Try your best to tamp down your instinctive fear of change.
EDITOR’S NOTE: Elizabeth Lamkin is the former CEO/Market President for Tenet Healthcare’s Hilton Head Regional Healthcare. She holds an undergraduate degree in Business Administration, Cum Laude and a Master’s in Healthcare Administration from the University of South Carolina.
This article is strictly my opinion, seen through the lens of my experience. You may have differing opinions based on the lens of your experience.
One often hears the quote, attributed to Benjamin Franklin, “nothing is certain except death and taxes”. Supposedly, Franklin said this is reference to the newly minted US constitution’s permanency. Perhaps if we asked Mr. Franklin what a global certainty might be, he may have referenced Greek philosopher Heraclitus who said, “the only constant in life is change.” For Americans we will go with death, taxes and change as certainties.
Intellectually, we know change is constant but somehow that doesn’t stop us from having strong reactions to change. If you are like me, you love change, you hate change, you create change, you fight change, and you complain about change, but finally must accept change.
As I think back over my long career there were constant changes big and small. These changes were both in and out of my control. Only now looking in the rear-view mirror, do I clearly the importance and impact of the changes. What I might have initially I viewed as a small change might have been the tip of a big change.
Let’s use my experience with the pant suit as an example. It was the eighties, and I was in an executive hospital role. All of us “gals” wore skirts or dresses. Of course, there were not many of us gals (two to be exact) because mostly the execs were men. I don’t remember ever being told skirts were the dress code at this organization, it was just how it was done.
Well, enter fashion week and the introduction of the professional women’s pant suits. It was a throwback to the 1920’s women’s pant suit craze. I saw one, I had to have one! The female version of the male executive uniform, what could be better? For those of you wondering, it was a snazzy pinstripe suit with wide leg pants.
The first opportunity to wear the pant suite presented itself for new employee orientation. We were a very enlightened and caring organization. Every executive from the president down was in attendance to personally welcome each new employee to the hospital.
The group of new employees, their hiring managers, human resources, and the execs including my own executive boss were having a wonderful informal pre-orientation mixer. And then it happened, the pantsuit came in the door. I cannot say for sure, but I thought I saw my boss’s head turn a complete 360 degrees. I wondered how he managed that! Then, he was apparently taken mute and his eyes were open and fixed, did he have a stroke? Let me be clear, I liked my boss very much and did not want to see him ill. What has possessed him?
During orientation he had time to recover so was able to speak once again. He immediately asked me, “what are you wearing?” It may have been other similar words, but it was too long ago to retain the actual conversation. The thing I retained was this change in my “uniform” was rather shocking to my male colleagues. My lateral male colleagues congratulated me on being brave but stood at a distance. Luckily this had no impact on my career, and I can happily report I view this part of my career as one the best.
What I failed to recognize concurrently was, this was an outward demonstration the women’s movement was under way, represented by a pant suit. Over the next few years both clothes and salaries were outward markers of societal change for women.
I do not have the space in this article to give you the story of the organization I was with in the 1990’s that required women to wear dresses to evening events, but as we know change can be slow.
As we talk about this today, it seems funny, what was the fuss about? Well, it is now clear to me now the reaction I got to the pantsuit was one of fear. Fear of change.
If only we could be more philosophical about change when it is happening to us. As we look around in 2022, change has been a constant stressor and has been accelerated due to adaptations to a pandemic. We are wearing more casual clothes, working from home, becoming tech savvy for virtual meetings.
Along with the accelerated change, there is much bemoaning of Gen Z and millennials with their tattoos and obsession with free time. When did sweatpants become work wear? Who will do the work? What will happen to us?
I will hazard a guess that all will be well and in 20 years the world molded by Gen Z and millennials will be different but as good. Everyone will have tattoos in full sight with our video camera lights giving them their best angles. The angst and handwringing based on fear of the change will seem just as funny as my pantsuit when reviewed in retrospect.
My advice is to think back over the changes in your life and maybe the over reactions. Try your best to tamp down your instinctive fear of change. You will not be fully successful, but you will be happier.
What details should the operative report include when billing code 31624? What requirements exist for bronchial alveolar lavage to be coded?
Under what conditions do we report new 2026 code 87494?
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
