February 2009 Archives

Gen X Takes Over, the January 13, 2009 article by Tammy Erikson on BusinessWeek.com (actually a prequel of her longer case study in February's Harvard Business Review) nominally comments on the Gen-X (Obama post Bush and Clinton) takeover. But it's mostly about the emerging generational inversion in the business world - which includes the world of health care leaders...
Health Care Leadership in a Recession Series

The Risk of Cultural (Not Economic) Risk Assessment By Leaders

The Key To Risk: It's All About Emotion, published on Forbes.com on February 23, examines the noneconomic factors that contribute to success or failure of organizations in times of stress or hardship. Health care leaders take notice! The author, Kevin Kelly, focuses on the often counterintuitive, culturally influenced decisions made by senior leaders and key staff under harsh environmental conditions which may have long lasting impact on companies and people. "We like to think we assess [risk] rationally, but we too often forget that we are emotional creatures first and foremost"...
A Scion Drives Toyota Back to Basics, in the Management section of yesterday's Wall Street Journal chronicles the factors that earlier this year led to the appointment of Akio Toyoda, grandson of the company's founder, as Toyota's next President. What's provocative about this, other than the potential intrigue of nepotism which always draws reader interest, is the "back to basics" subtheme which may bear examination for health care leaders as well...
Why Good Leaders Make Bad Decisions is a reminder of the unintended biases (health care) leaders may face in setting operational and strategic direction for complex organizations. In this article from the February, 2009 Harvard Business Review the authors, remind us how easily (and why) our brains can "...leap to conclusions and are reluctant to consider alternatives..." resulting in flawed decisions. In the complext decision making required of health care leaders, there's not much room for this...
Learning From Heroes, a short essay in the March, 2009 issue of the Harvard Business Review may explain why some of us have become less enamored with "how to" business books. Jack Covert and Todd Sattersten, principals of 800-CEO-Read, point out that there are five recurring challenges in business and life - which also apply to health care leaders ...
Health Care Leadership in a Recession Series

Strategy for a Layoff Strategy

On February 12, 2009 Klaus Kneale , the "layoff tracker" for Forbes.com authored You're Probably Doing Your Layoffs All Wrong,- a short but important opinion piece given the current economy - which will impact health care leaders sooner or later....
If you're a physician leader, it's well worth reading Stop Overdoing Your Strengths, by Robert E. Kaplan and Robert B. Kaiser, which appeared in the February 2009 issue of Harvard Business Review. It may give you some pause. In this iconoclastic piece, Kaplan and Kaiser make a good case for eschewing the conventional wisdom of "playing to your strengths" in order to offset your weaknesses as a leader...
Julia Angwin, a Wall Street Journal reporter wanted more flattering links at the top of the list when her name was Googled. She wrote It's a New Me (As Seen on Google) earlier this month about "search engine optimization" (SEO) and her discoveries of what it entailed. As health care leaders move their organizations to be more wired, this is not an insignificant issue.....
The Wall Street Journal of Friday, February 13 described President Obama's balancing act when engaging the Congress and the American public about the current economic crisis. In After Curbing Enthusiasm, Obama Must Ease Anxiety writer and commentator Gerald F. Seib describes the delicate leadership dance between the Scylla of raising expectations and the Charybdis of lowering them. Not unlike what health care leaders must do when launching new initiatives in tough or cynical environments...
David Sutton's Forbes.com interview with David Smith, CEO of the medical supply distributor, PSS World Medical, in How My Company Beats The Bigger Guys is all about how to run any successful business - the interview therefore covers all the important aspects of leading a successful health care delivery organization. In the equivalent of half a typed page. It's all anyone has to read...
Thomas Kuczmarski (perhaps tongue in cheek) suggests that President Obama create a new cabinet level position to introduce clearer thinking and creative solutions to heal the stagnant economy. In his February 11, 2009 Business Week article Obama Needs a Secretary of Innovation, Kuczmarski notes that real innovation takes work across traditional boundaries - something even less likely to happen when substantial attention is being paid to surviving within one's own boundaries. So to think about innovation, one needs to be able to think outside of one's own backyard box. We have a candidate for this position-from among our own health care leaders.....!
Health Care Leadership in a Recession Series

Concerned About Image In Lean Times?

Writing in the Business section of yesterday's New York Times (February 9, 2009) Leslie Wayne and Stephanie Clifford painted a not very pretty picture of the impact of scaled back corporate business events on the economy at large. Business Trip, or Just a Junket? It Matters Lately examines the snowballing economic effect of cancelled corporate events on the travel, lodging, and food industries that depend on that business. Not to mention the "internal" messages it sends - which are also of major concern to health care leaders...
The February 9, 2009 Wall Street Journal carried an opinion piece Time to Reinvent the Web (and Save Wall Street) written by L. Gordon Crovitz, a former publisher of the Journal and a well known advocate of digital technology. Mr. Crovitz discusses the importance of continuing digital innovation, despite a recessionary economy.
What Kind of Collaboration is Right for You?, which appeared in the December 2008 issue of the Harvard Business Review, explores the use of collaboration networks to achieve innovation. The authors codify models for external collaborations as they have been used to develop products and services in the high tech, pharma, and consumer products industries and propose a framework that can be useful for evaluating and selecting modes of external collaboration based on organizational requirements and market strategy. Their 2x2 matrix for classifying collaborations can be useful for health care and physician leaders....
In today's Wall Street Journal, Harvey Silvergate takes on the SEC on the thorny issue of privacy regarding the health of Apple Corporation's Steve Jobs. The SEC Should Leave Steve Jobs Alone explores whether the right of investors to know and evaluate "material" information about company management trumps SJ's right to protect and manage his own heath information. Silvergate asks us to ponder whether withholding detailed information about a corporate principal's health constitutes a prosecutable fraud? What about the health of health care leaders?....
What serves clinicians well may serve leaders poorly - particularly in lean times such as we currently face. In her December 2008 Harvard Business Review article, Give Me the Ball!" Is the Wrong Call McKinsey Award-winning author Tamara J. Erickson counsels leaders to resist their instinct to carry all the water for their organizations in times of economic crisis...

Trust Economies: Investigation into the New ROI of the Web, Julien Smith and Chris Brogan's Manifesto on Trust Economies undertakes a simultaneous debunking of traditional marketing and an urgent call for marketing through "trust economy communities". I don't find this so farfetched for the coming era of healthcare delivery to the baby boom generation.

These two modern marketers and social-media commentators have undertaken the manifesto as a means to advance marketing by businesses of all sizes whether web-based or bricks and mortar. Healthcare can fairly be described as trailing-edge in its adoption of web and internet related modalities in marketing; while notable exceptions exist--Paul Levy, the CEO of Boston's Beth Israel Deaconess Medical Center (BIDMC) who regularly posts to his blog and engages a diverse array of commentators there and on Twitter. Levy's blog and Twitter presence constitute "social-media" which effectively market BIDMC directly through the relationships Levy forges and through the coverage others, including this author in this post, contribute.

That's the new paradigm at the core of modern marketing and certainly at the core of the Health 2.0 movement of engaging the consumer-patient in their own care. Smith and Brogan point out that experienced web users quickly learn who's there to market and sell and who's there to build trust economy relationships through conversations. Yes, there's a job to do, but blunt marketing and sales efforts fail while "hand-to-hand" relationship building succeeds.

Smith and Brogan point out that in an era where all seem starved for time, "Attention is scarce--more valuable than cash and rarer than gold. When you get some, embrace it and find out how to get more." Practitioners can't afford to do that with reimbursement structured as it is--not for this post--yet it's this very lack of attention and embrace that may be accelerating the breakdown in trust between consumer-patient and practitioner; illustrating the supreme irony of primary care clinical practice today--the patient's hunger for the clinician's time, really attention.

We all want that connection to those we want to trust--the clinicians who care for us. Smith and Brogan point to our friends in the trust economy as there to help us value the network of relationships--taking the healthcare focus--sources of information and advice on clinician selection, perhaps even course of treatment. We healthcare providers must find the friends, even the lovers of our service and "equip them to evangelize" creating a volunteer army in support of our healthcare service or provider.

At first these concepts sound like hype in the conservative world of hospital medicine and physician practice, yet this past week's email from HealthLeaders touting The Complete Guide to Hospital Marketing and offered a sample chapter which discussed relationships with the medical staff and ". . . managing customer relationships in ways that benefit the organization." Not a word of the network of relationships with consumer-patients. The wave of baby boomers won't be satisfied with that; I sure won't be satisfied with that. Will you?

In Finding Anchors in the Storm: Mentors (Wall Street Journal, January 27, 2009) Toddi Gutner advises young workers to identify and use mentors to provide practical, operational, career guidance as they navigate the corporate world and the recession. "About 70% of Fortune 500 companies offer mentoring programs... At International Business Machines, for example, every employee is assigned a 'connection coach' before their first day; after they join, workers are assigned a formal mentor." Why would IBM do dedicate this much human resource to young people? As a profit making entity it must view mentoring as a strategic investment in its human capital.

Do hospitals, academic medical centers, and medical group practices routinely assign mentors to 70% of trainees, young staff physicians, junior scientists and faculty? Do we strategically invest in longitudinally committed coaches and mentors who have the experience to guide promising but raw talent through the arcane channels of career development and accelerate their progress? Or do we instead rely on Darwinian survival that anticipates the fittest among these talented young people will effectively manage challenging professional relationships, navigate arcane academic and scientific politics, and grow careers that result in substantial clinical and scientific advancement? Not to mention developing the newly required managerial skills essential to leadership success. That's how corporations used to do it. But they figured out that strategic investment in talent and career development yields results. We can use results now. What models are out there at hospitals, AMC's, and medical groups?

Managing Teams, Alliances, and Collaborations) (Series)

Is the Brightest Leadership Team Necessarily the Best Team?

In his New York Times column of December 7, 2008 (The Brightest Are Not Always the Best), Frank Rich sounded a cautionary note about the incoming Obama administration, especially the economic team. The latter is being filled with an all-star collection of intellectuals from economics, business and political life. He recalled David Halberstam's book, The Best and the Brightest, in which he described another all-star team assembled by President John Kennedy. This team, with McGeorge Bundy, Robert McNamara, and Walt Rostow had gilt-edged pedigrees from grade school through Ivy League institutions as students and professors, and in the business world. This was the same group that got us mired in Viet Nam: "...these bright and accomplished men repeatedly relied on their own biases to the exclusion of facts to the contrary, even when the whole approach was coming apart..."

The point of the column -- that the brightest are not always the best is what Halberstam says in his book: the title is intentionally ironic and its meaning is closer to Rich's title. Halberstam's classic history of Viet Nam showed how these bright and accomplished men repeatedly relied on their own biases to the exclusion of facts to the contrary, even when the whole approach was coming apart and destroyed the presidency of Lyndon Johnson. Arrogance and hubris rank high among fatal flaws seen in leaders. Humility is a precious attribute in leaders; its absence frequently leads to disaster. In healthcare, we see this when an outstanding scientist is recruited to be chairman of a department and turns out to be a disaster as a leader because he won't listen, won't take advice, or lacks humility and sage judgment.

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