Monday, May 22, 2017

HCSI Interview with Dr. Josh Luke

In this show, Lance King of HCSI ( interviewed Dr. Josh Luke, Healthcare Futurist and #1 Best Selling Author of “Re-admission Prevention: Solutions Across the Provider Continuum”(

Josh Luke began his career in sports marketing. He then was a nursing home administrator and then hospital CEO. After ten years, Luke found himself out of a job with no health insurance for his family, plus his mother was diagnosed with Alzheimer’s Disease. Because of his experiences on both sides of healthcare, he has a perspective few administrators do. Dr. Josh Luke now uses that perspective to build population management strategies that create new revenue streams for health systems.

Josh worked for failing hospitals and care centers and made them successful, so he was known as a turnaround king. He also had his share of failures of his career. His largest failure was helping hospitals implement value-based care. Case managers have been the advocates for patient choice, but hospitals need to educate case managers on what the actual choices are. Josh tried to change check-out process to be more efficient. There was such push-back from case managers that it almost didn't happen. He learned that case managers must be more educated by hospital administration, so that they can better educate patients on their options.
Another thing that needs to change in our healthcare system is scripting, where the physician or case manager communicates patient care needs and how to meet those needs. Often, a case manager doesn't communicate the patient's right to go home, the risks that involves, and the home-based options that are available. Patients have never felt empowered to question doctor orders to do inpatient care but they should.

Value-based Care
Josh didn't think anyone thought about what happens if Obamacare goes away until election night. He says to think about when your checking account is empty, you don't spend money.  Now government has no money in account, so something needs to change but there are no good options right now. The traditional hospital model was fee-for-service, where the provider gets a fee for providing service; there was no criteria or accountability. For example: ER doctors did not (and still often do not) evaluate whether a patient actually needs to be admitted; they tried to admit as many patients as possible to receive increased revenue. Now
, the Affordability Care Act forces hospitals to have a value-based approach, which gives incentives to providers for keeping patients healthy so they avoid the hospital. Josh says, “In value-based care, any time a patient goes to the emergency room, that shows a failure of the system 80 percent of the time.” This is similar to thoughts shared by Dr. Paul Roemer, in a previous interview.
The main reasons patients go to the emergency department are because the patient didn't call the hospital or doctor first, or a senior citizen is scared after being discharged from the hospital. Josh Luke says that the inherent challenge in delivery (fee-for-service) model is that people understand that they can go to emergency room to get care without having to pay for it. This concept pre-dated the ACA and until we talk about access to free clinics to eliminate this abuse of system healthcare costs will continue to increase.

Affordability Care Act
Dr. Josh Luke says the ACA is failing because not every American wants insurance, many are not willing to pay for it, and most people under 40 don't need insurance. Then, instead of having the healthy population who don't use insurance help cover the costs/risks associated with older and sicker people, they pay the penalty fee for not having insurance. This makes costs associated with the ACA higher than anticipated because fewer healthy people opt-into health insurance coverage. Josh says that the benefit of the ACA, whether you like it or not, is that it expanded access to healthcare. Americans did not have the expectation of healthcare as a right in the 1980s; now after almost a decade with the entitlement, the percent of Americans who view healthcare as a right has increased. The ACA forced hospitals to think about post-acute care because it is value-based. When the ACA was introduced, readmission prevention had no data or enthusiasm behind it. No one knew anything about it, and the ACA was punitive and difficult to understand. Josh realized he was becoming an expert in value-based healthcare and readmission avoidance because no one else wanted to be the expert. He saw that people really gravitated to his personal story and professional story. He's now a champion of hospitals coordinating care with nursing facilities, and home-based care.

Vision for the Future
Josh says that the model of future is not readmission prevention, it's admission prevention. Where the government or insurance says to the health system, “Here's the allotted amount of money; take care of this patient with this amount.” Health systems are being forced to be accountable, efficient, and use pre-authorizations, and patient education to contain costs. He thinks the long-term impact could be the elimination of middle-man insurer, or at least having the power be transferred from the hospital or health system to the insurer. The basic premise of the ACA is to reduce spending and dollars, but increase and improve care. This means that as revenue dips, staff will be reduced or hospital will be closed. Core staffing requires minimum number of employees to stay open. Hospitals/health systems will need to focus on ways to make money outside the hospital if they are going to be successful. Hospitals used to be the king in a health system; now, they're the biggest expense.  Josh specializes in helping administrators find other revenue streams besides the hospital.

How Can Patients Save Money in Healthcare
Josh says the best way for patients to save money in healthcare is to become educated on available treatment options, including home-based care, and feel empowered to question doctors orders. Josh has realized that the rest of us must adapt to millennial culture of having a computer-in-hand; healthcare needs to adopt technology. (This sentiment is shared by many of our past interviewees, such as Scott Roethle and Bruce Blausen.)  Also, millennials define healthcare as living healthy, which is the future of healthcare. Josh is writing two books, commissioned by Forbes, about this topic. The first one is titled Is Healthcare Bankrupting Your Business and What are You Going to do About it?, and it will be released Fall 2017. It will focus on how executives can save money on healthcare for employees. The second book is called Is Healthcare Bankrupting Your Family and What are You Going to do About it? Its expected release date is Fall 2018, but it may release as early as Spring 2018. This book will focus on ways people can save on healthcare for themselves, their family members, and their aging parents.

Personal Habit Contributed to Success
Josh has developed the power of listening to and understanding his audience. He has an undergraduate degree in communications which is how he learned the value of “understanding your audience before you open your mouth.”
Also, when he trained as a nursing home administrator, he worked in every department for two weeks. While washing dishes with an immigrant who only had a high school education that more employees that could relate to the dishwasher than a CEO in a corner office and he adapted his managerial approach accordingly.

Three Absolute Truths
Josh has learned three absolute truths in his life, and they are:
Having a partner that is committed and lifts you up (and whom you lift) is necessary. He is thankful to have found that in is wife of almost 20 years.
Having alone time is important. Meditation, prayer, and thinking alone helps you know who you are.
It's important to play as hard as you live. He loves to travel with his family and is glad to be able to teach his children that it requires hard work to achieve the things you want in life.

Parting Advice
With regards to healthcare, please feel empowered to ask questions for yourself, your family, and your aging parents. Ask what your options are and question doctors orders, especially if they involve staying in the hospital.

Books and Contact Info
Re-admission Prevention: Solutions Across the Provider Continuum is written for hospital administrators and healthcare practitioners. It is very tactical and the only idea that costs money is the actual price of the book.

Ex-Acute: A former hospital CEO tells all on what’s wrong with American healthcare, What every American needs to know exposes the underbelly of healthcare, talks about why it's so expensive and empowers patients to question providers and know their options. He says it's fun and entertaining, and a quick 3-hour read. It also includes a glossary of terms for those unfamiliar with the industry.

Look for Josh Luke on LinkedIn and twitter (@joshluke4health), or visit his website He would love to speak at your company's event, and he usually brings a free copy of Ex-Acute for attendees.

Josh Luke Bio
Dr. Josh Luke is a Healthcare Futurist and #1 Best Selling Author of Re-admission Prevention: Solutions Across the Provider Continuum. After ten years as a hospital CEO, Luke was out of a job, had no health insurance for his family, and his mother was diagnosed with Alzheimer’s Disease. He now finds solace in sharing his experiences as a caretaker for his mom; and being without health insurance for his family has given him a deeply emotional understanding of the other side of care delivery. Dr. Josh Luke’s expertise is in developing population management strategies that create new revenue streams for health systems. Luke shares Best Practices nationally to ensure hospitals develop revenue-driven programs in the post-acute, healthy lifestyle and wellness sectors. Peers describe Luke as innovative, a thought-leader on population management, coordinated care, and readmission prevention — as well as a “futurist” on the Affordable Care Act and how it will shape the continuum. He authored a book titled, “Re-admission Prevention: Solutions Across the Provider Continuum”, which is the best-selling management series book of the year for the American College of Healthcare Executives. Experience includes Executive Faculty at the University of Southern California, Sol Price School of Public Policy, in the Healthcare Administration Department at Cal State Long Beach and also at Cal State Fullerton. He is also a former Board member for the Hospital Association of Southern California and the California Hospital Association Center for Post-Acute Care. Having uniquely worked in acute & SNF, Luke founded the National Readmission Prevention Collaborative in 2013 and the National Bundled Payment Collaborative in 2015, to showcase Best Practice integration models. He currently serves in an Editorial and Advisory Board capacity for several organizations including the Readmission News. A veteran hospital CEO, Luke also designed the Total Wellness Torrance population management strategy working with the ACO, Bundled Payment & IPA teams while serving as Vice President, Post-Acute Services for Torrance Memorial Health System. TWT and its Post Acute Network received the 2013 Excellence in Programming award from CAHF.

Thanks to all our listeners and viewers! Remember to contact Lance King of Healthcare Compliance Solutions, Inc for all your compliance needs. See more interviews at our website,, on Facebook @hcsi, or on YouTube and PodCast and search for Doctor Entrepreneur.

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Tuesday, May 16, 2017

The Importance in Healthcare of a Disaster Recovery Plan (DRP) and how to Organize your Risk Analysis into an actionable DRP.

Creating Your Healthcare Disaster Recovery Plan and Best Practices

Just since the writing of this article the whole world has experienced the largest cyber ransom-ware attack to date effecting companies, healthcare systems, utilities, transportation, governments as well as individuals on an unprecedented scale.

When a covered entity performs a Security Risk Analysis, this is not the end but a begging to your HIPAA Security procedures and business continuity plan.

Information gained from the risk analysis then needs to further be organized into a tangible, well documented and actionable Disaster Recovery Plan (DRP).

All health care organizations (particularly hospitals and emergency care centers), must maintain a high degree of system and network availability. Patient's lives may depend on systems being up and running, and a patient's health could be jeopardized or negatively impacted by lack of access to health care data in the event of system downtime. 

The disaster recovery plan is a required implementation, defined within the HIPAA Contingency Plan standard in the Administrative Safeguards section of the HIPAA Security Rule. The Rule calls for HIPAA-compliant organizations to anticipate how natural or other disasters could damage systems that contain electronic health information and to develop policies and procedures for responding to such situations.

A HIPAA-compliant disaster recovery plan must state how operations will be conducted in an emergency situation and which workforce members are responsible for carrying out those operations. The plan must also explain how data will be safeguarded or moved without violating HIPAA standards for Privacy and Security.  It must also explain how confidential data and safeguards for that data will be restored.  Although HIPAA doesn't specify exactly how to do this, it does note that failure to adequately recover from a disaster could lead to noncompliance. Failure to comply exposes officers of the organization to repercussions, such as fines or possible jail time.

Unfortunately, when establishing IT budgets, many health care practices and organizations overlook the importance of developing a meaningful, functional and standardized disaster recovery plan. It's important for health care practice Administrators, Compliance Officers and CIOs to make the necessary business case model and receive a useful budget for disaster recovery planning. Making use of the, pay $10 now or $10,000 later, theorem comes to mind.
Formulating a detailed disaster recovery plan should be a primary objective of the entire practice and IT disaster recovery planning project. It is in these plans that you will set out the detailed steps needed to recover your IT EMR systems to a state in which they can support the practice (during, if necessary) and after a disaster.
But before you can create a detailed recovery plan, you will need to perform a Risk Analysis/Assessment (RA) to identify the IT services that support the organization’s critical business activities.
The next step is to establish recovery time objectives (RTOs)* and recovery point objectives (RPOs)**.
*The recovery time objective (RTO) is the targeted duration of time and a service level within which a business process must be restored after a disaster (or disruption) in order to avoid unacceptable consequences associated with a break in business continuity. It can include the time for trying to fix the problem without a recovery, the recovery itself, testing, and the communication to the users.
**A recovery point objective (RPO) is defined by business continuity planning. It is the maximum targeted period in which data might be lost from an IT service due to a major incident.
Now that you have that basic information gathering stage compiled, you can move on to the next stage.
Developing Disaster Recovery Strategies
ISO/IEC 27031, which is the global standard for IT disaster recovery, states, “Strategies should define the approaches to implement the required resilience so that the principles of incident prevention, detection, response, recovery and restoration are put in place.” Strategies define what you plan to do when responding to an incident, while plans describe how you will do it.
Once you have identified your critical systems, RTOs, RPOs, etc, create a table, similar to what is shown below, to help you formulate the disaster recovery strategies you will use to protect them.
Critical System(s)
Prevention Strategy
Response Strategy
Recovery Strategy
EMR System
6 hours/
3 hours
Server Failure/Loss of ePHI
Secure server room; UPS; Regularly backup server
Verify UPS running time, use backup server
Restore/replace primary sever; restore backup date  and input interim records
Accounts Payable/
8 hours/
4 hours
Server Failure/Loss of Billing records
Secure equipment room; UPS; Regularly backup server
Maintain paper records for later recovery
Restore/replace primary sever; restore backup date  and input interim records
Building Security
4 hours/
2 hours
Security System Destroyed
Place system in secure location; UPS; Use protective enclosures for sensors and cameras
Deploy security is available, secure and/or relocate vital system/ records
Repair/Replace security unit and devices
Table 1: Determining disaster recovery Strategies.
Remember to consider issues such as billing, budgets, management’s position with regard to risks, the availability of resources, costs versus benefits, human constraints, technological constraints and regulatory obligations.
Now let’s examine some additional factors in strategy definition:

This involves availability of staff/contractors, training needs of staff/contractors, duplication of critical skills so there can be a primary and at least one backup person, available documentation to be used by staff, and follow-up (ongoing training) to ensure staff and contractor retention of knowledge.

Physical facilities

Areas to look at are availability of alternate work areas within the same site, at a different company location, at a third-party-provided location, at employees’ homes or at a transportable work facility. Then consider site security, staff access procedures, ID badges and the location of the alternate space relative to the primary site.


You’ll need to consider access to equipment space that is properly configured for IT systems, with raised floors, for example; suitable heating, ventilation and air conditioning (HVAC) for IT systems; sufficient primary electrical power; suitable voice and data infrastructure; the distance of the alternate technology area from the primary site; provision for staffing at an alternate technology site; availability of failover (to a secondary server of backup system for example) and failback (returning to normal operations) technologies to facilitate recovery; support for legacy systems; and physical and information security capabilities at the alternate site.
Areas to look at include timely backup of critical data to a secure storage area in accordance with RTO/RPO requirements, method(s) of data storage (cloud, disk, tape, optical, etc), connectivity and bandwidth requirements to ensure all critical data can be backed up in accordance with RTO/RPO time scales, data protection capabilities at the alternate storage site, and availability of technical support from qualified third-party service providers.
You’ll need to identify and contract with primary and alternate suppliers, (including all Business Associates), for all critical systems, PHI data and processes, and even the sourcing of specific crucial people. Key areas where alternate suppliers will be important include hardware (such as servers, racks, etc), power (such as batteries, universal power supplies, power protection, etc), networks (voice and data network services), repair and replacement of components, and multiple delivery firms (FedEx, UPS, etc.).
Policies and procedures
Define policies and procedures describing your Disaster Recovery Plan and have them approved by senior management and Compliance Officer(s). Then define the step-by-step procedures to (for example) initiate data backup to secure alternate locations, relocate operations to an alternate space, recover systems and data at the alternate sites, and resume operations at either the original site or at a new location.
Be sure to obtain management sign-off for your strategies and be prepared to demonstrate that your strategies support the practices’ business and compliance goals.
Translating disaster recovery strategies into DR plans
Once your disaster recovery strategies have been developed, you’re ready to translate them into disaster recovery plans. Let’s take Table 1 and recast it into Table 2, seen below. Here we can see the critical system and associated threat, the response strategy and (new) response action steps, as well as the recovery strategy and (new) recovery action steps. This approach can help you quickly drill down and define high-level action steps.
Critical System(s)
Response Strategy
Response Action Steps
Recovery Strategy
Recovery Action Steps
EMR System
Server Failure/ Loss of ePHI
Switch over to backup server; create paper records
Confirm status of Server; Verify Data has been backed up including testing and restoring; Switch over to alternate server
Restore/replace primary sever; restore backup date  and input interim records
Verify primary system integrity and repair/replace if necessary; restore backups; incorporate offline records; fall back from secondary servers
Accounts Payable/
Server Failure/Loss of Billing info
Switch over to backup server; create paper records
Confirm status of Server; Verify Data has been backed up including testing and restoring; Switch over to alternate server
Restore/replace primary sever; restore backup date  and input interim records
Verify primary system integrity and repair/replace if necessary; restore backups; incorporate offline billing or accounting information; fall back from secondary servers
Building Security
Security System Destroyed
Deploy guards and/or secure server records room.
Verify status of security system and video storage; Organize guards and define duties;  have available alternative communication methods (2-way radio)
Obtain or re-install new system/sensors, etc.
Contact vendor to identify system failure issues and repair/replace any faulty components.
Table 2: Using strategies to create disaster recovery Plan.
From Table 2 (above) you can expand the high-level steps into more detailed step-by-step procedures, as you deem necessary. Be sure they are organized and linked in the proper sequence.
Developing DR plans
DR plans provide a step-by-step process for responding to a disruptive event. Procedures should ensure an easy-to-use and repeatable process for recovering damaged IT and ePHI assets then returning these hardware items and critical data back to normal operation as quickly as possible. If staff relocation to a third-party “hot site” or other alternate space is necessary, procedures must be developed for those possible scenarios.
Incident response
In addition, IT disaster recovery plans should be an inclusive part of an incident or emergency response plan that addresses the initial stages of the situation and the steps to be taken.
Note: Emergency management activities that may be needed to address situations where humans are injured or situations such as fires may be a concern must be addressed by local fire departments and/or other first responders.
The DR plan structure
The following section details the elements in a DR plan in the sequence defined by ISO 27031 and ISO 24762.
Important note: Best practice DR plans should begin with a few pages that summarize key action steps (such as where to assemble employees if forced to evacuate the building) and lists of key contacts and their contact information for ease of coordinating, authorizing and launching the plan.
  1. Introduction.  Following the initial emergency pages, DR plans have an introduction that includes the purpose and scope of the plan. This section should specify who has approved the plan, those who are authorized to activate it and a list of linkages to other relevant plans and documents.
  2. Roles and responsibilities. The next section should define roles and responsibilities of DR recovery team members, their contact details, spending limits (for example, if equipment has to be purchased) and the limits of their authority in a disaster situation.
  3. Incident response. During the incident response process, we typically become aware of an out-of-normal situation (such as being alerted by various system-level alarms), quickly assess the situation (and any damage) to make an early determination of its severity, attempt to contain the incident and bring it under control, and notify management and other key stakeholders.
  4. Plan activation. Based on the findings from incident response activities, the next step is to determine if disaster recovery plans should be launched, and which ones in particular should be invoked. If DR plans are to be invoked, incident response activities can be scaled back or terminated, depending on the incident, allowing for launch of the DR plans. This section defines the criteria for launching the plan, what data is needed and who makes the determination. Included within this part of the plan should be assembly areas for staff (primary and alternates), procedures for notifying and activating DR team members, and procedures for standing down the plan if management determines the DR plan response is not needed.
  5. Document history. A section on plan document dates and revisions is essential, and should include dates of revisions, what was revised and who approved the revisions. This can be located at the front of the plan document.
  6. Procedures. Once the plan has been launched, DR teams take the materials assigned to them and proceed with response and recovery activities as specified in the plans. The more detailed the plan is, the more likely the affected IT asset will be recovered and returned to normal operation. Technology DR plans can be enhanced with relevant recovery information and procedures obtained from system vendors. Check with your vendors while developing your DR plans to see what they have in terms of emergency recovery documentation.
  7. Appendixes. Located at the end of the plan, these can include systems inventories, hardware logs, software license keys, Insurance policies and/or agent contacts, application inventories, network asset inventories, contracts and service-level agreements, supplier contact data, and any additional documentation that will facilitate recovery.
Additional follow up activities:
Once your DR plans have been completed, they are ready to be exercised and most importantly, TESTED.
Don't neglect DRP testing, modification and critical system updates.
This Identifies most of the critical components of any DRP needed to respond to HIPAA disaster recovery requirements. Although not discussed above, addressable policies could be dealt with inside or outside the DRP. Nonetheless, as ePHI applications can be added to, deleted or modified, periodic planed tests and resultant corrections are vital to the continuing success of any HIPAA disaster recovery plan while supporting regulatory requirements. 
This process, along with controlled testing, will serve to verify and determine whether recovery, fail-over and restoration processes with records and IT assets function as planned.
In parallel to these activities are these additional and necessary supplementary requirements:
Create and implement employee awareness training, documented policies and records management procedures. These are essential in that they ensure employees are fully aware of DR plans and their responsibilities in a disaster, and DR team members have been trained in their roles and responsibilities as defined in the plans. And since DR planning generates a significant amount of documentation, records management (and change management) activities should also be initiated. If your organization already has records management or process management implementation and change management programs, incorporate them in your DR planning.
With natural disasters, security breaches (external and internal) along with cyber attacks occurring more and more frequently, the need for a practicable DRP is more essential than ever. In fact, having a viable DRP is something all covered entities and supporting Business Associates should have in place for their own business integrity and survival along with patient record and health data integrity, regardless of HIPAA or other governmental regulatory disaster recovery requirements.
Note: When developing your IT/EMR DR plans, be sure to review the global standards ISO/IEC 24762 for disaster recovery and ISO/IEC 27035 (formerly ISO 18044) for incident response activities.

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Monday, May 15, 2017

HCSI Interview with Jeromy Dixson of Smiles Dental Episode: 18

Lance King of Healthcare Compliance Solutions, Inc interviewed Jeromy Dixson. Dr. Dixson is a three- time INC Magazine 500/5000 awarded entrepreneur, the Founder and Former CEO of Smiles Services LLC and Founder and Former President of Smiles Dental Group PC.

Jeromy Dixson, DDS
Like most of the people in the healthcare industry that Lance has interviewed, Jeromy Dixson chose his career out of a desire to help other people. He spoke of two experiences in childhood that greatly influenced his path (-39:00 in interview). He had two injuries that required lengthy hospital stays. He decided he wanted to be like the people on the medical teams that took care of him during those times and dreamed of being a doctor. In college, Jeromy spoke to several doctors and they all recommended that he look into going into dentistry instead. He shadowed his dentist and discovered a love for the industry. He was excited to get to know families and even generations of families as patients.
He graduated from dental school in Southern Illinois University in 2004. About one-third to one-half of his graduating class went to work for Heartland Dental Group, the largest dental group in the nation at the time, and one of the first Dental Service Organizations (DSO) in the country.  When Jeromy returned 'home' to Portland, OR he brought back the idea of a DSO with him. He eventually founded the Smiles Dental Group, a DSO in the Portland Oregon area. Jeromy is currently on sabbatical with his wife and three children. They are taking a year off to travel around the world.

Smiles Dental Group
Smiles Dental Group is a DSO that buys private dental practices. Then, Smiles takes care of all the non-clinical aspects of running a practice, including (but not limited to) marketing, continuing education, facilities maintenance, and billing/insurance. Jeromy looked for the top 5-10 percent of practices in the area and then talked to the dentists about advantages of joining a DSO. The main reason dentists choose to go with Smiles Dental Group is because many new 
graduates don't want to own their own practice because of the complications involved with ownership.  Doctors want to focus on patient care. Also, many women are choosing to work part-time as a dentist. The DSO option allows more women to practice dentistry without spending time on the non-clinical parts. Another big driver for people choosing a DSO is the ability to adopt new technologies, such as CAD/CAM and CT machines. These devices facilitate greater patient care but are often cost prohibitive. With a DSO model, the group of practices share the cost so they can offer these treatment/diagnosing options, which will help differentiate their practices from competitors.

What Have You Learned From Failure?
Jeromy says that every successful entrepreneur has had catastrophic failures, and he's no exception. One of the most applicable lessons for anyone looking to buy a practice, or go into business with someone is to stay away from doctors who have both a big ego and whose identity is their practice. He said that you can work with one or the other, but not both. Also, he said that in any negotiation, if there's contention before the contract gets signed, there's going to be contention afterwards.  It's not worth working with someone who doesn't want to change or find common ground, so just walk away.

When asked about entrepreneurship, Jeromy said, “You'll always have things thrown at you that make you want to quit.”  He says the keys to being successful are not to quit, take informed risks, know what your vision is, and build a great team. When he first started, Jeromy said he was naive about how much work and sacrifice was required to build a flourishing company. He says that now he has a basic framework of knowledge, experience, and strategy so he can realize his vision.  He subscribes to the “Blue Ocean Strategy,” namely where you create your own market (blue ocean) instead of fighting over the same market as everyone else (red ocean).  He periodically considers where the 'blue ocean' will be in 10 years and readjusts his focus.

Habits of Success
According to Jeromy, “Anyone I've known that's been extremely successful and a great leader has a curious mind.” He makes time daily to meditate and learn. He says that once a person stops learning and growing, they become comfortable. Jeromy doesn't let himself stay comfortable very long.  He says, “When you move and grow, you become greater.”

Three Absolute Truths
1. “In a world where you can be anything, be kind,” is a quote that Jeromy's wife recently shared with him. As he and his family travel around the world through different places and cultures, they see the commonalities in the human family, and that most differences can be worked out with kindness.
2. The things that matter most are our relationships with people we love and our experiences together.
3. There is no such thing as a free lunch.  People see the tip of the iceberg of success, but they don't see the hard work and determination beneath the surface. He says, “If you're entitled or a victim, then you're never going to achieve your goals. It will always be someone else's fault that you don't have a great family, or a good job, or a successful business.” People with determination work hard to achieve what they want, whether that be in relationships or careers.

Parting Advice
A business is made of of three things—people, product/service, and profit. You have to follow that same order in priority. If you don't treat people well, your business will fail. If you don't have the right product or service, your business will fail. And if you take care of the first two, the third (profit) will follow.

Jeromy Dixson, Bio
Dr. Jeromy Dixson, of Smiles Services and Smiles Dental Group. Dr. Dixson is a three- time INC Magazine 500/5000 awarded entrepreneur, the Founder/Former CEO of Smiles Services LLC and Founder/Former President of Smiles Dental Group PC. He is a visionary, inspirational, and transformational leader who builds unified individuals, teams, cultures, and world-class organizations. Dr. Dixson became the managing partner of Smiles Dental in 2008. In 2010 he finalized a buyout of his former partners, assumed the role of President and immediately accomplished a successful re-launch of the organization, setting Smiles Dental on a path to explosive growth. The company proceeded to double its number of locations and triple revenue in the ensuing three years. From 2013 to 2015, Smiles Dental nearly tripled the number of locations, revenue and EBITDA again. Under Dr. Dixson's leadership, Smiles Dental was recognized three years in a row (2013-2015) by Inc. Magazine as one of the fastest growing privately held companies in the United States, topping out at #550 in 2013. Additionally in 2013, he completed a successful private equity transaction. He is currently on sabbatical overseas. Follow his family blog at to catch up with him through mid-2017.

As always, thanks so much for listening, reading, and following Lance King and Healthcare Compliance Solutions, Inc. Remember to find us on Facebook, iTunes, YouTube, and LinkedIn for more interviews, articles, and helpful information about healthcare compliance and more.

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