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 Nick Jacobs

The arts, tourism or health care; the profession didn’t matter. Volunteers have always been squarely in the center of my personal universe. No matter what the job, the challenge or the non profit profession, we have always worked very hard to create meaningful positions for volunteers. In fact, it has been our distinct pleasure to be intensely concerned with our volunteers over the years.

What have we discovered? There are virtually no boundaries, no Mission Impossible jobs, no challenges too great or too small and there is no end to what dedicated volunteers will do for any non profit organization. They need only to be empowered, encouraged and recognized. In fact, most of them will perform above and beyond the call of duty without even a nod and a smile.

The volunteer experiences that have become part of my personal history have been very unique but the essential ingredient for us has always been to be open, honest and thankful. It has been to provide them with a vision and ownership, but most importantly, it has been to embrace them as partners, as critical participants in our business, as key providers of the proverbial icing on whatever cake is being baked.

I remember once asking the father of one of my students to stand at the boy’s room and make sure that all went well there throughout an entire professional sports game where the students were performing. He never saw one minute of the game. I later found out that he was the president of a university? He had just told me to call him Frank?

Be it putting up tents in 100 degree weather, or making runs to buy the needed decorations required to top off the center pieces, we have always had people waiting in the wings to get it done. Our volunteers currently add at least 30 percent to our care giver numbers as they serve as greeters, are clowns, do hand massages, help family members, deliver communion, or sort files, our volunteers represent a bedrock element of our organization that would be impossible to replace.

Volunteers can make the difference between your patient’s happiness and comfort and their disgruntlement. They don’t have to do what they do. They do it out of commitment and caring, and your patients can feel that love, too!

by Jeff McKune

My Dad and I were recently discussing healthcare issues, and he told me that he argued healthcare topics when he was on his high school debate team. In fact, in 1947 he was given the debate topic "Should the Federal government provide a system of complete medical care available to all people at public expense?" Sixty years later, the question of government's involvement in healthcare is still a hot topic, and it is one of the leading topics of the 2008 presidential race.

A little over a week ago, John Stossel hosted a 20/20 program titled "Sick in America: Whose Body Is It, Anyway?" One of the things I liked most about the program was the way that Stossel covered some challenging issues such as the linking healthcare insurance to employment, over utilization, and the profit motive. He also had a nice segment comparing the system in the United States with those in other countries, specifically Canada. I found the whole program to be refreshingly frank.

The last part of the program focused on private solutions to healthcare problems versus government solutions, and the importance of competition and individual choice. Stossel gave a couple of examples where competition among healthcare providers has led to improved quality and lower prices, even during a time when most of the industry is experiencing higher prices. Those two examples were LASIK eye surgery and cosmetic surgery, both of which are usually not covered by insurance. LASIK prices have dropped 30%, and the quality has improved. Providers have to compete because patients are shopping around knowing they will pay for the procedure out of their own pocket.

When discussing healthcare challenges, we often focus on what does not work. But what does work? The things that work for healthcare are the things that have worked for our country in many other industries: Freedom of choice, competition, innovation, and the availability of information for potential buyers. If we know these things work, as hospital leaders, how can we best connect to these basic tenants?

by Jeff McKune

Early in my IT career, I specialized in a particular series of personal computers. One interesting feature of these systems was a self-diagnostic capability that would draw a picture of the internal boards in the computer, highlighting a defective board. It was pretty cool to watch, and I couldn't wait for my first customer demonstration. In the demo, I showed the customer how easy it was to access the boards by removing the one-piece cover. I then loosened one of the boards to simulate a "failure", put the cover back on, and hit the power switch to start the self-diagnosis process. But, nothing happened - the screen remained black. Unfortunately, it was the customer who saw the problem and spoke first: "You might want to check your connections. Looks like the power cord is not plugged in."

It would not take much to get so caught up in the administrative concerns associated with the delivery of healthcare, that we forget what connected us to healthcare in the first place. Sometimes it is a good idea to make sure we "check our connections" to remind us of our purpose.

There are a couple of things that I try to do on a regular basis to keep me connected to my team and more importantly to our patients. We handle many pediatric dental patients each week. Frequently they arrive afraid, wondering about the people in funny looking clothes and what the procedure will be like. I enjoy sitting down with these little ones and reading them a story, or playing a guessing game to take their mind off things. Making a difference to kids means a lot to me, and helping others is one of the reasons I connected with healthcare a few years ago.

I also enjoy dressing out in scrubs and helping my team. Being a former IT guy with no clinical training beyond my BLS, I cannot provide direct patient care. But I can help my team clean and make beds between patients, wheel a patient outside to their waiting family, or just help the housekeeper empty the trash. I have found that this powerfully connects me to my team like nothing else.

What do you do to stay connected to your purpose and direction in healthcare? I would be interested in hearing how you "check your connections."

by Nick Jacobs

We are living in a health care system that embraces episodic care, that does not reward or reimburse prevention, and that is currently on the precipice. It was the Treaty of Descartes that originally insisted upon the separation of the mind and spirit from the body in our hospitals.

As we observe the near turmoil that currently represents our health care system, we find ourselves attempting to hold onto beliefs and values that are no longer valid. This lack of validation causes concern and anger among many. Instead of just being afraid of these changes, many of us have become desperate victims as we attempt to project our past into a new, unknown future.

Although culture absolutely hates to apologize, science continues to unintentionally eat away at our values, beliefs and civilizing touch stones. Scientific truth is only true until the next discovery. Medical interventions are only valid until a more sophisticated more accurate intervention is developed. The world is FLAT.

As leaders we must create a vision for a better future, and then be able to tell persuasive stories about that vision. As leaders we must produce ideas that fit reality for the future, and those ideas must emanate from deeply engrained beliefs. It is also imperative that we truly espouse those beliefs through our daily lives, to have the integrity of commitment to responsibility, compassion and guidance. Finally, we must develop the skills to sort between what is good and what is not and then value what needs to be respected.

As we plot a course through these unknown areas and move toward a better future, let these thoughts be our starting point: In health care we must embrace the fact that we are in a kindness industry and that we should be committed to connections and to love.