The Monday Morning Quote #469

“Leadership is the capacity to look ahead, think ahead, plan ahead, and then influence other people to go ahead on the plan”

Ralph C Smedley

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Health Factory

I am fortunate, and grateful, to have a brother whose inclination and job means that he has an interest in many fields of medicine. Education, research, clinical and academia all provide him with stimulation. We are able to learn from each other (although I believe the balance favours and benefits me).

A part of his New Year clear out the 2010 film “Health Factory” arrived via a pretty large download yesterday and I would urge anyone who is involved in health care to watch it and then to ask themselves some very simple questions. Start with “Why?” as in “Why am I doing what I’m doing? and “Why am I doing it this way?”.

The film questions the way health services are provided and if the current obsession with the imposition of “business” processes benefits anyone, patients or (that awful word) providers.

As you can imagine for someone who describes himself as “The Dental Business Coach” I am capable of vigorously justifying the arguments for dealing with dentistry as a “business”. However this film has made me examine what I am doing for and with my clients.

It helped me to understand why gut feeling led me to turn down more clients than I accepted last year. Finally it reinforced the beliefs and convictions that led me into dentistry in the first place and made me realise that what I am doing these days is right.

Watching what happened when Norway imposed a new system and how hospitals were rewarded for “gaming” or “creative coding” took me back to my early days of NHS associateship. The culture  at that time, encouraged speed of work and high output leading to a “pile high sell cheap” approach where the work was made to match the narrative of the NHS scale of fees. As the fees evolved so did clinical practice to maximise income. It was only when I took control back by working privately on a one to one basis with patients that I felt in control and capable of giving my best without compromise.

One can argue, and I do, that dentistry easily adapts to “business” models and even fashion. There is much that can be measured easily and should be, a lot more that could be but isn’t because the “need “ is not appreciated. However the imposition and measurement of many Key Performance Indicators is frequently a waste of time and energy providing results that signify little.

You can’t measure trust, patience, co-operation or happiness (in spite of what some gurus would have you believe).

As one of the featured clinicians said, “You end up measuring what can be measured, which will always be marginal to what the core of the job is.”

So for me, it’s a return to examining the abstract, difficult to quantify elements of dentistry. Anyone can measure things. It takes experience, and dare I say it, a certain amount of gravitas, to feel, to empathise, to understand and analyse what health means, to both patients and clinicians.

Worth a look, you can rent it and see the preview HERE.

And there are more clips on YouTube

 

One rule for you, one rule for the rest…

Inspired by John Naughton.

Picture this – one dentist manages to lose one set of notes of one patient, who was one month old, who had made one visit to the practice as an emergency and treatment consisted of examination and parental reassurance. The notes are passed to a recognised third party for disposal but turn up on a patch of waste ground. The CQC and the GDC would be involved and that dentist would probably go through months of anxiety whilst it was decided how big the case was for them to answer.

Meanwhile…. “sometime between mid-May and July, Equifax was hacked via a security flaw in the Apache Struts software that it used to build its web applications. The flaw, which gave hackers an easy way to take control of sensitive sites, had been fixed on 6 March and patches were made available to every organisation that used Struts. That meant, as various commentators pointed out, that Equifax’s IT department had the tools to plug the security holeand two months in which to do it. For some reason, they didn’t.

As a result, the hackers were able to steal the personal information of 143 million Americans. It is the most important financial data available on any citizen – names, dates of birth, social security numbers, home addresses and in some instances a lot more, including credit card details of more than 200,000 US consumers (and some UK consumers). It’s everything you need to engage in identity theft on an epic scale. “On a scale of 1 to 10 in terms of risk to consumers,” said a fraud analyst at consultancy firm Gartner, “this is a 10.””….

…Equifax discovered the breach on 29 July, but didn’t reveal it publicly until 7 September, no doubt because the internal investigation was long and complex. During that period, however, three of its senior executives unloaded shares in the company valued at $1.8m. But this, apparently, was completely coincidental: the poor dears (who included the chief financial officer) were not aware that an intrusion had occurred when they sold their shares. 

…..if some poor unfortunate forgets to pay a library fine and then discovers that they can’t get a loan because a check on Equifax’s database reveals the payment lapse, well… that’s just tough. If you want to understand the populist revolt, then this is a good place to start.

The Monday Morning Quote #442

“The solutions are all simple – after you have arrived at them.

But they’re simple only when you know already what they are.”

Robert M. Pirsig

Zen and the Art of Motorcycle Maintenance

The Monday Morning Quote #439

“Culture eats strategy for breakfast.”

Peter Drucker

Read more here and here

The Monday Morning Quote #420

“If we can keep our competitors focused on us while we stay focused on the customer, ultimately we’ll turn out all right.”

Jeff Bezos

 

The Cost of Doing Nothing – in IT

From LRB comes Paul Taylor’s take on what has led up to the problems with NHS IT systems – the malware attack last Friday was a symptom of a far more complex and concerning issue.

Successive governments have spent billions without success. 

“There are no good news stories about computers and the NHS. The reporting of Friday’s malware attack may, however, be usefully different from the typical bad news story, in which hubristic politicians or nameless bureaucrats waste millions, if not billions, of public funds on projects which go over budget, fail to deliver, prove to be unusable or collapse under pressure. In this instance it seems that, for once, inaction and underinvestment have led to something sufficiently focused to be newsworthy, showing that there can be a political as well as a human cost to doing nothing.

For most of the 21st century, the story of NHS IT has been the slow unravelling of New Labour’s ambitions for the transformation of public services. In February 2002, Tony Blair committed his government to a programme that was supposed to take the NHS, in two years, from being largely paper-based to having a seamless IT architecture, enabling a new generation of consumer-friendly digital health services. The mistakes that were made in the pursuit of this vision, which became known as the National Programme for IT, have had devastating consequences for those whose care was supported by NHS IT systems over the last 15 years.

The government entered into huge contracts with large corporations that promised to supply systems they couldn’t engineer, and for which the NHS couldn’t specify the requirements…..”

Full article at LRB

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