by Nick Jacobs

The other day I received a phone call from a newspaper. One of its employees had heard me speak at a leadership conference on transformational leadership. She then went to her publisher and described all of the nontraditional things that had been instituted at my former place of employment in Windber, PA. The call was to ask me to make a presentation to the employees of that newspaper about re-inventing their organization. Interestingly, I had recently returned from a print-related company that had done just that some 15 or so years earlier. Today it has more engineers working for it than pressmen, and the result of its journey into the creative process has been success beyond anyone's wildest dreams.

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It initially was one of the top government printing organizations in the United States, with 212 million pieces of mail being sent from its own post office each year; it boasted additional expertise in all forms of protected documents and highly confidential specialty printing that is just short of the U.S. mint. Then, it began to look at a myriad of other opportunities for high tech, specialty production products. Yes, it was in printing, but there were no newspapers in sight, and now the nearly 600 employees who work there have job security beyond anyone's imagination.

A few weeks ago a friend sent me a blog regarding a layoff of nurses at a Seattle hospital. In that blog was more information about one of the local newspapers, the Seattle Post-Intelligencer, having to stop printing. The person who sent this to me, Dr. Deborah Kearney, quoted an op-ed by Kathleen Bartholomew that used these local hospital layoffs as a means of urging the public to rethink the way the United States provides healthcare. Ms. Bartholomew went on to say that "the layoff of 200 personnel and the elimination of the chief nursing position at Swedish Medical Center will greatly undermine the infrastructure on which already-stretched direct care nurses and physicians depend."

What the twin topics of the article pointed out to me was our inability to let go of the past and transform ourselves for a future that is absolutely not the same. As our writer indicated, "a vast percentage of all healthcare dollars are used to support the first and last six months of life, and we devote the vast majority of those dollars to the same five chronic illnesses that we can control, but don’t." Do you know why bicycle seats can be so painful? They were designed by saddle makers who could not let go of the past design. They simply made them smaller and smaller until they made no structural sense.

Not unlike the newspaper industry, which needs a complete overhaul--a change-or-die overhaul--the healthcare industry does as well. The primary question becomes "How do we remain relevant?" That is the same challenge faced by the producers of movies, music and magazines as their worlds become digitized.

As a former hospital CEO, I watched with interest the evolution of voice recognition and its impact, or potential impact, on transcriptionists. Hundreds, and even thousands, of employees across the United States were and are employed to transcribe the recorded words of physicians. Then, voice recognition was invented, and physicians began to dictate directly into their computers, only to see their words appear directly upon the monitor of that same computer. Some of those former transcriptionists are now scanning paper medical records into digitized versions of the same. Others are no longer employed. The point here is that this transition did not just sneak up on us, and the current healthcare dilemma was no secret either. It has been the topic of conversation since at least the late 80s, and not much has changed for the good.

Our system evolved around sick care--disease care--not chronic care, and we as a country must find a way to rework it to address wellness and prevention; as Bartholomew says, "overburdened nurses, physicians and managers have already reached their maximum capacity." What we truly are facing is a system that must evolve, and the relevancy of sick care needs to be challenged as we move into the new world order. Let's participate, not criticize. Ideas are more important now than they have been in the last 50 years, and for whatever reason, we have a vast shortage of good ones. Let go of the past, imagine the future and then let's create it together.