Stepping Out of the Routine

by Ron Culberson

Many of us live in an world of regular routines and yet we have multiple opportunities to live in a world of new experiences. The familiar can limiting but the unfamiliar can open up many possibilities.

My daily exercise routine often takes the form of brisk walking through our neighborhood and then through an adjacent cemetery. The cemetery keep my cynicism in check as I am reminded of the whole above- and below-ground situation.

So, I take the same path every day because I like my routines – I like the familiar. However, the other day, my wife suggested we walk on the trail behind our neighborhood instead. Wives are good like that. Always pushing the envelope.

I know about these trails…sort of. I know about them the same way I know many of my neighbors. I know they exist but I don’t know their names, their professions, or what their hobbies are. Essentially, I don’t really know them.

So walking on the trail was a new experience for me.

The trail system is way more extensive than I imagined. The trails wind throughout the woods and in between neighborhoods. They cross the Sugarland Run stream frequently, and at times, you would swear you’re deep in the forest. Yet you’re only minutes from a major highway and a mere 20 miles from Washington, DC.

I’ve lived in my neighborhood for 16 years but never considered walking on the trails. Go figure. In my mind, the trails seemed mysterious and unknown while my neighborhood sidewalks and the cemetery were familiar and part of my daily routine. Yet, once I walked the trails, I realized how wonderfully therapeutic this new option was – and it was there all along.

Routines give us comfort because they are reliable and familiar. But when we’re locked into them, we’re avoiding new growth experiences.

The musical director for KA, one of Cirque du Soleil shows, spoke at a conference I attended. He said that when they’re discussing a new show and someone comes up with an idea, no one in the room ever says, “we can’t do that.” Instead, they say, “how can we make that happen?” Their normal way of thinking is to get out of the routine way of thinking. That’s pretty cool.

I like my routines and I suspect that I will hold onto many of them. Yet I am constantly reminded of the benefits of new experiences. So, with the help of my envelope-pushing wife, I will try to break out of my routines whenever I can.

All it took to walk these new trails was taking the first step. That seems doable.

Giving IS Receiving

by Ronald Culberson

A retiring car dealer in Michigan gave each of his employees $1,000 for each year they worked at his 47-year-old car dealership.  As a way of thanking his employees, Howard Cooper gave each a cash payment when he sold his dealership – including one loyal long-term employee who received $46,000.

You can read the article and see a video here:  Retiring Car Dealer

I’m a big believer that giving is receiving.  By giving to others, whether it’s our time, money, or expertise, we receive a gift through the opportunity to share the blessings that we have received…or earned.

Sometimes, our society encourages us to get all we can get and hang onto it as long as we can.  I certainly want to have enough money to last through my lifetime and I want to be able to support my children should they need it.  But I don’t want to die with too much in “the bank” or I fear I will have missed opportunities to give along the way.

I love what Howard Cooper did.  Essentially, he said, “You helped me be successful and I want to thank you.”

To me, he Did it Well.  And he Made it Fun for his employees too!

The Neurohumor Notebook

by Karyn Buxman

In terms of scientific discovery, we’re living in one of the most exciting times ever. Researchers are doing more and more each day to uncover the relationship between the human experience and our physical well-being.

There are complex biochemical responses – things changing within our bodies, most particularly our brains – when we’re exposed to external stimuli that triggers strong emotional reactions. In other words, when we read a thrilling novel or look at a beautiful painting, something happens inside our brain.  It turns out that that something has a significant impact on how healthy we are.

Ready for some link soup?

This CNN article, What the Brain Draws From: Art and Neuro-Science, takes a long look at how the brain responds to different types of art, and why we may be hard-wired to prefer some patterns to others. Smiling human faces are the most popular type of image in the world – almost everyone loves them. I know I do!

This is Your Brain on Jane Austen looks at the types of brain activity generated when people were reading the world’s greatest novelist for pleasure, and then intently, as if studying for an exam. Stanford researchers are suggesting the intent reading does more to stimulate the brain, and can perhaps even promote cognitive health.

The topic of brain fitness and flexibility is becoming increasingly interesting as we, as a culture, look forward to increasing numbers of people facing Alzheimer’s Disease and dementia. As a proponent of humor and healing, I have to say knowing there are steps we can take to keep ourselves healthy is good news.  Knowing those steps are fun and enjoyable? That’s even better.

Today’s Joke:

A vampire bat came flapping in from the night covered in fresh blood and parked himself on the roof of the cave to get some sleep.

Pretty soon all the other bats smelled the blood and began hassling him about where he got it.

He told them to go away and let him get some sleep but they persisted until finally he gave in.

“OK, follow me” he said and flew out of the cave with hundreds of bats behind him.

Down through the valley they went, across a river and into a forest full of trees.

Finally he slowed down and all the other bats excitedly milled around him.

“Now, do you see that tree over there?” he asked.

“Yes, Yes, Yes!” the bats all screamed in a frenzy.

“Good” said the bat, “Because I sure didn’t!”

What healthcare must learn — from a chain restaurant

by Joe Flower

In Healthcare Beyond Reform: Doing it Right For Half The Cost I lay out the five strategies that healthcare must adopt, and is adopting in various ways and places, to make healthcare better and cheaper at the same time.

Strategy Five is “Rebuild Every Process.” It’s about “lean manufacturing,” smart standardization, measurement, “big data,” evidence-based design, teaching the innovation, all the detailed, rigorous, hard attention to intelligent process re-design that healthcare is so obviously lacking — and that is absolutely necessary if healthcare is to improve its abysmal cost/benefit ratio.

Now in The New Yorker writer/surgeon Atul Gawande has done a brilliant turn on this theme, by diving into, of all things, the processes of a restaurant chain, comparing them to the duplicative, chaotic, mistake-prone processes of traditional healthcare, and finally to some examples of smart, rebuilt healthcare processes that drive down costs while killing fewer people.

Gawande shows how The Cheesecake Factory manages to deliver 308 dinner menu items and 124 beverage choices to exacting standards, on time, from fresh ingredients, with only 2.5% wastage, in a linen-napkin and silverware environment, at lower cost, then compares that with the disconnected, uncoordinated, messy environment that is most of US healthcare. He details several examples of how new drives toward standardization and control of processes in the operating room and the emergency department, for instance, are making a difference, lowering costs and improving not only outcomes but the patient experience, all at the same time.

There are still voices in medicine decrying standardization as “cookbook medicine” and insisting that every medical decision and action must be made on the spot, on the fly, on the doctor’s judgment and say-so alone. Yet there are right and wrong ways to do most of medicine. There is no clinical justification for not elevating the head of the bed for a patient with pneumonia on a ventilator; or for not fully covering a patient during a central line emplacement; or keeping a patient on 100% oxygen for longer than absolutely necessary. As one of the docs engineering the standardization of a group of EDs told Gawande: “Customization should be five per cent, not ninety-five per cent, of what we do.”

The contrast in the diffusion of innovation is quite stark. The Cheesecake Factory changes some of its menu every six months, and all of its cooks throughout the chain must learn the cooking and presentation of the new items. The chain has a dedicated system for teaching the new items to managing, and then teaching them how to teach them, so that they can propagate the new items throughout the system. Healthcare has no such system at all. When some new fact or technique is established through research (whether the proper use of negative and positive ventilation flows in patient rooms, or a superior wound closure technique, or better post-op therapy after knee replacement surgery) there is no mechanism to propagate that discovery throughout healthcare. Studies show that the average medical innovation takes 15 years to reach even half of patients in the system. That is simply unacceptable. People die and suffer because of such resistance to doing things a better way. We must rebuild every process in healthcare continually, striving for better care, better results, and lower cost.

Reservations About Humor?

by Christine Cashen

When people think about humor, it usually relates to telling jokes, or situations where you double over in laughter. To me it’s more than that – it’s about having (and making) fun in the ordinary and often dull routines in everyday life.

For example, after dropping the kids off at school, I dread coming home to the disaster in my kitchen. Often times while cleaning up breakfast dishes and lunch prep chaos, our chocolate lab will plop down nearby with a heavy sigh.

In my effort to put off re-combobulating the kitchen for as long as possible, I call his name – Murphy – and then I hide behind the counter. When he scrambles to his feet, a chase around the center island ensues. Yes, I play Hide & Seek with my dog. Don’t judge me. It’s great fun and gets the blood flowing — for both of us.

Another fave in our family is the “Restaurant Name-Game.” Last week, I took my son on a lunch date to one of our favorite places, Which Wich. You build your own sandwich, turn in your order and write your name on the bottom of the bag. For kicks, we always put random names, like “Dude,” “Happy,” or “Tired Puppy” (that one would be mine). It is always a kick when the young employee yells out in a bland voice, “I have a turkey for… Tired Puppy.”

This can also backfire. My brother and his wife were going out for dinner and made reservations at their favorite restaurant. Also a goofball, he made the reservation using the name “Hungry,” and mentioned this was a special evening. At the end of their evening, the restaurant brought them a complimentary dessert with (in chocolate writing), “Happy Anniversary Mr. and Mrs. Hungry!”

How can you add fun to your daily routine? One thing is for certain – humor makes memories. Figure out ways to make the mundane into something memorable. Get out there and use humor to make the ordinary extraordinary!

Now Doesn’t Last Forever

by Ron Culberson

It’s Thursday, and our week has been a flurry of activity. Our traditional end-of-the-summer meal was on Tuesday. My son and I played golf yesterday, and last night the whole family attended a baseball game. My wife is taking my daughter to a concert tonight.

You see, we’re frantically preparing to be empty nesters.

On Saturday, my son will join my daughter at college, and they will never again live at home full time. One of my friends says I may be mistaken on that last point.

The irony in my approach to parenting is that I’m always looking toward the future, and then when the future gets here, it catches me off-guard.

When my children were on formula, I couldn’t wait for them to drink regular milk. When they were still in diapers, I could’t wait for them to be potty-trained. And when we were chauffeuring them around to ballgames, band concerts, and Scouts, I couldn’t wait until they could drive.

Now that they’re drinking milk, fully potty-trained, and driving off to college, I finally got what I had hoped for — but it doesn’t feel as good as I expected. While all of these milestones were good, I think I missed something along the way by wishing for them to arrive sooner rather than later.

As Eckhart Tolle, in The Power of Now, explains, “When we’re here and want to be somewhere else,” we’re missing what the present moment has to offer.

Yes, guilty as charged.

But I suspect I’m not alone when it comes to focusing on the future at the expense of the present. It’s easy to do when there are so many things to anticipate and worry about. So, even though I consider myself a work in progress, there are a couple of things I try to do to keep my focus on the moment.

First, when I feel myself reacting because my current situation is not what I think it should be, I remind myself that “it is what it is” and that if I can’t do anything to change it, I should find something to appreciate in it.

Second, when I find myself too focused on something in the future, I ask myself, “What am I missinghere by focusing on there?”

And last, I continually remind myself that while I should take responsibility for the things I can control, I should not feel responsible for the things I can’t control. For more information on this, consider the weather, other people’s opinions of me, and traffic.

When it comes to our empty nest, absence will make the heart grow fonder. And when it comes to life in general, I suspect that presence makes the heart grow richer.

Tonight, my son and I will cap off our evening with a visit to our favorite frozen yogurt shop. I plan to savor every bite… and every minute.

For more by Ron Culberson, MSW, CSP, click here.

Are We There Yet?

by Christine Cashen

On our car trip in Michigan this summer, it wasn’t long before the kids started asking the universal car question --”Are we there yet??”

Knowing we still had a long way to go, I had to quash this line of questioning straight away. “Yes, we are exactly where we need to be.” This bought us a little bit of silence as they tried to figure out what I was saying. That was my answer the next time as well. They stopped asking.

As annoying as Are we there yet? is when my kids ask it again and again, I’ve found that many adults ask that question throughout their lives. Am I there yet? I will be there when I graduate from college, get a job, get married, have kids, when kids move out, change jobs, make X number of dollars, retire, etc. So many of us wait for a certain event to happen before we believe we’ll reach our destination of happiness and contentment.

Stop.

You are exactly where you need to be. If you don’t like where you are now, think like a GPS: recalculate and change direction. But whatever you do, take time to enjoy the journey. You’ve probably heard the saying,Wherever you go…there you are. And you are. Enjoy.

 

Trend Report: The Future of Health, Fitness, and Wellness

by Jim Carroll

I keep advising my personal trainer that she needs to get an iPhone. She shrugs, noting that there is a queue in the family for the next mobile upgrade, and her 14 year old daughter might have more of a claim in the line than she does.

Hogwash! There is an absolute revolution going on involving the “consumerization of fitness and wellness” — and this super long blog post will put into perspective why. And maybe this will help to sort out some of her family politics over the ‘next phone.’ The fact is, the very nature of the future fitness opportunity is changing ….

Update: After I wrote this blog post, Adweek ran the article, “Nike+ Officially Turns Your Workout Into a Video Game” – you want to read it.

Here’s the main gist of this post — In May and June, I spoke at a tremendous number of corporate, association and private events; it was a busy couple of months, and hence the lack of regular postings to the blog.

Three of these were events related to the issue of corporate wellness programs.

It was the perfect timing for such a keynote; through the last year and I half, I’ve been following what I believe to be a fairly aggressive personal fitness regime, with the help of my personal trainer, as well as personally exploring the wealth of new fitness and wellness mobile applications that are flooding the market.

The entire premise of my keynote? At this moment in time, we are witnessing the perfect confluence of several major trends:

• the first signs of the reality of the massive scope of the health care crisis (both disease, lifestyle and funding related) as baby boomers begin to flood the health care system with requirements for extra care
• a renewed and significant focus on “preventative” health care concepts” ;
• structural change aimed at wellness programs so that people work harder to avoid or reduce the impact of lifestyle disease;
• and the rapid emergence of new technologies — many involving the smartphones that have become a ubiquitous part of our lifestyle – that can motivate consumers to do so much more with their personal fitness and wellness.

Why a keynote on wellness? Because companies are recognizing there is a big opportunity to be innovative with managing healthcare costs through a proactive approach that involves wellness. It’s a good example of the deep, transformative thinking that is occurring with many organizations in the healthcare system worldwide . Organizations are moving beyond the endless political debate, and are instead, putting in place practical, innovative programs that can help organizations manage healthcare costs, and employees can actively work at improving their overall health and fitness.

Let’s consider the trends which are all coming together.

1. It’s crisis time!

Throughout the western worldwide, the obesity, diabetes and lifestyle health care crisis is really making itself felt with massive demands being placed on the system. The future is stark ; if something is not done, we will continue to see:

• a continued rapid increase in lifestyle disease, resulting in even more massive future demands on the system
• a bigger demographic challenge – more boomers placing demand on the system, with fewer workers to support the massive uptick in spending that results
• a resultant massive supply / demand imbalance
• and an expectation gap likely to increase scope of challenge : a trend I wrote about in my “Trending in 2011: 10 Major Trends to Start Thinking About Now.” It’s worth a read — check the first big trend in the list.

Clearly, something needs to be done. Hence, a lot of innovative thinking!

2. A massive shift to preventative medical concepts

Given that the Western world has such a big problem, it’s also fascinating to note that there is a huge amount of innovation occurring in the health care system now – and it has absolutely nothing to do with the raging (and now seemingly pointless) political debate occurring in the US.

What is happening is this: we are in the midst of a long term trend in which “preventative medical care” will come to exceed what we spend on “reactive medical care.” Preventative care takes many forms, from genetic testing (to determine what conditions people are likely to develop in their lifetime) to wellness and other preventative programs. Simply put, let’s fix people before they are sick, rather than treating them after they’ve developed a condition.

We’ve got a heck of a long way to go with this trend: according to a PriceWaterhouseCoopers report, “a mere 3% of spending goes towards prevention of chronic disease among industrialized countries.”

But what is happening is an acceleration of the trends that take us to a world of preventative healthcare. Consider the trend line with genomic medicine:

• it took $3 billion to sequence the first human genome
• by 2009, that was down to $100,000
• it’s now under $10,000
• and it is estimated by the end of 2012, $1,000

Give it a few years, and you’ll be able to go out and buy a $5 genomic sequencing machine at Radio Shack! That might seem like a joke, and it is. But the significance of a cost curve such as this is that it accelerates a significant shift in spending.

It isn’t occurring with genomic medicine — its happening everywhere throughout the world of healthcare. Last year, when I keynoted one of the largest seniors care conferences in the US, I noted the same type of focus on preventative thinking was becoming routine:

• “Identifying dementia early can cut the cost of care by nearly 30 percent … routine screening that identified patients with early signs of dementia helped cut average healthcare costs by nearly $2,000 per patient in the first year, often by eliminating money spent on unnecessary tests and treatments. Early diagnosis can cut Alzheimer’s costs, Reuters Health E-Line, July 2010

The health and wellness theme fits into this agenda as well, which have undergone very much a sea-change in the last, in terms of perception, importance and approach:

• “In businesses across the nation, workplace wellness has morphed from a “nice-to-have” fringe benefit to a “must-have” cost-containment strategy.” 23 April 2012, GlobeNewswire
• Employers determined to contain medical costs must focus on creating a culture that supports healthy behaviors. If they can do that, they can enhance not only their bottom lines but also transform the lives of their workers. 28 April 2012, Obesity, Fitness & Wellness Week
• “In businesses across the nation, workplace wellness has morphed from a “nice-to-have” fringe benefit to a “must-have” cost-containment strategy.” 23 April 2012, GlobeNewswire
• “64 percent of employers surveyed indicated that wellness initiatives are among the top three most effective tactics for controlling health care costs” 2012 Annual Plan Design Survey, National Business Group on Health

Studies show that for every $1 spent on a wellness program, medical expenses fall by at least $3.

Part 3: Time for some more aggressive action!

What is interesting is that in corporate organizations throughout the Western world, wellness programs are rapidly shifting : they’re going from a “nice-to-have” type of program, to a “we really need to see some results!” approach. Consider the trends; certainly many more organizations are putting such programs in place:

• A recent study by Willis North America’s Human Capital Practice found about 60 percent of the companies surveyed have wellness programs, an increase of 13 percent from 2010. Companies encourage wellness, Pittsburgh Post-Gazette, 22 April 2012

But not only are more organizations adopting wellness programs: they are working to put in place structures, methodologies and measurement technologies that can help to ensure that employees are benefitting from such programs:

• One of the fastest-growing categories of new insurance includes significant penalties for those who don’t participate or backslide on targets – penalties that may include deductible spikes or loss of health-savings accounts. Workers’ wellness can turn a profit Insurers offer incentives for health and penalize workers who can’t meet goals, The Denver Post , 25 December 2011
• A national survey of large employers by the National Business Group on Health found that 80 percent plan to offer financial rewards for health in 2012, up from 54 percent this year. Workers’ wellness can turn a profit Insurers offer incentives for health and penalize workers who can’t meet goals, The Denver Post , 25 December 2011

And this is where tech comes along at the perfect time!

4. In comes technology – and the new consumerization of health care!

Technology is going to provide for more creative disruption in the world of healthcare than we’ve ever seen. Simply put, it changes everything.

• “Imagine a far more extreme transformation, in which advances in IT, biology and engineering allow us to move much of health care out of hospitals, clinics and doctors offices, and into our everyday lives.” Our high-tech health care future, New York Times, 10 Nov 2011

The Withings Wi-FI Body Scale measures weight, BMI and fat mass, and transmits the info to a password protected site. I’ve got one and love it. They sell them at the Apple Store!

Cast your mind out 5 years or more, and we will see significant change in everything we do in the world of health care:

• “…. you’ll be sitting in front of a big multitouch screen actually watching what’s going on in your body in a very intuitive, fun kind of animation. When you leave, the doctor will download prescriptions and treatments onto your cellphone – which not only remind you, but encourage you to follow the medicine’s or other lifestyle procedures. [You'll see] a periodic video message from the doctor to encourage you if you’re doing well or maybe to encourage you if you’re not. It’ll be continuous care rather than the episodic, periodic care that occurs today.” Better living with technology, The Boston Globe, 21 November 2011

Extend that type of thinking, and we are headed to a future in which we literally have a dashboard for the human body…..

And it is starting to happen now — with a flood of new mobile and other healthcare technologies that help consumers to take more of an active role in their level of wellness and fitness. Consider the current trends:

• 78% of consumers are interested in mobile health wellness fitness solutions
• medical fitness health care apps are 3rd fast growing category for iPhone and Android phones
• the Apple App store now has 17,000 health care related apps, 60% of which are aimed at the consumer
• sports, fitness and wellness apps will grow from 154 million downloads in 2010 to 908 million by 2016
• the number of wearable wireless “gadgets” will grow from 8 million to 72 million over the same period

I’m using a number of mobile wellness and fitness apps — for example, MapMyWalk, which I use to track the pace and timing of the five mile — or more — walk that I do while at home or travelling. I’ve also got a Withings Wi-Fi Body Scale — which tracks weight, BMI and body-fat mass, transmitting those details to a personally-password protected Web site. Utilize such technology, and all of a sudden you’ve got the opportunity to be more involved in your own well being.

Or, as I commented in New York at the keynote the impact of consumer fitness, wellness and healthcare technologies is that  “...they increase how often individuals think about their health…”

And clearly, it’s a pretty big trend:

•  “500 million mobile users, or about 30% of an estimated 1.4 billion smartphone subscribers worldwide, will be using health/fitness apps by 2015. Healthcare in your hands
International Herald Tribune, March 2011

The Withings Blood Pressure Monitor works with your iPhone. It’s an example of the start of the trend I call “bio-connectivity.”

It isn’t just consumers who are rapidly adopting such technology — so are doctors and other professionals throughout the healthcare system.

• By the end of the year 90 percent of physicians will have smart phones. Health apps soon will get an incubator, The San Francisco Chronicle, 11 April 2011

We are only beginning to scratch the surface of the innovations that will occur here. I’ve been suggesting that one of the biggest trends to sweep the world of healthcare and medicine will be that of ‘bio-connectivity,’ a phrase I coined well over a decade ago. Consider this post which I wrote before keynoting the World Healthcare Innovation & Technology Congress in Washington.

Bio-connectivity provides huge opportunity for innovation in the space of healthcare. The same company – Withings — has brought out the Withings iPhone Blood Pressure Monitor — seen on the right. All of a sudden, someone working to manage their blood pressure doesn’t need to rely on pencils and paper to track their progress — it’s automatically captured through the smartphone which is becoming an integral, everyday part of their life.

Not only that, but they can transmit their blood pressure readings and charts to their doctor or other health care provider via email. This provides for the virtualization of healthcare ; no longer are hospital or doctor visits restricted to actual physical locations known as hospitals or doctors offices — instead, it becomes a part of the global Internet. If you think about what is happening here: there is a change in the centuries old relationship between doctor and patient!

Did you know that researchers have already figured out how to make an ultra-thin heart monitor that goes on like a tattoo? Talk about a trend that is going to drive a lot of change!

Link all of these trends together, and the simple fact is this: we are going to witness more change in the world of healthcare, wellness and fitness in the next five years, than we have seen in the previous one hundred years.

And if you follow that path down the road of wellness and fitness — the very nature of fitness is changing. Ten years out, most folks going to the gym will have a smartphone attached to their hip, and will be working with their trainer on a regimen that includes this type of personal fitness tracking.

Sure, it sounds odd, but ten years ago, we didn’t have Facebook, Twitter, Youtube or many other of today’s life changing technologies.

My personal trainer really needs to get an iPhone!

What’s So Funny About Business?

by Karen Buxman

You might not have an immediate answer for that question.  Business is hard work. Owning and operating a business can consume your life.  Working for somebody else – whether that’s in operations, marketing, hr, or the dreaded accounting division – isn’t necessarily a piece of cake, either.  We devote tremendous amounts of time, energy, and resources into our work, because so much depends on being successful.

Surely this is no laughing matter.

Actually, laughing is the best thing you can be doing.  We’d even argue that you have to laugh, if you want to succeed. Don’t believe us? Just ask the people at Southwest.  Their uniquely humorous approach has earned them significant goodwill and provided them with a valuable differentiator in a crowded and competitive marketplace.

You see, it turns out that the strategic use of humor is one of the single most important tools businesses have at their disposal.  The ability to use humor:

• effectively attracts more customers to your brand, increasing market share and profitability
• augments and enhances every marketing strategy
• makes your company appear more ‘human’ and approachable – vital in a world driven by social media
• helps ensure superior customer service, from effective customer engagement to resolving complaints quickly
• makes it easier to attract and retain valuable employees
• creates a positive workplace environment

And there’s more!