Friday, Nov 30 2012 

Albert Schweitzer Photo

 

The full measure of a man is not to be found in the man himself, but in the colors and textures that come alive in others because of him.


– Albert Schweitzer

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The ‘Great Boss’ checklist: How do you rate? Saturday, Nov 24 2012 

by the writers of Business Management Daily

Great bosses aren’t born, they’re made. And becoming a great boss requires honest self-analysis and periodic reassessments. The following check­­list was designed to guide you in that analysis. Use it to take stock of your people skills. Be honest with yourself.

Then, tuck it away and revisit it in six months. Ask yourself: Are you working to maintain those strengths and abilities you already possess? Have you improved where you are weak?

Look in the mirror

Place a check mark in the box next to the behaviors that you feel confident you exhibit on a routine basis.

1. Guide, don’t control. Don’t take a completely hands-off approach, but don’t micromanage either. Explain what needs to get done, but don’t dictate exactly how you want it done.

2. Utilize employees’ strengths. All of your employees have something to offer. Identify, recognize and cultivate their specific skills.

3. Empower employees. Give them the tools they need to succeed and the opportunities to learn new skills.

4. Trust. Don’t second-guess your employees’ abilities. Believe that you hired good personnel.

5. Take an active interest in em­­ployees as individuals. Inquire about their families and hobbies. Remember their birthdays. Offer condolences when necessary.

6. Offer praise. Be quick to give a compliment for a job well done.

7. Respect employees. Your position of authority doesn’t excuse belittling, abusing or humiliating workers, no matter how unintentional. Check that your tone isn’t condescending or parental, especially when giving in­­struc­­tions or critiques.

8. Admit shortcomings and ask for help. There is no shame in admitting to an employee that they are more skilled in a particular area than you. Asking for help shows that you respect the employee’s knowledge.

9. Have integrity. Avoid a “do as I say and not as I do” attitude. Hold yourself to the same standards to which you hold employees. Give credit where credit is due. For instance, if you use an idea from an employee in a proposal you submit to your boss, give the employee credit.

10. Learn from your mistakes. It’s not enough to admit when you make mistakes. Learn not to repeat them. Otherwise, employees are going to consider your admissions of error and accompanying apologies as nothing more than lip service.

11. Don’t play the blame game. In the face of adversity, look to solve the problem, not place blame. Employees value knowing that you have their backs. That doesn’t mean you should in­­sulate them against deserved discipline. Just don’t throw employees under the bus when they make honest mistakes.

12. Give employees a voice. When­­­­ever possible, let them have a say in decisions that directly impact them. Also, ask them for feedback. If you cannot implement their suggestions, explain why.

13. Listen, really listen, to what employees are saying. Sometimes, you have to read between the lines or listen for what’s not said.

14. Keep employees in the loop. Let them know when, why and how decisions are made. Also, explain the reasons behind new policies or changes to existing policies.

15. Keep things in perspective. Don’t go crazy over something trivial. Ask yourself, “Will this matter in a week from now?” If not, it might be best to just let it go.

16. Don’t waste employees’ time. Call meetings only when absolutely necessary. Have a clear agenda and be organized. Also, recognize that employees have lives outside of work and give them the flexibility to live it.

17. Compromise. Meeting em­­ployees halfway goes a long way! Be careful, however, of compromising too often. If you do, employees may start to think they can bend your will whenever they want, and, in the process, lose respect for your authority.

18. Be blunt, but tactful. Don’t beat around the bush. Burying your message in small talk, for example, could result in the message getting lost.

19. Hold all employees accountable, i.e., don’t play favorites. Not only will a failure to treat similarly situated employees similarly pit them against each other, but it could also result in a discrimination claim.

20. Open your door, and walk out of it. It’s important for employees to know that your door is always open to them. But be careful of waiting for them to come to you. Make a habit of walking around the department and interacting with employees in their workspaces.

Source: by the writers of Business Management Daily

 

Go Ahead…Be Bored Friday, Nov 23 2012 

by Carole Jackson>, Bottom Line Health

I never thought that I would see an entire book written about the concept of boredom — let alone find it interesting! But I certainly did. The recently published Boredom: A Lively History made me realize how underrated it actually is. Between e-mailing, texting and updating Facebook statuses… working anywhere and everywhere on laptops… and responding to endless phone calls, it seems like no matter where we are, we fill every minute of our free time. And that leaves precious few moments to simply daydream, which helps our creative juices flow. In today’s busy, wired world, slowing down and carving out moments for ourselves is more important than ever. To discuss the latest findings, I called the author, Peter Toohey, PhD, a professor of classics at the University of Calgary in Canada.

SPARKING NEW IDEAS

Dr. Toohey explained to me that research increasingly supports the notion that daydreaming — just like dreaming at night while you sleep — is actually a dynamic period for the brain. For example, in a recent study done by the University of British Columbia in Canada, investigators placed a group of students in functional magnetic resonance imaging (fMRI) scanners and asked them to push a button when numbers appeared on a screen — a mindless, routine task that would give them an opportunity to daydream. After the exercise was over and researchers looked at the fMRI brain scans, they found that the parts of the students’ brains that are associated with complex problem-solving had actually been highly active during episodes of daydreaming.

In other words, while you are bored and daydreaming, you are unknowingly working your way through puzzles that are bothering you, such as figuring out the perfect theme for your child’s birthday party or discovering exactly what to say to your mother-in-law that will prevent her from spending the whole week with your family but won’t insult her. “Sometimes the most useful ideas and solutions come to us when we are trying the least hard,” said Dr. Toohey.

DREAM ON

Of course, there are times when concentration is key. Dr. Toohey wouldn’t recommend daydreaming while, say, driving, rushing to meet an important deadline or having a heart-to-heart conversation with your spouse. But there are ways to create space for yourself — dull moments during which it’s perfectly acceptable to let your mind wander.

I don’t know about you, but for me technology — as great as it can be — is often the biggest obstacle. So I’m going to try unplugging myself from all of my various devices (yes — that means the phone, the computer and the TV!) for about 30 minutes a day. Instead, I’m going to go for a walk or a bike ride, whittle a stick or knit a scarf, which will hopefully allow my thoughts to drift off into whatever direction they like.

I know what you’re thinking — it sounds boring. It gives us an uncomfortable feeling when we think about cutting off communication and facing silence. But, ironically, when we’re less wired, our brains’ batteries seem to recharge, so why not give it a shot?

Source:
Peter Toohey, PhD, professor of classics, faculty of arts, University of Calgary, Alberta, Canada. Dr. Toohey is author of Boredom: A Lively History (Yale).

The Star Profile: 13 Steps to Becoming a Better Boss Thursday, Nov 22 2012 

by the writers of Business Management Daily

Managers aren’t only responsible for an organization’s fiscal assets, they’re also responsible for its human assets. According to a recent Adecco report, here are 13 simple ideas you can implement today to become a more effective manager:

1. Recognize a job well-done

Everyone likes to know when they’ve done something well. Make your employees feel important every day. Show enthusiasm for their work.

2. Encourage staff to take risks

Give them enough freedom to take prudent risks. You will find employees at all levels come up with good ideas.

3. Always be honest

Let employees know you trust them, and be honest and open in return. Just one deception can destroy your credibility for good. A recent Gallup Poll found that one in five workers say their bosses don’t treat their employees fairly.

4. Offer a challenge

Productivity and enthusiasm significantly decrease with boredom. A survey by the American Productivity & Quality Center found that the best motivator for employees is challenging work. Your challenge is to keep them challenged.

5. Realize that money isn’t everything

Studies show that money isn’t the only motivator for employees. In fact, most studies show that employees choose factors like recognition for a good job, personal development and challenging work as being more important than salary. So if you want to keep employees, a pat on the back can be just as effective as additional pay.

6. Be a straight shooter

Don’t set foggy goals for your employees. People want to know what you expect of them. Give directions to employees in simple language. Tell them precisely what is involved and why you think they’re best for the job.

7. Know when, where to criticize

Inform employees when they perform well and when they don’t. Tell them immediately. Don’t lump all your complaints in one session.

Don’t criticize employees in front of others. Highlighting failures in public will discourage innovation by everyone involved, and you will quickly turn colleagues into enemies.

8. Keep communication lines open

Employees crave clear, ongoing, understandable and unambiguous communication. Don’t communicate just in times of trouble. Relay positive news as well. Give employees information before, not after, important events.

9. Make employees feel important

The need to feel needed—everyone has it.

One study found that more than half of the employees surveyed felt their managers failed to make them feel important as individuals. And 77% of those employees also said they were thinking of looking for another job.

Allow employees to contribute. Ask for their opinions and advice. Reduce the number of autocratic decisions.

10. Be consistent

Workers can learn to live with any boss if they know what to expect. If you keep them guessing, you will keep them looking … for another job. Inconsistent behavior breeds anger, frustration, dismay and disappointment.

11. Be impartial

Don’t play favorites. Discrimination destroys morale, hurts productivity and opens the door to lawsuits. Bosses who promote unfairly will quickly lose employees’ confidence in them. Treat everyone the same, politely.

12. Take an interest in employees’ careers

Coach or counsel employees on how they can climb the corporate ladder. Become a mentor to employees with real potential and fire.

13. Know how to say “no”

There will be plenty of times that you can’t be Mr./Ms. Nice Guy. You have to say no. How? Just do it.

Explain the reason for your refusal so you don’t seem unreasonable. Avoid making a snap decision unless time constraints force your hand. If possible, tell the employee that you will consider the request and decide in a day or two. Take enough time to let the employee know that the request has had a fair hearing.

Source: by the writers of Business Management Daily

 

The Secret Power of Fiber Wednesday, Nov 21 2012 

by Carole Jackson>, Bottom Line Health

When we think about making sure that we have the healthiest hearts possible, the first thing that comes to mind is what not to eat. Bye-bye, ice cream sundaes, big steaks and fried chicken! But a new study suggests that what we add to our diets — not what we eliminate — may be even more important.

To find out what our hearts (if not our minds) really want us to eat, I spoke to Joseph Carlson, PhD, RD, director of the division of sports and cardiovascular nutrition at Michigan State University’s College of Osteopathic Medicine in East Lansing and the lead author of the study. His research was published in the November 2011 issue of Journal of the American Dietetic Association.

IT WASN’T THE FAT

Dr. Carlson told me that he and his colleagues chose to study teens, in particular, because of the dramatic increase over the past few decades in the number of adolescents with cardiovascular risk factors. And his findings echo what other studies have discovered in terms of adult heart health. They evaluated data from a large federal survey on the health and nutritional status of adults and children. During one part of the survey, 2,100 participants ages 12 to 19 were asked to list everything that they had eaten and drunk in the 24 hours before having a physical exam. Based on their answers, the researchers calculated how many grams of fiber and saturated (“bad”) fat and how many milligrams of cholesterol the youngsters had eaten per 1,000 calories. Then, during the physicals, their cardiac risk factors were assessed.

The results: Compared with those who consumed the most fiber, those who consumed the least fiber were three times more likely to have what’s called metabolic syndrome, which means having at least three of these cardiovascular risk factors — excess abdominal fat… high blood pressure… elevated blood sugar… high amount of triglycerides (blood fats)… and low HDL (“good”) cholesterol. What was even more interesting: Eating less of what we all tend to think of as “bad” foods filled with saturated fat and cholesterol was not associated with a lower risk for metabolic syndrome.

Wait a minute… does that mean that you can throw as much cheese on your omelet as you want — as long as you eat it with whole-grain toast? Unfortunately, no, said Dr. Carlson. Consuming saturated fats and cholesterol can raise your LDL “bad” cholesterol, increase inflammation and hurt your circulation. But these were not components used to evaluate metabolic syndrome in this study. In other words, this research did not show that overdoing saturated fat and cholesterol hurts your cardiovascular health — but we already know that it can. What the study did show, however, is that consuming foods rich in fiber is very powerful for maintaining heart health.

WHY FIBER IS A DIET “MUST”

There are many reasons that adding fiber to your meals may lead to better heart health, Dr. Carlson noted. For one thing, he said, it’s very filling — when you eat more of it, you tend to eat less overall, so you are less likely to be overweight. High-fiber diets, he continued, may also improve glycemic response (the effect of food on blood sugar) and dyslipidemia (an abnormal concentration of cholesterol or triglycerides in the blood). Minerals that may reduce the risk for metabolic syndrome, such as potassium and magnesium, are plentiful in a fiber-rich, plant-based diet, he said. And plant-based foods tend to be high in antioxidants, which may offset oxidative stress and inflammation that are elevated in people with metabolic syndrome.

I know it isn’t news to you that fiber is good for you — but really, before reading this, did you appreciate just how important fiber is? Dr. Carlson told me that Americans’ average fiber intake is less than 15 grams a day, well below the recommendation of 25 grams and 37 grams for females and males, respectively. But this goal can be reached by choosing a variety of fiber-rich foods daily, including fruits, vegetables, whole grains, beans, nuts and seeds. Remember, as a bonus, high-fiber foods fill you up, making you less likely to reach for fatty foods — a win-win for your heart.

Source:
Joseph Carlson, PhD, RD, associate professor and director, division of sports and cardiovascular nutrition, College of Osteopathic Medicine, Michigan State University, East Lansing.

Memo to managers: Recordkeeping guidelines Tuesday, Nov 20 2012 

by the writers of Business Management Daily

“Out with the old, in with the new!” chant managers as they dispose of documents that have accumulated in their office throughout the year. But, in your quest to keep a clean, organized desk, you might run the risk of getting rid of documents you must keep under the law.

To help you with your documentation efforts, we’re sharing these recordkeeping guidelines with you. Here are some of the documents you should probably retain and a handy list of required document retention periods for the ones you’re most likely to reference.

To Keep or Not to Keep

Generally speaking, managers are not responsible for maintaining personnel files, but a majority of the documents that go into those files originate from your office. Check with HR before pitching anything related to:

  • hiring and termination
  • performance
  • promotions and demotions
  • discipline
  • work hours
  • leave requests
  • accommodation requests
  • selection for training opportunities
  • safety and health

This doesn’t just include paper documents. It includes electronic ones, as well. Employees, especially those with email access during the workday, might be more inclined to email you and ask, say, if it’s okay to take a day off for a doctor’s appointment than they are to put the request on paper or to walk down the hall to ask you in person. While the request might not seem retention-worthy to you, it’s best to let HR make the call, since they might be aware of extenuating circumstances you’re not.

Record-Retention Requirements

An effective document management system depends on knowing not only what to get rid of, but also when it’s permissible to get rid of the document. Besides the fact that records take up space and administrative effort, the more you keep, the more likely it is that sensitive information could fall into the wrong hands. By purging old records, you can reduce the risk of superfluous or obsolete records being seen in the wrong light and used against you. But getting rid of records too soon could land you in legal hot water. Federal or state statutes typically dictate record-retention requirements.

Important: While you might not be tasked with personally retaining all of the documents listed below, it doesn’t hurt to know the required retention periods of those documents you may reference.

  • Accommodation requests: one year after record is made.
  • Applications for employment: one year from date of submission.
  • Basic employee information: four years after record is made.
  • Basic payroll information: three years after record is made.
  • Dates Family and Medical Leave Act (FMLA) leave is taken: three years from end of leave.
  • Demotion records: one year from date of action.
  • Form I-9: three years from date of hire or one year after termination, whichever is later.
  • Job advertisements: one year after record is made.
  • Job descriptions: two years after record is made.
  • Job evaluations: two years after record is made.
  • Layoff, reduction-in-force, recall records: one year from time of request.
  • Merit, incentive, seniority system records: two years from the date record is made.
  • OSHA Forms 300, 300A, 301: five years following the end of calendar year records cover.
  • Pre-employment tests: one year from date of test.
  • Promotion records: one year from date of action.
  • Records relating to discrimination charges: until final disposition of charges.
  • References: one year after record is made.
  • Résumés: one year after submission.
  • Termination records: one year after termination.
  • Time cards/sheets: two years after record is made.
  • Transfer records: one year from date of action.

Do you always know which records to keep?

It’s usually up to HR to meet state and federal recordkeeping requirements. But managers need to have good knowledge of the requirements, too, since they are responsible for a great deal of what goes into them.

Source: by the writers of Business Management Daily

5 Simple Tips for Teleworkers Tuesday, Nov 13 2012 

by Lea Green

The distinction between professional and personal lives for teleworkers is tenuous at best. To achieve optimal levels of productivity, creativity and happiness in both realms of work and leisure, we must develop boundaries. Here are five lessons I’ve learned  as a telecommuter:

  1. Empower yourself to power down. When your workplace is also your home, it’s all too easy to forget where one ends and the other begins. If you leave your computer open, you’ll remain a slave to it; eventually, your work will be less creative and less rewarding. “Just one more minute” almost always turns into 30. Choose a specified time each day to power down your computer, put your smartphone on vibrate, and just relax.
  2. Compartmentalize to create and recreate. A healthy balance between professional and leisure time begins with establishing clear boundaries. Compartmentalizing involves making and keeping commitments to yourself by creating a designated space devoted to your work. Remove the piles of laundry and the kids’ homework. Formalize routine by establishing a schedule with specific start and stop times, and transition time in between. When the day’s work is done, activities such as working out, gardening or walking the dog can clear the mind, mitigate tension and prevent burnout. Work is work, play is play — strive to be exceptional at both.
  3. Experiment with your creative cycles. Maintaining a regular routine helps keep you disciplined, but discovering your optimal creative cycle is where the magic begins. Telecommuting liberates you to do both in ways that office environments cannot. Understanding the triggers of creative thoughts can be a challenge; however, periods of deep thinking generally require alternating cycles of rest. Recognizing where one ends and the other begins is key. Try getting up early when everyone is asleep or burning some midnight oil. Periods of work and rest that deviate from the typical 9-to-5 schedule may inspire creative cycles.
  4. Daydream to dream big. Telecommuting provides space and opportunity to daydream, an activity that companies such as Google and Gore-Texencourage among their office-bound employees. Rarely inside your cube or while staring at your computer screen does inspiration appear. Instead, insights occur in those odd moments when you’re puttering in the garden, folding laundry or mowing the yard. Although daydreaming might seem counter-intuitive to productivity, it actually increases creative thought.
  5. Train your mind to focus. Whether it’s our work, our hobbies or our families, wherever we place our attention will grow in our lives. Attention has become fragmented in our device-dominated world. Practices such as meditation or yoga train us to focus the mind, increasing our mental endurance and productivity.

The considerations presented here have helped me establish a healthy balance between my job responsibilities and my need for downtime, though undoubtedly others will be added as my circumstances evolve. Balance isn’t always 50/50, and a successful teleworker always seeks to improve the relationship between professional obligations and goals, personal pursuits and desires.

Lea Green is the social media content manager at PGi and telecommutes regularly. She writes for the PGi blog and is passionate about creative writing, collaborative communications technologies, and improving our planet’s well-being. E-mail Greenor follow her on Twitter @lelainey.

Jocks Make Better Docs Saturday, Nov 10 2012 

by Carole Jackson Bottom Line Health

Want to find out if a doctor is any good?

Sure, you can Google his/her name to find out where he trained or what medical awards he has won…or ask friends and relatives for their opinions.

But what about asking if he excelled at playing a team sport in his younger years?

It may seem like a strange question, but a recent study suggests that it’s not, well, completely out of left field.

Researchers in the department of otolaryngology–head and neck surgery at Washington University School of Medicine in St. Louis found that prior excellence in a team sport was a better predictor of overall performance as a doctor in their residency program than the more standard criteria of medical school grades, standardized test scores and letters of recommendation.

SPORTS TRUMP SCORES

Who would have thought that joining, say, a soccer team would boost medical skills more than cramming for an exam?

For the study, researchers asked faculty members to rate 46 recent graduates of the residency program with regard to their overall quality as clinicians. The faculty members rated the graduates using a five-point scale, with 1 meaning “should not have graduated” and 5 meaning “outstanding—I would choose him/her as my doctor.”

The researchers then reviewed each graduate’s residency application, looking at factors such as medical school grades, standardized test scores and letters of recommendation, which all are standard criteria used to judge an applicant’s likelihood of success in a residency program.

They also sent the graduates a simple questionnaire regarding their pre-residency experience in both athletics and music.

Questions included…

    • Do you have established excellence in a team sport? (The researchers made judgment calls in terms of what was considered a “team sport.” If the individual was on a track team, for example, being on a relay team would count, but throwing a javelin would not. The person had to have worked with others in order to win. )
    • Do you have established excellence in an orchestra, band or choir?

Results: Researchers found that there was no correlation between medical school grades, standardized test scores or letters of recommendation and the faculty assessments of who ended up being a good doctor. However, there was a significant correlation between achievement in a team sport and a graduate’s faculty rating. (There was a slight correlation between achievement in music and faculty ratings, but it wasn’t statistically significant.)

To learn more about the study and its findings, I spoke to lead author Richard A. Chole, MD, PhD.

One limitation to the study worth noting is that the particular residency program that was studied is highly competitive. In other words, all the doctors were extremely bright, so there wasn’t an extremely wide range of grades or test scores. “In a residency program where there’s a greater spectrum of grades and test scores, the correlation may not be as strong,” said Dr. Chole. Nevertheless, the findings point to a very intriguing link.

MEDICINE IS A TEAM SPORT

The study shows that there’s a lot more to being a good doctor than being an “A” student, Dr. Chole told me. “What our findings illustrate is that the best doctors tend to be the ones who are good at participating with their colleagues as part of a team, and playing a team sport is great preparation for that,” he said.

So instead of asking our doctors for their diplomas, perhaps we should be asking them for their high school and college yearbooks, so we can see whether they were on basketball, baseball, football, soccer, lacrosse or other sports teams!

Source: Richard A. Chole, MD, PhD, chairman of the department of otolaryngology-head and neck surgery at Washington University School of Medicine in St. Louis. The study was published in Archives of Otolaryngology-Head & Neck Surgery.

The Distasteful Sandwich Friday, Nov 9 2012 

by Collette Carlson

Have you been taught to “sandwich” constructive criticism be­­tween two positive statements?

Example: “Barb, you are a wonderful communicator, but the last three meetings you’ve dominated the conversation and even interrupted others while speaking. I’d appreciate you being more aware and giving others a chance to contribute. And by the way, your recent report outlining team goals was well-written.”

I think this is a distasteful way of delivering feedback and here’s why:

1.  ”But” is an eraser word. We all have been taught that anything that follows the word “but” negates everything said prior. The positive information gets discounted.

2.  The message doesn’t sound sincere. Since too many of us are familiar with this technique, it screams technique, which lowers trust and believability.

3.  It destroys the truth behind the positive messages. Most of us walk away from the “sandwiched” approach only hearing the critical feedback. We focus on the meat and completely miss the positive messages. It’s better to save the bread for another time to reinforce someone’s talents.

When you’re able to communicate effectively, you’ll see positive results — and sidestep some dangerous pitfalls. Get your copy of Feedback: How to Give It, How to Get It

What to do instead?

  1. Share the specific event, behavior or performance that concerns you.
  2. Explain how this creates a challenge.
  3. Ask for the desired behavior change.
  4. Be supportive and listen.

In the above example you would simply say, “Barb, the past three team meetings I’ve noticed you spoke the majority of the time and interrupted others. Others end up not contributing and we could be losing out on some great input. During our meeting later today, I’d like you to be more aware of your communication style and allow others the floor. I still want your input today. The team needs you and values your contribution. Can I support you in this in any way?”

You may think, “Hey, that was just an open-faced sandwich!” It was a sincere way to help Barb understand that she is valued. And the comment is also specific to the issue at hand.

by the writers of Business Management Daily

 

When to Skip the Specialist Thursday, Nov 8 2012 

by Carole Jackson Bottom Line Health

According to the latest statistics on the topic, there’s a good chance that you’ve been seeing a specialist for primary care problems.

For example, maybe you’ve been seeing your ear, nose and throat physician any time that you get a sore throat.

Or you might be the kind of person who goes to an orthopedist every time your back hurts.

But let me ask you this—is that what’s best for your health?

A new study reports that it probably isn’t.

WE’RE SEEING THE WRONG DOCTORS

Just how often are we Americans seeing specialists for primary care?

The study reports that over 40% of doctor visits for primary care in the US occur in the offices of specialists. These include both preventive exams and appointments that deal with common symptoms and diseases, such as fever, nasal congestion, anemia and asthma. The research found that all kinds of specialists were treating primary care problems, such as ob/gyns, cardiologists, gastroenterologists and nephrologists.

While the study didn’t delve into why patients were taking primary care concerns to specialists, lead researcher Minal S. Kale, MD, said that one reason may be the growing shortage of primary care doctors.

The number of medical students choosing to go into primary care started falling in the late 1990s. Based on a supply-and-demand analysis done by the Association of American Medical Colleges, in 2010, there were 9,000 fewer primary care doctors than were needed nationwide. And the association predicts that this shortage will grow to 65,800 by 2025—assuming that the Patient Protection and Affordable Care Act (aka “Obamacare”) is fully implemented so that formerly uninsured people can begin seeking medical care. The doctor shortage is worst in rural areas, said Dr. Kale.

Another reason patients go to specialists for routine care—patients may believe that specialists are better qualified to treat them. But past research shows that the opposite is actually true.

DOCTORING “THE WHOLE YOU”

Dr. Kale acknowledged that there are certain situations in which it is appropriate to see a specialist. For example, a person in the midst of chemotherapy should certainly see his oncologist, rather than his primary care physician, if he develops a rash…and a person with chronic heart failure should see his cardiologist if he develops chest congestion. But these are symptoms that almost everyone else should discuss with a primary care physician.

“Primary care physicians usually have long-standing relationships with patients, so they tend to have a full understanding of the totality of their medical conditions,” Dr. Kale said. A specialist might look at a patient with a specialist’s eye—in other words, a gastroenterologist may be specifically on the lookout for stomach and intestinal problems if a patient comes in with abdominal pain. He or she might be alert to common causes such as indigestion, constipation, food poisoning, ulcers, gallstones or kidney stones. But a gastroenterologist might not notice that the problem is stemming from another part of the body entirely, such as from a migraine headache or psychological stress. Since primary care doctors deliver preventive health care and treat lots of different conditions on a routine basis, they have more expertise in treating the whole you.

And there’s science that supports Dr. Kale’s point. Other national research from the Primary Care Institute at University of Rochester School of Medicine and Dentistry in New York found that people who used primary care physicians, rather than specialists, as their regular source of health care were more likely to report fewer medical diagnoses and had a lower mortality rate, on average.

SAVE THE SPECIALIST FOR SPECIAL PROBLEMS

So if you’re scheduling your annual, preventive physical or if you’re planning to see a doctor about a common symptom, such as a nagging cough, the message is—call your primary care physician. If you don’t have one, take the time to find one—get suggestions from friends and family members and/or search your insurer’s Web site for in-network doctors. You can always see a specialist later if you need to—but you generally won’t!

Source: Minal Kale, MD, research associate, general internal medicine, The Mount Sinai Hospital, New York City. She is coauthor of a research letter published in Archives of Internal Medicine.