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Showing posts from 2011

9 Health Care Jobs Expected to Grow by 2018

9 Health Care Jobs Expected to Grow by 2018

#3: Public Relations Specialists As the health care industry becomes more technologically savvy, smartphones and social media will become more common tools of the trade, in addition to traditional machinery. Therefore, hospital public relations will grow 52%.

#9: Customer Service Representatives
Hospitals are trending toward customer service satisfaction, conducting surveys and becoming more attentive to patients as customers. Therefore, expect to see this field in health care grow 52%.

Just me being creative!

Creativity Is...

"Creativity is allowing yourself to make mistakes. Art is knowing which ones to keep."

(Scott Adams (1957 - ), 'The Dilbert Principle')

The HBR List of Audacious Ideas

I'm wasn't sure 2011's waning days needed yet another list of some kind, but Harvard Business Review's list of audacious ideas is pretty good.  Why audacious ideas?
"(Because) even though (businesses are) sitting on $2 trillion in cash, they’re risk-averse, strategically incremental, and notably lacking in fresh ideas. "We think this stinks. The world needs invention and daring now more than ever.  Now is the time for audacity, not austerity. " So here's HBR's list (the full article requires registration.)
Tackling the World EconomyGive People Shares of GDP, by Robert J. ShillerDouble Down on Start-ups, by Bruce Gibney and Ken HoweryPartner with China in Afghanistan, by Wayne PorterEnroll the World in For-Profit Universities, by Parag Khanna and Karan KhemkaTackling Science ChallengesGive NASA a Real Mission, by Gregg EasterbrookDeclare 20% of the Ocean Off-Limits, by Enric SalaElectrify the Bottom of the Pyramid, by Arun MajumdarTackling Social P…

"I've Cracked It!"

Reportedly Steve Jobs' final words about Apple's long-rumored venture into the thickets of TV programming.  So has Apple, indeed, "cracked it?"  Let's hope so.
Analyst Shaw Wu on why Apple should enter the TV business: “What’s missing is live broadcast television,” he wrote. “One obvious way to offer this is via the traditional way where a user subscribes to cable or satellite. But a more revolutionary, disruptive and differentiated way, is via the internet or IPTV which would be more in-line with its iTunes and iCloud model. Because of the high dependence on content providers, we believe exact timing is difficult to pinpoint.”
He added, “We continue to hear what AAPL would love to do is offer users the ability to choose their own customized programming, i.e., whichever channels/shows they want for a monthly subscription fee. This is obviously much more complicated from a licensing standpoint. And in our view, would change the game for television and give AAPL a …

Job: Pres/CEO Rochelle (IL) Community Hospital

"The ideal candidate will be a dynamic and exceptional leader with documented success in leadership, management, strategic planning, and execution of the strategic plan and vision. This candidate will have the ability to analyze problems and develop systems to accurately control the human, physical, financial, and informational resources of the organization. The CEO will have excellent communication and presentation skills at a professional level. Not only will the successful candidate serve as a highly visible role model to all, he or she must also develop positive working relationship with the RCHA board of directors, medical staff, community leaders and employees." (12/21/2011)

Contact: Stacey Sibley Human Resources Manager
Rochelle Community Hospital
900 N 2nd Street
Rochelle, IL 61068
Fax 815-561-3125
No phone calls or recruiters please

(Disclaimer: I'm beginning to post interesting healthcare-related job opportunities as they come to my attention.  These are not …

Surviving A Hospital Stay With Luck and Pluck

A grad-school colleague once described his hobby – military history – as stories of luck and pluck stitched end-to-end.  Stories replete with derring-do and narrow escapes.  Suffering losses bravely while hoping for the occasional happy ending.

I feel much the same way about hospital customer service anecdotes (except there’s more unnecessary deaths and even fewer happy endings.) Still, I can’t help regaling you with another adventure through healthcare's minefields.

A friend’s father recently sought treatment for a leg infected with what appeared to be a nasty staph infection. A late-Saturday ER visit resulted in his admission and the first of what was supposed to be multiple doses of IV antibiotics.

Now this is a well-regarded hospital with a spanking new facility, a member of one of the industry’s most highly-regarded national systems. So far so good, right?

At 4:30 P.M. the next day, as the attending physician reviewed the chart, she wondered why no antibiotics had been adm…

You Need To Get Out More!

"The trouble in corporate America is that too many people with too much power live in a box (their home), then travel the same road every day to another box (their office)." - Faith Popcorn, The Popcorn Report, 1991 

Many pundits and more organizations are, rather suddenly, talking about innovation - what it is, how to do it, whether it offers a cure to what ails health care.

It's a long-time theme here on Health Care Strategist and if I could offer would-be innovators one bit of free advice, it would be this: get out more.  You'll never get where you want to go from where you are.   Boring, predictable, comfortable, sameness and routine are deadly to innovative thinking.

So see the world. Read voraciously and widely. Confront challenging ideas. Blow through your comfort zones. Chat up strangers (not counting new members at the country club.)

In fact, if you're serious about innovation and ideas, resign from the CC and hang out at a soup kitchen. The fo…

Your Idea Can Change the World

"Your idea doesn't have to be big. It just has to be yours alone. The more the idea is yours alone, the more freedom you have to do something really amazing. The more amazing, the more people will click with your idea. The more people click with your idea, the more it will change the world." - (Hugh Macleod, How To Be Creative: 2, 08-22-04"

Wal-Mart Wants To Be Your Doctor

And your manager of chronic diseases. And your pharmacist. And maybe your health coach. They could even play in your ACO sandbox.

In response to the article, Wal-Mart says they’re NOT, repeat NOT “… building a national, integrated low-cost primary health care platform..." OK, got it.  Not.

Unless, of course, they are.

It’s hard to deny their interest when a few scant weeks ago the retailer sent out a request for partners to help it "dramatically ... lower the cost of healthcare ... by becoming the largest provider of primary healthcare services in the nation."

It's no surprise that hospitals and physicians face stiff competition from unexpected directions.  These deep-pocketed newcomers care not a fig for our outdated business models, our glacial decision-making and our ability to pervert most innovations that might disrupt the status quo.

[Read more from NPR blogs...]

My Healthcare Innovation

We're shaking up healthcare with social innovation, says John Soloninka, CEO of the Health Technology Exchange:

"Health systems have been very slow to innovate and we under-realize our return from our investment in medical research and human resources. What we need is a health system that can distill and articulate its high priority problems, share them to the innovation community (internally and externally), reward innovators and facilitate rapid implementation of "disruptive" technologies. HTX is interested in My Healthcare Innovation as a way of creating and interconnecting communities of interest to share problems and best practices, while maintaining a safe and secure environment for frank discussion."

[Read more...]

I'm Sorry Mr. President

I'm sorry Mr. President. I know a little something about Teddy Roosevelt and you're not him.

He fought for this country. You wrote law review articles.

He was a true outdoorsman and naturalist. You play golf, summer on Martha's Vineyard and wouldn't know a morel from a moral.

He said "Speak softly and carry a big stick." You deliver great speeches and, well, that's pretty much all.

Next time you channel someone, pick a lesser light.  You won't suffer so badly by comparison.

(Image from here, based on Creative Commons search.)

The Doctor In Your Car

Ford Exec To Keynote Digital Health Event At CES: Gary Strumolo, global manager of health, wellness, interiors and infotainment for Ford Research and Innovation will be the day one luncheon keynote speaker for the Digital Health Summit at the 2012 International CES.

From the article:

"Just as mobile has enabled Americans to take a more active role in managing their health and well-being, automobile manufacturers like Ford are looking to develop a series of health and wellness in-car connectivity solutions designed to empower people with self-help information while they drive," said Jill Gilbert, co-producer, Digital Health Summit. "As the most progressive automobile brand in the health space, Ford has both the credibility and expertise to share insights on next generation innovations around consumer oriented health and wellness solutions on the go."

"Leveraging the Ford Sync connectivity platform and its ability to connect to mobile devices via Bluetooth, acces…

Winners of the Making More Health Competition Bring Fresh Innovation to Solving Problems in Health

Winners of the Making More Health Competition Bring Fresh Innovation to Solving Problems in Health

Example: ColaLife - piggybacking simple medicines on soft drink supply chains, saving lives in underserved areas of rural Africa. Medicine has a hard time getting to where it's needed but cola is everywhere. Why not combine the two? Great idea!

"Aggravate a traveler, then hand them a smartphone..."

Especially a traveler who is also a composer and musician.  From Alexandra Samuel, blogging at HBR Blog Network about Qantas Airways' misadventures through the social media minefield: 

"We've been saying this for a while now but it's worth repeating: Social media turns branding into a true (if often accidental) collaboration between company and customer, in the way it enables constant and often bottom-up collaboration within organizations, and in the way it accelerates the pace of conversation and organizational change. Social media tends to flatten hierarchies, disempower gatekeepers, and give a voice to anyone who cares to speak about an issue, or a brand."
Still a doubter?  Maybe you should Google "United Breaks Guitars"  - another airline but still the poster child for customer revenge, and the point that started this post...

Rated Lower On Satisfaction, Hospitals Blame ‘Cranky’ New Yorkers

Say the headlines. Of course the official explanation is “Well, Manhattan residents are crankier, tougher to satisfy and have higher expectations than those ‘nice’ Midwesterners.”

Really? Let’s parse cause and effect here. (Fair warning: I’m not the least bit sympathetic to the official explanation.)

The NY Times’ article offers an anecdote of a NYC patient waiting 8 hours for an imaging exam and not getting a magazine when she asked for one. And she refused to give the hospital a top score because…she’s CRANKY?

Excuse me?

And there’s this: NYU Medical Center is building new elevators to reduce waiting times, though they won’t be ready until a new building opens in 2017. How long has NYU known about their slow elevators? Decades, probably, yet we’re still 5 years and several hundred million dollars away from a solution. And we’re supposed to believe the problem is…CRANKY PATIENTS?

Excuse me?

I’ve worked in markets ranked #183 (Hinsdale, IL), #27 (Omaha, NE) and now #1 (M…

"It is so simple, just do what you love."

Christina Stevens writes about senior living at her blog "Next Wave." Good stuff.

Haven't read it yet, but love the title!

Questions For A Sunday Morning

Weight loss:  Commercial weight-loss schemes outperform physician recommendations.  Does your heart follow where your pocketbook leads?  (Chicago Tribune)
Prostate surgery: Risks associated with prostate surgery are lower at academic medical centers.  Does practice make, if not ‘perfect,’ at least ‘better?’  (Chicago Tribune)
Quality measures:  Will your physician ‘fire’ you to meet standards for incentive-based compensation? Are you a parent who refuses to vaccinate your kids?  “You’re fired!” (Advisory Board)
Disease management:  Programs for Medicare patients do not improve quality, reduce costs or decrease hospital and ED visits.  It’s only one study, but disappointing nevertheless. (NEJM)

 (Image from via a Creative Commons search)

"Major segments of the US economy have been lost, in some cases, forever."

From Clayton Christensen being interviewed by Steve Denning for Forbes:

"Firms need to be evaluating future investments strategically in terms of how they will affect their capacity to go on delighting their customers for a sustained period in the future.

"For managers trained in traditional business school thinking, the idea that pursuit of profit is the problem, rather than the solution to the economy’s problems, may come as a shock. For business school professors who have spent their lives teaching the focus on profits and the use of IRR and RONA to measure profits, the coming change may be even more disturbing.

"Like all new ideas, in the first instance it will be rejected. Then it will be ridiculed. Finally it will be self-evident and no one will be able to remember why anyone ever thought otherwise."

What I'm Reading: "Different; Escaping the Competitive Herd"

"...every year, I tell my students that marketing is the only function in the organization that is expressly designed to sit at the intersection where business meets people.  Real people.  And the problem with real people is that they don't see the world the same way a businessperson does.  They don't speak the language of bullet points; they don't organize the world into flowcharts and frameworks.  People, real people, view the world more organically.  They are idiosyncratic.  They are unpredictable.  They are beautifully disorganized."  
(From "Different; Escaping the Competitive Herd" by Youngme Moon.)

" is the only function in the organization that is expressly designed to sit at the intersection where business meets people."  I like that.

(Image from found via a Creative Commons search)

Jawbone’s Wristband Health Monitor

Bloomberg Business Week:  "And now there’s UP. “The big idea here is to help make people consumers of their own health,” Rahman says. “We probably know less about our bodies than we do about our phones.” UP is supposed to change that. The pliable rubber-coated wristband is meant to be worn nonstop for 10 days at a time, even in bed and in the shower. An accelerometer inside tracks data like the number of steps a person takes in a day and the number of calories he or she has burned. The device also monitors sleep patterns and can be programmed as an alarm that wakes the wearer, within a preset time range, at the ideal moment in their sleep cycle. The accompanying iPhone application lets users share their UP data with friends, create personal challenges, and record and track each meal they eat."
On sale later this month for $100 at Best Buy, Target and Apple stores, UP may be the best $100 you've spent on your health.
[More, here.]

An Apple A Day...

From From Doors Of Perception:  "...between 1995 and 2010, North American taxpayers spent over $260 billion on subsidies of junk food ingredients compared to $262 million - *one thousand times less* - subsidising apples [which is pretty much the only fresh food to get a subsidy at all]."

The Challenges Facing Low-Quality Universities

From The New Republic: "A Much Needed Challenge To Low-Quality Universities."  Higher education is in crisis.  Out of touch thinkers and policymakers. Skyrocketing costs (even faster than healthcare.)  Mounting student loan debts.  De-emphasized teaching and research while administrative layers grow without limit.

Despite the serenity of most college campuses, "...the reality of higher education is that most students today don’t have access idyllic (and expensive) college experience, never have, and never will. Instead, many get stuck in big, low-cost lecture courses of indifferent quality provided by institutions that treat students like anonymous tenants. Those are the places that are going to be transformed by technology.

"These disruptions will take many forms. While it’s impossible to predict exactly what the typical college student’s educational experience of the future will look like, the changes will almost definitely include a decline in the numbe…

If Disney Took Out Your Trash

If you’re a reasonably long-time reader of Health Care Strategist, you’ve heard me criticize health care's apparent incuriosity about the innovative world beyond some walnut-paneled boardroom.

“Not invented here. Can’t work. Let’s take it to committee. Better yet, let's form a NEW committee!  It’s too risky. Health care is different. You don’t understand - we’re a hospital, not Google! Nobody else is doing it. Why should we?”

Some of you think I’m being too hard on an industry that’s paid my bills for 25+ years. Really? Then tell me why this story is headline-worthy:

"Community Hospital Borrows Show Biz Staging."

Visit any Disney property and what you WON’T see are maintenance carts, food deliveries, trash removals or employees rushing to their job station. All that operational stuff happens behind the scenes, away from the paying public’s eyes.

 Disney pioneered this separation of public and private spaces in the early 1960s at Anaheim’s Disneyland and a decade…

Your Next Health Coach May Be...

...your car.  From Edmunds Inside Line:

"Ford cars and trucks may soon be able to tell you when to take a puff on your asthma inhaler or test your blood glucose level, as the Dearborn automaker is poised to take its Sync communications system far beyond infotainment.

"The Dearborn automaker offered a tantalizing — if somewhat disconcerting — look on Wednesday at the potential for a vehicle to be your partner and coach when it comes to health and wellness.
"Ford said it was intent on demonstrating a paradigm shift in the way its Sync communications system is used. In the not-too-distant future, a car could let you know the UV index so you could apply the proper amount of sunscreen, monitor your food choices at McDonald's, or check your calendar to see whether you'll be playing sports that day and may need an extra puff or two on your asthma inhaler.
'"We're not trying to turn the car into a medical device," said Alan Hall, a Ford spokesman in a …

Hospital Marketers: TIme To Own the Growth Agenda

Hospitals' salad days are over, at least if you believe the breathless headlines.  Gone are the days when business models could be built simply by chasing Medicare's hot reimbursement du jour
Unfortunately, more than business models were built on such crabbed thinking. Where Medicare led, capital structures, facilities, strategic thinking, indeed the very definition of 'success' were sure to follow. 
And follow they did. Massive was the party. Crushing are the debt loads and mediocre the results. Naturally a pounding hangover ensues, though the remedy - perhaps a 'rescuing'  full-asset merger - is neither quick nor painless.

(Example: Elmhurst Memorial Healthcare's dalliance with Northwestern Memorial HealthCare.  “I think having that new facility is going to be a real challenge for (Elmhurst)  financially,” says my friend Brian Sanderson, a partner at Oak Brook-based accounting firm Crowe Horwath LLP) 
"We've nothing left to cut!" is t…

Marketing LEADS

Some hospital marketers are obsessed with control.  You probably know one or two like that, more's the pity.
"Stop interrupting!" they tell their organizations. "We're working our plan and we know what's best for you!"
Anything outside that neatly packaged world view becomes an imposition, a ripple on the quiet millpond of reality.  "He LEADS" is never said about marketing control freaks because they're never Listening, never Engaging or Adapting, rarely Delivering Strategic Separation (I know that's 2 'S's.'  Humor me.)
Having a plan is fine. Having an opinion is expected. An emphasis on control benefits neither.
LEADS means empowerment, not control.  The best ideas, not MY ideas.  Teaching, not telling.  Learning, not arguing.  Listening, not talking.  'We,' not 'I.'  All of us are smarter than one of us.
Try to be the marketer about whom it is always said "She LEADS."  Everything else is ju…

Seth Godin: "If Committees Told the Truth."

That truth would be:
"Hi, we're here to take your project to places you didn't imagine.
With us on board, your project will now take three times as long.
It will cost five times as much.
And we will compromise the art and the vision out of it, we will make it reasonable and safe and boring."
Or as I always say, committees are where ideas go to die.

An eBay For Purchasers and Providers

BIlling itself as a "health services exchange," Open Health Market offers discounted, fixed, packaged pricing for an episode of health care.

Discounts.  Fixed pricing.  Packaged services.  Easy access.  Transparent quality data. 

From the article:   "...this concept goes flying over the head of four out of five" U.S. hospital executives. "I'm stunned at how difficult it is for most of them to get their minds around it."
Stunned?  Really?

More here at Open Health Market's website.

“He told them it was ugly and too complex..."

From The Daily News Blog: "Bio: Steve Jobs was a details man, even in his Memphis hospital bed."

"In Walter Isaacson’s biography of Apple CEO Steve Jobs that went on sale Monday, there’s some fascinating detail about Jobs’ stay in Memphis during 2009, when he got a liver transplant at Methodist University Hospital’s transplant institute.

"Jobs, who died earlier this month at age 56, was ever the details man, even in his hospital bed.

"There’s a moment in the book’s recounting of Jobs’ transplant when Jobs pulled off an oxygen mask, grumbled about the design and ordered someone to bring him five different choices of masks. He said he’d pick the one he liked.

"Same for the oxygen monitor on his finger.

“He told them it was ugly and too complex,” Isaacson writes of the monitor. “He suggested ways it could be designed more simply.”

So here's a question for you:  before, during and maybe even after Jobs' hospital stay, how many hospital staffers saw thos…

Great PowerPoint Presentations: Oxymoronic?

No, but sometimes they can be rocket science as Edward Tufte shows in "PowerPoint Does Rocket Science--and Better Techniques for Technical Reports." 

Tufte studied NASA's PowerPoint-fueled discussions as engineers struggled to assess the damage, if any, space shuttle Columbia sustained during a 2003 liftoff when a small piece of foam insulation broke off, striking the orbiter's left wing.  We all know how that story turned out.
Thankfully I'm called to deliver presentations with ideas, not lives, hanging in the balance. Still, telling a story clearly, concisely and powerfully never hurts.

Sun Comes Up, It's Tuesday Morning

Not very organized today, so you'll have to put up with a few random things catching my eye...
1.  Distrusting their government's message on nuclear safety, Tokyo residents self-organize and go looking for radioactive hot spots.  Guess what they find?

Watch this "self-organization" trend.  It's coming to a health care neighborhood near you.  Maybe they'll self-organize into a booster club for your current business model...though I wouldn't bet on it.

2.  The Regenstrief Institute (IN) launches an initiative to encourage innovation, naming John Duke, M.D., the Institute's first Innovation Officer. "We are encouraging everyone associated with the Institute to come forth with ideas. Traditionally researchers develop ideas and then pursue funding. Learning from successful organizations such as Google, Facebook and Netflix, we are both accelerating and democratizing the idea process. We are encouraging everyone, from established researchers to fello…

Social Media In the C-Suite

C-Suite denizens have had difficulties warming up to social media.  Most are used to being, if not the entire conversation, at least in charge of what's said, when and to whom.  Social media's democratizing effect threatens that neatly-ordered world.
And it's humbling to learn that your thoughts and opinions aren't crystalline, brilliant or even very persuasive.  Readers talk back, using adjectives like idiotic and clueless, sometimes alone or in very creative combinations.  (Happens to me all the time, in case you're wondering.)
A critical (though common) misperception is that social media is about "Me talk.  You listen.  Me talk more.  You do what I say!"  That never worked with my daughters and I doubt it'll work for many hospital CEOs.
In "Social Media in the C-Suite: Listening, Learning and Creating a  Strategy from the Top Down" Knowledge @ Wharton interviews author Michael Lewis about the opportunities and pitfalls in implementing a …
Randy Lewis writing in the LA Times, discusses a little-known aspect of Steve Jobs' legacy: 
"Stevie Wonder said Thursday that he sought Jobs out late in his life to express his gratitude for matters that went well beyond what he and his company did for music.

"The one thing people aren't talking about is how he has made his technology accessible to the blind and the deaf and people who are quadriplegics and paraplegics," Wonder, 61, said. "He has affected not just my world, but the world of millions of people who without that technology would not be able to discover the world.

"His company was the first to come up with technology that made it accessible without screaming out loud 'This is for the blind; This is for the deaf.' He made it part of the actual unit itself. There was application inside the technology that allowed you to use it or not use it.

"The iPhone, iPad touch, iPod touch, all these things, even now the computer, are acces…
David Leonhardt writing in the NY Times: "Health care is far larger, with the United States spending at least 50 percent more per person on medical care than any other country, without getting vastly better results. (Some aspects of our care, like certain cancer treatments, are better, while others, like medical error rates, are worse.) The contrast suggests that a significant portion of medical spending is wasted, be it on approaches that do not make people healthier or on insurance-company bureaucracy."

This May Hurt A Little Bit: Entrepreneurs Can Fix Health Care

Washington Business Journal WBJ BizBeat:  "Former Kaiser CEO:  Entrepreneurs can fix health care."
"Entrepreneurs — not the government and surely not established industry players — will be the ones who ultimately fix the deeply flawed American health care system, said Dr. David Lawrence, the retired CEO of Kaiser Permanente."“The problem with incumbent medical care systems is, they don’t change,” Lawrence said. “What they tend to do is capture the innovation, the entrepreneurial activity, and either slow it or they transform it to what their needs will be, and they often bastardize what are very, very important innovations.”

Lawrence predicted pain as the system evolves.“To do these well is going to require disrupting traditional medical relationships with patients, it’s going to require disrupting sources of income for the traditional medical care system, and it’s going to require disrupting the relationship of the consumer to the medical care system," he said.…

Why The Next Steve Jobs Will Never Work For Your Hospital

Your hospital has thousands of employees, but could you use your very own version of Steve Jobs?  Probably, but don't kid yourself. He'd never get past your H-R department's first line of defense, with his attitude and his iconoclastic views and his wardrobe. Someone would scrawl "Weird and Possibly Dangerous" across his resume and that'd be that.

But don't fret.  I'm pretty sure the feeling would be mutual.  And that's why your hospital's branding tagline really ought to read "We're no worse than anybody else."

The NY Times' David Pogue on Steve Jobs: "Imitated, Never Duplicated:"
"Here’s a guy who never finished college, never went to business school, never worked for anyone else a day in his adult life. So how did he become the visionary who changed every business he touched? Actually, he’s given us clues all along. Remember the “Think Different” ad campaign he introduced upon his return to Apple in 1997?


Doctors Learning to Speak "Iowan"

From Iowa Public Radio: Doctors Learning to Speak Iowan at Mercy Medical Center in Mason City, IA.
"Learning to speak English is one thing, learning to speak Iowan may be something else entirely. Iowa, especially in its more rural areas, has many foreign-born physicians practicing in clinics and hospitals. On today's program, we’ll find out about an innovative program in Mason City that helps doctors understand our state with courses like "Topics for Small Talk with Iowans." We'll talk to the teachers in the program at Mercy Medical Center North Iowa, Univ. of Northern Iowa professors Mark Grey and Michele Devlin. We'll also hear from the man who devised the program, Dr. David Little, and Family Medicine Residents Dr. Sreevalli Dega and Dr. Anileen Prabhakaran."

“You’re looking at a generation of 20- and 30-year-olds who are used to self-organizing,”

NY Times:  "As Scorn for Vote Grows, Protests Surge Around Globe."

Political and financial institutions are seen as clueless at best, venal at worst.  A new generation vents their frustration through self-organizing, decentralized coalitions.  

Many health care strategists will read this article with a sense of detachment.  That's a mistake because, above all, successful strategists are trend-aware.  

So be aware of this:  

A trend driven by economic frustration and doubt about the future may start in the political arena, but that's seldom where it stops.

From the article:
"Increasingly, citizens of all ages, but particularly the young, are rejecting conventional structures like parties and trade unions in favor of a less hierarchical, more participatory system modeled in many ways on the culture of the Web.

"In that sense, the protest movements in democracies are not altogether unlike those that have rocked authoritarian governments this year, toppling longtime …