Art: “Hmms,” “Hmphs,” and “Ahas”

Andy Warhol was quoted as saying, “Making money is art and working is art and good business is the best art.”  And since Twyla Tharp said, “Metaphor is the lifeblood of all art,” I’m taking an art history class this quarter to add some perspective to my health care business thinking (if you’re skeptical, you aren’t the first; using A Whole New Mind by Dan Pink as evidence I was able to get this reluctantly approved by the powers that be).  Classes like art history should become part of an MHA curriculum to inspire new approaches to health care’s tired problems.

Here’s the thing: art is difficult to interpret (this is my first foray into the effort), especially modern art (especially conceptual art).  There is a fine line between over-analysis and under-analysis.  Finding meaning isn’t always the easiest task, either.  But. That. Is. Exactly. The. Point.  This is challenging my thinking in a way it’s never been challenged.  It is definitely exciting (at least for the time being, a research paper is required for the final and my experience with art history research papers is slim, at best.)

But there is a relation between art and health care and business here.  Sitting in lecture and reading the necessities has provided more than a few “Hmms,” “Hmphs,” and “Ahas.”  Sol LeWitt‘s “Sentences on Conceptual Art” is the first extensively business-related reading we’ve had in the class.  The most thought-provoking metaphorical “sentences” appear below (many have been axed for various reasons) and a personal analysis of their meaning is encouraged (share in the comments if you would like):

2. Rational judgements repeat rational judgements.
3. Irrational judgements lead to new experience.
5. Irrational thoughts should be followed absolutely and logically.
6. If the artist changes his mind midway through the execution of the piece he compromises the result and repeats past results.
9. The concept and idea are different. The former implies a general direction while the latter is the component. Ideas implement the concept.
12. For each work of art that becomes physical there are many variations that do not.
13. The words of one artist to another may induce an idea chain, if they share the same concept.
19. The conventions of art are altered by works of art.
20. Successful art changes our understanding of the conventions by altering our perceptions.
21. Perception of ideas leads to new ideas.
24. Perception is subjective.
30. There are many elements involved in a work of art. The most important are the most obvious.
32. Banal ideas cannot be rescued by beautiful execution.

For some Friday entertainment (I can’t help but smile at this) here is a clip of John Baldessari singing LeWitt’s “Sentences:”


“…these sentences have been hidden too long in the pages of exhibition catalogs…”

Hopefully, they do some good here, too.

Presentation Season

The MHA world is entering the presentation season again.  Here’s last year’s reaction.  Here’s this year’s proaction courtesy of Seth.

Best Point: Don’t use PowerPoint at all.

Best Articulation:

Here’s the deal: You should have to put $5 into the coffee fund for every single word on the wordiest slide in your deck. 400 words costs $2000. If that were true, would you use fewer words? A lot fewer? I’ve said this before, but I need to try again: words belong in memos. Powerpoint is for ideas. If you have bullets, please, please, please only use one word in each bullet. Two if you have to. Three never.

Likemind in Columbus + A Call to Action

In an effort to continuously bring new perspective to my health care thinking, I braved up and attended Likemind in Columbus on Friday.

Not only did I receive a free book (Buying In) and sip free coffee, I greatly enjoyed the conversation I had with the folks in attendance.

At the beginning of my MHA program it was fun to hear people describe why they decided to pursue a career in health care. Most had some twist on the save-the-world mantra (you know, fix our health care problems). And then the first day of school starts and we begin to hear that the problems we are going to try to solve are (more or less) the same problems we’ve had all along. To say there has been no progress would be disrespectful and naive. To say that the problems have become more problematic is truth. Two steps forward, one step back. But I do get the feeling that many in health care often try to shut out the rest of the world with the thinking that only “we” in the inner circle know what is best for health care. Shoot, many would like to argue that administrators have only exasperated the problem.

Well, no matter what side of the fence you fall on, this is clear: the fact that we have been in this “health care crisis” for 40+ years makes me wonder if we are approaching the issues from misplaced perspective.

And that is why I appreciate Health 2.0 so much. That is why I’m encouraged by Jay Parkinson. That is why retail clinics interest me. That is why I am intrigued by the paradigm shift from sick care to preventive care.

I love this attributed Einstein quote and used it on day one to introduce this blog: “The significant problems we have cannot be solved at the same level of thinking with which we created them.”

So whether it is Likemind, or books and magazines and blogs that have nothing to do with health care, or talking to people with no health care experience, please make the attempt to expand your perspective. It very well could be the only way we improve what we’ve got.

Understanding the Differences

One of the best aspects of my MHA program (and one of the reasons I chose it) is a clinical rounds class that places MHA students with a hospital service for five weeks to observe medical students, interns, residents, fellows, and attendings do  rounds.  I have often heard that learning on the job is the best way to learn; this experience is no different, a key to understanding others and learning about what they do is to immerse yourself in their situation.

One of the important differences that separates health care from other “business” is that most providers—who are directly responsible for admitting patients into the hospital and thus, relied upon in order for hospitals to make money—are not employees of the hospital.  It is understandable why problems develop.

The age-old health care management problem involves a disconnect between providers and management—most likely to do with a lack of communication.  This class, while admittedly too short, is an effort to help administration students (most with limited clinical experience) gain an understanding of the medical education process (and a general look into the provider’s decision-making process).

I’ve always respected physicians, but my respect has increased dramatically after just a few meetings with my care team.   Decision making can be difficult as there is always some uncertainty in the decision making process.  Limiting that uncertainty is a key to making good decisions.

Here is what I’ve come to understand well: Uncertainty rules the day in medical care.  And patients expect miracles.  While the competent provider (of which I have yet to meet one on the other side) often has a good idea/understanding of a patient’s medical problem, they just never know for sure.  Here’s the problem: (constant!) vague and incomplete information.  Besides a detective, who else deals with so much constant uncertainty?  Or if that isn’t enough, how about dealing with uncertainty and knowing the decisions made could have a negative impact on another human life?

Differences between providers and administrators will always exist.  The two have very different job descriptions with very different expectations.  The differences create a necessary balance.  While only for a short period of time, being exposed to providers doing their job is helping me visualize those differences.  The hope is that this experience will translate to a better understanding of it all.

If we all were great presenters the world would be a better place

This may be a bit of a digression from the usual on our own system, but some ideas are just so important…

How to present…well.

It is not an easy thing, but being a good presenter can be a powerful tool. And in this information age we live in there are countless tools available, for free. In fact, some of the best give their ideas away because they can’t stand to see any more bad presentations.

It starts with preparation, and a lot of it. Garr Reynolds gives us plenty of help in this area, here, with ten steps to guide our planning. An excerpt from step No. 7, Dakara nani?, which roughly translates into:

So what?” — always be asking yourself this very important, simple question. If you can’t really answer that question, then cut that bit of content out of your talk.

Your presence during a presentation is key. Mr. Reynolds strikes again with ten more great tips to help with delivery.

If I had only one tip to give, it would be to be passionate about your topic and let that enthusiasm come out. Yes, you need great content. Yes, you need professional, well designed visuals. But it is all for naught if you do not have a deep, heartfelt belief in your topic.

And finally, the software program which has become the crutch of most presentations–and make your presentation an instant failure even if you have prepared well and are a competent deliverer, PowerPoint.

Seth Godin has a great post titled Really Bad PowerPoint, and how to avoid it with four components of a good presentation. Mr. Reynolds provides ten more tips on this subject.

And putting it all together, Guy Kawasaki, who listens to many a presentation, works hard to evangelize the 10/20/30 Rule: “It’s quite simple: a PowerPoint presentation should have ten slides, last no more than twenty minutes, and contain no font smaller than thirty points.”

Here’s Mr. Kawasaki on the 10/20/30 Rule:

And the best way to get better is to learn from others who present well. The TED website is a great opportunity to do just that, TED is a yearly conference that stands for Technology, Entertainment, Design where individuals come together to give “Inspired talks by the world’s greatest thinkers and doers.” There is some really good stuff here.

For tips on a regular basis, Mr. Reynolds’s Presentation Zen blog is great.

OK, so great presentations take a good amount of time to do. But it’s worth it. As an audience member, please, please take the time.

Did You Know?

Was in St. Louis (great city!) over the weekend…and talked health care goings on during the product testing phase of the Anheuser-Busch Brewery Tour.

Anyway, how do St. Louis and Columbus compare when it comes to health care? While it may take some significant time to compare every aspect of health care delivery, treatment, reimbursement, etc., the Dartmouth Atlas makes comparing everything-Medicare simple.

For instance:

Average Total Medicare Reimbursement
National: $6968.21, St. Louis: $6569.24, Columbus: $6367.26

Acute Myocardial Infarction Discharges per 1,000 Medicare Enrollees
National: 8.44, St. Louis: 8.36, Columbus: 6.53

Be forewarned: you could spend an endless amount of time on this site if you’re inclined to useful information…

From the website:

The Dartmouth Atlas Project works to accurately describe how medical resources are distributed and used in the United States. The project offers comprehensive information and analysis about national, regional, and local markets, as well as individual hospitals and their affiliated physicians, in order to provide a basis for improving health and health systems. Through this analysis, the project has demonstrated glaring variations in how health care is delivered across the United States. The project is run by The Dartmouth Institute for Health Policy and Clinical Practice (TDI).

Have fun.

A Helpful Website

Are you interested in pursuing a Master in Health Administration (MHA) or MHSA, or a MBA with a health care focus (as you can see there are a few different names for a degree to become an administrator in a health services organization)?

A great place to start is this website. It is a very extensive listing of health administration programs. Start exploring. And if you have any related questions email me, I’ll give you my thoughts.