Health Care Strategist

I've been in Steamboat Springs for a few days, enjoying a holiday of skiing and family togetherness. But what's a vacation without a little market research? I spent the evening of December 23rd doing some belated shopping in Steamboat Springs' downtown business district, a 10 blocks-long strip of low-down country and high fashion. Though the streets were busy and the restaurants were jumping, I'd say only about a third of the stores were open at 8:00 P.M. I spent time (and some money) in two of those stores. In each, I inquired of the owner how the economy had affected their small businesses. Same answer, both places: we're holding our own and doing much better then we'd expected, frankly. The next day I returned to a store that WASN"T open the previous night, made a purchase, asked the same question and got a very different answer: "We're thinking about closing our doors after 27 years. Things are terrible." I'm sorry for them. They seeme...

Forecast for retail clinics: heading upwards.  Writing in Hospitals & Health Networks magazine, David Ellis surveys the retail clinic landscape and finds reasons for optimism: "If a growing market demand for primary and geriatric care, a dwindling supply of primary and geriatric care, and a growing retail clinic industry are not enough to persuade anyone that there may be some correlations here, consider that so far there have been no retail clinic patient horror stories, that the little data published to date indicate that retail clinics are delivering high-quality care, and that hospital systems are slowly but surely getting into the business themselves. The reasonable conclusion is that the retail clinic, if not “very sound,” at least deserves a passing grade." And now pharmacy giant Walgreens is moving the concept into another niche: worksite clinics. "One work-site clinic, which has served a 60-employee company for three years and five hours a week, charges em...

"Hawks Lead (the NHL) In Attendance."  Now there's a surprising headline.  Yes, I'm a Blackhawks' fan but I also like a good turnaround tale, especially one with a provisional happy ending. The resurgent Hawks prove how quickly a brand can be resurrected from decades of callous mistreatment and outright stupidity.  Bad business decisions off the ice and bad player decisions on, haughty refusals to build a TV audience, disdain for a rich legacy...and yet fans never really left.   Oh sure, they stopped buying tickets and attending games.  And they COULDN'T watch most games on TV even if they were so inclined.  But the loyalty fires ran deep, thankfully, and never went out entirely.  You can say the Hawks are lucky. They TRIED to drive loyalists away and were 'this' close to succeeding.   What a difference a year makes.  Intelligence and passion are replacing old-school stupidity.  TV audiences are up 78%, players are once again household names and the U...

So I'm sitting in my kitchen a few minutes ago, having some dinner and listening to my refrigerator compressor hum away, turning warm air into cold.  Hmmm   Am I the only one struck by the sheer absurdity of MAKING cold air when just several feet away, outside the wall, sits trillions of cubic feet of air, already cold and free for the taking?  How hard would it be to pipe small, metered, portions of said air into the frig through some kind of thermostatically-controlled valve or something? It might require new compressor designs and maybe some re-thinking of kitchen layout but, at least where I live, refrigeration would be free half the year.  I'd take that.

...big things one day come!"  says the gospel according to Dave Edmunds.   So, I'm thinking: is that gospel at work in the housing market?  Beyond the things we're all painful aware of  - the rampant speculation, mortgages given to people with no hope of paying the money back, toxic assets securitized and resold several times - could there also be a small thing at work here, a little gospel spark causing a big conflagration? The spark, of course, being the crackdown on immigration, legal or otherwise. Think about it.  Regardless of your attitudes toward immigrants, housing depends on a ready supply of new homeowners moving in at the market's low end.  Those starter homeowners trade up as their incomes rise and economic confidence improves.  And their "trading up" supports the next highest ranks of homeowners and so on and so on, up the chain it goes. The housing market may need those "trader-uppers" more than it thinks.  It's the "trickle-u...

Excellent Linkedin Question and Answer thread about non-traditional methods of fundraising for not-for-profit organizations. Many people believe fundraising is all about "the ask" when it's really about the relationship.  Like most of life, fundraising success comes from building deep, enduring relationships, converting fans into "believers", and not just when you need something - a job, a referral or a donation.  The relationship makes "the ask" easier and, maybe, unnecessary. The thread discusses ideas that recognize today's micro/macro networked world as a world of new connections - communities, really - with thousands of people sharing your passion, your causes and, maybe, even your history. People you've never met but, somehow, you always knew were out there because you had a sense you weren't alone. They want to join with you.  Make it easy for them.

Ad Age ranks the top 150 media and marketing blogs .  Some good stuff there.

"...the most important rule of business in today’s integrated and digitized global market, where knowledge and innovation tools are so widely distributed. It’s this: Whatever can be done, will be done. The only question is will it be done by you or to you." Thomas Friedman writing in the New York Times today about an electric car network company called Better Place which, Friedman believes, is "...building a car company off the new industrial platform of the 21st century, not the one from the 20th - the exact same way that Steve Jobs did to overturn the music business." There are models at work to do the same thing to health care. Stay tuned.

McKinsey examines value creation in health care and finds most of it created outside the provider space (free registration required.)    It probably won't come as a surprise that providers are termed "value-destroyers." After the fact, providers tend to define any lost strategic battle as "non-strategic."  "Oh well," they shrug, watching yet another revenue stream diminish, "It wasn't really a 'core competency' anyway."   And thus is another value-creating service ceded to the entrepreneurs among us.  Not that I'm complaining...

"What Apple did was learn from history, and adopt, adapt, and assimilate past success to current context."

"We disappointed and betrayed consumers." Well, yes, but admitting the problem is usually the first step on the road to recovery. And they're in good company.

Writing in Business Week, Jeneanne Rae offers advice to President-Elect Obama: simple "change" may not be enough to satisfy expectations or address the current crises. So think in terms of "radical innovation." "...let's be clear: without an informed approach to the practice of innovation along with an innovation tool kit, they will probably fail to meet expectations." Learn from other environments and from your own failures. Analyze bureaucracy. Look globally.  

Business Week's review of Don Tapscott's new book "Grown Up Digital: How the Net Generation Is Changing Your World" offers this little gem of an idea: "Take Best Buy (BBY), most of whose retail employees are 16- to 24-year-olds. The retailer recently teamed six young, tech-savvy staffers with three professional developers to build online collaboration into Best Buy's operations on the cheap. In weeks, the team created a wiki that lets the company's 150,000 employees contribute insights on competition and popular trends. " What if you had all your employees and physicians adding their knowledge to your own?  Yes, the information would need careful filtering and editing but, who knows, you just might learn something.

Having your head in the clouds may not be such a bad thing after all.  Whew!

FALLS CHURCH, Va., Dec. 3 /PRNewswire/ -- With access to capital becoming more restricted accompanied by a significant decline in philanthropic giving, dwindling investment income, increasing bad debt and growing charity care, many hospitals and health systems are extremely vulnerable .

From Linkedin user Tony Gatteri, here's a rant worth reading: Recently I read a story about a critical, negative barber who never had a pleasant thing to say. A salesman came in for a haircut and mentioned that he was about to make a trip to Rome, Italy. “What airline are you taking and at what hotel will you be staying?” asked the barber. When the salesman told him, the barber criticized the airline for being undependable and the hotel for having horrible service. “You’d be better off to say at home”, he advised. “But I expect to close a big deal. Then I’m going to see the Pope”, said the salesman. “You’ll be disappointed trying to do business in Italy”, said the barber, “and don’t count on seeing the Pope. He only grants audiences to very important people. “ Two months later the salesman returned to the barber shop. “And how was your trip?’ asked the barber. “Wonderful!” replied the salesman. “The flight was perfect, the service at the hotel was excellent; I made a big sale, and...

Personally, I think the stock market and the broader economy are close to establishing a new equilibrium.  The question is: what will that new equilibrium look like? The tentative answer:  quite different from what we're all used to, especially in the use of leverage to boost earnings and asset values.  Financial service firms, industrial giants and consumers alike are waking up with a massive, pounding, risk-fleeing hangover.  I believe the cure - a headlong flight AWAY from leverage - is likely to be long-lasting and have a pervasive impact on many organization's growth prospects and strategies. Here's a summary of recent industry trends from the American Hospital Association, as reported in Yahoo News. What effect might all this have on the strategies of health care providers? Lower debt-to-capitalization ratios? Lower returns on investment portfolios, just when providers most need the funds? A renewed focus on liquidity and the ability to fund capital spending from curr...

McKinsey Quarterly on the new rules for recession-challenged marketers; "...not everything from the past is outmoded: marketers must still reexamine the value propositions of their brands, fine-tune products and pricing, and manage the cost of media agencies and other vendors carefully. But these steps aren’t enough. To weather the storm, it will be necessary to identify anew who and where the profitable customers are and to prioritize the most effective marketing and sales vehicles for reaching them. "When marketing and sales executives do so, it’s critical to bear something in mind: the broader forces at work in the global economy mean that the underlying economics of strategies could continue shifting with unprecedented speed and scale. Such extreme uncertainty demands constant attention, frequent reprioritization, and strategies that anticipate and respond to a changing landscape."

Journalist Emily Friedman writing on impunity in politics, business and in health care, closing with four  great suggestions for turning back the tide: Engage in small acts of resistance. Don't give up in the face of impunity. Don't get starry-eyed in the face of those who seem invulnerable. Be responsible for your OWN behavior. Read the entire article.

One of the world's most innovative thinkers - S eth Godin - presents to one of the world's most innovative organizations - Acumen Fund - on "Influencing the Masses." Where and how to start, what's important, and the need for a tribe.  Every day it gets easier. "...stop thinking about mass marketing to the world, and start thinking instead about tiny identifiable groups of connected people we can tell a story to, so that story will spread."

If you read the post below, you'll rightfully infer that I'm a fan of using evidence to improve medical practice.   But as a recent article in the New York Times makes clear, sometimes it's as much about the politics as the evidence. A point worth remembering as you consider evidence-based strategic planning.