When I first read the October 15 New York Times article "Suit Accuses S.E.C. of Failing to Detect Madoff Scheme" I noticed a welling up of "justice deserved" sentiment coupled with admiration for the victims who had found a novel way to circumvent apparent obstacles to suing regulators for compensation as they attempted to recover losses that may, in part, have been enabled by regulatory incompetence. And then came the pause and unease. Diana Henruiqes' discussion of the SEC's immunity - and its potential limitations as claimed by the plaintiffs - made me think of the protection afforded hospital QI and peer review processes. And its potential vulnerability under similar circumstances.

For the first time in a while I spent fully half the weekend NOT working at anything but my embarrassing golf game and some online sleuthing into what I am convinced is a foolish "can't lose" medical device investment that a friend is trying to get me to participate in (before the greedy people grab the opportunity). So when I finally picked up Friday's (August 14) Wall Street Journal print edition on Saturday night and was immediately drawn to the front page feature: Flying Low Is Flying High As Demand for Crop-Dusters Soars, I wasn't sure what instinct was drawing me to relate it to the experience of health care leaders. Well the 24 online comments as of this writing, all by and about the "ag pilots" celebrated in this article, revealed no health care gadflies leaping to make the connection. So here goes...

Nobody likes bad reviews. Especially health care delivery or service organizations. Because bad press means customers (patients, referring physicians, etc.) will think we are unsafe or unfriendly. And it will surely lead to lawsuits, regulatory intervention, loss of competitive positioning, etc. Especially if it's online. Well maybe there's another side to this story - at least if you believe the lessons of The Upside Of Bad Online Customer Reviews which appeared on Forbes.com August 4, 2009. This short piece by Mirela Iverac, a frequent Forbes contributor, is a provocative read for those health care leaders who might be willing to consider the other side of conventional wisdom on this point...

In a July 27 feature, Business Week, published a profile of Honda's new CEO, Takanobu Ito. The spin in Honda's New CEO Is Also Chief Innovator by Reena Jana and Ian Rowley is an examination of the value and wisdom of appointing an "in the trenches" engineer (Ito is also Honda's Director of Research and Development) to the chief executive post, thereby combining the company's leadership accountability for innovation and business success. It struck me that health care organizations face similar questions when considering whether or not to place clinicians in top executive management positions. So read the article and think about the issues it raises...

The July-August issue of Harvard Business Review is far from light holiday reading. Through a wide range of lenses, it aims squarely at business strategy and leadership challenges to be faced in the post-2009 recession world. Leadership in a (Permanent) Crisis by Ronald Heifetz and his colleagues at Cambridge Leadership Associates, reflecting the volume as a whole, is all about national and global post recession trends in the broader business environment that will shape industries over the next several years. As physician and health care leaders we owe it to ourselves, our patients, and our organizations to examine how these will impact us...

Bill Buxton, author and Principal Scientist at Microsoft Research, provided us with Innovation Calls For I-Shaped People - the Insight opinion column in BusinessWeek online on July 13, 2009. Taking yet another stab at identifying the elusive idealized leadership or design team member, this concept is a counterpoint to the "T Shaped" collaborator prototype attributed by Buxton to Bill Moggridge of the design consultancy, IDEO. Since health care leaders are in the business of empanelling high functioning teams and hiring talent to work innovatively and collaboratively, we must pause to think about each prototype that comes along - especially when its from such a worthy source...

The July 8, 2009 Wall Street Journal noted the passing of Robert S. McNamara (former Ford CEO, Secretary of Defense, and President of the World Bank) with From McNamara to Obama an opinion piece by Bret Stephens who comments on the dangers of too much rationalism - or more aptly - on the dangers of hubris. Not an insignificant pitfall for health care leaders to consider...

In health care, possibly more than other industries, we consider ourselves so expert that innovation is generally expected to come from within - and deep within at that. Can We Innovate Ourselves Out of Recession published July 1, 2009 in the Knowledge@Wharton column on Forbes. Com examines a different approach taken by industry. It describes the effective use of external innovation networks to generate solutions to technical problems in the non health care world. It occurred to me that health care leaders might want to consider how to harness fresh ideas from smart people outside our somewhat insular industry...

A few months ago, this blog commented on a short piece about the use of ethnography as a strategic tool (Try Ethnography for Health Care Strategy). The source article had been a short, theoretical, and perhaps even whimsical exploration of the use of anthropologists in developing business strategy. Well, along comes Business Week on June 24 with "How to Kick off an Innovation Project" by Jessie Scanlon which gets practical really fast in describing how Office Max used ethnography to do an image turnaround - complete with a "how to" guide. It struck me then, and now, that there are valuable pearls for health care leaders here...

I was reading two issues of the Harvard Business Review simultaneously (a hazard of being overly busy), so I rapidly became aware of complementary articles that appeared in successive months addressing the related issues of candor (What's Needed Next: A Culture of Candor by James O'Toole and Warren Bennis a full article in the June HBR) and transparency (Heed the Calls for Transparency by Sam Wilkin in the Forethought section of the July-August issue). The latter was just received by subscribers so the online link is not yet available so if you don't subscribe watch the HBR web site in the coming week for it. Both are essential business reading for health care leaders...