Twice in the span of twelve hours, I received unsolicited and honest feedback from two individuals whose opinion I value, about my attempt to share with you my thoughts about a range of issues concerning the business of healthcare. One came from my father; since he holds that role he is allowed to offer unsolicited advice any time he wants, and I am entitled to listen to his advice. The other bit of advice came in response to an email I wrote. He is one of you, and he wrote the following:
I agree with many of your points and disagree with a few of them, and regardless, it’s a compelling, buzz-worthy angle that gets a lot of re-tweets and what have you, but I think it’s worth considering how these positions are affecting your ability to land consulting gigs in HIT. People want to hire consultants that they think will help them succeed, that think positively and pragmatically, and that are problem solvers (as opposed to problem recognizers): “we can do this together…I’ve had success before and if you let me, I will help you succeed…” that kind of thing. Just my 2 cents. It’s a trade-off, I know. You want to be honest and forthcoming, so I see the dilemma.
This was like being hit by lightening twice in the same day, so I thought I should take time to consider their input. The feedback led me to ask if there are others who share the same opinion. Is it possible my ramblings are about as well received, as I would be if I were to walk the streets of Tehran wearing a Star-of-David t-shirt? What portion of readers drag my postings to their email folder entitled, “Kill him Later”?
Some believe a more effective use of consultants would be to compost them and use the energy generated to power a weed-eater.
Please permit me a few lines to try to explain my thought process for writing in my particular style and tone. Before I began expressing my opinions on healthcare, I began reading what I considered the best healthcare blogs and editorials. The first thing I learned is that I had nothing to offer of value on the clinical side of healthcare, so I focused my efforts on discovering what business issues providers dealt with, and which ones might benefit from receiving professional help—a consultant’s twelve-step program for problem solving.
I did a lot of homework; in addition to reading, I interviewed more than a hundred healthcare executives. What was my takeaway? One CEO told me the most needed skill on the business side of healthcare was “adult supervision”. I did not charge in with uncorroborated opinions. I used LinkedIn discussion groups to pose hundreds of questions about possible problems, studied the responses, and used them as a basis to formulate ideas about what was broken and what needed to be done to fix it.
I should note many of the blogs I read shared two traits; they often stated the same facts available on other blogs, and they rarely seemed to question the efficacy of the impact many of the Healthcare IT initiatives would have on operating healthcare’s business model—ours is not to wonder why, ours is but to do or die.
Not wanting to be superfluous, when I came to the fork in the road, I chose not to take a me-too position. Instead, I threw metaphorical tomatoes and tried to get people interested in looking at the business model in a more disruptive manner. Often, I did this by taking extreme positions on issues in the hope I might hit a hot button, and someone would think, “Perhaps we ought to talk to the tomato thrower and see if he can help us”.
My approach may prove to be less than brilliant. What’s your take?