Living Well Journal

Distilling the Complexities of ACA

In a recent article in the Wall Street Journal, the bumpy-start of the healthcare exchanges were explained by the sheer complexity of the Accountable Care Act itself.  The authors cited a beautiful (and daunting) graphic that congressional staff created to illustrate how some 150 agencies, existing and new, form a mosaic of the new regulatory structure:  

Elegant organizational systems distill the complex to make it simpler for the user.  (That's why I'm an Apple convert!)  Effective leaders continually draw their teams to design systems to anticipate and surpass the needs and desires of the customer.  We have a long road ahead.

Transitioning to the new world of healthcare, one centered around Value rather than Volume, will be the work of a decade for healthcare leaders.  The complexity of the new world order of healthcare, codified in ACA, will take years to sift, distill, revise and refine.  Virtually every dimension of what we know as healthcare leaders will be up for change.

The next generation of healthcare leaders will need to learn how to Patiently, yet Persistently, distill the complexities, inspiring their teams to think through the eyes of the customer as they redesign systems of care and service to provide Value.  It will be up to us to simplify the complex for our patients.

5 Ways to Drive Innovation in Healthcare

Innovation is an over-used - - and under-realized - - word in the world of healthcare.

Our sense of the gravity of the work we do pulls us to be careful, honoring the tried-and-truth methods.  As in all aspects of life, however, a strength that is overplayed becomes a weakness.  Hence the 15 year lag between the benchtop and the bedside for clinical innovations in healthcare.

A recent article in Beckers Hospital Review highlights the attributes most highly correlated among healthcare institutions and their leaders who are weaving real-time innovations into their daily work.  

5 Things the Most Innovative Health Systems Do Differently

Living in Day-Tight Compartments

Dale Carnegie was born in 1888 as a poor farmer's boy from Missouri.  Over the course of his life, through persistence and hard work, he became a world-renowned speaker, author and motivator of people.

Dale Carnegie is best known for his massive best-seller, "How to Win Friends and Influence People," a book with continued relevance for today.  Yet he wrote another powerful book that changed my life.

"How to Stop Worrying and Start Living" starts with a chapter called, "Living in Day-Tight Compartments."

Think of the old WW II movies of submarines in battle.  The first thing the captain calls for is to close all the water-tight doors between the compartments of the ship - - those big, oval doors with a big steering wheel to make them air tight.  If the sub sprang a leak in one compartment, the rest of the ship could keep on fighting.

That's the picture Dale Carnegie shares about living worry-free:  the best way to prepare for tomorrow is to do the work at hand TODAY!  Focus on the task at hand. In fact, it isn't possible to do anything more to prepare for tomorrow than what you can do today.

Worry is the most non-productive way to invest your time.  It accomplishes nothing other than to germinate fear.  The human mind literally cannot think clearly in the presence of fear.

I think this is a piece of age-old wisdom that was first captured 2000 years ago. As Jesus said to his disciples, "Do not be anxious about tomorrow, for tomorrow will be anxious for itself.  Sufficient for the day is its own troubles." Matthew 6:34

So the take-away is this:  Focus your attention on what you can do Today to move toward your goals.  Live in a Day-Tight Compartment so as to resist the temptation to be anxious about what may or may not happen tomorrow: you can do nothing more than today's work.  If you keep your focus on doing today's work, and tomorrow you do tomorrow's work, you will reach your goals!

Ideal Performance for Corporate Athletes

In my work with executives, one theme always come to the forefront early in our work together:  the need to slow down, think, and recover energy.  The following excerpts come from "The Making of a Corporate Athlete" by Loehr and Schwartz in The Harvard Business Review, January 2001.

"To bring mind, body and spirit to peak condition, executives need to learn what world-class athletes already know:  recovering energy is as important as expending it." 

"Extensive research in sports science has confirmed that the capacity to mobilize energy on demand is the foundation of Ideal Performance State (IPS).... effective energy management has two key components.  The first is the rhythmic movement between energy expenditure (stress) and energy renewal (recovery), which we term "oscillation."  In the living laboratory of sports, we learned that the real enemy of high performance is not stress, which, paradoxical as it may seem, is actually the stimulus for growth.  Rather, the problem is the absence of disciplined, intermittent recovery. Chronic stress without recovery depletes energy reserves, leads to burnout and breakdown, and ultimately undermines performance.  Rituals that promote oscillation - - rhythic stress and recovery -- are the the second component of high performance. Repeated regularly, these highly precise, consciously developed routines become automatic over time."

The recent achievement by Diana Nyad, swimming 103 miles from Cuba to Key West, was capped by an interview where she shared the secret to her accomplishment:  Swim until night time, then reset the goal to swim until dawn ... and repeat the cycle 3 times.  Even in an event designed to test the outer limits of physical exhaustion, the mind must recycle its energy to keep going. I highly recommend this article for anyone who wants to balance the stress of work with ideal performance in all aspects of their life.

Guys, Take Note of How to Do This

em·pa·thy  ˈempəTHē/

noun         the ability to understand and share the feelings of another.

It's NOT About the Nail

Lessons for a Corporate Athlete

This morning the world is watching 64-year old extreme marathon swimmer Diana Nyad finally accomplish a feat she has tried 4 times before: a swim through the shark-infested waters from Cuba to Key West.

The physical feat itself is beyond my comprehension.  But the mental experience Diana describes just might be within my grasp.

James W. Pipkin, in his book, "Sporting Lives: Metaphor and Myth in American Sports Autobiographies", describes Nyads ability to "dissociate" during her marathon swims:  

"Unlike what happens in any other sports, the sensory deprivation in marathon swimming is almost absolute.  Nyad participated in scientific experiments of sensory deprivation in which she floated in a isolation tank, but she claims that marathon swimming magnifies a hundredfold the effect created by the tank and that the physical exhaustion during a race adds even more to the effect... Her crew communicated with her by blowing a police whistle; but they usually had to blow it twelve or more times before it broke through into her consciousness..."

"She says her superior, pinpoint focus released her mind to travel, remember, and imagine...The peace she felt had its counterpart in a joy that lifted her up, a 'mental exhilaration' she calls it."

You and I may never reach the extreme experience that Nyad describes, but the opportunity to enhance our focus and performance is well-within our reach.

Pipkin compares Nyad to Bill Bradley, the All American basketball player of the 1960s.  Bradley once scored 58 points in a final four game against Witchita State, describing it as "being in the flow."  

"[S]ports is particularly conducive to such moments, if the athlete is open and willing... because the right and left sides of [the] brain open simultaneously... confirming Bradley's notion about the wholeness of being that athletes achieve in these moments... The athlete's laser-like focus allows the body to act freely and intuitively as you have devotedly taught it, without interferences from the conscious mind, and the sensation that follows  is like, "zooming away."

Lest you come away from this blog thinking it's about sports, realize that this sense of "flow" is common to anyone who routinely trains his or her brain to connect its Left (conscious) and Right (intuitive) dimensions. 

To understand how this phenomenon can be part of your business tool kit, check out this TED Talk by renowned researcher Mihaly Csikszentmihalyi, author of FLOW.

What Matters Most?

What's the most important thing you can have?

Is it money? Is it love? Is it happiness? Or is it something else?

 has the answer.

This 5 minute video by best-selling author and nationally syndicated radio host Dennis Prager may change the way you Live life Well!

What Matters Most?

Honor and Happiness

It has been said that happy people are invariably grateful people.  

Gratefulness must have an object.  For example, we can be grateful to those who paved the way for us.

That's why I was arrested by this quote by Anthony Esolen, Professor of English at Providence College, speaking on the brilliant achievements of people in the Middle Ages - - an era now commonly written off as The Dark Ages:  "In one crucial way we are less civilized than those who enhanced human existence over a 1000 years ago(through spectacular works of art, music, science and architecture that are unequalled to this day).We dismiss the achievements of our ancestors, and fall short of them.  They honored their ancestors, and surpassed them."

Ready to Dump Your Health Insurance?

It is becoming increasingly apparent to me that the future of cash-based healthcare services is brighter than many people might think.

I know a man, a very successful entrepreneur, who got fed up with his $900+ monthly premium on his $10,000 deductible health plan for himself and his wife.  So he said, "I'm out."

He dropped his health plan and joined a Christian healthcare cooperative instead.  Because he lives a life free of substance abuse and unsafe lifestyles, he pays $300 a month as a donation to the co-op.  His donations pay for the healthcare expenses incurred by other co-op members.  It is not insurance (but the Accountable Care Act provides an exclusion for membership in such co-ops).

It sounded flakey to me until he told me what happened when he needed cervical spine surgery.  

The projected cost of the surgery was $45,000.  He negotiated with his preferred surgeon, the hospital and the anesthesiologist and got a total cash price of $14,000.  He had the surgery, submitted the bill to the co-op and they paid it.  And all he paid was his monthly $300 co-op donation - - no deductibe, no copay.

Now stop and think:  everyone was happy with this arrangement!  The hospital and the physicians voluntarily accepted this deal - - which can only mean it was a better deal than they would have gotten from Aetna.  And with no delay in payment, no denials, no EOBs, no collections efforts.  Just cash.

So, as the classic question goes, "What's wrong with this picture?"  The answer is, "Nothing!"

This insight was affirmed in a must-read Op-Ed article in today's Wall Street Journal entitled, "Jeffrey Singer:  The Man Who Was Treated for $17,000 Less."  If health plan premiums rise as precipitously as some are projecting under ObamaCare, a lot of people will be dumping their insurance like this!

If Airlines Worked Like Healthcare

As we struggle through the transformation from the Old to the New World of healthcare in the US, this is a (painfully) funny way to see ourselves from another perspective ... Laughter makes the heart healthy!

If Healthcare Worked Like Airlines