This is more along the lines of “can’t get this meme out of my head,” it’s so important.
Being steeped in something of an Eastern mindset by family and martial arts background, I’ve always believed that “calmly living in the present” was a high calling. It’s a recurrent theme in Zen and other Asian belief systems, for living The Good Life, as well as avoiding a beheading in the heat of battle. The past is gone, the future’s a maybe — don’t waste time being pissed about woulda-coulda-shoulda, and focus on the now.
It’s sage advice for the individual and carries over well to the realm of one-on-one patient care. Pay attention to what’s in front of you, and only what’s in front of you, or you’ll miss something. But when it comes to systems of healthcare IT, paying closer attention harder doesn’t help matters at all.
Some old-fashioned “looking off into the glorious distance” is going to get you a lot farther with EHRs for the foreseeable future. To say nothing of the wider American healthcare system.
Fire In The Belly
In his little book, The Presentation Secrets Of Steve Jobs, Carmine Gallo describes the techniques used by the master of slide presentations, former Apple CEO Steve Jobs, to woo, convince, and convert his audience into awestruck fans — even when they were resistant, skeptical journalists.
The key, says Gallo, is Jobs’ passion for turning his vision into reality. A quote from Gallup analyst Marcus Buckingham describes the essence of this outlook, and just about blew my saffron-colored socks off:
You are a leader, if and only if, you are restless for change, impatient for progress, and deeply dissatisfied with the status quo…you are never satisfied with the present, because in your head you can see a better future, and the friction between “what is” and “what could be” burns you, stirs you up, propels you forward. This is leadership.
Two key things about this: driving hard towards a lofty, far off goal, and on taking charge. Pretty much the opposite of what most physicians are focusing on these days, and to judge from Jobs’ example, fairly important to getting ahead and making good things happen.
It’s Not THAT Far Off, But It May As Well Be Mars
How far off are we from where we should be? As I said in the last post, we now know enough about what’s possible with EHRs and healthcare IT to realize how much we suck.
We don’t suck eggs at the national healthcare delivery level. But we generally don’t do what makes perfectly good sense, and what’s been vetted for years in other fields and business models:
- quantifying performance
- reporting what we actually accomplish vs. how great we think we’re doing
- identifying easy-to-fix problems that have just gotten ignored
- setting long-term, out of the box, “What Would You Aim For If You Couldn’t Fail?” goals
- creating a recurring process of look-tweak-repeat to drive improvement — emphasis on the LOOKING
This isn’t rocket science, yet these basic, proven principles of process improvement are ignored by the vast majority of front line physicians in America. (And by the way, rocket scientists use these principles.)
Why don’t we do the obvious? It’s the spinning grindstone syndrome, or the hamster on a wheel disorder:
You’re so busy sprinting with your nose pressed up against The Work that you’ve got no time, energy, or inclination to do anything else, like network, streamline your office processes, or improve your patients’ experiences.
This Spinning Grindstone thing is killing us as a profession.
You Don’t Have To Lead, You Just Have To Dance
Channeling Steve Jobs…that would be leading. It takes a lot of passion, and a fair amount of pushing. You may or may not want to do that.
Stepping away from the spinning wheel — that’s agreeing to walk onto the dance floor. Anyone can do it, and it’s immediately more enjoyable than being clenched all day, every day.
Push back, unkink your neck, and look around a little. Connect with that guy over there — remember him? — and learn a thing or two. Regroup and hit it again, but this time like you’ve got a purpose. Repeat.
This particular process has truly universal applications. It turns you away from being nearsighted and isolated, and opens you up to colleagues, new experiences, and better ways of doing things. You can expand your sphere of influence from the patient 3 feet in front of you, to your entire medical office, to your local grouping of colleagues, to the entire interconnected system of doctors + care facilities + hospitals + all things IT.
But it all starts with LOOKING UP.
