President’s Blog

December 16, 2016: The Generational Gap

I was recently at a strategy meeting where we discussed reaching out and providing service to our customers or constituents.  As the discussion continued, it appeared that we broke down our plan using generational categories.  The Millennial was thought to be self-absorbed and impatient, while very tech savvy.  The Boomers were thought to be hard working, loyal, and more set in their ways.  Should we really stereotype each generation to make decisions on how to serve our customers?  Yes, I’ve been to those classes that present the generational categories and label the groups with certain characteristics.

I must say, that while I was on active duty and deployed to the combat zone, I found none of the stereotypes of the Millennial to be accurate.  I also found that many of my Boomer colleagues were very tech savvy, not set in their ways, and were excited to learn new and innovative ways of making improvements to our current situation.  I found those attributes to be true with the X and Y generations as well.

I would submit that each generation, each culture, each religion, each ethnic group has their foundation of reality, but also individuality.  I don’t think labeling a person because of their age is doing anyone justice anymore.  Sure, do some fit into the little boxes that researchers have placed them in?  Maybe, but each individual is unique.  Each with their own set of values, customs maybe, and possibly idiosyncrasies.  Sometimes it all boils down to how we communicate with each other.  I understand that our “perceptions are reality” concept, but take a step back and look at the whole person and what they bring to the party.  It may amaze you.  I know I’ve been amazed.  Have a great holiday season and a fantastic 2017!

Your thoughts? Continue this conversation on Facebook or Twitter.


November 9, 2016: Communication for Change

Well, that was quite an election cycle with shocking results for many.  So, where do we go from here?  How do we take what has been a divisive environment and unify a country to set sights on a clear vision for the future?  Or can we?  Are we talking transformation here or will it be business as usual?

If you can’t imagine the enormity of transforming an entire nation, think about what it takes to bring a health care system together for a shared vision and a clearly identified mission.  The first step is shoring up enterprise communications.  A strategic communications plan, if not number one on the list, should be, at least, in the top three.

A communication plan targets all levels of an organization.  It lays out all channels of communication that will be utilized as well as how it is delivered and by whom. It has been proven that transparency is the best policy.  Another important aspect is crisis communication.  When a tragic event happens that affects a community or, possibly, a nation, how is it presented and controlled?  Or can it be controlled.  These plans are essential for success, I would argue, not only for a health system, but also for any industry, including the government.  I believe that all organizations have a communications piece to their infrastructure, but I’m not sure they function in the most useful capacity.  Your thoughts? Continue this conversation on Facebook or Twitter.


October 16, 2016:  Experience versus Satisfaction

I’ve read a few articles recently that talked about patient experience versus patient satisfaction and how we need to change our survey methods to match and trend those qualities in health care.  Are we splitting hairs here?  In one of the articles, it breaks down in two columns the alleged difference between the two.  I ponder whether or not the patient distinguishes between satisfaction and experience.

For example, I related a story about a cystoscopy I had recently.  I wasn’t sure what to expect, so there was some anxiety associated with this procedure.  The urology technician told me that that she was applying an anesthetic gel to lessen the pain.  As the camera was inserted, I stopped breathing for the first, probably minute, of the procedure.  It may have been less, but it felt like a long time.  I think I hyperventilated after that.  My wife told me to stop being a baby, because you know, there was no comparison to childbirth.  I couldn’t argue that.

It was an unpleasant, but necessary experience.  The satisfaction was that the urologist was able to see what he wanted to see and make his diagnosis.  Could the experience have been better?  Could I have been more satisfied?  My friend told me he had the urologist use conscious sedation when he had his procedure.  I wasn’t given that option.  Is that an experience or a satisfaction issue?  Your thoughts? Continue this conversation on Facebook or Twitter.


September 8, 2016: VIP Health Care by President Bob Rahal

I read an article recently entitled, “VIP Syndrome can be a risk in caring for stars.”  It talked about the death of Prince and Michael Jackson, and how special medical care put them in a position to depend on treatment that was considered outside the standard of care and dangerous.  Most had to do with the treatment of pain, but it mostly concerned the prescribing and delivery of pain medication such as fentanyl, and the anesthetic propofol, used in Michael Jackson’s case to ease his pain and help him sleep.

Even the military has a protocol office that provides an executive treatment process for senior officers, senators, congressmen and women, and yes, even the President of the United States.  There is also a process for executive care provided for foreign dignitaries and senior officers.  It is named the “Executive Medicine Clinic” at the Walter Reed National Military Medical Center in Bethesda.  It makes sense that they would have something like that, being in the Washington DC metro area and all.

It is possible that the expectation of care graduates with the socio-economic situation of patients.  Many that can afford it, will want the best tests and the best treatments money can buy.  Others will take what they can get or afford.  The question is, “should care only be provided to the extent that is medically necessary?”  And what or who determines that?  Certainly, after medical school and residencies, physicians will find their own keys to successful treatments.

So, could this be an equity of care issue, that isn’t necessarily racially charged? However, there could be a socio-economic argument here.  It is monetarily and status charged.  Should an abundance of care be afforded those with status and/or money while the middle and lower class get what they can?  Is this, in some way, driving up the cost of health care?  It is true that those with health insurance may have a leg up, so to speak, on those who have none.  Should those with crazy money and status have it any better than the rest of us?  Sometimes, as noted with some of our memorable performers, more is not necessarily better.  Continue this conversation on Facebook or Twitter.

August 17, 2016: Diversity and Inclusion by President Bob Rahal

Today, I sat through a webinar on Diversity and Inclusion.  There were two chapters that touted their successes in this area of health care.  If you haven’t heard or read, there are two new communities in the ACHE forum.  They are the Asian and LGBT communities.  At first I read that membership had to join one of these communities.  I inquired and ACHE Corporate said that it wasn’t a requirement.

Diversity and Inclusion have been a fast moving part of many chapters of ACHE nationwide.  It’s like, if you aren’t on board, you are falling behind the wagon train.  I’m not sure if this is something that can be forced upon people.  There is still so much to learn about this area of health care, but there are also many references that can be researched and many people within and outside of health care that are subject matter experts in this field of study in the industry.

South Texas has the highest Hispanic percentage of membership of any chapter in ACHE.  This is something, I believe, is probably due to the high percentage of Hispanic members in this region of the U.S.  One of the articles talked about in the webinar is Why Diversity Programs Fail.  This can be found on the Harvard Business Review website:

Another article that I found interesting was the Navy is expected to name a ship after Gay Rights Activist Harvey Milk.  I found this on the website:

There has been a great deal of attention given to the LBGT community over the past, probably, 5 years or so.  My take on diversity and inclusion is what each individual brings a unique set of skills, culture, and perspectives to the table.  It’s not only about color, religion, sexual orientation, sex, or ethnicity.  I’d like to get your take on diversity and inclusion, and what you think we can do, as a chapter, to further enhance our position in this area. Continue this conversation on Facebook or Twitter.