Seven years of blogging!

I'd like to take this opportunity to acknowledge the seventh anniversary of this blog. On August 2, 2006, I took the leap with this short post, noting:

The other day, I was reading a NY Times article that menitoned that only 1 CEO of a Fortune 500 company had a blog. I don't run a Fortune 500 company, but I do run Beth Israel Deaconess Medical Center, a large academic medical center in Boston. I thought it would be fun to share thoughts with people about my experience here and their experiences in the hospital world. 

Truly, I had no idea where this would lead.  Would anyone be interested in what I said? Would there be enough topics to write about?

As you might expect, thing started slowly.  After a couple of weeks, I did a Google search for my blog, and it didn't show up! Why? Not enough traffic to stimulate the search algorithm.  So I sent an email to my 500 (!) closest friends telling them about the blog, asking them to read it, and asking them to tell their friends about it.  I also started linking my blog to others in the health care field and creating relationships with other bloggers by commenting on their posts.  Shortly thereafter, I showed up in the search engine.

Things really broke open, though, when the Boston Globe's Chris Rowland wrote an article about it on October 6. Privately, too, Chris suggested that my writing style was a bit boring and proposed that I make my articles a bit more edgy and controversial.  As regular readers know, I took that to heart.

Cross-linking to other social media over time was also an important way to gain readership.  When Facebook opened up to nonstudents, Nick Jacobs--the first hospital CEO blogger--suggested I join.  He said, "I think you'll have fun with it."

I owe Scott Hensley, one of the authors of the Wall Street Journal Health Blog, "thanks" for leading me to the addiction that is known as Twitter. Shortly after, I confessed my dependence, quoting Bob Coffield, who writes the Health Care Law blog: "Facebook was the gateway drug that led me to the crack that is Twitter."

Over time, the blog evolved into something that I never predicted. The kinds of stories I wrote morphed into a wide variety of commentary on things happening in my hospital to issues of wide social import.  Along the way, I "invented" transparency as a management tool by posting actual infection rates and other clinical outcomes from our hospital, in real time, for the world to see. I did not understand that doing so would help result in a transformation of care in our hospital, as we adopted a goal of eliminating preventable harm and holding ourselves publicly accountable for the standard of care we delivered.  Little did I realize, too, the pervasive impact that doing so would have on the health care profession as a whole, indeed beyond the borders of the US.

I documented, too, our learning experience with Lean process improvement, offering stories of success from the front-line staff.

Meanwhile, I helped expose the inequities in the hospital pricing environment in Massachusetts, where market power--rather than quality--rules the roost.  Over time, this issue got the attention of newspaper columnists and eventually the body politic.  It clearly riled some politically powerful people, who were used to getting their way and who took the matter very personally.

I also must mention the very important series of about 50 posts over a five-year period in which I exposed the corporate campaign being run against our hospital by an aggressive union that sought to infringe the rights of our workers. This led to my book, How A Blog Held Off the Most Powerful Union in America.

I also tried to take on the medical arms race, pointing out how marketing by suppliers and mispricing by Medicare results in the expansion of the use high cost equipment, with no regard to medical efficacy.

For a while, I devoted my Wednesday columns to answering questions posed by students. Among the most-read posts, to this day, is the one from 2007 entitled, "For Students: Don't collect degrees." In it, I answered this question: As someone who is in on the business/medical/policy of today's health care system, what do you think about the career prospects of those pursuing a joint JD/MPH? Is it worth it?

And, of course, there were the occasional columns about my passion, coaching girls soccer and refereeing youth games.  These led to my book, Goal Play! Leadership Lessons from the Soccer Field.

Along the way, I would often get the question of how much time I spent on the blog and other social media.  As noted here, I suggested that this was the wrong question: That's like asking how much time you spend talking with people. 

When I left the hospital in early 2011, I briefly considered ending the blog, but persisted out of habit and upon the suggestions of some loyal readers.  The name changed.  A highlight was being introduced to a doctor in California a few months later who said, "Oh, you're Not Running a Hospital!"

As I noted two years ago:

I have been pleasantly surprised to see that viewership has continued to grow.  My topics have become less Boston-centric (except where Massachusetts offers broader lessons).  Also, of course, I no longer present inside stories about my former hospital.  I now consider myself an unabashed advocate for those causes mentioned in the masthead.  In that capacity, I am more free to be even more direct than before (if that is possible!) about things that matter to patients and families, and also to doctors, nurses, and other people involved in the delivery of care.

I have found, too, that many of you are eager to join in by sending me story ideas from your regions -- events and concepts that you know are important to your constituencies and more broadly.  I welcome those suggestions and promise to maintain your confidentiality as I rewrite them for the general audience.

The blog has also turned into a bit of a magazine over the years, with other topics of interest to me and, I hope, to you.  You don’t have to stick with me very long to know of my passion for soccer, infrastructure, civil rights, effective government, good food, and nature.  I hope that the articles on those topics provide a nice break for you, as they do for me.  After all, you can’t talk about health care all the time!

I repeat my thanks to you -- regular readers, occasional readers, newly arrived readers -- for allowing me the privilege to let this site provide useful, informative, or entertaining content in your lives.