “There’s just no way that you can establish the type of relationship with your patients that’s going to really foster their care like I experienced with my mom. There’s no way you can do that in the 10 minutes that you have to see each patient.”

For now, all she can think to do is hold on to her determined spirit. She knows what to expect: the long hours, waiting rooms packed with patients, even personal sacrifices.

“There’s really no question about where I want to go,” she says. “I’m going to be making a difference in at least one small community.”

AAPS Sues over Maintenance of Certification

BlogApril 28, 2013Healthcare Careers, Performance, Training


The Association of American Physicians & Surgeons (AAPS) filed suit April 23, 2013, against the American Board of Medical Specialties (ABMS) over their maintenance of certification program. The suit, filed in a New Jersey federal court, alleges that the ABMS is restraining trade and causing a reduction in patient access due to burdensome recertification processes.

Jane Orient, MD, the AAPS’ executive director, graciously agreed to discuss the issues with me.

Martin Merritt: I understand maintenance of certification (MOC) is one of the hottest topics in the field of medicine today?

Jane Orient: Yes. Many physicians are outraged, not only by the cost an expense which must be incurred to maintain certification, but also by the fear that MOC  is being advanced as a requirement for hospital privileges, and perhaps even maintenance of licensure (MOL).

MM: The public might think the ABMS is a government entity?

Jane Orient, MD JO: The ABMS is a not-for-profit corporation. According to the lawsuit filed by AAPS, the ABMS seems to exist to enrich its own executives, with little appreciable evidence that the MOC program has an effect on the quality of care.

MM: How does the ABMS MOC program actually work?

JO: I can mostly speak about what the lawsuit contains. ABMS and 24 separate corporations, which make up the 24 recognized board-certified specialties have agreed to impose on physicians a recertification program called the ABMS Maintenance of Certification. At one time, a physician could voluntarily choose to become board certified, and upon completion of the process, he or she was board certified for life. Now, the ABMS has decided to force board certified physicians to purchase its products every 10 years. If a physician cannot afford the time or the expense of recertification, he or she may be designated as “not meeting” the requirements of the ABMS, which tends to imply that a physician is less than qualified to care for patients.

MM: What is the AAPS seeking in the suit?

JO: AAPS’ lawsuit, seeks declaratory and injunctive relief to enjoin ABMS’s continuing violations of antitrust law and misrepresentations about the medical skills of physicians who decline to purchase and spend time on its program. AAPS also seeks a refund of fees paid by its members to ABMS and its 24 other corporations as a result of ABMS’ conduct.

Again, the lawsuit itself is the best source for information about the relief requested, but in a nutshell, what we are worried about is the fact that perfectly capable physicians are being black-balled, or locked out of the ability to treat patients, because they do not have the time, or inclination to purchase a product from a private corporation, which has nothing to do with the physician’s ability to treat patients.

MM. You cite an example in the lawsuit, I believe.

JO: In a case cited in this lawsuit, a first-rate physician in New Jersey was excluded from the medical staff at a hospital in his state simply because he had not paid for and spent time on recertification with one of these private corporations. He runs a charity clinic that has logged more than 30,000 visits, but now none of those patients can see him at the local hospital because of the money-making scheme of recertification.MM: I would like to thank Dr. Orient for speaking with us. You can follow this lawsuit and other issues of concern at the AAPS website.

Maintenance of Certification: A New Way to Control Docs?


Is board certification, the decades-old process by which physicians prove their clinical chops within their specialties, becoming a back-door way to micromanage them? Many doctors think so, and they’re planning to debate the subject tomorrow in Philadelphia. You’re invited.

Herbert Kunkle, an orthopedic surgeon in Pennsylvania, argues that board certification is overrated as a means of demonstrating clinical acumen, unproven as a way of driving healthcare quality, and is lately becoming intolerably onerous.

He acknowledges that board certification is “a time-honored thing” that physicians accept as part of the job, even though many feel “tortured by” it. “No one’s ever shown [a clear link between] board certification and clinical acumen and quality,” Kunkle says. “But it’s there and it’s accepted.”

What is angering the critics now are the boards’ implementation of plans to transform what started out as a once-in-your-career certification into something that’s “always on,” watching you. So-called “maintenance of certification” (MOC) was introduced, in principle, more than a decade ago when the 24 member boards of the American Board of Medical Specialties (ABMS) agreed to it, but the actual MOC programs are only now being implemented by the specialties.

The purpose is to ensure “that the physician is committed to lifelong learning and competency,” by “requiring ongoing measurement of six core competencies,” according to the ABMS. Only two of those competencies seem, by my reading, directly related to clinical knowledge. The others appear aimed more at ensuring that you work and play well with others. For example, you’ll now be expected to “demonstrate awareness of and responsibility to [the] larger context and systems of healthcare” and “call on system resources to provide optimal care.” You’ll also by judged on “interpersonal communication,” including your “active listening” skills.

These are nice ideals but they’re subjective. Many physicians worry that requirements like that are just thinly veiled attempts by hospitals, academics, and associations — what Kunkle calls healthcare’s “artificial aristocracy” — to control the way doctors work and interact with the healthcare system, not just how effectively they treat patients.

“If you think about lawyers, they pass the board once, that’s it,” says Beth Haynes, a family doctor in San Francisco and executive director of the Benjamin Rush Society, the physicians’ group that’s putting on the debate at the University of Pennsylania. (Can’t make it? Stream it live at 6 pm ET.) Haynes is referring to the bar exam, of course. “That’s what we used to with board certification. It was a lifetime mark of achievement, period. But now it’s becoming this very intrusive way of trying to tell people how to practice. … It’s just complete micromanaging of physicians.”

The boards are technically voluntary. You’re not required by law to be board-certified to practice, and as many as a quarter of U.S. docs aren’t. But outside of rural areas where doctors are sparse, board-certification is a prerequisite for hospital privileges and payer credentialing. You can’t work without board certification, so attempts to broaden certification requirements to include the kind of “soft” skills often valued by administrators, as well as the fact that measurement is now “ongoing” rather than periodic, strikes some as an attempt by bureaucrats to control docs.

Kunkle’s assertion, by the way, about the lack of firm evidence of the boards’ value in driving healthcare quality is a matter of debate. There are studies that demonstrate a correlation between the boards and quality, though proving causation requires the ability to control for other factors that might affect quality, and that’s a very difficult thing to do. Yet even if one accepts the premise that it makes sense to measure a physician’s skills related to her chosen specialty, what’s needed is evidence of how well and by much board-certification drives quality. Otherwise it’s hard to see a scientific basis for new and expanded requirements.