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  • 1
    object(stdClass)#14499 (59) {
      ["id"]=>
      string(4) "6123"
      ["title"]=>
      string(49) "Innovation Readiness is Not Improvement Readiness"
      ["alias"]=>
      string(49) "innovation-readiness-is-not-improvement-readiness"
      ["introtext"]=>
      string(89) "

    Most of what you have read lately is about how COVID has accelerated innovation.

    " ["fulltext"]=> string(8400) "

    What might have taken 5 years to get to patients is now taking months, like telemedicine, supply chain speed and drug discovery and development.

    However, there is a difference between an idea, an invention, an improvement and an innovation. Sometimes what is really happening is not new at all, but simply an example of speedier dissemination and implementation across the chasm, frequently out of necessity.

    Standards-based reform is a series of improvement efforts with a focus on doing things better. Online learning and new learning models are examples of disruptive innovation–doing things differently to dramatically improve outcomes. Doug Lemov’s book, Teach Like a Champion, is about improvement. Clay Christensen’s book, Disrupting Class, is about innovation.

    Physician leaders occupy the next level and are expected to provide vision, direction and inspiration and drive the change process. Some see their role as incremental tweakers, leading to the painful and difficult process of changing the existing model. Others see their role as making the model obsolete. They typically try to follow John Kotter's 8 step change paradigm: unfreeze by creating a sense of urgency, changing behavior, and then refreezing the new behaviors to engraft them on to the culture and make them sustainable.

    Physician entrepreneurs take it one step further, taking advantage of an opportunity with scarce, uncontrolled resources with the goal of creating user-defined value through the deployment of biomedical and clinical innovation. Often times, their outcomes will be in conflict with physician managers who are there to protect, not disrupt, the status quo, or leaders who don't have the same vision.

    Some physician entrepreneurs are innovators, occupying a space in the upper right hand corner of the novelty-value matrix

    Innovation Readiness is Not Improvement Readiness

    Where you sit on the matrix is dependent on how much time you're spending on the now (lower left), the next (right lower) or the new (upper right quadrant). The upper left quadrant is the place in hell reserved for shiny new objects that create little or no user-defined value at significant multiples when compared to the competition or the status quo.

    For example, understood as a virtual army in the war against COVID-19, AI has vast stockpiles of potential weaponry with which to wage many a battle. That’s the good news.

    The not-so-good news is that potential, so far at least, is all the technology has to show for all the chest-beating of its enthusiasts. AI’s success or lack thereof in taking on COVID-19 is all a matter of data. Privacy regulations and balkanized data silos will stop you even before the antiquated, error-filled health databases do. That happens in Washington and state capitals, not in the data lab.

    Improvement readiness assessment and innovation readiness assessment, therefore, are not the same. While there are similarities, there are significant differences that determine the outcomes of a change initiative. Most of them have to do with how pervasive is the process of how those with an entrepreneurial mindset collide with an organization that has a culture of innovation, not just improvement.

    Here is what physician entrepreneurs should know about innovation and why it is a heavier lift than improvement.

    1. You need to lead innovators, not manage innovation.

    2. Innovative universities and organizations are not necessarily entrepreneurial.

    3. Patients and other stakeholders are your main source of opportunity to create innovation.

    4. Big Device should change their R/D models.

    5. You need an Innovation Management System to create impact.

    6. You need to clarify your innovation expectations and encourage innovators to go beyond them or dial them back. Sometimes tinkering is the first step towards something bigger.

    7. Have you validated your business model assumptions?

    8. Rules create ecosystems. Ecosystems drive innovative business models. Think, TV, the Internet, electric cars.

    9. Stop blowing innovation smoke and raise your innovation bar.

    10. Create user defined value through the deployment of innovation, not just companies.

    Post COVID you should not be asking yourself when we will return to normal. That ship has sailed. You should be shooting to make the old normal obsolete, not disseminating bad products, services and models to more people inequitably and calling it innovation.

    Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD and Facebook.

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    Innovation Readiness is Not Improvement Readiness

    Arlen Meyers, MD, MBA
  • 2
    object(stdClass)#14498 (59) {
      ["id"]=>
      string(4) "6081"
      ["title"]=>
      string(14) "Ode to Mothers"
      ["alias"]=>
      string(14) "ode-to-mothers"
      ["introtext"]=>
      string(113) "

    Day in and day out, I interact with mothers.

    " ["fulltext"]=> string(3312) "

    Sometimes I help women become mothers, sometimes I help women not become mothers. Sometimes I witness the heartache of losing a mother or losing the ability to be a mother. Sometimes I share in the joy of their child’s achievements or laugh at their crazy stories. And sometimes I see women become  mothers to children they did not birth.

    To each one of you I say:

    You are brave.

    You are brave to hold more sacred than your life the life growing inside of you.

    You are brave to willingly walk through the valley of pain to reach the land of motherhood.

    You are brave to open yourself and give every bit of your heart to another.

    You are brave to roar as a lioness to protect your cub.

    You are strong.

    You are strong to hold together your broken heart for others to lean on.

    You are strong to carry the weight of the world on your shoulders so others don’t have to.

    You are strong in your tears, you are strong in your laugh.

    You are strong in letting go.

    You are courageous.

    You are courageous in saying no.

    You are courageous in saying yes.

    You are courageous when you hear the cry in the night.

    You are courageous even when you are scared.

    And although you don’t hear it often enough

    You are loved.

    You are appreciated.

    You are a heroine.

    You are my heroine.

    " ["checked_out"]=> string(1) "0" ["checked_out_time"]=> string(19) "0000-00-00 00:00:00" ["catid"]=> string(3) "118" ["created"]=> string(19) "2020-05-19 11:30:03" ["created_by"]=> string(3) "526" ["created_by_alias"]=> string(0) "" ["state"]=> string(1) "1" ["modified"]=> string(19) "2020-05-19 11:39:27" ["modified_by"]=> string(3) "333" ["modified_by_name"]=> string(13) "Badr Berrada " ["publish_up"]=> string(19) "2020-05-19 11:30:03" ["publish_down"]=> string(19) "0000-00-00 00:00:00" ["images"]=> string(307) "{"image_intro":"images\/articles\/global-economy\/Ode_to_Mothers.jpeg","float_intro":"","image_intro_alt":"Ode to Mothers","image_intro_caption":"","image_fulltext":"images\/articles\/global-economy\/Ode_to_Mothers.jpeg","float_fulltext":"","image_fulltext_alt":"Ode to Mothers","image_fulltext_caption":""}" ["urls"]=> string(121) "{"urla":false,"urlatext":"","targeta":"","urlb":false,"urlbtext":"","targetb":"","urlc":false,"urlctext":"","targetc":""}" ["attribs"]=> string(667) "{"article_layout":"","show_title":"","link_titles":"","show_tags":"","show_intro":"","info_block_position":"","info_block_show_title":"","show_category":"","link_category":"","show_parent_category":"","link_parent_category":"","show_associations":"","show_author":"","link_author":"","show_create_date":"","show_modify_date":"","show_publish_date":"","show_item_navigation":"","show_icons":"","show_print_icon":"","show_email_icon":"","show_vote":"","show_hits":"","show_noauth":"","urls_position":"","alternative_readmore":"","article_page_title":"","show_publishing_options":"","show_article_options":"","show_urls_images_backend":"","show_urls_images_frontend":""}" ["metadata"]=> string(53) "{"robots":"","author":"","rights":"","xreference":""}" ["metakey"]=> string(6) "mother" ["metadesc"]=> string(44) "Day in and day out, I interact with mothers." 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    Ode to Mothers

    Andrea Eisenberg, MD
  • 3
    object(stdClass)#14501 (59) {
      ["id"]=>
      string(4) "6070"
      ["title"]=>
      string(55) "The Nameless Saviors in This Dangerous Time of Covid-19"
      ["alias"]=>
      string(55) "the-nameless-saviors-in-this-dangerous-time-of-covid-19"
      ["introtext"]=>
      string(201) "

    I’m ashamed of myself. I don’t know your name—anything about your kids, what they did this weekend.

    " ["fulltext"]=> string(4179) "

    I went through my Facebook friends list and I don’t think any of you are on it. I try to always say hello when I pass you in the hall, but I do that with everyone—sometimes it’s returned.  

    I can’t do my job without you. Without you I’m frozen in time. The entire hospital will come to a standstill. Yet I don’t know half of your names and I should.

    You are the ones that clean urine out of the sinks and human excrement off the floors. You mop liters of blood and vomit off walls and tiles, and IV poles and monitors. You scrub down Covid-covered bed frames, hepatitis- and HIV-soiled linens, and surround yourself with more guts and gore and hazardous waste on a daily basis than most of us would encounter in a lifetime. 

    You work nights and days, and weekends and all those moments when others might be sitting at home contemplating a day of blessings and sparklers and tinsel and turkey—and you do it mostly for survival and for those you love, I imagine. 

    Us doctors and nurses, we save the lives of some horribly injured and ill people on a daily basis. The carnage left in its wake is at times the stuff of our darkest nightmares. Now the world shines this light on us and the incredible first responders providing care in this dangerous of times.

    Housekeepers

    But I see you—wiping, washing, disinfecting, polishing, mopping, and making sure that room is sterile and safe and clean and ready for the next father or mother or son or daughter.

    You are my heroes, you are my salvation in this time of Covid.

    You are housekeeping . . . please tell me your name.

     

     

    Dr. Louis M. Profeta is an emergency physician practicing in Indianapolis and a member of the Indianapolis Forensic Services Board. He is a national award-winning writer, public speaker and one of LinkedIn's Top Voices and the author of the critically acclaimed book, The Patient in Room Nine Says He's God. Feedback at louermd@att.net is welcomed. For other publications and for speaking dates, go to louisprofeta.com. For college speaking inquiries, contact bookings@greekuniversity.org.

    Louis M Profeta
     

    Cover Photo By Emily Hallberg RN.

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I don’t know your name—anything about your kids, what they did this weekend." ["access"]=> string(1) "1" ["hits"]=> string(3) "229" ["xreference"]=> string(0) "" ["featured"]=> string(1) "1" ["language"]=> string(5) "en-GB" ["readmore"]=> string(4) "4179" ["ordering"]=> string(1) "6" ["category_title"]=> string(7) "Science" ["category_route"]=> string(7) "science" ["category_access"]=> string(1) "1" ["category_alias"]=> string(7) "science" ["published"]=> string(1) "1" ["parents_published"]=> string(1) "1" ["lft"]=> string(3) "127" ["author"]=> string(16) "Louis M. Profeta" ["author_email"]=> string(26) "louisprofetamgmt@gmail.com" ["parent_title"]=> string(4) "ROOT" ["parent_id"]=> string(1) "1" ["parent_route"]=> string(0) "" ["parent_alias"]=> string(4) "root" ["rating"]=> string(1) "0" ["rating_count"]=> string(1) "0" ["alternative_readmore"]=> NULL ["layout"]=> NULL ["params"]=> object(Joomla\Registry\Registry)#14511 (3) { ["data":protected]=> object(stdClass)#14514 (96) { ["article_layout"]=> string(9) "_:default" ["show_title"]=> string(1) "1" ["link_titles"]=> string(1) "1" ["show_intro"]=> string(1) "1" ["info_block_position"]=> string(1) "0" ["info_block_show_title"]=> string(1) "1" ["show_category"]=> string(1) "1" ["link_category"]=> string(1) "1" ["show_parent_category"]=> string(1) "0" ["link_parent_category"]=> string(1) "0" ["show_associations"]=> string(1) "0" ["flags"]=> string(1) "1" ["show_author"]=> string(1) "1" ["link_author"]=> string(1) "0" ["show_create_date"]=> string(1) "1" ["show_modify_date"]=> string(1) "0" ["show_publish_date"]=> string(1) "0" ["show_item_navigation"]=> string(1) "0" ["show_vote"]=> string(1) "1" ["show_readmore"]=> string(1) "1" ["show_readmore_title"]=> string(1) "0" ["readmore_limit"]=> string(3) "100" ["show_tags"]=> string(1) "1" ["show_icons"]=> string(1) "0" ["show_print_icon"]=> string(1) "0" ["show_email_icon"]=> string(1) "0" ["show_hits"]=> string(1) "0" ["show_noauth"]=> string(1) "1" ["urls_position"]=> string(1) "0" ["captcha"]=> string(0) "" ["show_publishing_options"]=> string(1) "1" ["show_article_options"]=> string(1) "1" ["save_history"]=> string(1) "0" ["history_limit"]=> int(10) ["show_urls_images_frontend"]=> string(1) "0" ["show_urls_images_backend"]=> string(1) "1" ["targeta"]=> int(0) ["targetb"]=> int(0) ["targetc"]=> int(0) ["float_intro"]=> string(4) "left" ["float_fulltext"]=> string(4) "left" ["category_layout"]=> string(6) "_:blog" ["show_category_heading_title_text"]=> string(1) "0" ["show_category_title"]=> string(1) "0" ["show_description"]=> string(1) "0" ["show_description_image"]=> string(1) "0" ["maxLevel"]=> string(1) "1" ["show_empty_categories"]=> string(1) "0" ["show_no_articles"]=> string(1) "1" ["show_subcat_desc"]=> string(1) "1" ["show_cat_num_articles"]=> string(1) "0" ["show_cat_tags"]=> string(1) "1" ["show_base_description"]=> string(1) "1" ["maxLevelcat"]=> string(2) "-1" ["show_empty_categories_cat"]=> string(1) "0" ["show_subcat_desc_cat"]=> string(1) "1" ["show_cat_num_articles_cat"]=> string(1) "1" ["num_leading_articles"]=> string(1) "0" ["num_intro_articles"]=> string(2) "10" ["num_columns"]=> string(1) "1" ["num_links"]=> string(1) "5" ["multi_column_order"]=> string(1) "1" ["show_subcategory_content"]=> string(1) "0" ["show_pagination_limit"]=> string(1) "1" ["filter_field"]=> string(4) "hide" ["show_headings"]=> string(1) "1" ["list_show_date"]=> string(9) "published" ["date_format"]=> string(5) "Y-Y-Y" ["list_show_hits"]=> string(1) "1" ["list_show_author"]=> string(1) "1" ["list_show_votes"]=> string(1) "0" ["list_show_ratings"]=> string(1) "0" ["orderby_pri"]=> string(5) "order" ["orderby_sec"]=> string(5) "rdate" ["order_date"]=> string(9) "published" ["show_pagination"]=> string(1) "1" ["show_pagination_results"]=> string(1) "1" ["show_featured"]=> string(4) "hide" ["show_feed_link"]=> string(1) "1" ["feed_summary"]=> string(1) "0" ["feed_show_readmore"]=> string(1) "1" ["sef_advanced"]=> int(0) ["sef_ids"]=> int(0) ["custom_fields_enable"]=> string(1) "1" ["show_page_heading"]=> int(0) ["layout_type"]=> string(4) "blog" ["menu_text"]=> int(1) ["menu_show"]=> int(1) ["pageclass_sfx"]=> string(24) " full-blog page-category" ["secure"]=> int(0) ["page_title"]=> string(7) "Science" ["page_description"]=> string(126) "BBN Times provides the latest insights from experts in technology, healthcare, leadership, entrepreneurship and global economy" ["page_rights"]=> NULL ["robots"]=> NULL ["page_heading"]=> string(7) "Science" ["access-view"]=> bool(true) } ["initialized":protected]=> bool(true) ["separator"]=> string(1) "." } ["displayDate"]=> string(0) "" ["slug"]=> string(60) "6070:the-nameless-saviors-in-this-dangerous-time-of-covid-19" ["catslug"]=> string(11) "118:science" ["link"]=> string(64) "/science/the-nameless-saviors-in-this-dangerous-time-of-covid-19" ["active"]=> string(0) "" ["displayCategoryLink"]=> string(8) "/science" ["displayCategoryTitle"]=> string(0) "" ["displayHits"]=> string(0) "" ["displayAuthorName"]=> string(16) "Louis M. 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    The Nameless Saviors in This Dangerous Time of Covid-19

    Louis M. Profeta
  • 4
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      ["title"]=>
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      string(478) "

    The COVID-19 pandemic has revealed glaring inequities in health outcomes. Global physician social entrepreneurs now have the opportunity to minimize them in the future.

    " ["fulltext"]=> string(3657) "

    The Social entrepreneur builds strong and sustainable organizations that primarily drive social innovation and transformation. 

    A social enterprise is an organization that advances a social mission through entrepreneurial strategies.

    If you have an existing non-profit or social enterprise or are planning to start one, you should focus on the 5Ms: mindset, mission, members,money, model

    MINDSET

    Innovation starts with mindset. The entrepreneurial mindset is as important for someone starting a commercial enterprise as it is for the leader of a social enterprise. Without it, you will fail.

    MISSION

    MISSION.png

    Start with answering the"Why?" before you try to construct and explain the what and how. 

    MEMBERS

    Your beneficiaries are the heros of your story. Your sponsors and stakeholders are the guides. How you tell your story will drive engagement.

    MONEY

    You have heard it before...no margin, no mission. You have to manage the profit and loss statement

    MODEL

    Most businesses will fail because they make a product or service no one wants or they don't have a viable business model. The same holds true to non-profits and mission driven organizations.

    The 6Ms of Physician Social Entrepreneurship

    MARKETING

    MARKETING

    Colleges and universities are businesses too, so, why aren't they run like one?

    Global social entrepreneurs are changing the world, now more than ever. Be the solution.

    Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD and Facebook.

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    The 6Ms of Physician Social Entrepreneurship

    Arlen Meyers, MD, MBA
  • 5
    object(stdClass)#14505 (59) {
      ["id"]=>
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      ["title"]=>
      string(41) "The Right Response to COVID-19: How, Now?"
      ["alias"]=>
      string(38) "the-right-response-to-covid-19-how-now"
      ["introtext"]=>
      string(206) "

    We must, to some extent, be something like flotsam in the currents of culture, debris on the winds of the Zeitgeist; a bit helpless against the buffeting of “now,” in all its particulars. 

    " ["fulltext"]=> string(10693) "

    Perhaps it is the Internet and social media; perhaps the constant immediacy of news cycles. Whatever the reasons intrinsic to “now,” they exert some dominion over our thinking, and seemingly the dictates of now call for: pretty dumb.

    Our thinking, debate, and discourse are, in a word- dumb. As dumb as a choice between completely raw, or  - cooked, by virtue of setting the house on fire.

    Not necessarily at the start, at the diverse sources of ideas; there, much is refined and fully formed. But our culture is an idea meat grinder; much the same dubious sausage issues from it, whatever the early inputs.

    The public discussions we seem to be having about COVID have all the subtlety of a light switch. Society is opened, or closed; we go back, or we stay put. Life is on, or off. The positions, precautions, and postures of so many of even the most expert among us seem, in this time of polarized dissent, to devolve to: this corner, or that corner.

    There is no choice to be made between human lives and any other priorities. Human lives are the only priority in this crisis. Rather, there is a need to save all the lives we possibly can while also giving people an opportunity to live them. We need a remedy that doesn’t save lives by taking other lives, and that doesn’t ruin orders of magnitude more lives. Such is the collateral damage of in/out, on/off, locked down or laissez faire thinking.

    That remedy is some version of vertical interdiction

    Figure 1Vertical Interdiction.

    The Right Response to COVID19: How, Now?

    In another world, we might have actively ‘decided’ on vertical interdiction. We might have shopped together in the marketplace of ideas, across an expanse of nationality, ideology, party, and native perspective. We might have considered one another’s ideas before attacking them for their imagined immoralities.

    We might have run all competing ideas through the gauntlet of our open-minded skepticism, and invited only the most robust to survive. We might have considered all contenders with the same commitment to fair treatment, the same antipathy for disfiguring ideas into caricatures, with the same respect for science and data. We might have been willing to shop both Sweden, and Singapore, as if from a Chinese menu.

    We might have acknowledged that total harm minimization was a valid and shared objective, even as we debated the best ways to measure harm in its every incarnation, risk in its every expression, and all the best means of achieving our common ends.

    That would have transpired in a universe parallel to this one. In this one, we are blundering toward vertical interdiction anyway, but haphazardly, and absent nearly every desirable element of process at the level of our national governance. We are getting there by virtue of impatience and impulse, exhaustion and disgust- rather than caution, consideration, compassion, and the careful sifting of best practices. Oh, well.

    We are seemingly getting there, just the same. So, although we have dealt with “whether” to shift to risk-based interdiction in only the worst ways, we are now obligated to think past it to “how.” We seem destined to practice some version of vertical interdiction now; how do we do it well?

    The general concept is simple. We use the best available data to stratify our risks of bad outcomes from SARS-CoV-2 infection. For those in the highest risk tiers, the liabilities of sheltering-in-place are reliably less than the liabilities of exposure. For those in the lowest risk tiers, the converse is true. The lines of competing liability cross somewhere in the middle tiers of risk.

    Risk at the population level can be catalogued simplistically, as in Figure 1 above, or with far more nuance, incorporating sex, biometrics, anthropometrics, location, and variations in the social determinants of health. The stratification of risk by population group can be taken to its logical extreme, with personalized risk calculation based on entries at the n-of-1 level. Generalized guidance and public policy might issue from the former, an individually customized prescription for optimal self-defense, from the latter.

    The societal goals of pandemic interdiction were never to prevent every case of infection for the simple sake of doing so. One goal was to save lives- but lives are not saved when lives not at risk get protections they don’t need. Another goal was to avoid overwhelming hospitals- but hospitals are not overwhelmed by people who never get sick enough to need one. An unstated, presumptive goal was to keep living through some acceptable level of risk, for if not- we would long since have shut society down to spare ourselves the dizzying array of threats to life and limb that populate our daily routines.

    We need better data to practice vertical interdiction optimally; we should get them. But we certainly know enough already for well-informed steps. We know that the threat to lives and hospital capacity is massively concentrated among the highly vulnerable we can readily identify. We know that even just meticulous protection of nursing homes could slash hospital demand and halve COVID mortality.

    Of course, there are challenges in the mechanics of vertical interdiction. How best do we handle families and households that span several risk tiers? How best do we service the needs of the most vulnerable, while ensuring those delivering such services do not carry along the threat of viral transmission?

    There are many good and detailed ideas on these and innumerable other “what about?” scenarios already on public display. For our purposes here, we may simply note that implementing public policy almost always requires the often dull details of a policy manual. The collective “we” is fully capable of writing the one that pertains to COVID19.

    Perhaps there won’t be subsequent waves of COVID19, but perhaps there will. The more emphatically we lock down everything now, the greater our communal vulnerability later- and the more probable successive waves. But whatever waves may be do nothing to change the objective through them all: total harm minimization. The best way to contend with a next wave begins by establishing the best way of dealing with this one.

    In the end of so much debate about a 21st century pandemic, there is a very simple idea expressed in the early days of the 20th century that warrants our collective attention: form should follow function. If the intended function of pandemic response is to minimize the total harms done to people, some version of vertical interdiction is the corresponding form.

    It hides in plain sight, between “lock it all down,” and “let it all loose”- waiting for us to turn on, and see by, a common light.

     

    Dr. David L. Katz is a board-certified specialist in Preventive Medicine/Public Health.

    Click here to access the one-page summary of #TotalHarmMinimization.

    Click here to access the total harm minimization resource library. 

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    The Right Response to COVID-19: How, Now?

    David Katz

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