by Tony Chen

2006 was the year of consumer-driven health care. Two years ago was the year of retail clinics. Last year was the year of health IT (with Google and Microsoft making big splash entries). So, what will 2009 bring? Here are some predictions sure to go wrong:

1. The number of uninsured and underinsured will increase dramatically.

Think about it: Unemployment was once close to 5 percent. At some point in 2009, it could get up to 10 percent. Add to that the many businesses that will be cutting healthcare coverage for the sake of business survival, as well as the folks who will decide to forego buying individual health insurance to make ends meet.

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by Tony Chen

One of the key perspectives I've learning about as I read through Management Lessons from Mayo Clinic is to "act like a small organization even when you're a large one."

This is quite a task, given how huge Mayo is as a clinic. Think about how impersonal the service could be, how thick their policy book could be, how much bureaucracy there could be. So why doesn't it feel like a mammoth clinic to patients? It is because they allow, and in fact empower, everyone to relate to patients personally, respecting each one's individuality and uniqueness.

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by Nick Jacobs

As I approach my retirement from running a hospital Tony asked me to write some thoughts regarding this position.

Remember, no matter how far you push the envelope; it still ends up to be stationery.

The primary reason that I wanted to be the President/CEO was so that I would have the power to make things happen. After nearly thirty years of working to achieve that status in healthcare; after three degrees, two certifications and a fellowship, when the mantle of power was finally bestowed upon me, I made a choice to “never be a president like the majority of the presidents who had been in charge of me.” My primary motivation for this path was that, for the most part, their leadership had not felt very rewarding or productive. The discomfort that they had caused both me and my family was why I wanted to become the boss.

It was my dream to become a benevolent despot, a kind and reasonable leader who cared about his co-workers, but clearly was in charge.

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by Nick Jacobs

Upon entering the world of healthcare management, it only took about a week for me to “get it” regarding the realities of the job. Having started my adult work life as a professional musician, band and orchestral director, the structure of a hospital was so similar that it was, in fact, almost disconcerting. Obviously, the entire ensemble was in some way reportable to me, and, not unlike standing on the conductor’s podium and looking into the music score in front of you, running a hospital had dozens of departments, each with specific assignments and each interconnected. For me, a Systems Approach to running a hospital was not only necessary, it was also imperative.

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by Nick Jacobs

Dale Dauten in an article written for CAP Today entitled, A Call for Imagination, talks about the differences between great bosses and ordinary ones. His first very salient point was that one boss spends the day answering questions while the other spends the day asking questions. Mr. Dauten quoted the late business guru, Peter Drucker, as having said, “My greatest strength as a consultant is to be ignorant and ask questions.”

What a phenomenal gift, ignorance. Think of it. The recognition that ignorance can be strength. By studying best practices, by asking plenty of questions, by not knowing the answers, and finally by leading thought patterns toward better, faster, cheaper; things can change in a positive manner. By asking the “what would it take” questions, we have an opportunity to short circuit the usual objections because it assumes the old methods aren’t enough.

Instead of asking, “Is that the best you can do,” the uplifting question, according to Dauten, becomes “How could it be even better?”

So, the call completely changes from a call for accumulated knowledge to a call for imagination, and the old methodologies begin to change dramatically.