In: Gleaned Ideas

Jack Covert and Todd Sattersten of and authors of the new book The 100 Best Business Books of All Time (it’s a go to guide on key ideas from each “best” book) gleaned ten ideas from their recent work and used the forum at Fortune’s Postcards blog to share. My two favorites especially related to health care:

Any industry is ripe for reinvention. Billy Beane turned Major League Baseball upside down by using unusual metrics to evaluate talent when his team couldn’t compete with money. Michael Lewis’ Moneyball (2003) proves that all businesses are in danger of disruption. So you might as well do some of your own reinventing.

Be unreasonable. The cliché is that change is the only thing predictable in an unpredictable world. Charles Handy would disagree with this. He says that we’re living in The Age of Unreason (1990). Change is unpredictable. The best way to combat change? Become a changeling yourself.

Not only is baseball being turned upside down, but the NBA tooSo is bankingSo is health care.

Be unreasonable.  It rolls off the tongue and flies in the face of kumbaya. What great sentiment; don’t get comfortable, get moving.

Learning to manage people

I’m closing in on six (+) years (the + is for my victory lap at the undergrad level) of business-related education and I’ve yet to take a class explicitly intended to teach me how to manage people.  Now, there might be some sort of academic theory against teaching someone how to manage people but I studied organizational management for four + years and now, upon reflection, wonder why I’ve never taken such a class.

Maybe it’s not sexy enough.  But organizations expect us to know how to manage when we get there (kind of like personal money management, but we’ve seen what that assumption has done to many Americans’ finances).  Yet the common reality is that people (many? most?) quit their jobs because of their managers (not hard evidence, but it will do here).

All that to get to this: Aaron Swartz’s Raw Thought has a post on Non-Hierarchical Management—a very appropriate primer on management basics for anyone new to the responsibility (or, for that matter, anyone who isn’t any good at it).  Lots of good thoughts, especially this one (a smart person once told me that his job was to clear obstacles for physicians, he described his job as a problem solver, good stuff):

Point 5: Clear obstacles.

This is the bulk of what non-hierarchical management is about. You’ve got good people, they’ve got good responsibilities. Now it’s your job to do everything in your power to help them get them done.

A good way to start is just by asking people what they need. Is their office too noisy? Did they get confused about something you said? Are they stuck on a particular problem? Are they overwhelmed with work? It’s your job to help them out: get them a quieter office, clarify things, find them advice or answers, shift some stuff off their plate. They shouldn’t be wasting time with things that annoy them; that’s your job.

But you have to be proactive as well. People tend to suffer quietly, both because they don’t want to come whining to you and just because when you’re stuck in a rut all your attention is focused on the rut. A key part of being a manager is checking in with people, pointing out that they’re stuck in a rut, and gently helping them out.

Some think non-hierarchical management (NHM) is hooey.  I think health care is in desperate need of letting more people make more decisions especially at the patient care level (as front line as it gets) and NHM is a start.

Anyway, good luck in that new management role.

ADDITION: An acquaintance made an in-person comment today that “management is common sense.”  I’d amend: management is composed of common sense principles.  The problem is that “common sense” is defined differently by different people.  And not everyone is lucky enough to have “it.”

Health care’s problems encapsulated

The St. Louis Post-Dispatch reports on several health care meets the internet stories, the first about a cardiology group where “cardiology patients can hop online to request prescription refills, check portions of their medical records or send questions about their conditions.”

Great, but get this:

Within a few years, the interventional cardiologist expects to be trading e-mails with patients and possibly holding real-time Web chats.

Within a few years?  Four words (“within a few years”) sum up health care’s issues.  The pace of change in health care is infuriating (speaking of years)…

On the positive side, much of the article is about American Well—especially their deal in Hawaii; also included is apt skepticism provided by old grumps.

An internet infusion at Mercy Medical Group provides a bit of traditional health care delivery hope:

The patients will be able see lab results, get information about X-rays and schedule appointments through an interactive calendar.

Patients can take a picture of a suspicious rash and send the image in an e-mail. Doctors can respond to an e-mail question about high cholesterol with links to health-related websites.

Surliness ceased…for now.

The first of many…

With traditional revenue sources tightening hospitals are looking for new markets.  Example given (somewhat under the radar):

The Cleveland health-care giant today announced a new partnership with MinuteClinic, which runs walk-in medical practices inside CVS Pharmacy stores.

Under the multiyear deal, the Cleveland Clinic will provide medical supervision for MinuteClinic’s nine Northeast Ohio locations, including a site that recently opened in the FirstMerit Tower building on South Main Street in Akron. (Akron Beacon Journal)

Some hospitals have tried retail clinics of their own lending credibility to the value proposition (if hospitals are doing it, it must be worth the risk, right?).  This partnership gives MinuteClinic local brand strength, it gives the Cleveland Clinic a new market, and it gives patients access to convenient health care.

Win/win/win in my book.  Except that the model has shown not to lower costs.  Can’t win ’em all.

In: Hospital Description

A completely unfiltered, no holds barred description of hospitals from Aaron Swartz’s blog (it was published waaaaaay back in 2006):

Were the large sign reading “Hospital” to go missing, one might easily mistake the facility as one for torture: men whose clothes have been replaced by dreary gowns slowly wander the halls in dreary stupor, their battered faces making them appear as if they have been badly beaten. They are not permitted to escape.

Brutal, yes.  Worth the read, yes.

Consequence of economic downturn: the growth of local

One economic downturn reality beginning to reveal itself: an emphasis on local.

Peggy Noonan in Friday’s Wall Street Journal:

Dynamism has been leached from our system for now, but not from the human brain or heart. Just as our political regeneration will happen locally, in counties and states that learn how to control themselves and demonstrate how to govern effectively in a time of limits, so will our economic regeneration. That will begin in someone’s garage, somebody’s kitchen, as it did in the case of Messrs. Jobs and Wozniak. The comeback will be from the ground up and will start with innovation. No one trusts big anymore. In the future everything will be local. That’s where the magic will be. And no amount of pessimism will stop it once it starts.

There’s a trust composed of transparity at the local level.  A comfort level that can’t be found elsewhere.  Relationships are more familiar.  Business goings on clearer.  At at time when comfort is at a premium, local just feels better.

Implications for health care delivery are yet to be discovered (there is one nationally integrated system, but some are close, which very well could be positive).  Concerns could also arise, possibly regarding national expansion plans or organizational motivations.  We’ve yet to discover how big is too big in health care delivery (except for maybe this place).

An emphasis on local could certainly be a welcome development.  Shop local campaigns are blossomingGrowing food locally is rising in popularity, eating local too.  Health care has almost always been delivered locally; maybe it needs to stay that way.  Who better to understand the health care challenges of a community than local delivery organizations?