Random – But, Focused – Thoughts - 12/31/18

Thoughts needing your feedback…

Considering For A Moment The Realities Of Our Time – Sometimes as we deal with the daily burdens of our lives – both professional and personal – we tend to neglect the changes that are percolating across societies throughout the world.  I was really struck by an animated depiction of the GDPs of various countries throughout the world.  In particular, China has continued its rise as a major economic force throughout the world.  In fact, when I was selected as a Kellogg Fellow in 1985, one of my points of study was to learn more about China because I noted for the Kellogg Foundation that “China will most likely become the dominant economic force of the next century.”  Well – the next century is here and the prediction has become a reality.  Take a few minutes to watch this video.  It becomes clear that the economic changes are a marker for political and social changes as well.  We need to take note because even though the changes are outside of health care they will both directly and indirectly impact on health care.  Resources are what makes societies hum.  Embracing nations is how we’ve done it historically.  We should get back that approach.

Chasing Squirrels – About a week ago, I was upstairs in my office when I suddenly heard this horrible choking sound coming from the first floor.  It sounded as if my dog – Toto – was choking on something, although I’ve never heard him choking :-) .  He loves to chew on tennis balls so the fleeting thought was well deserved.  In a flash, I ran downstairs only to find Toto staring intently at the kitchen.  But, the sound continued.  I couldn’t figure it out but is was obvious that Toto was focused on something.  Then, I saw it.  Toto had cornered a squirrel that was screaming its head off atop a large painting hung on the wall.  He had cornered a squirrel!!  From simple observation around the squirrels outside the home, I knew that there was no way I was going to capture that squirrel by myself.  So, I calmly went downstairs and gathered up my son and his friend to assist me.  The next screen is directly from the Keystone Cops!  The three of us with coats and towels to protect us from the squirrel along with Toto gave hot pursuit to the wily little creature.  He gave us a run for the money.  We chased it back and forth and around the house.  He would occasionally stop and simply stare at us as if to say, “Are you kidding?  You think you’re going to catch me?”  But, then we thought wiser by opening the windows and the doors before restarting our hot pursuit.  Within a minute, he was out the door and we were staring at one another with laughter at how easy that had been – at the end.  So, what’s this got to do with health care?

As I was thinking about the squirrel incident when it came to me that much of activity in health care today is like chasing squirrels.  We’ve got the various parts of the system going in different directions.  Some are chasing the proverbial squirrel with large leather coats, others with towels and still others with open jaws in sheer intuitive instinct like Toto!  We’re not coordinated.  One part of the industry is trying to go in one direction, and another part is going in a different direction.  Meanwhile, the squirrel of health care costs and inefficiency is getting away with dart here and a dash there.  It is only by getting all of the parts to work in a coordinated fashion that we’ll solve the problem.  Fee-for-service providers working in isolation from public health programs who are not connected to social support initiatives that use emergency rooms as fail-safe support systems during off hours only results in more costs.  Then, there is the drug and medical device industry toddling along to their own drummer quite apart from the insurance industry to say nothing about the confusing role government now seems to play in the health care community of today.  We’re chasing squirrels!!  It’s time to stop and take thoughtful consideration of the situation before continuing the chase.  It seems to me that if we actually worked together – across the boundaries of the industry – we’d solve this squirrel problem that has captured the attention of the health care community.  What do you think?

The Importance of Listening…

Observations and thoughts about the world we live in…

I’ve been working on a new book which I hope to release sometime in early 2019 – although that timeline may slip a bit given the other pressing demands of life. It seems that the many projects, making sure that Toto – the wonder dog and constant companion – goes for a walk every day when I’m at home as well as watching to make sure that the tides continue to go up and down ten feet at least twice a day at our home in Kittery, Maine :-) among the many other requirements of daily living.  These diversions sometimes pull me away from the petitions of my editor to cut out the wordy segments, reduce the number of metaphors and synthesize my thoughts more effectively so that readers will actually learn something about the lessons of leadership on persistence derived through focus, tenacity, failure, learning, understanding and reflecting – but emanating from the power of listening.  

The following thoughts are an adaptation from one of the chapters, “On Listening”.  As we step away from the travails and torment of our current political dialogue and offer tribute to our veterans, it seemed like a good time to step back and consider the need for listening to one another.  In reading the above bipartisan quotes, I’m particularly drawn to the notion that in honoring our veterans we are honoring the principles upon which our nation has been sustained.  It is through our diversity of cultural background, our diversity of ideas, our diversity of industry and our diversity of perspective that we have been allowed  and encouraged to hold diverse viewpoints across the whole of society.  But, all of this diversity cannot – will not – be sustained if we don’t listen.  So, I offer the following thoughts on

Learning the Art of Listening.

The Persistent Leader must acquire one characteristic above all others and that is the art of listening.  It is perhaps the most difficult but the most treasured of art forms for any leader.  In fact, it is the one area where I continue to diligently focus ongoing effort toward refining my skills in hopes of doing better over time. I must say that the recent debates, discussions and dialogues have challenged me in this regard.  Some of the discussions have been heated.  Others have been abruptly terminated because of the heat.  Some have even had the door closed on them before the discussion began.  And, still others have resulted in both sides simply shaking their heads and wondering – what the hell is he or she thinking?  The most productive; however, have been those where both sides persevered and listened carefully to the other to gain an understanding, to discover a core nugget of truth, to obtain an appreciation of the other’s ideas.  When we support such an approach in our dialogues, debates and discussions and don’t cut off our communications from one another – that’s when we have learned the art of listening. 

Now, please note that I am a student on the art of listening – not an expert.  I view listening as a continuing education skill.  I first learned the art of listening from a college friend’s father.  Her name was Sally and her Dad was Butch.  I met Sally through my best friend in college who eventually became her spouse.  She grew up on a farm not far from our university town so we would frequently “…go out to the farm” as a retreat from the rigors of university learning for a bit of reality learning.  When we arrived – often in a caravan of cars – we were always greeted by Butch (her Dad) and Ellen Ann (her Mom) with open arms.  It’s as if we had become part of the extended family which in many respects we were.  

When we arrived at the farm, we often sat around the kitchen table simply talking about university life and the latest events that seemingly swirled around us.  It was the early 1970’s and there was always a swirling “event” of some sort – much like today’s world except that the swirl came with the evening news with Walter Cronkite or Huntley and Brinkley rather than the 24x7 news cycle and the assault of Twitter from every political and social dimension you can think of. The important part of the conversations with Butch was that up until that time, he was the most conservative person I had ever had the opportunity to meet, debate and discuss the issues of the day.  My Dad often debated me and he was quite conservative but Butch made him look centrist.  Butch was an ardent – but extremely thoughtful – advocate for the conservative perspective in society.

Now imagine what a long-haired, university-based, student liberal who always wore a peace symbol around his neck from the early 1970s might be like when he sat down for coffee with Butch. Well, that was me!  The formative years of my life at university contained the rich experiences of the Vietnam War in a far off land, Kent State shootings in Ohio, the Watergate scandals in DC, the Stonewall Riots in New York City, and a host of other experiences that pushed me toward the more liberal perspective.  If you don’t know about these events, follow the hyperlinks.  You’ll get a sense of the discord that exuded America in the late 60’s and early 70’s.  It was a period where a distraught society boiled over in anger – until we finally sat down and listened, for a while, to one another.  The time for listening has returned…

But, back to my story.  Despite my political leanings, I was quite taken by Butch.  He was not only the most conservative person I had ever interacted with, he was also one of the most learned.  Here we were, out on the prairie in North Dakota sitting around a kitchen table, debating the tenor of the times and Butch was quoting John Locke, Edmund Burke, Alexander Hamilton and other conservative thought leaders.  He was awesome!  He never raised his voice.  He always looked you in the eye.  He often would smile in an exchange where he disagreed and point out that he disagreed, very politely. 

What I learned from Butch, in addition to the ideology of conservativism, was the beginning skills of listening.  We would sip our coffee, I would pontificate about some burning (often in a very real sense) issue of the day and Butch would listen.  He would then listen some more.  Finally, he would offer his thoughts in a very reasoned fashion and often with a fleck of humor.  Through our dialogue I learned that I needed to be prepared.  I needed to think my position through.  I needed to more fully understand alternative viewpoints to make sure that my viewpoint could stand the test of time.  I learned to listen (NOTE:  I’m still learning – just ask my wife :-)  ).

Butch was not only intelligent but he was able to lay out a perspective on an issue we were debating by cementing his ideas together with perspectives that made sense. His listening was disarming.  His reasoning was clear and often data filled.  The important lesson in the art of listening I learned was that it was important for those of us sitting around the table to be equally clear with similar precision as we articulated our rebuttal positions.  With Butch you didn’t simply flame out.  You did not pontificate – which is something we hear from both sides of the aisle far too much these days.  You didn’t yell or call people names.  In order to respond effectively as an artful listener, we learned that the same degree of clarity on thought, distillation of information and formation of perspective that Butch offered must be constructed for our arguments if we were going to withstand the thoughtful responses of Butch’s positions and perspectives.  By listening, he often gained the upper hand in our discussions and for some, he even carried the day.  I admired Butch.  He embodied what my good friend, Senator David Durenberger (R-MN) once offered to me in a conversation at my home when he said, “We need to listen to the other side to make a difference.” I must say that I have diligently attempted to adopt Dave’s philosophy as my working mantra over the years as part of my foundation for learning the art of listening.

To this day, I count Butch – and, Dave by the way – as a couple of the most influential people in my life – along with Tommy Joe, which is whole other story.  By virtue of demonstration, Butch revealed an important skill that is woefully undeveloped among too many leaders and missing from today’s societal dialogue.  Too many leaders are not listening very well.  Yet, to gain the respect and gratitude of those who sit around our proverbial kitchen tables, listening is one of the most important skills that has been shunted aside among the diatribes we often hear in today’s political debates. Listening is a skill that requires honing every day of your life as a leader.  It is a skill that you must always monitor to assure it is on full alert and omnipresent in your life so that it can be called upon at a moment’s notice. 

So, on this Veteran’s Day 2018, I encourage all of us to ponder the most wonderful gift we have been given by our forefathers  and the veterans who have served our nation – the ability to listen and figure out for ourselves what we believe and where we want our communities and nation to stand.  Unlike so many societies both present and past, we in the United States of America are so very gifted to have the right of freedom of expression.  Let’s not destroy it by not listening to one another.  In fact, sometimes the best lessons in life come from sitting around the kitchen table.  I encourage all of us to take time on Veteran’s Day to not only honor our veterans but to reflect on what they have given us.

Finally, I would like to salute my Uncle Gary and one of my life long friends, Ralph for their service to our country.  Uncle Gary rose to the level of Master Sargent which is the very highest rank for an enlisted person who enters the military.  He served in many locations throughout the world during the course of his career – including in Vietnam, a war I opposed.  And, also to Ralph who enlisted midway through college after receiving a low lottery number in the draft during the Vietnam War.  He did the practical thing and enlisted. Irony of ironies, Uncle Gary and Ralph ended up working directly together in Vietnam.  It is, in fact, a very small world.  And, that is yet another story for another day…

Now, to close out – please note that I frequently disagree with Uncle Gary and Ralph on any number of issues but, I always listen – just like I did with Butch. It is important to listen and to understand because it is only by understanding that we learn to use our knowledge for making a difference.  Again, thank you to all of the vets – of all perspectives, all    persuasions, and from all cultures – who have served on the front lines of democracy so that we can have our debates, engage in our discussions, and hold our dialogues.  But, we need to remember that we will only move forward by also engaging in the opportunity to listen as part of our assembly as families, as communities, as a nation…

Thoughts Beyond Health Care…10/11/18

In an era of considerable name calling and ugliness – there are some very good things happening…  

womenWitnessing The Revolution: Building The Foundation Through #MeToo – The #MeToo movement has been top of mind for most of us over the last month.  In a world where every day brings a flurry of new news as the life of our national soap opera unfolds, the Kavanaugh hearings were perhaps a seminal turning point in our nation’s dialogue.  The hearings brought to the forefront the #MeToo movement.  Witness the sign we saw in the window of a shop as we strolled to dinner the day of the Kavanaugh vote in the US Senate.  It speaks about all women and the role of all people and all families.  I suspect that Tarana Burke – the Founder of #MeToo in 2006 – never anticipated that the community initiative she created for connecting survivors of sexual violence would have such national and international ramifications.  Although I can point to incredible gains that have been made for women over the course  of my lifetime – we have a long way to go…and, I’ll leave it at that!  So, while the issue of sexual violence, let alone sexual disrespect, is an extremely important one for society to address, I believe the movement is extending beyond the too frequently disempowered, one-half of our nation’s and world’s population – women!  In fact, when we look back in a couple of decades, my prediction is that the #MeToo movement will be as much about bringing into the fold the diversity of the whole human populace rather than just half of it – or, at least that is my prediction for the United States.  We are seeing the last hurrah of domination by old white men (I am one of them by happenstance of birth) in America.  Women AND people of other cultures, perspectives, preferences and colors are coming to the forefront of society – AND, THAT IS A VERY, VERY GOOD OUTCOME!!  The #MeToo movement is highlighting the acceptance of diversity across the nation.  It’s about time.  It’s about women but, it’s more than just about women.  In fact, I believe the #MeToo movement is the cornerstone of the diversity movement which is finally coming to America.  We’ve been struggling with it since the Civil War.  I suspect we will continue to struggle with it in the years ahead.  But, hopefully, the new generations will take the lead and move acceptance to a higher plane – a calling, if you will – for what the United States of American stands for…  To all women – thank you for changing our society for the better.  Yes, we’ve come a long way but we have so much further to go!  The Kavanaugh hearings have helped the nation extend a dialogue that is only just now beginning to reshape society.  Don’t be disheartened.  The picture in the window caught the spirit of the changes we are experiencing.  We all need to continue the quest for making the spirit a reality for women and everyone. 

Crossing The Boundaries – To my point above, I recently read a news story about a young women who won the homecoming queen vote at her school and saved the day for her school’s football team – all on the same night.  She’s a student at Ocean Springs MS High School in Florida.  Senior Kaylee Foster had the double honor of being named homecoming queen and serving up the winning points as the kicker for the football team.  The younger generation are crossing all sorts of boundaries.  I look forward to their leadership as they take the reins of society and guide us into the new millennia.  In a similar vein, our youngest was arrested for demonstrating while in Washington, DC.  When Senator Susan Collins gave her speech (apologia) on the US Senate floor last week, there was an outburst in the gallery.  The outburst was a statement of angst about all of the events over the preceding weeks.  But, even though the protest did not stop the speech, the arrest awakened within her the desire to “make a difference” just as the protests of the 60s did the same for my generation.  The flame of change to make a difference is bright and alive. It will change society.  Let’s also hope and pray that some of that energy, that desire, that focus for change will be invested in making health care better! 

A Shameless Advertisement Or, Two…

A Mom and Adopted Dad Made Proud… 

Cookie Is Her Real Name – Our youngest, Cookie Harrist – is a “post-modern dancer”.  She made the big leap by moving to San Francisco this past year which is one of two epicenters for the movement.  The other is Berlin which we are anticipating is next in line for places to visit.  Cookie recently was hosted as one of the centerpiece dancers in “Standing Still” – an experiential dance show at the Haas-Lilienthal House in San Francisco.  Here is one of featured songs and some selected pieces from the show.  Enjoy!

But, There’s More – Michael is a musician.  In addition to his career as a modal musician (music from the Middle East), he’s also part of Amerinouche.  He’s the bassist with a fabulous beat.  Watch him play.  His mind and body become one with the music.  It’s fun to watch – and, hear. 

 

Random Considerations - 5/1/18

Observations, Books or Articles worth a Thought or Two…

A Buzz To Remember – The brewing controversy over the response of Facebook to a number of issues but primarily related to its position on the use of personal information by the more than 2 billion users is not an incident but a growing cacophony.  It wasn’t helped this past week by a piece in Buzz Feed on the role of Vice President Andrew Bosworth – a provocative Vice President for consumer hardware – when it was revealed that in an internal post back in 2016 he wrote the following:  “The ugly truth is that we believe in connecting people so deeply that anything that allows us to connect more people more often is *de facto* good. It is perhaps the only area where the metrics do tell the true story as far as we are concernedThat isn’t something we are doing for ourselves. Or for our stock price (ha!). It is literally just what we do. We connect people. Period.” You must read the whole article to get a sense of the issue and how the use of data and information by Facebook has not only created wealth but also now consternation among many on their team. 

Change Happens When You’re Not Looking – I feel like I’ve been hiding under a rock or something.  This past week, I attended the American Telemedicine Association conference – one of my favorite annual treks.  This year the meeting was held in Chicago at McCormick Place but the important point is that the other ongoing event at the same venue was America’s Beauty Show!  Yes, America’s Beauty Show.  It was a lesson in “changeor, “what happens when you’re not paying attention”.  I have never seen so much blue (I mean really blue), green, pink, red, yellow, fuchsia and other assorted colors of hair!!  Not only that, but many of the people (mostly women – not a statement, just an observation) were wearing jeans with frayed fronts and/or holes – something we would have patched over in the 1960s with an upside down flag or something.  I felt like what was normal had been turned upside down.  Shouldn’t colored hair be natural and subdued rather than bold, if not outrageous, and iridescent?

Now………..imagine how the medical and health care community feels when we tell them that a lot of their thinking will be replaced by artificial intelligence, that robots are coming which can actually interact with people, that the way to increased productivity is through the use of remote care management monitoring devices and on and on.  Imagine you grew up when the Beatles and Rolling Stones were popular and now there is some weird kind of music you can’t figure out.  That’s called “change” and, it happens.  If you think you’ve seen a lot of change in health care over the last decade think blue (I mean really blue), green, pink, red, yellow, fuchsia and other assorted colors as the metaphor for what’s happening.  It will help you to understand how much change is coming.  And, it won’t take five decades…

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