What could WOL for Healthcare look like?

Her note started off nicely enough. Then I read her feedback, including a challenge I didn’t know what to do with.

Bettina had heard about WOL Circles at a conference and liked the idea. “I started my first Circle directly. With great success!” She said she is working as a Change Manager in a large non-profit healthcare organization in Germany, and that she wanted to spread Circles. But she made it clear that WOL, in its current form, would never work. 

“The nurses, doctors, and other professionals do not have 60 minutes a week for WOL, there is too much text, the examples have to refer to the health sector…” 

Ouch. She even said the German translation wasn’t acceptable, as the informal pronoun (“du”) simply isn’t used in her organization’s “official papers.”

I knew she was right. I asked if we could speak on the phone. 

The challenges in Healthcare

Healthcare organizations suffer from the same cultural issues that plague many large companies. The hierarchical structures limit information flows in ways that are bad for individuals, the organization, and the patient. Too often, nurses don’t question doctors and medical technicians don’t question the ambulance manager. (Atul Gawande, surgeon, author, and CEO of the recently-formed healthcare venture formed by Amazon, Berkshire Hathaway, and JP Morgan Chase, captured these challenges in dramatic fashion in The Checklist Manifesto.) 

The same is true across the hierarchy as well. People in a given role are not in the habit of of sharing problems and solutions to improve quality, and in many cases there may be no mechanism to do so. So the same mistakes get repeated, and innovations don’t spread. 

On top of such challenges, all of this takes place in an environment that is extraordinarily demanding. It’s busy, stressful, and unpredictable - and the stakes are extremely high.

One possibility

Of course, not all healthcare organizations have the same cultural issues. Buurtzorg, for example, has over 10,000 professionals in “a nurse-led model of holistic care” that emphasizes “humanity over bureaucracy.” They are portrayed in Reinventing Organizations as a model of self-organization and self-management. But for every Buurtzorg, there are thousands of traditional companies. 

How could WOL help?

I told Bettina how we had already adapted WOL for leaders by making it shorter and simpler, and by integrating it into a reverse mentoring program. Perhaps we could do something similar. 

Together, we decided that Bettina’s colleagues could also meet in pairs (perhaps one with more experience and one new to the organization), and we could limit meeting to no more than 30 minutes. Then we identified eight different exercises over eight weeks - eight contributions they could make that would help them find their voice, improve their craft of patient care, and enable them to re-connect with the sense of purpose that inspired them to join the profession in the first place.

What would you do?

The challenges faced by people in healthcare environment are similar to those in other operational environments, be it manufacturing, retail, transportation.

As different as those jobs may be, the people doing them all share the same human needs for control, competence, and connection. And all of the organizations they work in need to improve quality for their customers and for their own sustainability. The future of work isn’t limited to people working in offices.

Bettina and I will meet in Frankfurt this week to work on details of a pilot. Whatever the outcome, we’ll surely learn something that can help us take a next step and try again.

If you were Bettina, what would you do? What could WOL for Healthcare look like?

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What would we do if terrorists were making 27 million Americans deathly ill?

My mother died the way big companies fail, the way people go broke: gradually, then suddenly. She was diagnosed with diabetes in her 40s. Back then, we had little understanding of the disease or of nutrition. So we didn’t pay much attention to it except for occasionally chiding her to eat better or control her sugar.

Then, in her 70s, she grew increasingly stiffer and struggled to get around. She was short of breath after shorter walks. She moved less and less.

When she broke her hip, her body couldn’t fight her post-surgery infection or heal itself. She had a hole in her leg that never closed. “This isn’t living,” she told me as she looked up from her bed. She died a few weeks later.

Killing us softly

Seeing my mother die that way made me more mindful of the link between what I was eating and what my health would be like in my 60s, 70s, and beyond. The prospect of dying like my mother scared me into paying attention.

So I became increasingly aware of how the things that are making us sick are actively promoted, even celebrated, everywhere. I had grown up singing “I’d like to buy the world a Coke.”  You could argue we didn't know better back then.

I'd Like to Buy the World a Coke Commercial - 1971

But now? 44 years after the Coke ad I grew up with, we’re still programmed to associate joy with the things that are killing us. And the people who make money from doing so will protect their interests by all means at their disposal.

Here, for example, is an excerpt from an interview with Coca-Cola's president of sparkling beverages in North America. It was in response to proposed legislation limiting the size of sodas that can be sold. The parallels to tobacco executives denying health claims are both striking and chilling.

Q: But critics call soft drinks "empty" calories.

A: A calorie is a calorie. What our drinks offer is hydration. That's essential to the human body. We offer great taste and benefits whether it's an uplift or carbohydrates or energy. We don't believe in empty calories. We believe in hydration.

Q: Because sugary drinks have been linked with obesity, some suggest soft-drink makers place "warning" labels on cans and bottles.

A: There is no scientific evidence that connects sugary beverages to obesity.

Terror at home

Type II diabetes - the kind that’s preventable as opposed to the kind you’re born with - is the 7th leading cause of death in the United States and it’s considered under-reported. One of every 10 adults in the US has diabetes. The Center for Disease Control projects that number to double or triple by 2050. If you have a child born after 2000, there is a 33 percent chance they will develop diabetes. If your child is black, there’s a 50% chance.

All these people are dying gradually, then suddenly.

CampFunstonKS-InfluenzaHospitalNow try the following thought experiment. Imagine we discovered that the diabetes epidemic was the result of a secret terrorist plot. What would our response be? Think of how we respond to other terrorist acts that affect a few hundred or a few thousand people. We wage wars and sacrifice some of our basic rights in the name of protecting ourselves. Imagine what we would do if terrorists were killing so many of us.

But the enemy is here at home, and it’s everywhere. Soda is just one product. There are thousands of others that are making us sick. We’ve grown so used to it that it’s just the way things are.

One thing you can do

My children mock my anger at the “evil major corporations.” Perhaps they’re right to do so. It seems silly to think anyone can change the sugar industry, government policies, advertising, and all the aspects of a system that’s killing us.

But there is one thing every individual can do that can make a difference: be mindful of what you eat and drink.

Consume whatever you want. Just make sure it’s your choice and not the result of corporate programming trying to make money from your misfortune. The more informed you are, the more you know about food and what’s in it and how it affects you, the easier this is. Think for yourself. Is this what I really want? Is this in my best interest or some corporation’s?

Over the holidays, my daughter passed an ad picturing Santa Claus offering her a drink, encouraging her to “open happiness.” She asked why companies would want to sell something that makes people sick. She wanted to make a video to warn other children. She’s 7 years old.

"That's my girl," I thought. And it gave me hope.

Why I’m thrilled to be 50 years old

Little Johnny Here I am as a baby. When this picture was taken, my whole life was ahead of me.

At some point, though, most of us stop looking forward and start looking back. We stop thinking that the best is yet to come.

For me, that point came in my 30s. That’s when I started thinking of aging as a process of inevitable decay. I saw signs of it in myself, and if you asked me then what I’d feel like at 50, I’d have likely said “depressed.”

Well, I’ll turn 50 this week and I’m not depressed about it. Instead, I’m genuinely happy.

Here’s why.

The basic elements of a good, long life

In my 40s, I started learning that the secrets to a good, long life weren’t so secret. While the science isn’t perfect, there’s broad agreement on the basics: good food, regular exercise, strong social connections, a sense of purpose. Persistence and conscientiousness help, too.

These things don’t guarantee a long, healthy life, but they do increase the odds quite a bit. And you can readily learn about them by reading up on The Longevity Project, for example, or by watching this TED talk on “How to live to be 100.”

Certain cultures seems to live this way naturally. The people in Okinawa, Japan for example, have the longest disability-free life expectancy in the world partly because they have a very different diet and way of living than, say, people in New York City. They’re also aware of the importance of having "ikigai”, meaning "the reason you wake up in the morning."

Their outlook on life and aging, one I increasingly admire, is reflected in this Okinawan saying:

"At 70 you are still a child, at 80 a young man or woman. And if at 90 someone from Heaven invites you over, tell him: 'Just go away, and come back when I am 100.'”

Changing habits, changing perspective

When are the best years of your life? I’ve realized that the answer to that question depends more on your habits and your perspective than on how long you’ve been on the planet.

As I learned more about better ways of living, I gradually changed my life. I exchanged junk food for whole foods (and ultimately a vegetarian diet). I stopped commuting and started exercising regularly. I unplugged cable TV and started spending more time learning new things. And, thanks to the work I do, I developed a bigger social network and found my “ikigai.”

Of course, these habits may not be right for you. But my hope is that, no matter how old you are, you make choices that give you a healthy perspective. And you develop habits that help you live with both an appreciation of the present and a sense of excitement about the possibilities.