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January 28, 2014 By e-Patient Dave 12 Comments

Speaker Academy #16: Getting paid (being businesslike about cash flow)

Cash is King image from Image: mobilepaymentsworld.com — Image: mobilepaymentsworld.com

Update 4/11/2014: Substantially expanded the section “submit bills electronically”
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This is the latest in the Speaker Academy series, which started here. The series is addressed to patients and advocates who basically know how to give a speech but want to make a business out of it. I’ll try to be clear to all readers, but parts may assume you’ve read earlier entries.

This post is about cash flow – an important part of being responsible for ourselves financially. In earlier posts we discussed getting agreement from your client on the value of your message and the need to get paid: Ratty Boxers, A turning point for patient voices, and Speaker Academy #15: The Contract. This post is about managing how the cash actually gets to you, because many hearts have been broken along that road.

1. For a small business, cash is king

One of the most common causes of small business failure is running out of cash. So if you want to build a business, even a small one, it’s your responsibility to be businesslike about cash flow. On About.com, Scott Allan put it this way:

Cash (Flow) Really Is King

One of the most important lessons entrepreneurs have to learn, often painfully, is that cash really is king. I’m not talking about paper money — I’m talking about cash flow. Simply put, it doesn’t matter how much money is coming in the future if you don’t have enough money to get from here to there.

Don’t plan to spend money you don’t have yet.

[Read more…]

January 25, 2014 By e-Patient Dave Leave a Comment

e-Patient request: business traveler with diabetes seeks virtual health coach

Latest in a series of e-patient requests.

Last year in an airport I bumped into a long-ago co-worker. In light of the work I do in my travels it was stunning, because he said he’d been diagnosed with diabetes and he’d felt so alone … he’d never met another person with diabetes.

It stunned me because I’ve long said that diabetes patients are the archtypical e-patients – they have to be engaged in their care, and diabetes has long been the disease with the biggest online communities. But his providers had never mentioned connecting with others.

We parted, and he went back and did so. Today we’re Facebook friends, and now he writes this call for assistance. Kerri, Manny, Amy, Ginger, any of you, what say you? Thanks!

(As I read his notes below about all the things he’s done to be proactive, it’s deeply moving. He’s made a lot of progress but with some embarrassment he’s owning up to what’s not working; still committed to his goal, he’s reaching out for more support. Ain’t that engaged, empowered and responsible??)

So please, DOC (diabetes online community), dish up some advice. I’ll link this discussion on my Patient Communities page for future reference.
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December 18, 2013 By e-Patient Dave 4 Comments

New wheelchair icon nails the shift to “empowered and engaged”

Brian Glenney and Sara Hendren holding the new wheelchair sign in front of the old one — Photo by John Tlumacki, Boston Globe staff. Caption: “Brian Glenney and Sara Hendren have begun a campaign to change the design of wheelchair signs.”

My Twitter feed was abuzz yesterday with last week’s Boston Globe article by Billy Baker, Wheelchair icon revamped by guerrilla art project, and boy am I glad: aside from being a great story, it sums up everything I’ve been trying to explain about the shift to patient engagement.

I’ve spent time in a wheelchair, I used to teach in a school for handicapped kids, and my wife sometimes uses a chair, especially in airports. The usual view of the chair-bound person is as limited, confined, less able. In some ways that’s valid, but too often it’s overdone. Look at this photo, and compare the new icon with the one in the back:

Old: Occupant is sitting, being wheeled around.
New: Occupant is in power, leaning forward, doing as much as s/he can. (Their site says “Here the person is the ‘driver’ or decision maker about her mobility.”)
Old: Occupant seems to be part of the chair.
New (per the Globe): “the human [is] distinct from the chair, in an active position, with a feeling of forward movement.”

I’ll extend the metaphor: [Read more…]

December 11, 2013 By e-Patient Dave 1 Comment

Interview with Dr. Brian Goldman @NightShiftMD last May

Last May I spoke at Kingston General Hospital in Kingston, Ontario, a couple of hours northeast of Toronto. They’re a remarkable hospital – five years ago they were a disaster, and under the leadership of CEO Leslee Thompson and her team, they’ve become spectacular. One key example: their staffers’ hand hygiene achievement is now at 96%! (Most hospitals are at 60% or lower, which is the primary cause of hospital acquired infections ending in death.)

A key to KGH’s turnaround was to actively partner with patients they’d previously wronged, and many more patients since; patients are now part of every decision team, even hiring of doctors. As you might imagine, working with them on this event was one of the highlights of my year.

A major treat was meeting two bright stars of Canadian health media, journalist André Picard @PicardOnHealth and Dr. Brian Goldman @NightShiftMD, author of The Night Shift: Real Life in the Heart of the ER and host of the CBC Radio program White Coat, Black Art.

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December 7, 2013 By e-Patient Dave 17 Comments

My best friend has died.

Levy family visit 2007 — Dorron & family during their visit when I was sick

The smartest man I’ve ever worked with, my best friend, died unexpectedly this week. I’m en route to Tel Aviv for his funeral. He’d been having significant swings in his health, and this time, just as it seemed there was a breakthrough, time ran out.

His name was Dorron Levy, and my daughter describes him to friends as the Israeli version of me. He taught me how to think about complex problems. He taught me to be very picky about coffee. His family and I fell in love. And he taught me how to construct a speech in a way that it opens a big question in an audience’s mind and then fills it, leaving them with a new view of how the world works.

He loved books, he loved solving impossible problems, he loved learning, and he loved teaching. (He once said the biggest compliment was to hear “You really taught me something.”) He loved digging down into the deep underlying causes. And when that led to solving an impossible problem, the glee on his face was a wonder to see. And as a dual citizen – born in Denver to Israeli parents – he was extremely astute about differences in culture.

I worked with Dorron at Indigo America in the 1990s, [Read more…]