Category Archives: healthcare

No time for blame

Each of us is tasked with playing the hand we’re dealt. Some of the cards are stacked in our favor; many are not. Nonetheless, it’s a package deal, and the better we understand those cards, the more we’ll be able to accomplish.

I thought about this after reading David Remnick’s sad portrait of Hillary Clinton, in which she blames her gender — among other things — for her loss.  Mrs. Clinton is a super-sized public figure and a role model of tremendous potential.  Perhaps it is a necessary catharsis, but I was disappointed to read that she chose to waste her time.

The New Yorker

What could have been: The cover The New Yorker Had Planned for Hillary Clinton’s victory in the 2016 election. Courtesy of The New Yorker, Sept. 24, 2017

It’s helpful to understand why we fail. But blame is time consuming.  This I know: the faster we lay it aside, the less time we waste. Contrasting the Clinton debacle with Al Gore’s loss to George W. Bush in 2000, Remnick notes that Gore was 52 at the time; Clinton, 69. Gore had time to grieve, move on, make a fortune and win a Nobel Peace Prize.  Clinton is 69. “She will have a hard time finding a similar peace or place in public affairs.”

Oh, gosh I hope not.

The “genderizing’ conundrum

It’s always worrisome when a noun becomes a verb. So let’s step back. The 19th Amendment was passed in 1920. When I was in high school, girls weren’t allowed to learn small engine repair; we were shuffled off to home economics and white sauce. When I left school and took a temporary job with H.Ross Perot’s Electronic Data Systems, I was humiliated by a fellow (male) employee’s passing me a handwritten note warning me that my sleeveless dress was inappropriate because it revealed my arms. I left the job.

Mrs. Clinton, like Texas Governor Miriam “Ma” Ferguson who presided in the 1920’s and 30’s, rose to power on the coattails of her husband. She, like Sherry Lansing in Hollywood, Toni Morrison in literature, and Indra Nooyi and others among the Fortune 50, carved their roles out of a male tradition  There was no can-do legacy. Unlike Athena, the goddess of wisdom, who sprang fully formed from Zeus’ head, confidence is earned, not awarded.

Focus on making the world a better place — starting where you are

So why not focus our time and energy on moving forward? The fields of law and medicine are being transformed by women. I look forward to seeing similar trends in education and politics (you go, Mrs. Clinton). But no question, it’s a slippery slope. Every day I see young women reverting to baby talk, tantrums, behavior that may have worked in middle school, but is cringe-making in the workplace.

We have a limited time to do what we want and need to do. Life tosses storm debris in our way.  I don’t know how many times I said, “I can’t find the job I want until after my mother dies.”  I didn’t want to face the conflict and ultimately wasted precious time blaming absent siblings, geography — and gender — for lost time and opportunity.

It was a waste of time.  Ultimately, we’re shaped by the battles we fight, and its our ability to accept our faults and failures that make us role models.

whining

Navigating Obligations: Keep Working

Rushing to work one morning last week, I listened to Mihir Desai talk about his new book The Wisdom of Finance: Discovering Humanity in the World of Risk and Reward. The topic is bankruptcy; the lesson: Life is chaos, and our task is to navigate through the it.  He kicked off the interview with an anecdote about American Airline’s 2011 bankruptcy filing (when the stock fell 79%):

 The first CEO said for a long time he’ll never go bankrupt, because it was his duty to make sure every obligation gets paid off. Of course, he gets dragged into bankruptcy at the very end, they switch the CEO. The second CEO comes in, restructures all the obligations, guts the pensions. But American Airlines goes on to live another day. So the idea there is, you know, who’s the hero of that story? Is it the guy who said, “I have to stand by all my obligations,” but took the company down? Or the guy who said, “I actually got to manage these conflicting obligations”?

Employees, or many of them, kept their jobs, and shareholders came out way ahead. Maybe the lady wasn’t as advertised, but she was a better option than the tiger.  So it goes with the ways we manage not just our working lives, but our personal ones as well.

Conflicting obligations come at you from all directions  

If it weren't for you

“If it weren’t for you I would have conquered the world by now.”                  

Unexpected interruptions — kids, divorce, illness, death — not to mention layoffs, separations and unplanned early retirement intrude. Financial hardship complicates things.

Living longer + Putting yourself last = Poverty 

Women are particularly vulnerable to the call of obligations. We tend to put others’ needs before our own, although perhaps this trend will shift as we evolve and more men take on caregiving responsibilities.  But as it stands now, Kerry Hanson’s “Money Worries” column is a wake-up call:

Women were 80 percent more likely than men to be impoverished at age 65 or older while women age 75 to 79 were three times more likely to fall below the poverty level than men the same age.

When I turned around after taking time off to care for my parents, I fully expected to step back into a job comparable to the one I’d left. But someone had moved that career ladder. It’s taken years, and a few unplanned twists and turns to accept where I am professionally.  I realize now that if I’d been less focused on doing everything perfectly and more on my future, I’d be in a better position financially.

Health care expanses:  A ticking time bomb 

Changes to health care policy pose a real threat to anyone over the age of 65 who does not have robust retirement savings.  Today 60 percent of the elderly in nursing homes are on Medicaid. Many have spent their savings on assisted living and residential care. Getting old is expensive. According to Hanson, a healthy 65-year old woman retiring in 2016 will pay $300,000 on Medicare premiums and out-of-pocket costs for hearing dental and vision care by the time she reaches 89.  That, of course, is in addition to living and personal care expanses.

Stay in touch with your possibilities 

Do what you need to do to keep a firm footing on that career ladder. But don’t get rattled if something knocks you off.  Expand your thinking and your network.

Desai’s interview closed with a tip of the hat to Martha Nussbaum’s “The Fragility of Goodness” and the example set by the ancient Greeks:

Fundamentally, this is about undercutting the idea that you have to follow duty. Most Greek tragedies are about people who have these conflicting obligations, and it’s a mess, and you have to navigate them. And she says that’s a good life. If you don’t have conflicting obligations, you’re doing something wrong.

So, it is as it’s always been. Keep working. Do your best; take smart risks and most of all, take care of yourself.

 

*  Cartoon is courtesy of Harry Bliss and The New Yorker, March 18, 2016.

Coding is Only the Tip of the Iceberg, Ivanka

News that Ivanka Trump plans take coding classes with her five-year old daughter reminded me how important it is for public figures to use role-model power carefully, strategically.  Witness Michelle Obama’s use of fashion as a channel for her message.

I get that women are under-represented in technical fields. I also get that many young women are unprepared to make enough money to buy a car, home, support kids and their own old age. But not everyone is a coder, and the odds are that almost any skill acquired today will be outdated tomorrow.

Jobs are more than coding, and there are more jobs than coding

I’m not minimizing programming skills; they cultivate patience and problem solving ability.  But, coding is not the silver bullet of gender equality. Girls need more than C++.  They need to be able to read and write and think. Companies have layoffs and starts ups fail.  Jobs disappear. Spouses die and family members need care. We age.  Technology is a big part of the way we live, but what about education, health care, finance, dog training?

Case in point:  a young friend, Mary Hill, was in town to celebrate winning a $100,000 in angel funding.  Mary is developing an at-home test for sexually-transmitted diseases, a global market that’s projected to reach $190,000 million by 2022. Mary, I should mention, was raised by a single mom who worked for a state agency.  She went to a public high school, an arts magnet no less,  and nurtured by a very creative family, was able to take it from there. She doesn’t know how to code, but she is definitely a problem solver.

Apprenticeships across industries?

So, here’s hoping Ivanka’s coding will help. Maybe her example will help her dad encourage some big-pocketed businesses — pharmaceutical companies, large banks,  retailers, real estate developers — to invest in some education and training to caulk some of the gaps in our educational system, much like technology companies are doing today with coding sponsorships.  It’s good business and smart investing.

 

 

Trying a New Approach to Collaboration, Large and Small

When I think of horrific meeting experiences, my mind rewinds to a hands-on seminar I led years ago for Apple. The objective was to introduce teachers to Apple’s desktop. It was a group presentation with auditorium-style seating and keyboards for participants to use in conjunction with the talk. About 10 minutes into my sch-peel, a tiny grandmotherly-looking woman stood up and said to the group: “We’re not idiots. Why do we have to listen to this person, let’s just do this!”  And away they went, clicking happily along in utter chaos. That was point my boss walked in. Needless to say it was an interesting debrief.

meeting

The 20th century approach to informing, educating and convincing a group of people. 

I thought about that woman this week during a Liberating Structures workshop led by Keith McCandless (who wrote the book) and Anna Jackson who spearheads an LS meetup group here in Austin. Is there a better way to inform, collaborate, teach and motivate a group of people?  I’m a newbie but I’d say the tools they introduced me to are the best I’ve seen so far. I can see how they could work in all kinds of organizations. The idea is to tweak the feng shui of group interactions – topic, space, pacing, participation – and deploy a set of tools that better focus and distribute the conversation among the people who matter.

liberated meeting

Are there more possibilities here? Bigger group, more leaders. See the 1-2-4-All tool.  

You can read more on the Liberating Structures website. It lists all the tools and gives you a menu of when/how to apply them.

Since I haven’t applied it yet, the results are theoretical. But hey, if it works for The World Bank and The Gates Foundation, I’m all in. I’m intrigued about seeing how the tools would work cross-culturally, in situations where some of the participants are remote (there’s a technology conversation) and when selling one’s ideas to executives.

More to come.  I only wish I, like Merlin, could live backwards: Just think how I could have helped and gained from that woman who was so frustrated and anxious to learn so long ago.  I hope she’s running a company somewhere.

 

 

Can We Adapt Before Change Happens?

If a lifelong attraction to fortune tellers has taught me anything, it’s that the future never turns out according to plan. And a planner I’ve always been.

So I was fascinated when Dr. Liz Alexander posed the question:  Can we adapt predictively?  That is, can we read trends wisely enough to see what will be required for a future that’s still around the corner?

Liz, who among other things, guides thought leaders through the process of articulating and packaging their theories, pointed out that if:

  • The past is a predictor of the future
  • Corporate shelf life continues to drop (it’s now in the low double digits)
  • We remain flexible professionally, accepting that each of us will have multiple professions during our working life
  • Then, if we pay attention to mega trends, we can determine where our professional strengths can best be applied

So much depends on seeing opportunity when it presents itself.  I pulled myself away from watching the Democratic National Convention to write this. Al Franken, former comedian, current U.S. senator spoke, and I was struck by Gail Collins’ oped piece pointing out that Hillary Clinton is running for president at a time when most women are thinking about gardening, grandchildren and the occasional cruise.

These are remarkable people, obviously, but they are also tips of an iceberg of change, reminding us to stay flexible, pay attention and don’t be afraid of opportunity.  Maybe that in itself is predictive adaptation.

 

 

 

 

SXSW Interactive: Can design change the way we think about healthcare delivery?

Can we use the creativity and rigors of the design process to change how we deliver health care?  After a week of SXSW Interactive, I’d say yes, it makes sense and certainly couldn’t hurt. After over a decade seeing two parents through the Kafka-esque twists and turns of the health care system, I consider the American approach to delivering medical (and elder-) care on par with Chinese water torture, only more expensive.

Pauline van Dongen's solar-paneled dress prompts us to re-examine why we wear clothing. Why not apply that same thinking to health care?

Pauline van Dongen’s solar-paneled dress prompts us to re-examine why we wear clothing. Why not apply that same thinking to health care?

Here in Austin, The University of Texas announced a radical-sounding partnership between the Dell Medical School and The University of Texas Dept. of Art called The Design Institute for Health. The newly-formed group, led by two veterans from IDEO, the design firm famous for its longstanding relationship with Apple, are part of a push to figure out how to deliver community-based health care funded based on the “value it creates.”  The medical school’s charismatic dean, Dr. Clay Johnston, is inviting hospitals, doctors, nonprofits and the community as a whole to help re-think what the farm animals in the movie “Babe called “the way things are.”  I can’t imagine many things more challenging, or exciting.

If you have any doubts about the mind-unleashing power of design, I refer you to Paola Antonelli’s SXSW keynote, “Curious Bridges: How Designers Grow the Future.”  Antonelli, the curator of architecture for the Museum of Modern Art, guides us through a series of examples of design that provokes us to re-think the “way things are.”  Examples include a belt that simulates menstruation (to, one presumes, produce empathy in the opposite sex) and wearable clothing made with 3D printers that simulates the body’s movement created by Pauline van Dongen, who wore a sweater made of flattened solar cells during her session later that day. Think about it, technology-based clothing that’s comfortable, practical and adaptable.

Design was the subtext of a fascinating but sparsely-attended talk by Eric Topol’s called “Democratizing Health Care.” Here is a doctor, researcher and (I have to assume) AMA member, who understands that people want healthcare to be simple, affordable and effective. After opening his talk by citing medication errors as the fourth cause of death in the United States, Topol showed a portfolio of on-demand tools — a wrist band to detect seizures, an app to measure arrhythmia, or using a smartphone to digitize the heart — technology moving at the pace of Moore’s Law to troubleshoot, coordinate and identify illness — without causing the patient to go broke or die.  I don’t think any of the devices Dr. Topol showed were ready for prime time, but they they — or improved versions — will be, and they will advance the revolution.

Why not?  If we can cast off stilettos and create sympathy for PMS, why not re-think health care as a human service for real people?