By Nick Jacobs

Well, the temperature was 16 degrees and it was snowing when I left Pittsburgh. By the time I arrived in Ft. Lauderdale, it was 74, down from a high of 83 degrees. The trip was for two days and for 12 credits toward continuing certification as a Fellow in the American College of Healthcare Executives. The classes were held in an overly air conditioned room with dark shades drawn over both windows. For all intents and purposes, it could have been held in Erie, PA. The course was on Managing Change for the 21st Century, and the instructor John Sena, PhD, a professor at Ohio State University, was truly an expert in his field.

Although I could share numerous tidbits from this course that would help each and everyone of you manage change, I'll just say, spend the $1000 and go take it. That would be good for both John and for the ACHE continuing education program.

What I will talk about briefly in this blog is that, in spite of the wisdom present in the room represented by both the instructor and the participants, it was painfully clear to me that the field of healthcare management in the United States has not made much progress since 1990 when I first started taking these courses.

The sad thing about that statement is that everyone in the room acknowledged it in one way or the other through the two day course. If the clocks were turned back to 1990, and the instructor was changed, and most of us were still wearing neckties and jackets to this business casual course, not much of the dialogue, admissions or observations had changed.

We discussed healthcare's approach to business delivery, customer service, business development, patient centered care, and physician relationships all in relation to managing change. Except for the fact that I have less hair, the conversations could have been audio taped from 17 years ago. No, we have not adapted the Ritz Carlton model for patient care/customer service. No, we have not adopted the Hertz model for registration. No, we have not embraced the concepts utilized by Google for employee satisfaction or Microsoft or 3 M for strategic planning. No, we have not made much progress with our food service or our room service. Unlike utilities and other industries, we have not made our billing practices transparent. We have not embraced the model develop by . . .

Well, you get the point, and, as the future closes in on us with LPN's in Wal Marts and stand alone specialty hospitals, we will pay the price for our lack of responsiveness, our inability to get even a little bit out of our comfort zone and our "herd mentality" approach to doing business. Our populations are diverse, but our healthcare leadership was primarily made up of guys like me: old, white, and conservative. Okay, well, I am old and white!