Archives: March 2008

Ten Years in the Making!

The attachment herein [updated 7 April], more heavily annotated than any I have done before, took 10 years of preparation. I have been working on and off with healthcare issues for a decade. Thanks in part to a slew of gangbuster books that have recently appeared, I have been able to reach some temporary closure. Hence, you will find here my best shot at compassing the healthcare issue as I see it. As I say at the outset in my annotation, this presentation is not about Hillarycare or some such. It is about turf upon which I can claim some expertise—organizational and operational effectiveness. For instance, healthcare financing—except as it causes horrid distortions in priorities, a bias against improving our health—is not dealt with. (By choice.)

I hope that you will "enjoy" this, though most of the story is grim. And I hope that some of you might spend some serious time on the presentation, and give me your feedback. And of course, as always, I hope you will "rob me blind"—and use some of this material in your own work.

Americans mostly think we have the best healthcare in the world, even if the most expensive. In short, that doesn't fit with the fact that our life expectancy is 45th globally and dropping, that our hospitals unnecessarily kill hundreds of thousands of us each year, and that seeking care at our most prestigious healthcare centers will surely reduce our lifespan compared to care at "St Elsewhere," as one writer put it.

Read on!

Love It or Leave It

The speaking business, that is. That's Tom's advice for new authors who are considering speaking as a career. (Never the half-way sort, that's Tom's career advice for anyone. Period.) Tom spoke with Jon Mueller at 800-CEO-READ's Author Blog today about his chosen profession. They covered a lot of ground concerning the ins and outs of being a professional speaker. If you're curious about how Tom got his start, or how to communicate effectively with an audience (including one that speaks another language), you should listen to this half hour interview.

Depression as Opportunity?

At a client meeting this week, I was taken aback when he deliberately chose to describe the current economic outlook in the UK with the word "depression." I have become used to talking to colleagues and clients alike about the coming recession, but a depression is entirely a different matter. I've never lived through one of those! This client is the CEO of a financial services group and extremely well connected in UK banking circles. If he's thinking and talking this way, so, too, I bet, are the heads of many other sizeable financial institutions.

Our conversation moved on to what the best strategies were for both our businesses to successfully navigate through the testing times that lie ahead. What could he do, and did we have anything different to offer that might help him to do it better or more quickly? You won't be surprised that most of the "common sense" stuff we began to discuss, in nautical parlance at least, focused on "lightening the ship, battening down the hatches, and hoping to be amongst those who survived the storm." But we're the Tom Peters Company, dammit!

Back in 1990, Tom released a brilliantly counterintuitive video called "Recession as Opportunity—smart moves for tough times!" Its core message for those dark days was that "smart people should redouble their attention to improving product quality and service excellence." This was a good place to start and changed the tone of our conversation. We then talked about the importance of engaging peoples' hearts and minds, and especially so in tough times. Everyone on the payroll has to do work that is worth their wages. How to make "the work matter" to people. Creating a context where people can do the best work of their lives. Spreading messages of doom and gloom all round the patch certainly won't do that.

I left the session feeling quite pleased with my contribution to the debate. I might have helped my client to get past his personal malaise and into some "uncommon sense" areas where he could deploy his considerable leadership talent to potential competitive advantage. But I came back to earth with a bump today when I read the current Annual Review and Summary from HBOS plc (a competitor of my client), and found this comment prominent in CEO Andy Hornby's remarks: "As we face the unprecedented financial turmoil in global markets, our focus on colleague [talent] development has never been more important. Our ability to execute our strategy within these tough markets relies on engaging with, and motivating, our colleagues to deliver consistently outstanding performance."

Perhaps the common sense stuff came at the end of the discussion, and not at the start? Does anyone have any stories of people who are already making smart moves for tough times?

Cool Friends Interview #121: Gibson & Skarzynski

Our new Cool Friends, Rowan Gibson and Peter Skarzynski, have a combined experience of over 40 years in helping organizations become more innovative, seize new growth opportunities, and invigorate their approach to markets. Rowan is a well-known speaker and the author of the best-selling Rethinking the Future. Peter is co-founder with Gary Hamel of the innovation strategies company Strategos, which helps organizations "build a systemic capability to innovate." Peter and Rowan have combined their expertise to write the new (out last week!) Innovation to the Core: A Blueprint for Transforming the Way Your Company Innovates. It goes beyond the reasons why innovation is imperative to how you make innovation happen, where to get fresh insights for your particular problems, how to measure your innovation program, and how to know if it's being implemented effectively within the organization. Read their Cool Friends interview to learn more.


Got my foot caught in power cord, here in my Las Vegas hotel room. Hence, my computer did not just "fall off a table" three feet high—it flew (!!) off the table, landing about three, or perhaps more, feet away. It "took a licking and kept on ticking." Hooray for my Panasonic CF-W5 TOUGHBOOK!

Event Slides: Kindred Healthcare

As Tom says above, he is in Las Vegas, and he's speaking to a group from Kindred Healthcare. You might recall that healthcare is at the top of Tom's list of reading subjects recently, so I'm sure he has a great deal to say to them. If anyone who attends the event would like to comment, we'd love to hear from you! If you'd like to get the slides, you can download them here: Kindred, Part 1 and Kindred, Part 2

Four Hearty Cheers!

Shopping for Easter dinner in a crowded Shaw's [market] in Manchester Center VT at about 1 p.m. Saturday. As I check out, I'm delighted to see a bagger—an effort to relieve congestion. I am even more delighted to see that my bagger is the Store Manager!!

Four hearty cheers! (And, alas, ever so rare.)

100 Ways to Succeed #111:

Get Out And About!

Get out! [Of your office.]
Get out!
Get out!
Get out!
Now! [Within the ... hour!]

[Attached, as a reminder, is a link to our "'Top 50' 'Have Yous,'" PDF or PPT, posted earlier.]


I love some of Michael Crichton's books. And have real problems with others.

But I heartily recommend Next, just out in paperback. It's called "fiction," but it is already mostly (?) true. The genetic revolution has great promise—and great peril. Some may call this book "alarmist"; I am not among them. How about "instructive"?

Simply the Best!

I am doing more and more work in healthcare. I am not engaging in the policy debate—or at least only marginally. Instead, I am interested in why we spend so much money, and yet trail Bosnia in life expectancy. (Our rank: 45.)

Along the way, and recently, I came across Phillip Longman's Best Care Anywhere: Why VA Healthcare Is Better Than Yours. All I'll say is that it is a stunning book, and the claim holds up.

Consider: "Generally, the more prestigious the hospital you check into, and the more eminent and numerous the physicians who attend you, the more likely you are to receive low-quality or even dangerous and unnecessary care."

Attached you will find some extracts from the book (and from Shannon Brownlee's Overtreated) that I've collected. If you are interested in 1/7th of our economy, let alone your health, read on. (One result of the book is my declining a major test that would have been of marginal value—and since it was intrusive, it would have exposed me to many of the factors that lead to our hospitals unnecessarily killing between 100,000 and 300,000 patients per year.*)

[*"The results are deadly. In addition to the 98,000 killed by medical errors in hospitals and the 90,000 deaths caused by hospital infections, another 126,000 die from their doctor's failure to observe evidence-based protocols for just four common conditions: hypertension, heart attack, pneumonia, and colorectal cancer." TP: total 314,000. FYI: In one evaluation, by the prestigious RAND consultants, the VA system ranked first on 294 measures of quality, compared to other major systems.]

[Now I'm starting on the very new Our Daily Meds, by Melody Petersen—yet another damning treatise.]