What you should care about in healthcare today, from the editors of Becker's Hospital Review

Innovation's moral quandary: When am I obligated to reinvent the wheel?

Healthcare has a lot of problems, and oh, if only problem-solving were simple.

When we talk about creating solutions to problems in healthcare, the 'how' is becoming just as important has the 'what.' Often, the question is a helpful one. But recently, the answer to 'how' dissolves automatically, and sometimes meaninglessly, into everyone's favorite buzzwords: disruption and innovation.

Let me make one thing clear: Innovation is crucial. Leave anything in an echo-chamber of ideas for long enough, and all hope for progressive movement is over. However, the overwhelming desire to throw the baby out with the bathwater seems to have overtaken the healthcare industry.

Not all problems are in need of an innovative fix.

Take low handwashing compliance. People can (and do) write books on this simple, but common problem.

You're the head of infection control at a major, resource-rich health system, and it comes to your attention that providers just aren't remembering to wash their hands. You had previously considered this problem and already have a reminder program in place, but it's clearly insufficient. Do you a) consult with similar providers and adopt a preexisting program that has proven results at another institution, or b) scrap your current program and build one from scratch?

The answer isn't always clear. Maybe you know of another system with stellar handwashing statistics, and you recognize the possibility of adoption and customization. Or perhaps, as director of the infection control program at your resource-rich system, you feel an obligation to create an even better program or technology — one that collects data by itself, for instance. Surely this would be an improvement upon simple handwashing compliance success.

What would you do? What should you do?


Hey bosses: Your employees think they can do a better job than you

Nearly 85 percent of Americans think they can outperform their manager, according to an international poll recently conducted by

This might mean a couple of things.

First, the assertion by an employee that he or she could do a better job managing the organization than whoever is currently boss could be symptomatic of plain old lack of respect. If this is the case, Monster career advice expert Mary Ellen Slayter said it might be time to make a change. "If you don't respect your boss, it's time to start exploring options for making a move. Perhaps you would like a lateral move, as you could be a valuable asset to another workplace, working under someone you find more inspiring. Or, if you're feeling ambitious, maybe it's time to start thinking about becoming the boss yourself," she said.

Respect is cyclical. Upon closer analysis, the lack of respect some employees may have for their boss may in fact be a reaction to a perceived lack of respect from their bosses. According to a survey by the Harvard Business Review, being treated with respect has a profound effect on employee performance. Respondents who reported feeling respected by their leaders reported 55 percent more engagement, 56 percent better health and well-being, 89 percent greater enjoyment and job satisfaction, 92 percent greater focus and prioritization and 1.26 times more meaning and significance in their work, according to the survey.

More than half of employees — 54 percent — reported they don't consistently get respect from their leaders. According to the Harvard Business Review, this can lead to less engagement, more turnover, less productivity and increased healthcare costs.

But believing you can outperform your boss isn't always a sign of trouble.

Alternatively, employees who reported believing they could do a better job than their managers may instead have a stronger desire for a more significant sense of leadership, personal investment in the success of the organization and, importantly, commitment. In short: These are the people bosses should want on their team.

In this case, CEOs, other C-suiters and managers shouldn't feel threatened by or condemn employees' assertions that they could do a better job in their role. Rather, bosses should encourage them. A strong sense of leadership and drive among employees is fundamental for growing a successful organization, for if these traits aren't embedded in the culture, there is no shared motivation to push the organization forward.


5 traits of "the most ambitious CEO in the universe"

Fortune has pegged Google's Larry Page, 42, as the most ambitious CEO in the universe. He has helped cement the company's core search business and is now a driving force behind Google's new and bigger bets.

So as CEO of a 55,000-person company, what does Mr. Page do differently from other leaders? (Aside from innovating ingestible nanoparticles that may rewrite the rules of modern medicine and designing balloons that can beam down broadband signals, that is.) Here are five of his most remarkable behaviors or traits, as observed by Fortune.

1. He has sky-high expectations that are almost cartoon-like. Setting the bar high and motivating employees to exceed expectations is a cornerstone of good management, but Mr. Page takes this to the next level. For instance, Google was founded with the mission to "organize the world's information and make it universally accessible and useful" — no small feat. But today, Mr. Page says that vision is "probably a bit too narrow." That statement conveys the size of his intentions, and the urgency he feels to move technology forward.

The individuals Mr. Page oversees are aware of this ambition, and reciprocate in-kind. Take businessman and scientist Andy Conrad, for example. He leads Google X's latest project, ingestible nanoparticles that would monitor people for diseases. He describe to Fortune what it feels like when discussing ideas with Mr. Page: "You feel terrified, inspired and nurtured at the same time." There's also a joke that has made the rounds at Google X, a tall tale in which a scientist wants to show Mr. Page a time machine. "As the scientist reaches for the power cord to begin a demo, Page fires off a dismissive question: 'Why do you need to plug it in?'"

2. He is an aggressive dreamer, but also an assertive executive. Mr. Page was previously part of a three-member executive team: Eric Schmidt ran the company as CEO, and Mr. Page and his cofounder Sergey Brin served as presidents. When that arrangement dissolved in 2011, Mr. Page took on the CEO role. Since then, he has reorganized top ranks twice, eliminated numerous products, integrated the look and feel of those that remained and encouraged Google's engineers to simplify.

Google has grown more than 20 percent annually for the past three years. In its most recent quarter, revenue topped $16 billion. This challenges the notion that creative people have a hard time managing or that big-thinkers pay little notice to operational details. Mr. Page is not merely concocting Willy Wonka-like dreams in his C-suite, but acting as a hands-on executive who makes hard decisions. He reigns in his imagination when he must, choosing which pursuits to continue and which to kill.

3. He is committed to consistently reinventing the company. Mr. Page has taken note of tech giants of yore — many companies rested on their laurels and simply kept doing what they did best. Eventually, they grew irrelevant. Mr. Page knows top talent in tech and science do not want to work for one-trick ponies. To keep Google rich with the brightest minds and thriving for generations instead of a couple of decades, Mr. Page continues to push Google to diversify its offerings. The company's "bucket of investments" includes bets of the short-, medium- and long-term variety.


The things I learned from working next to my boss

Lindsey Dunn never introduced me as anything but her coworker, even when she was editor in chief and I was a lowly reporter. "We work together," Lindsey would tell everyone, from other magazine editors to health system CEOs. Such a statement could easily come off as a Kumbaya best practice ripped from the pages of Harvard Business Review, but not in this case. She made sure it was absolutely true.

When I began working at Becker's Healthcare, our editorial team — and consequently, our office — was significantly smaller, with five people. Lindsey's desk was immediately next to mine, about four feet to my right. This let me see the precise shape of her workday, between interviews, meetings, writing and editing stories. The visibility of her workload made me realize the value of even 10 minutes of her time.

People like to say there's no such thing as a stupid question, but come on. There is. Our seating arrangement would have made it easy for me to lean back in my chair and ask what an ACO is, what a letter of intent means or what a certificate of need does, but Lindsey made it known she was not a walking encyclopedia. I had to do a fair amount of research before asking any question about healthcare policy. In turn, Lindsey's answers were never rushed when I did come to her, and I started gaining confidence that I could figure out more on my own than I initially thought. She helped me earn the things I learned.  

Working four feet away from Lindsey taught me how crucial face time is to building trust. When I made a mistake, Lindsey and I talked about it in person. When I did something well, we talked about that in person, too. She printed out my stories, edited them in the evening and left them for me on the seat of my chair, where I found them each morning when I got to the office. "Let me know when you're settled and we can talk about my feedback," she'd say. Lindsey treated easy and difficult conversations equally — with face-to-face talks — and that consistency made me feel assured about her support of my work, which I valued.

I've yet to see Lindsey lose her cool. This set an example for our entire team. If something did go awry, Lindsey built a three-step strategy into the discussion: This is the mistake, this is the effect and this is how we're not going to let it happen again. I often hear stories about mercurial bosses who let emotion get the best of them, which makes me all the more grateful to have worked under a professional who expected all of us to stay calm and find solutions.   

To work alongside Lindsey at Becker's — in the most literal sense of the phrase — helped me in many ways, big and small. I have big shoes to fill as editor-in-chief of Becker's Hospital Review, but somehow the role already feels oddly familiar. For that, I thank Lindsey, for insisting we worked together since day one.


How having an opinion changed my career

Editor in chief Lindsey Dunn pens her last column, sharing lessons from Becker's six years of remarkable growth

This is my last column for Becker's Hospital Review. While I'm looking forward to the next stage of my career, it's not without some sadness that I leave the Becker's team. When I joined just six years ago, we had a staff of five and had just launched Becker's Hospital Review. Today, we're 30-plus strong, and our website garners more than a million views each month.

Early on, I was charged with regularly connecting with our target audience of C-suite hospital and health system leaders. However, this proved a difficult feat. Busy CEOs running million- and billion-dollar organizations were hesitant to grant an interview to a publication they'd never heard of, and rightfully so.

My luck changed when Dr. David Feinberg, then CEO of UCLA's hospitals (he was promoted in 2011 to CEO of the system), agreed to an interview. We talked for nearly an hour, and I learned more about running a hospital in those 60 minutes than I ever imagined. The interview served as a foundation for my knowledge base on covering healthcare and also opened doors to numerous other interviews. You can read the interview here; I apologize for the lack of headline cleverness — I was just starting out.

I attached a link to Dr. Feinberg's interview to nearly every CEO interview request I made for the next sixth months; my requests were approved by health systems at a much greater rate after!

Becker's reputation has changed considerably from my first year here. We went from a relatively unknown trade book to one with web traffic rivaling its competitors. We host industry events with thousands of attendees and prominent healthcare executives. Four years ago, I really thought we'd achieved something when 40,000 visitors came to in a single month. Today that number exceeds 650,000.

How'd we do it?

Great people producing great content. Our reporters and editors are some of the most intelligent and driven people I've ever had the pleasure of working with. That drive propelled us to achievements, both readership- and revenue-wise, I didn't really think possible back in 2009.

Becker's is also extremely nimble, adjusting strategy and digital, print and event platforms to market forces and new opportunities. There's never red tape here, which is an element of organizational culture that's very rare to find.

And while I can't link it directly to our growth, one of the most valuable pieces of advice I received during my time as editor in chief of our once fledgling and now industry-leading publication came from Chuck Lauer, former publisher of Modern Healthcare.


For innovation, look to the 90s

If this headline caught your attention, that was my intention. Certainly the 1990s, at least today, aren't viewed as a particularly innovative time in healthcare. The 90s brought the rise (and fall) of managed care, a rush to employ (and then divest) physicians and perhaps the worst era of patient satisfaction in the history of modern medicine.

However, the 90s also brought us something else: Millennials. Today, these 90s babies are the new human capital of our nation's workforce.

While many industry veterans are tempted to roll their eyes at this generation, which has often been referred to as 'entitled,' Liz Wisemen, a management and development researcher who studies the role of organizational newcomers, says rookies can be a big asset to organizations.

"Newcomers face a steeper learning curve, but, because they're mindful of the gap and want to gain ground, they often deliver results faster," Wiseman writes in a recent Harvard Business Review article. "In our comparative study, rookies scored 60% higher than experienced colleagues on the timeliness of their output. They're cautious at first as they gather data and study a situation, but once they jump in, they move quickly, making them perfectly suited for lean and agile development projects."

Rookies accelerate innovation, she says. At eBay, 2013 graduates contributed 25 percent more patent ideas than the rest of the company.

Wiseman urges companies to encourage rookies to contribute right off the bat; allowing them to do so may bring more innovative ideas than you ever expected.

For those of us that are far removed from our rookie days, take note: Wiseman says anyone can display what she calls "rookie smarts."

She explains: "The real game-changer is ensuring that your entire team is able and willing to adopt the newcomer's mindset when necessary — mobilizing experts, forging new territory and accelerating innovation — no matter their age or career stage."


Republicans to take Congress: 4 things healthcare leaders should know

Election day is finally here, and it brings with it a strong chance that the United States will have elected a Republican Congress by day’s end. As of this morning, the Washington Post Election Lab was forecasting a 99 percent chance of Republican victory in the House and a 98 percent chance of the same in the Senate. 

Important races, where there could be potential surprises, include some usual suspects: Colorado, Iowa, New Hampshire and North Carolina. Among states Republicans seemed poised to win from Democratic incumbents are Montana, West Virginia, South Dakota, Arkansas, Alaska and Louisiana.

But what does this strong Republican position mean for healthcare?

Read More...'s plan to take on healthcare

Will one of America's most innovative companies be able to disrupt healthcare?

Earlier this week, Reuters broke the news of's plans to enter the healthcare industry. The cloud-based CRM juggernaut has set its sights quite high — to the tune of $1 billion in annual revenue from healthcare clients.

If the company is successful in pulling in $1 billion in healthcare revenue, healthcare will makeup one-fifth of total company revenue, according to the Reuters report. already counts UCSF Medical Center and Blue Cross of California as customers, said Reuters' sources.

And in June, and Philips partnered to create a data-sharing platform and apps to aid providers and patients in care coordination. Two of the first apps to be launched on the platform, Philips eCareCoordinator and Philips eCareCompanion, will aid remote monitoring for patients with chronic conditions. isn't expected to release official word on its plans for the industry until November, but the rumblings of a large-scale move into healthcare by one of America's 40 most innovative companies could mean big changes for the health IT competitive landscape. has conquered the world of CRM. And while CRM is related to health management, care coordination and patient engagement, keeping a patient healthy is a lot different than turning leads into customers. The question on the minds of those who understand the force that is and the challenges that characterize the healthcare industry goes something like this: Is this 800-lb CRM gorilla good enough, and does it understand the nature of healthcare well enough, to become the dominant provider of care management solutions?


3 of the most frightening things in healthcare today

Halloween will come and go, but three problems in healthcare today will likely persist for longer than anyone in their right mind would like.

1. Ebola.  Ebola is harrowing at its most basic pathological level, with severe symptoms, a high mortality rate and no vaccine. But the Ebola epidemic has proven deeply alarming in many ways beyond its science. There were more than 10,141 confirmed, probable or suspected cases reported as of last weekend, according to the World Health Organization. While Ebola cases in West Africa continued to climb, national attention turned inward as American public health officials and politicians sparred over how to appropriately stop the virus' spread. The debate unfolded as the number of diagnosed Ebola cases on American soil dropped to one Tuesday, when nurse Amber Vinson was discharged from Emory Hospital in Atlanta, Ebola-free.   

The American healthcare system has performed remarkably well in past moments of national distress. Remember how it functioned in the sobering aftermath of 9/11, and more recently, the Boston Marathon. Emergency workers, physicians, nurses and hospitals worked as a united front, delivering much-needed medical care that rose above tough media scrutiny and the fray of politics or opinion.

But the Ebola epidemic has proven more damaging to our domestic healthcare system and global health thinking. It has brought on a sense of self-interested panic that is feeding divisions over national security, whether between the White House, governors, media outlets, healthcare professionals, CDC, mission workers, Texans, New York City residents — the list goes on. The number of lives Ebola has affected or taken in West Africa is devastating and the United States' poor response is disappointing. If anything, the confusion, schisms and shifting of blame have only exacerbated the crisis, taking attention away from the intervention desperately needed in West Africa.

2. The depersonalization of medicine. Transitioning from Ebola is uncomfortable, since the weight of other problems seems to shrink in the shadows of a  global emergency. The depersonalization of medicine is not nearly as visible or grave. Rather, concerns about the weakening physician-patient bond have gradually intensified throughout the healthcare system and are likely to persist for some time. With no easy solution, if one at all, this dilemma is often placed on the backburner to make room for the dozens of other pressing healthcare concerns du jour.

In many cases, the term "burnout" is too mild to describe the disenchantment many physicians feel about their work. "I don't know about other physicians but I am tired — tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine," orthopedic surgeon Daniel Craviotto, MD, wrote in a Wall Street Journal op-ed this spring. Dr. Craviotto is just one of many physicians to take his thoughts to pen and paper. In a piece for The Atlantic, essayist Meghan O'Rourke drew attention to how many physicians are writing books about their professional problems. (The titles often share a common tone, such as "The Doctor Crisis" or "Doctored: The Disillusionment of an American Physician.")

"What's going on is more dysfunctional than I imagined in my worst moments," wrote Ms. O'Rourke. "Although we're all aware of pervasive healthcare problems and the coming shortage of general practitioners, few of us have a clear idea of how truly disillusioned many doctors are with a system that has shifted profoundly over the past four decades."


10 leadership lessons from "The Front-Line Leader"

Chris Van Gorder, CEO of Scripps Health, has been a remarkable leader for the San Diego-based, five-hospital system. After joining the system in 2000, at a time when the medical staff had voted no confidence in the previous administration and the system was losing millions, Chris led its remarkable $150 million turnaround. And he did so without any layoffs. Today, Scripps' facilities routinely appear in national hospital rankings, and the system recently opened a $220 million cancer center and has a $450 million cardiac center in the works.

If you ask him how he did it though, he's quick to correct you: He didn't do it, the more than 13,000 dedicated physicians and staff did. He just guided them.

In fact, guidance — through vision, purpose and empowerment — is a key theme of his new book, "The Front-Line Leader: Building a High-Performance Organization from the Ground Up" (Jossey-Bass, 2014).

The book provides numerous leadership lessons and stories that highlight the importance of inclusive but accountable leadership. Here are 10 of our favorites:  Frontlineleader

1. Leadership should be hands-on. You can't understand your organization, its challenges and opportunities by staying in your office all day. Chris is the epitome of a hands-on leader, visiting departments and asking to be bossed around, so he can understand the duties of each team. His efforts have led to his assisting in surgery and even using a floor polisher under the supervision of the environmental staff. Hands-on leadership breeds trust, which is critical to gaining the buy-in of employees.   

2. Great leaders have a passion for what they do. That is, they love the industry they're a part of, not just leading. Chris started his career as a police officer in California. He was hospitalized after a domestic disturbance call that ended in him being hit by a car. While in the hospital, he became in awe of the care he received from his nurses. He recovered, but his injuries left him unable to return to the force. He asked the hospital that treated him to hire him as director of security. He got it by agreeing to work for minimum wage for 90 days. He proved himself, and the rest is history: He earned his master's in healthcare administration from University of Southern California and began working his way up through the hospital administration ranks. The experience of being a patient made him understand the importance of healthcare to our society and engrained in him a passion to improve it. 

3. The best leaders recognize organizational success isn't about the top of the organization, but the bottom — the front-line leaders. The leadership approach Chris shares is somewhat counter-intuitive: Leaders lead down, not up. He advocates leading or managing "down," whereby each level of management ensures those below have the tools and support they need to do their jobs well.

4. Leadership success is largely due to communication. Having a vision for an organization is one thing, but achieving it requires the buy-in from front-line workers and their understanding of what behaviors are needed to reach it. How do you gain buy in? Through communication and education. Employees don't have to love every decision leadership makes, but they need to understand the 'why' behind it.

5. Being a good communicator requires being accessible and responsive. Chris is a brilliant leader and skilled communicator. He understands the importance of communicating with all stakeholders, especially employees, and hosts regular town halls to hear employee concerns and feedback. And he's a whiz at email. Try emailing him; you'll likely hear back in less than an hour. He responds quickly because he values others' input, and wants to demonstrate that.