My day begins at 5:20 a.m. when my alarm annoys me enough that I finally force my eyes open. After laying in the darkness of the early morning for several minutes, going back and forth with myself about whether I really want to do this, I slide out of bed. It's the same routine every morning, the same arguments with my irresponsible id (think Freud), and ultimately the same result. I leave the house around 6:00, stop for coffee, make the 30-minute drive to the office while listening to Josh Bell's "Romancing the Violin." What can I say? I'm a man of habit. I arrive at the office around 6:40 a.m., get settled in, and begin my day with some introspection. I usually read a chapter from the Bible to center myself internally and a chapter from a leadership book to center myself externally. I have a day of meetings, reports, conversations, and projects ahead of me. I need to start the day on the right foot.

The first thing I do each morning is get a handle on where we are before beginning the day. What does our patient census look like? What do the scheduling queues look like? I check various dashboards to see how we are doing month-to-date regarding financials, productivity, and quality. I then review emails I flagged from the previous day and new messages I received overnight and begin making a to-do list. Then, next to that list I write out my schedule for the day with every meeting noted. These two lists guide me throughout the day; they are my road map. I find that starting with a view of what's ahead keeps me grounded and purposeful.

At 8 a.m. the meetings begin. Every morning starts with a team huddle run by one of our supervisors. Following that we may have case conference or another meeting I'm either hosting or have been invited to participate in. Most of these meetings are virtual and, I'll be honest, I struggle with that. I rely heavily on my ability to read people. Body language, facial expressions, "energy." I've always had a knack for reading nonverbal cues. Virtual meetings make that extremely difficult, and I find myself resenting this new form of interaction and the "convenience" it brings. But I do realize the importance of my presence. Every participant brings a unique point-of-view to an issue; we each have thoughts and ideas and opinions that matter. And it's only in the collaboration of two or more that a challenge or opportunity can be seen from various angles, dissected, and analyzed, and a solution found.

Meetings vary from one-on-ones to small group problem-solving, to large-scale information dumps. We tackle issues brought to us by staff, patient challenges, scheduling barriers, productivity barriers, budgetary reviews and planning, and current projects we're engaged in. I enjoy these meetings (mostly) because it gives us the opportunity to see a team in action. Different personalities blend and sometimes clash. Varying ideas born from varying experiences meet and sometimes get along and sometimes . . . not so much. Different passions and focuses intermingle and create a beautiful map of possible paths forward. These meetings embody what teams are about: a collection of unique individuals finding a way to work together, to complement each other, to not step too heavily on another's toes, to set aside personal agendas, and do what is best and right for the organization, for the staff, and ultimately, for patients.

I'm currently leading two large-scale projects. One, to standardize our patient experience across our agency so patients get the very best experience during every contact. And two, to dissect and rebuild our scheduling module to make it clinician- and patient-centric. These are usually weekly meetings with work done on the days between meetings. Thankfully my day isn't all meetings. There are usually multiple conversations with each of the supervisors on my team. Check-ins, problem-solving, updates, strategic planning, you name it. I enjoy these conversations. They are usually in-person and are bright spots sprinkled throughout my day. They help keep my finger on the pulse of the field staff.

I also take time each day to recognize staff who have gone that extra mile for a patient or colleague. It's important to make that point of contact and let people know they are appreciated and that the work they do is meaningful and worthwhile and doesn't go unnoticed. I keep a spreadsheet to track who I have recognized and try to hit all 60 staff members at least once a month. This keeps me intentional about recognition and motivates me to look for the good and find something about everyone that I can celebrate.

In addition to touching base with supervisors and staff, I touch base with patients in the form of leader-patient rounding calls. These calls are more conversation and less survey. They are friendly check-ins to see how everything is going, how they are being treated, if they are satisfied with the care they are receiving, and to probe them for any barriers they've faced and suggestions for improvement they may want to offer. These calls are special because they allow me to interact with patients or a family member and hear of the wonderful care our clinicians are delivering. And on rare occasions they allow me to listen to a patient's concerns or complaints and engage them in finding a solution. I have found that these rounding calls are invaluable.

A typical day often takes me through a range of emotions. From elation and joy to frustration and disappointment. Sometimes discouragement. But sometimes the utter thrill of success. I wouldn't trade it, though. At the end of the day (well, most days), I am satisfied that I did all I could to make an impact on the lives of others. And that's why I do this. That's why I pour myself out every day and scoop up whatever is left to head home with. I want to make a difference.

I head home around 4:30 and listen to a local classic rock radio station to decompress. I'm still dumbfounded that what is now considered "classic" rock is the music I grew up with. Of course, "classic" is preferable to "oldies." I arrive home around 5 and jump right into family life. We have five daughters and a grandson living with us (in addition to a very energetic border collie) so the house is bustling when I walk through the door. I don't talk much about my workday. I prefer to take that hat off at the door and put on my husband and dad hats. I must say, as much as I enjoy the former, the latter sit a little more comfortably on my head.

Daily multivitamin may improve cognition in older adults

NIH: Alzheimer's disease and related dementias affect more than 46 million people worldwide. Deficiencies in vitamins and minerals may increase the risk for cognitive decline and dementia. A total of 2,200 participants, ages 65 and older, who enrolled in the study were given a cocoa extract supplement and/or a multivitamin-mineral supplement daily for 3 years, or a placebo for comparison. They completed cognitive tests at the beginning of the study and once a year afterward. The team found no difference in global cognition between those who took cocoa extract and those who did not, but those taking the multivitamin had higher global cognition scores than those who didn't. The improvement was most pronounced in those with a history of cardiovascular disease. Significant improvements with daily multivitamin use were also seen in memory and executive function. Cocoa extract had no effect on either.