A Matter of Disagreement

Yesterday, I attended two educational sessions at the Governance Institute's annual meeting for CEOs and Board Members.  For the most part, the sessions were extremely informative.  However, there was a major point of disagreement based on the information shared in one of the sessions.  

One of the presenters said that the health care reform initiatives will not take hold in the US until 2025.  He feels that way based of the following: the overall learning curve is too steep for all stakeholders; there is a lot depending on the successful implementation of clinical information systems; the newly implemented insurance exchanges will take much longer to come on line due to their many current challenges; the amount of primary care restructuring that is necessary; the influx of millions of new patients; the lack of funding for the transition and less willingness on the part of patients to pay out of pocket for their care.  

Really?  I will say that it takes a lot to change how hospitals do business in shifting from volume to value since we lived it.  The presenter's points are well taken, but twelve years to make the change?  The majority within WMHS has gotten it and I recognize such change did take several years.  It does take a great deal to change, especially in the community outside of the hospital, as we move away from the traditional health care model.  But, again, twelve years is a quite a long time especially, since we don't have that kind of time with the cost of health care at $2.7 trillion dollars on an annual basis and increasing each year.

You Have Got to be Kidding Me

I just received my latest issue of Harvard Business Review (HBR).  I have found HBR to be interesting and informative over the years.  Do I understand every article in each issue?  Heck no!  Sometimes the articles are very good, sometimes I say "what was it that I just read" and sometimes I say "you have got to be kidding me," as is the case with today's blog.  

As I looked at the table of contents, my eye caught an article entitled, "Delivering World-Class Health Care, Affordably."  I thought, wow, how appropriate for me to read, especially with what is going on with US health care.  I went to page 117 and low and behold, there is a photo of a health clinic in Mysore, India.  In the photo, there is a male nurse or aide preparing a bed for a patient in, from what I could see in the photo, one room where there were around 17 beds.  The entire photo depicts a scene from what would be comparable to a US hospital in the 1930's or 40's. The sub-title for the article was, "Innovative hospitals in India are pointing the way." When I read further, the article described innovations in the delivery of care and quality in hospitals in India, comparing their results favorably to US benchmarks.  The article suggests that US hospitals could learn a great deal from India in their delivery of care model and that we should be applying their low-cost innovations.  

What the article seems to lose sight of or gloss over is that in the US we have 122,000 federal regulations that we are responsible for as we care for our patients and is data that is being captured truly comparing apples to apples.  We don't even capture data in the US in a standardized manner.  For example, infant mortality is defined differently from state to state.  In addition, our salaries for staff and physicians are not comparable to India; we have medical liability issues where they have none; and we have considerable investments in our infrastructure, as is so well contrasted in the photo of the clinic in Mysore, India.  

As the physicians in India look to the West for advances in medicine, I will stick with the innovations that we are now introducing through health care reform and let those in India concentrate on keeping the cost of care low so they can meet the basic health care needs of its many citizens.  Currently, their ability to meet those needs is described as abysmal. 

Under Armour Challenge

Last week, my nephew participated in the Under Armour Challenge, where over 4000 participants submitted products and / or technology to be considered for development by Under Armour.  My nephew, Chris Forgey, is an entrepreneur as well as a VP for an IT company.  He invented an embedded lighting technology for snow boards, skate boards, long boards and helmets.  His company is called Lightbohrd and it is getting a lot of attention of snow board manufacturers.  

During the summer, he shopped the idea of lighted technology to Under Armour to be added to their products.  Right now, their running gear, shoes and backpacks have reflective material, as do all other similar manufacturers.  Under Armour encouraged him to submitted his technology as part of the Under Armour Challenge, so he was one of the 4000.  He was invited to Baltimore to make a presentation in September and was then invited to return as one of 12 with products to be considered by their employees at a company fair.  Chris' technology was selected by the employees at the fair and the next day he was one of six invited to present to Kevin Plank the CEO of Under Armour.  Last Friday, he won the Challenge for his lighted technology that can be embedded in fabric with thread like wire; it can be washed and is rechargeable by placing it on a pad.  Kevin Plank said that he has been looking for that technology for some time and has been unable to develop it.  Chris won $25,000 from Under Armour and will now be negotiating with them on use of his technology.

Entreprenurship is a whole new world for me and I am thrilled to be an original investor in Lightbohrd.  Congratulations, Chris!

http://usatoday30.usatoday.com/video/under-armour-picks-winning-products/2743374259001

The Need to Change

This AM in USA Today, I read a great Q&A with the CEO of Redfin, a real estate brokerage firm.  Glenn Kelman talks about almost being fired thirteen years ago and how that changed his professional life.  In the Q&A, he talks about being told that he was fired by the CEO and how he reacted; most importantly, what he did as a result.  He said that he cried, begged for mercy and promised to change.  He was saved and said that if he weren’t saved that would have been a very negative point in his career and would have consumed him.  Instead, he did change and to this day constantly thinks about how he can change to be better at what he does.  He said that you have to police yourself.  He said that we all know what our fatal flaw is; that one thing that we can do better.  We need to focus on change as a work in progress.  

He also commented on firing from the CEO perspective.  He said that no one should be surprised that they are being fired.  He said talk to the individual.  Let them know what's wrong and if they are willing to change, give them a shot.  Give them a direct account of what they need to do better.  All in all, very useful advice from both the employee’s perspective as well as the manager's (in this case the CEO's) perspective.

No Time to Do a Blog Today

Because I had a whirlwind trip to State College PA for a concert with Boz Scaggs and Rod Stewart (see photos), there will not be a blog for today.  I left for the concert late yesterday and got back to this office late morning, and I have been busy catching up and in meetings all day.  

By the way, it was a great concert, Boz Scaggs opened with songs from his new album, Memphis, very bluesy, as well as old favorites like JoJo, Lido Shuffle and Lowdown.  At least one daughter had no idea who Boz Scaggs was.  Rod Stewart was great.  What an entertainer.  It was great having floor seats for the concert and State College is a great venue.

The Health Care Recession

This morning, there were a series of articles related to the thousand of jobs being eliminated within the health care field.  For decades, hospitals have been a very reliable source for employment; however of late, hospitals are now in a recession.  Wow!  Across the US, the economic picture is improving dramatically, but not in hospitals.  In reporting job loss for September, hospitals led all industries with over 8000 jobs lost; year to date, the number exceeds 40,000.  Large academic medical centers seem to be the hardest hit.  For example, UMMS took action across their system in August and September, Cleveland Clinic is now offering a buyout to over 3000 employees and Vanderbilt University Medical Center is eliminating 1000 positions.  Some are saying that the cuts are short term due to the expected expansion of coverage under the Affordable Care Act to 30 million Americans, but if there isn't any money to pay for those positions, they won't be returning.  At WMHS, we eliminated 88 positions last year as a cost savings measure and have made every effort to not fill those positions going forward.  We constantly assess every vacancy when it occurs and if we can work effectively without that position going forward, then we don't fill the position.  Every hospital across the US has to be focused on reducing their labor and supply costs, two areas that consume most every hospital's operating budget.  This is a very different time in health care as the changes are coming very fast and furious.  

Come Together

This morning I was in NYC and stopped by Starbucks--not to get a cafe latte since I don't drink coffee--but to sign the petition to our leaders in Washington DC.  The petition is allowing us to have our voices heard in Washington, especially since my last few letters related to health care issues have gone unanswered by my congressional representatives.  Through the petition, we are asking our "leaders" to come together to reopen our government to serve the people; pay our debts on time to avoid another financial crisis and pass a bipartisan, long-term budget deal by the end of the year.  I am applauding the actions of Howard Schultz, Starbucks CEO, who is giving us an opportunity to complain about the shutdown since there is no other means at this point.  If you would like to follow the progress of Starbucks in this initiative, text JOIN to 20757.