Archives: December 2005

Raw Meat for "Resolutions"

I may write more, even a lot more, about New Year's Resolutions. Or not. But when I sat down, quietly, to think about my stance toward 2006, a quote of Eleanor Roosevelt's drifted before my mind's eye: "Do one thing every day that scares you."

I don't know where I'll go with this, if anywhere—but it feels like a perfect, and in fact profound, stepping off point. (And I do believe that New Year's is indeed an opportunity-punctuation mark along life's path not to be missed or dismissed.)

Joys of Global Blogging Recalled

Thanks for the thoughtful and heartfelt comments on my last Post. As I read them, I as usual enjoyed the content—nodding, smiling, and scowling as I proceeded. But I was also, maybe mostly, thrilled (right word) anew at the global reach of the Web and Blogging. After 63+ years as a U.S. citizen, I obviously write with and cannot conceal, even if I wished to, a distinct U.S. bias that I'm not even aware of much of the time. (Not so much "pro-U.S." as, "Hey this is the only thing I know at a deep cultural level.") Nonetheless, it was a thrill (that word again) back in 1982 to see that so many from so many places took a shine to In Search of Excellence—a 100% American book. The reason, in retrospect, was obvious and not nationalistic—the book was "just" about people, people treated as intelligent + creative + worthy of the utmost respect, people contributing/capable of contributing to a greater goal that was fulfilling, even uplifting, to their enterprise and themselves, and hopefully a larger community beyond their/our immediate environs. (And to re-state the obvious, these obvious ideas that obviously led to better-sustaining performance were largely unobvious in all nooks and crannies around the world.) Likewise today in the Blogosphere, here at your-our site,, we are all humble and connected servants of matchless (exactly the right word!!) opportunities to engage in and contribute to this carnival called GlobalLife.2005, GlobalLife.2006. "Flat world," "global village," whatever ... we are indeed full-scale participants in a borderless (overused word—but the right one nonetheless) conversation (overused word—but the right one nonetheless) of utterly unheard of proportion—just 5 years ago. I love it, outrageous problems notwithstanding, outrageous opportunities considered—and as I said when I began these remarks, I am so heartened by the contributions/comments that appear here at all hours of the day from all corners of the globe. May our modest community continue to thrive and needle and contend about some very important (and unimportant!) stuff in 2006. I guess I should close with a homily about a "fulfilling," "uplifting" New Year. Instead I'll stick with the tried—and still true: Happy New Year! (While—to stay on message—readily acknowledging as a striving Yankee globalist that even new year's at the end of this week is very un-global. Among other things, Anglo-Saxon Moi, as usual, looks forward to traipsing to San Francisco in a couple of months for the sole purpose of enjoying an annual highlight—the Chinese New Year's parade!) (Hmmmmm ... maybe "start Mandarin lessons" ought to be on my upcoming Resolutions list.) (And, yes, I do know that Cantonese—Guangzhou-ese?—is the S.F. Chinese-American community principal non-English language, not Mandarin or simplified Mandarin.)

A Touch of Thoughtfulness from Thee & Me

Following a brief and successful hospitalization last week to deal with a decade+ old arrhythmia problem, I plan to take it easy over the next two weeks. (Healthcare criticisms aside, my minor procedure was a tribute to MedicineTech2005!! Of course—conundrum of the first order—I was lucky enough to have the best-of-the-best slicing & dicing.) The "event-with-happy-ending" makes me more aware than usual of my blessings as 25 December approaches. I'm healthy as a hound. My head is "in a good place" as our New Age pals would say. Susan, Max, and Ben are likewise skipping along with personal and professional success. I'm loving what I'm doing (!!!!), learning new stuff, enjoying blogging and our blogging community.

The world beyond the end of my Vermont farm's snow-covered fields, of course, does not lack for major-flabbergasting problems. I was giving a speech to senior big-project managers a couple of weeks ago, and was questioned on off-shoring and its "devastating" impact on America (no, it was not Lou Dobbs); after giving my rather perfunctory "professional answer," I actually exploded ... mostly at myself. "We are spoiled brats," I snapped, "300 million North Americans, 325M citizens of the EU, and 125M or so Japanese ... out of a 6B global population. What right do we have to bitch & moan about a handful of jobs going to India & China?" (I apologized to the CEO for my rant—a few days later he emailed me to say it might have been the best/most important thing that happened to him this year.) I am not sure of my own direction. "You can do so much, Tom," some of you will say. We'll see.

I know action beats talk 1000:1, but at least this holiday season give a thought and prayer to, in particular, our neighbors in Africa, living daily with unimaginable burdens that the rich states are as usual mostly ignoring. (Yeah, yeah, a little debt relief, farm subsidies tagged to end in 2013—in France? Right.) How many Africans, other than the dictators, near-dictators and their cronies, could have had the procedure I had last week at Inova Fairfax in VA? Alas, many hundreds of millions will not see an age old enough to even develop the sort of problem-irritant I had.

Enjoy the season of rejoicing, and at least for the Christians among us, think long & hard about the beliefs concerning the needy that the guy whose birthday is coming up pronounced upon so passionately.

Be well. My best to you and your families and neighbors.

(I miss my Mom—AWOL after giving me 64 years of love and support. The best I can do is a red and green bouquet on her grave in Annapolis tomorrow. My heartfelt condolences to those of you who have lost close friends and relatives in 2005.)

TP's Healthcare Twenty-seven/December 2005

In preparation for a healthcare client conference call, I hastily jotted down this list of my more or less "beliefs" about healthcare (no particular order, not in order of importance—but main points are BOLD):

  1. Fully utilize Physician's Assistants to do routine work in a timely fashion. ("Doc in a Kiosk" at Wal*Mart is great!)
  2. Maximize Outpatient Services!
  3. Short hospital stays work!
  4. Support home care to the max. (E.g., "Declaration of Independents"—Beacon Hill/Boston)
  5. STOP THE 100K+ NEEDLESS DEATHS—much/most of the "quality stuff" is eminently fixable. (Don Berwick for President! AHA for Hall of Shame!) (Strong, vicious insurer incentives!!!)
  6. FLIP HC 177 DEGREES TO EMPHASIZE PREVENTION & WELLNESS. ("Steps" are being taken but not enough. Med schools: Awful! Insurers: Little better. Support for appropriate-proven alternative therapies is an important part.) (HUGE INCENTIVES FOR EFFECTIVE WELLNESS-PREVENTION PROGRAMS-MEASURABLE SUCCESSES.)
  7. "Boomers" will determine HC's (very different?) future. (They are from a different & demanding planet compared to yesterday's Oldsters.)
  8. "Focus on Women." (It's my generic—and correct—rallying cry, and it applies to HC in spades, women-as-patients-with different-woes-than-men; women-as-HC decision makers at the "consumer"—and commercial—level.)
  9. "Patient/Consumer-driven" may be a buzz phrase bandied about all to easily ... but it is true. (And changes the game.)
  10. Reduce incentives for unnecessary tests. (Malpractice caps would help, though the issue is complex. Insurers-HMOs doing so-so on this.)
  11. OUTCOME-BASED MEDICINE IS A MUST! (There is a long, long way to go!) (Measure until you're blue in the face!)
  12. Science-based medicine is a terrific idea!! (Many-most "therapies" unproven scientifically, uneven in application when proven.)
  13. Over the next 5-25 years, the Life Sciences Revolution will make the likes of the "info revolution" look like small beer. (Get ready.)
  14. Radical increase in "best practices" utilization—inculcate in Med school!
  15. Med school "revolution" imperative—outcome-based medicine, abiding emphasis on Wellness & Prevention, etc.
  16. Get info to Patients! (HIPAA mostly good.—"I wanna see my records!") (Detailed hospital-by-hospital, disease-by-disease, doc-by-doc success records a must—despite controversy.)
  17. Upgrade IS-IT in the entire system, starting with acute-care institutions. (Current grade: D-.) (Winners include: Indiana Heart Hospital; Inova Fairfax Heart Institute.)
  18. Healtheon WebMD-like (if it had worked) mega-, integrated-info network will-should emerge. (A healthcare Google+?)
  20. By hook or by crook, something approximating basic universal care, starting with kids—50 state partial experiments is a help; some are quite far along. ("Market-based" as much as possible—but this is far from a "perfect market.")
  21. Deal with the enormous HMO "I want my doc" perception problem. (Fact: MARCUS WELBY, STATISTICALLY, AIN'T THAT GREAT A HEALER IN TODAY'S "HIGH SCIENCE" WORLD! Incidentally, same perception problem re Congress, schools. "My Congressman is great, Congress has 434 other crook-clowns." "My kids' school is good, the system is awful.")
  22. Blitzkrieg of Patient/Customer/Citizen education (e.g., re "outcomes-based HC," "Get the most for your HC dollar"). (Corporate cuts should motivate this.)
  23. "Healing-centric" care supported. (E.g., Planetree model—reduces future problems.)
  24. Emphasize front-to-back "customer care" practices—cuts waaaaay down on malpractice claims among other things.
  25. Specialization in acute care works wonders, regardless of howls! (E.g., Shouldice/hernia repair.)
  26. Shorten the FDA approval process. (Tom, age 63, wants the good new stuff and will accept associated risk; so will most boomers-geezers.)

More Healthcare

Re prior post, I read/re-read these exceptional books as I buffed up my HKQ/Healthcare Knowledge Quotient:

The Economic Evolution of American Health Care—David Dranove

Market-Driven Health Care—Regina Herzlinger

Prescription for a Healthy Nation—Tom Farley & Deborah Cohen

The Health Care Mess—Julius Richmond & Rashi Fein

Demanding Medical Excellence—Michael Millenson

A Day …

No, hardly time to throw in the towel, but surely one more (of a jillion) spurs to the press for dramatic change. Today, but one day, 12.21.2005, New York Times biz section, page 1:

"That Blur? It's China Moving Up in the Pack: New Economic Figures Could Put the Nation No.4 Globally."

"Toyota Closes in on G.M.: Signs Point Toward Japanese Maker Being the Top Seller Soon"

"Chinese PC Firm Hires a Dell Executive"

"Ex-Chief of Quest Is Indicted: Federal Charges of Insider Trades"

No Comment

Wall Street Journal, p.1, Section B, 12.19.2005:

Para #2: "US Airways Group eliminated health coverage for 28,000 employees and 10,800 retirees late last year. But the financially ailing airline had already guaranteed departing CEO David Siegel and his family medical coverage for life."

Para #4: "Health care is essential for our employees, and I live with the same plan as everyone."—Tom Wolf, CEO, STS Consulting (600 employees in 14 states)

"Remarkable" Is a Remarkable Idea!

"TV is not dead, but if you're going to do TV, you have to create stuff that people seek out. Just because you buy 30 seconds doesn't mean you'll have an impact. You have to do something remarkable with it."—David Lubars, Creative Director, BBDO (USA Today/12.19.2005

"Remarkable." Duh! (But invariably honored in the breach.)

Cool Friend: Castronova

Edward Castronova is the author of Synthetic Worlds: The Business and Culture of Online Games. Adding him to our Cool Friends brings us back to this suject. We first talked about gaming culture with J.C. Herz in December, 2000. Castronova has a more scholarly approach to the topic, but the message is the same. The worlds you enter by playing are complex; it takes time to learn your role among the many other players—potentially millions. This makes the online gaming experience unique among games you can play. Read Castronova's Cool Friends interview here.

Christmas Music Favorites and …

Red Christmas Ornaments
The top-selling UK Christmas single ever is Slade's early-70s rocker "Merry Christmas Everybody." It has enlivened innumerable Christmas bashes I've attended over the years, but I'm not sure if it crosses the Atlantic very well? Sir Cliff Richard's yuletide shocker "Mistletoe and Wine" is the kind of release that gets the UK pop music business a bad name at this time of year. Anyone else got their best and worst Christmas party music tips ready to share?