From Virginia and many fine airports. Healthcare administration, foodie, music buff and fan of all things porcine, skis backwards

Editors note: yes, I went there on the title. Yes, I studied English in college and no I’m not ashamed of the cliche turn of phrase…. maybe a little

My first reaction was to laugh, I think it caught my doctor off guard. “It’s the ACL,” he said shaking his head. The look on his face was earnest disappointment at the diagnosis. Maybe it was the eight weeks that had passed since the injury, or the fact that I skied out the rest of the season, but my only reaction was laughter. And, when you consider the circumstances, it is pretty funny.

Last April, we were out in Vail on the first day of a week long trip. My dad and I separated from my mother and my wife to go ski outer Mongolia in some soft but quite nice spring snow. Since he had the video camera, I had him go first with the intention of rocking through the bumps and getting some ego footage. I had a great run and took my time coming to a stop at the relatively flat bottom. As I was coasting slowly I lost my balance, the back of my ski dug in to some lose snow and I went over like a slinky. I heard a pop, shouted some choice words and lay there in pain for at least 10 minutes.I managed to ski down the front side of Vail, mostly on one ski (thanks years of race training for that useful trick!).

(I documented a lot of that process here and tagged posts as ACL)
I had the reconstruction at home and this winter was back on the snow, skiing better than before the fall. It was a painful surgery and the rehab was hard – mostly because  it was boring and time consuming, not all together painful.
On the one year anniversary, to the day, of that fall we were out in Steamboat. Same story- the old man and I hitting the back bowls. On our way back to the front, we came upon The Boat’s section of double black diamonds. So I did the reasonable thing and sent my father ahead with the video camera. My thought was to get a video to send to my orthopedic doc to show him my full recovery. What would be a better testimonial than me flying down an impossably steep double black one year after my injury and reconstruction?

Right as I was taking off, Dire Straits’ Espresso Love came on my iPod. For the whole year, I had avoided listening to that song. It was playing when I went down last year! But I was in mid turn, and off to a nice start and decided to ignore it. I skied a fairly iced out steep pitch nicely, although not as gracefully as I would I have liked. I took a pause and came to a gliding stop and thats when it happened.

The same, exact fall. Right knee this time. Same pop, but not nearly as much pain and no loss of range of motion (no swelling)
I again skied off the mountain and even skied the rest of that week; followed by another two trips out west of some seriously hard skiing. In fact, I even bought two new pairs of skis this year because I was skiing so well. Unfortunately this right knee just has not changed. It is no worse, but no better either, there  is a constant dull pain. I’ve been in the gym pretty hard (squatting 360lbs often) and it feels stable when I run. Walking is another story, it does not totally slip out like my left did pre-surgery, but it locks up a bit with some significant pain at random times.

I broke down, had the MRI and consult. The diagnosis is a torn right ACL. Surgery seems imminent, and I am begining to make peace with that. My hope is, since I did not swell and do not have the resulting muscle loss, that I can do an abbreviated PT schedule and get back into the gym sooner. I’d rather not lose the ground on the weight loss and fitness while I convalesce for another 6 months.

So add this to the list of posts on this blog tagged with ACL… lets home this does not become an annual feature!

For a little something different…
The Richmond Times Dispatch ran an article last week on the Sous Vide style of cooking. I’ve become a huge fan (can you tell?) and was delighted when a friend suggested my name to the RTD. The article is a nice recap of the technique. And, like I said, I think it’s here to stay:

Dawson says he looks for the machine to soon be more prevalent when the price begins to decline. “Right now, it’s a bit of a luxury product, but I don’t think we’re far from seeing it become a mainstay in American kitchens.”

Part 2 of a 34-part series
The next level of growth for healthcare social media, must come from within the organization and involve all employees in the effort.

The previous post in this series reviewed the first year of healthcare social media and noted the correlation between engaged employees and customer service. I’ve predicted that in the coming year we’ll see progressive organizations extending the use of social tools to their employees; thereby creating a culture of information exchange and online service. Achieving a socially connected employee base at a healthcare provider is not without challenges, although it may be easier than some would suggest.

Action conquers fear

We have no reluctance about hiring someone to register a patient or letting nurses tend to patients. Healthcare providers, as Lee Aase of the Mayo Clinic has quipped, are accustomed to embracing cutting edge advances in medicine but ironically slow to adopt new business practices. And so, it should come as no surprise that many hospital systems balk at the idea of allowing a nurse or registrar represent their brand online. Many concerns can be easily relieved by exposure to social media tools and education about their use.

Compliance and regulatory issues usually top the list of concerns and rightfully so. A well-intentioned caregiver posting a patient’s picture could unwittingly generate serious legal problems for a provider. Similarly, I would not suggest completely dismissing issues relative to branding. Again, a well-intentioned employee could post offensive or misleading information.

But there are also concerns that rest on a much less solid foundation. Here, I’m referring to the red herrings of productivity, viruses (or other technological malfeasance), and inflammatory discourse. I suggest these concerns can be allayed by  what psychologists call exposure therapy.

The tools that organizations are scared to give their employees  can, in fact, be the way to overcome fears – real and imagined. It is time to begin using social media internally, within provider organizations. Doing so will help assuage naysayers and allow organizations to cultivate online ambassadors.

Connecting the dots by connecting employees

Out-of-the-gate it may not make sense to extend Twitter to 5,000 employees. However, a simple forum site, accessible only internally, may be a gentle introduction for both the organization and its employees. Consider augmenting the intranet site with a forum. Make the rules clear and accessible — no foul language, no insults, and no patient information. This is not a unique idea.

Paul Levy, the widely-read CEO blogger from Beth Israel Deaconess Medical Center in Boston set up forums when facing a difficult financial position last year. He explained that layoffs seemed inevitable, but offered an online, intranet for employees to discuss other options. It worked. Employees collaborated openly and created ways to reduce costs and save jobs. Concerns about inflammatory language proved unfounded, the conversation was civil and professional. Levy is a seasoned leader who knows criticism is often a suggestion in disguise; he’s fearless about letting employees speak freely.

If forums are the first steps, a more feature-rich social platform may follow. Multi-user content management systems like open source Word Press MU or commercial Microsoft SharePoint can be used to build powerful internal social networks. As a colleague puts it: “I can log into Facebook and see what everyone I know is up to in broad strokes, and it only takes minutes a day. Why can’t we do that across our organization?”

Imagine logging into an intranet and discovering what’s going on in finance, surgical services, registration, administration, and infection control,– all from short status updates. Wouldn’t knowing where the company as a team was headed be useful?

These kinds of controlled, internal social efforts also help employees better understand what leadership looks like. Leaders,  coached by those who understand social networks and organizational development, can model leadership by their participation in online communities. Most companies already have online training tools, so including Social Media Communications 101 is an easy drop-in that will lead to an internally connected and engaged workforce.

Next time, a deeper look at the the tools to build an internal social network…

subtitled: and takes a few well deserved jabs a comment I made on a healthcare marketing site. Chris and the gang at Interval Marketing produced a great podcast this week.

Of the topics discussed, one that really resonates with me are some of the complications surrounding the reimbursement challenges of our third party payor system. For those of us who work in that part of the industry it can be easy to be lulled into forgetting how complicated the system is. Ask any patient who has been denied after seeing a doctor and they can remind you about the challenges.

The Interval crew also delved into a question posted on Health Leaders Media: “If You Could Tell the CEO One Thing About Marketing, What Would it Be?” My comment on that post was, “marketing is dead”. As ambiguous and inflammatory as that comment sounds, the Interval team did a great job of interpreting my meaning. One of my favorite concepts is the idea of the “experience economy”. The term comes right from the title of a book by Pine and  Glilmore. The essence is that we live in a time when ubiquitous connectivity and real time communication (IE social media) enable consumer to discuss products and experiences in real time. To put that in context, I do not need to see a billboard about a hospital in town, I can see what people are saying about that hospital right now online. Those experiences will have a much greater impact that marketing.

Chris makes an eloquent counter point about marketing. When applied as the “art and science  of [retaining and growing a customer base]” it is not far afield from the experience economy. I would argue that under that definition the onus (and effort) moves off of traditional marketing and is placed on operations, customer service and clinical outcomes. In that sense, the need for billboards and print ads becomes superfluous – marketing, at least in that sense, is dead.

I have had the recent pleasure of some deep conversations with a friend who knows a lot more about these concepts than I do. Without a doubt those who “get it” understand that the future of healthcare marketing is not about a bigger watermelon truck. Business development has to be strategic and tied to the proverbial bottom line. When service and the patient experience are approached with the same attention, the results are surprisingly affirmative in advancing that bottom line number.

Enough of my drivel, have a listen to Chris and the Interval team here on their site, or subscribe via iTunes