Saturday, September 23, 2006

Advice from friends

I sent an email to a bunch of friends to let them know about this site. Here are some of their reactions, which include a lot of advice about what to include, how to write it, and so on. (Lots of them didn't know how to reply to the blog itself, so I have copied their comments from emails they sent me.)

37 comments:

Anonymous said...

I did read it. Its always nice to hear your views and what’s going on at BIDMC. I do think that, in order to get discussions going, you need to be a bit more provocative. You mention that there are many forces working against hospitals today. I think it would be interesting to hear you think out loud about how some of these forces effect day-to-day decision making, either administrative decisions, or patient care decisions. People need to understand how difficult an operating environment it really is. Right now, your prose is too sublime - all I can think of is ‘wow, what a nice place’ or “wow, what wonderful people” – not much to weigh in on. Payor pressures, competition for doctors, state pressure on indigent care, expensive new technologies, complicated cases from third-world countries, capital constraints, unions, cutbacks in NIH funding, mandates for financial disclosures, OIG audits, cutbacks in Medicare payments, Pay for performance, nursing shortages all have significant collective and individual effects on the way we think about decision making, both strategically and operationally. On any given day, I am sure that one of these issues, or others, weighs heavily on you. Hearing your ruminations, opinions, solutions, approaches, complaints, etc would probably solicit some feedback and open a dialogue. Of course, you would probably need to be a little careful with such a public forum about certain opinions or actions. Truthfully, right now it feels a little too much like “feel good” advertising for the BIDMC.

Anonymous said...

I am not a big blogs person, but I read this one; it is well written. Unionization is a very complicated issue

Anonymous said...

I don't know quite what to say. I think you'd get a lot more feedback if you wrote about kayaking. My gut instinct is that most people do not want to read about other's work experiences in their free time.

If I blogged about my job, you wouldn't care and you wouldn't read it! I'm not sure your job is any more interesting than anyone else's. We all have heartfelt moments, just maybe not in the same context or as frequently.

That's my take on it . . . probably not what you wanted to hear, but nonetheless honest. Now prove me wrong! :)

Anonymous said...

For what it's worth, I think you might be in an impossible situation--you can't really be controversial, snarky, mean, or even particulary funny, while writing in your official capacity. The pieces you have sound too much like press releases for the hospital and don't really have your voice. You can't recount great stories of near disasters and unexpected triumphs or the nitty gritty of what you do everyday without compromising the hospital. Anyway, for what it's worth, either write for your own enjoyment in a different venue, or continue as a quasi-official newslettter from the hospital.

Anonymous said...

One thing that holds me back (probably holds back some others, too) is a concern that I'll say something that's a little off, which I would have phrased differently if I'd been more aware of one thing or another. So if you spot something in my posts that could benefit from something I didn't realize, feel free to say so in a reply, or to suggest a refinement of my post before releasing it.

I mean it when I say I'm a strong proponent of what you're up to. In my view your domain (delivery of health services) will be one of the most important, most vital, lasting legacies we leave to the next generation. (I should probably say that on the blog at some point.) If I imagine my (non-existent yet) grandchildren as adults, I want them to have a world where health services are delivered readily and reliably by people like I've encountered at your hospital.

Anonymous said...

Hope you have some fun with this! I just made a posting and will pass this along to others.

Anonymous said...

Are you sure you want to hear from people who deal with hospitals a lot from the patient side???

I'm still trying to figure out what a blog is, but I will look at it.

Anonymous said...

Thanks - look forward to following up. Good Stuff!

Anonymous said...

I was pleased to be included in your email.
Your blog is more evidence of your personal
integrity, compassion for people and committment
to your job.

FYI, before I retired last year, I worked for a large
insurance agency in Hartford which had the area's largest
hospitals as clients. I was mostly involved in
worker's compensation and property insurance issues.
I have passed on your email to a few of my former
colleagues.

Good luck with this. I think it is a great idea and
service to the medical care community

Anonymous said...

I loved your blog. In the olden days, I would have called it a newsletter, but the modern title makes it cool. Your first article about the humanity of the hospital and staff in the face of family crisis was very warm and understanding. I did comment on the piece but it took me an inordinate amount of time to get registered enough to do so.

Anonymous said...

Thanks for sending along your blog. I think it's a very interesting idea, especially the mix of personal observations and policy positions.

Anonymous said...

Thanks for the invitation to read and contribute to your new blog. I think it’s an interesting and potentially useful undertaking, but how do you find the time? My impression of bloggers to date has been that of people with too little else on their plates—guess I’ll have to revise that view! Good luck with the effort…

Anonymous said...

So far, it's not as interesting as you are. I think you're pretty constrained in your position to say what you'd say to friends over lunch.
Maybe talking more about the big health care issues would be something that wouldn't come back to bite you. The single payer system piece was the most interesting, but I don't want to mess around with registering just to read your review.

I have a lot of interesting things going on at work, but I don't want to talk about them in a totally public forum. As a result, most of what I say for public consumption is rather bland.

Anonymous said...

I don’t know a thing about blogs, but found this interesting. I’ve forwarded it to a few people.

Anonymous said...

Congratulations to you for this innovation, and it seems off to a great start as regards content. I'm an avid reader of blogs, to the point where I get most of my news from the internet and most opinion / analysis from blogs as opposed to the Globe op ed page. There is an etiquette and culture in the blogosphere that builds buzz, content and circulation through links: you have to read other blogs in a related vein, you have to link to them, and you have to tell the other bloggers that you have done so. They will then link to you. Most start by creating a "blogroll" of related or simpatico blogs to which they invite their readers. You should certainly create a blogroll of other medically-related blogs, although you shouldn't be limited to healthcare. You should scan them periodically, and when something interesting appears, post a note and a link, with an email to the blogger.


You'll know you've hit the jackpot when you get a link on Instapundit or DailyKos (shame on you) or Andrew Sullivan or one of the other very high traffic blogs. If that happens your ISP will notify you that you've exceeded your alloted bandwidth...that's a good thing.

Anonymous said...

I like the style, the content and the tone. Very down to earth and approachable.

Anonymous said...

I only had time to take a quick look so far but I think this is very interesting and would be of interest to those in leadership positions even if not in a hospital. I will think about whom to pass it on to.

Anonymous said...

Paul, this is fascinating.

I could not find a similar blog (at least not from a health care CEO). For me it is the tone rather than the content that is most informative. You blend sensitivity to the topics, depth of understanding of their complexity, and firmness in your arguments for optimal policy positions. This is most instructive: a path to solutions that is goal-driven, but as inclusive as possible (and useful). I will continue to read.

Thank you for sending this along.

Anonymous said...

I like it—informative, provocative, and touching. Nice work. I disagree about the concept of single-party payer. There has to be a better way of channeling health care dollars than into the pockets of insurance executives. And the government hasn’t screwed up MediCare too badly.

Anonymous said...

You are rarely boring.

Anonymous said...

You need dirty jokes, soft porn pix and trance-inducing political musings.

Anonymous said...

OK, I read it. I enjoyed it, both the personal stories which are always moving and reminds us why we do what we do, and the political statements about union organizing, single payer system.
I'm wondering, not ever having read a blog before (ok, I'm dating myself), what do you want to have happen here? It's doesn't really convey the complexity and challenges you are facing of running the hospital, nor go into depth enough to lend insight on any issue. Obviously, that's not what you were trying to accomplish. It DOES give people like me, who are intrinsically interested in what you are doing, a chance to "pop in" for a moment and observe. That may be the goal.

Anonymous said...

Paul, I like it! I'd encourage you to keep going. My guess is that when people read it they will send it to someone else, who will do the same, etc.

I'll keep looking at it for sure.

Anonymous said...

Good stuff and good mix of human interest and policy. You’ll either be hailed as a pioneer or burned in effigy. No sense plotting a middle course.

Anonymous said...

The "ramblings" are wonderful. It was real eye opening. I'll refer my pre-meds to it. Sorry for short, terse sentences; I am not awake. My only very minor comment would be on formatting. The text is centered, and extends to the limits of the left and right margins. My brain is limited in capacity and visual acuity. I am a dinosaur used to seeing margins. Your messages were still loud and clear. Great idea, as usual. Keep in touch.

Anonymous said...

You obviously have too much time on your hands. I read some in detail and skimmed some. It would be particularly interesting to the college set who are considering health care as a profession. You should contact college counselors to consider making the link known or related groups on campuses.

Anonymous said...

I have read your blog and although I find that most of these publications are emotional blabberings, I found that yours is quite special.

My father was a cardiologist at the MGH, so I have a particular interest in hospitals. I shall continue to read your blog.

Anonymous said...

I can think of several hundred people who should view the blog...[and will send it to some of them].

Anonymous said...

Thanks for letting me know. I will share this with others. One suggestion: more discussion on the leadership challenges you face and your decision-making style, your interaction with the board, how to deal with the phone calls from Menino and Kennedy and the always hovering presence of gov regulation, etc.

Assume that for at least of the blog that you are teaching an ongoing seminar in "Leadership in HealthCare Settings", with you and BIDMC as a case study.

Anonymous said...

You're the first blogger I have ever read. Wow, the 21st Century. Wow.

Wait....I do love Maira Kalman's thingie in the NYT every month.
I guess that's a blog. Hey, that's what you need---illustrations!!

I appreciate all you have written, and I love your writing.

And...I think people will definitely be interested in the thoughts
and feelings of a hospital CEO. Beats soap operas!


Of course, I do not agree with you about government health insurance;
before the Republican Congress decided that balancing
the budget was more important than health care, etc., Medicare was a pretty efficient program;
and, as I recall, it was one of the least expensive programs run by the government.


I remember, when working for the Lowell VNA/Hospice, the agency had to cut back
on home calls to REALLLY OLD PEOPLE. Ridiculous. That care kept them out of hospitals
and nursing homes.

Why can't a correctly-run program like Medicare be expanded to help all? Can it really be true
that open-market bargaining with insurance companies (who refuse to lose money..see Katrina
and Florida...), is a better deal for all?

Patient Dave said...

I'm really, really glad to see all these comments. This is my first blog, too. It would be nice if newcomers could become contributors without going through the registration process, but then I guess that's our protection against blogs filling up with spam and other junk. Dialog works better when there's some accountability.

Having managed several online forums in the CompuServe days, I know it takes a chunk of time to review posts. It says a lot about Paul (imo) that he's willing to invest this much in opening up the issues to dialog.

Think about it: when was the last time someone in a leadership role, in a vital part of our society, opened the door for dialog like this? I intend to learn what I can about the issues, here, and see if/how I can contribute to others.

Anonymous said...

Paul -- this is fascinating, and, as you say, all new -- risky, revealing, fulfilling, annoying, amusing, important??!? I hope you stay with it and that those in the field and associated (who's not associated with the medical field) near and far, help build a full, fair exchange of professional/personal thoughts, advice, musings, concerns, etc.

Anonymous said...

I have several friends who would be interested in this blog. One friend is a Harvard and Columbia trained psychiatrist who has gotten fired from two hospitals for reporting unethical actions by a fellow physician. Another friend who worked for Partners started a business to better deliver healthcare to individuals by provided greater preventive medicine and better access to information. Another friend works for a technology start up that is providing better outcome information to doctors and pharmaceutical companies. I’m sure they will find the site valuable.

Anonymous said...

I liked your blog. As is always the case, the blog reflects the blogger. So, your blog is intelligent, on point and very sincere/respectful regarding people. The question is whether people give a shit about smart and sincere. Unfortunately, I’m not so sure they do.

Anonymous said...

I wanted to say HI and offer a word of encouragement on your blog! I am now working on the government relations team (of two) for a Medicaid-only HMO. As you can imagine, when your paying customer is state government, there are a lot of "relations" to do! I am loving learning about the business of health care, and I get to spend a lot of time hearing our nurses on the phone with our members, helping them understand new diagnoses, face their personal challenges, and navigate the health care system. The system is intricate and there are no easy answers, so I am appreciating your blog.

Anonymous said...

I tend to agree with some of the comments that it seems more like a puff piece -- I don't think you can really get into the controversial. Like for example, I complimented my chiropractor on the way he scheduled patients since he always seems to be able to accommodate emergencies and he said he has to change because rather than schedule 3 15 minute appointments per hour with 15 minutes for catchup/paperwork/etc. BC/BS is changing their requirements from 8-15 minutes per procedure to 15 and say that he must schedule only 3 20 minute appts per hour. I imagine that BIDMC has similar issues with insurers that people would be very interested in. Anyway, its a good idea if you can get any substance or controversy into it.

Paul said...

Golly, I thought the union issues and single payer might be a little controversial. Maybe not. What else do people want to hear about?