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?
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.