The books are starting to pile up on my bedside table. January was such an intense month that I wasn’t able to keep up with my reading or my writing. I didn’t get any work done on my book, I’ve got an article due to eHealthcare Strategy & Trends that I have to finish today, and there are at least three books that I’d like to read but haven’t gotten to.

The Emperor of All Maladies: A Biography of Cancer – This book, written by Siddhartha Mukherjee, was recommended to me by an oncologist at the Levine Cancer Institute of Carolinas HealthCare System. The author is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a staff physician at Columbia University Medical Center. According to the write-up for the book, “it is a magnificent, profoundly humane “biography” of cancer – from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence.” This is at the top of my reading list.

The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care – Author Eric Topol, M.D. argues that radical innovation and a true democratization of medical care are within reach, but only if consumers force the issue. Consumers are in the position to force medicine to undergo its biggest shakeup in history. This looks like an amazing book and I can’t wait to learn from Dr. Topol.

Healthcare Reform: What It Is, Why It’s Necessary, How It Works  (Graphic Novel) – This comic book-style introduction to the issues surrounding health care reform, is written by Jonathan Gruber (highly respected economist) and illustrated by Nathan Schreiber. If you’d like to know more, you can reference an earlier post I wrote about this book by clicking on this link (“Can a Comic book Make Healthcare Reform More Palatable or Understandable?”).

Each of these books is available online through Amazon.com.

“The people are turbulent and changing; they seldom judge or determine right. Give therefore to the first class a distinct, permanent share in the government. They will check the unsteadiness of the second, and as they cannot receive any advantage by a change, they therefore will ever maintain good government.“ (Source: Alexander Hamilton, Farrand’s Records of the Federal Convention, v. 1, p. 299.)

James Madison, in Federalist #10, expressed a similar perspective:

“The latent causes of faction are thus sown in the nature of man; and we see them everywhere brought into different degrees of activity, according to the different circumstances of civil society. A zeal for different opinions concerning religion, concerning government, and many other points, as well of speculation as of practice; an attachment to different leaders ambitiously contending for pre-eminence and power; or to persons of other descriptions whose fortunes have been interesting to the human passions, have, in turn, divided mankind into parties, inflamed them with mutual animosity, and rendered them much more disposed to vex and oppress each other than to co-operate for their common good.” (Source: James Madison, Federalist #10)

Today, in our nation’s third century, there is a communications revolution taking place that may well have stunned our founders. In the 1700s, America’s Founding Fathers worked laboriously to develop a system of government that was insulated from the passions and opinions of the masses. According to James Madison, in Federalist #10, “So strong is this propensity of mankind to fall into mutual animosities, that where no substantial occasion presents itself, the most frivolous and fanciful distinctions have been sufficient to kindle their unfriendly passions and excite their most violent conflicts.” The democratic republic was designed to be slow and deliberate, protecting against rapid changes that might occur in response to the passions and impulses of the common people, entrusting decision-making to “first-class” citizens, those educated and holding property. They would speak for the masses and protect our society from the potential negative effects of true democracy.

“In keeping with their desire to contain the majority, the founders inserted “auxiliary precautions” designed to fragment power without democratizing it. By separating the executive, legislative, and judicial functions and then providing a system of checks and balances among the various branches, including staggering elections, executive veto, Senate confirmation of appointments and ratification of treaties, and a bicameral legislature, they hoped to dilute the impact of popular sentiments.” (Michael Parenti, Democracy for the Few, p.67)

According to Merrill Jensen in The New Nation, the decision-makers of the revolutionary era were an affluent elite. At that time in our nation’s history, these “first-class citizens” were the people with a voice:

“Their power was born of place, position, and fortune. They were located at or near the seats of government and they were in direct contact with legislatures and government offices. They influenced and often dominated the local newspapers which voiced the ideas and interests of commerce and identified them with the good of the whole people, the state, and the nation. The published writings of the leaders of the period are almost without exception those of merchants, of their lawyers, or of politicians sympathetic with them.”

Imagine the Founding Fathers’ reaction to the rise of social media. After working so hard to suppress the opinions of the masses, technology has led to a situation where anyone with Internet access now has a voice and any number of methods for disseminating his or her opinions. Americans today live in the age of the democratization of communication. Certainly one could argue that these new technologies represent an expansion of freedom of expression, but the founders might ask: At what cost?

“It has been observed that a pure democracy if it were practicable would be the most perfect government. Experience has proved that no position is more false than this. The ancient democracies in which the people themselves deliberated never possessed one good feature of government. Their very character was tyranny; their figure deformity. “ ( Source: Alexander Hamilton, Speech in New York, urging ratification of the U.S. Constitution)

If the Founding Fathers were alive today, my guess is they would be congratulating one another for the decisions they made when it came to the design of our government. In an age where the populace has the ability to openly vent its frustration with government policy, our slow and deliberate form of government, with all of its checks and balances, means that dramatic change will not take place over night. And although social media allows the most abhorrent opinions to be expressed, I do believe the Founders would stand behind the individual’s right to freedom of expression. The quote below from Thomas Jefferson speaks directly to the belief that our constitution allows for the expression unpopular points of view, even those directly challenging our form of government.

“If there be any among us who would wish to dissolve this Union or to change its republican form, let them stand undisturbed as monuments of the safety with which error of opinion may be tolerated where reason is left free to combat it.” (Thomas Jefferson, First Inaugural Address, Washington, D.C., Wednesday, March 4, 1801)

Although social media will be abused and misappropriated, like all forms of communication, my belief is that the Founders would have seen this form of communication as a democratic tool to be protected. If they had technology like this back in the 1700s, some of them may have ended up early adopters, embracing the platform and using it to support their political agenda. Somebody like Thomas Jefferson would probably have been the first in line at the Apple store to get his new electronic device. What do you think? I welcome your thoughts on the subject.

Early in the morning, before my 8am dental appointment, I checked my email and spent some time on Twitter. It was there that I ran into a link to Paul Levy’s post (Not Running a Hospital Blog) about how water walls and water features in hospitals have been associated with the transmission of Legionella pneumophila serogroup 1 infection. Legionnaires Disease. This is a big deal! Hospitals are unknowingly creating environments that could be harmful to patients, families and employees. And they are doing it with the best of intentions. Anyway, I digress.

I finished reading the post about legionnaires disease, and headed out the door with all kinds of anxiety. Next stop was the dental office. I found the place with no problem and walked in the front door. The place blew me away. It was beautifully decorated and serene. I loved it – until I saw the water wall in the waiting area! I was doomed! What are the odds? The whole experience was surreal. The good news is that my visit to the dentist went really well. They fixed me up and sent me on my way.

The real reason for this blog post is the follow-up email I received from my new dentist the following morning. Yes, I received an email from my dentist. I have never gotten an email from my primary care physician or any physician. Never. I once got a handwritten note from a PA who worked for Minute Clinic and that made a huge impression with me.

The email from my dentist was essentially a thank you note with a link to a patient satisfaction survey. It also contained a “refer a friend” link that took me to a simple referral form (see below). How hard was it for the dentist to send me this “canned” follow-up email or to set up the referral form? Not hard. And they were smart to ask for my email address on the new patient information form.

I once wrote a blog post about how the veterinarian who takes care of our cats is a better marketer than most primary care physicians I know.  Now I have to add dentists to the list of superior marketers! Obviously some PCPs have figured all of this out, and some dentists are still living in the dark ages when it comes to running a business. But the stark contrast between my personal experiences with my primary care doctor and my new dentist was stunning. Not to mention the fact that my dentist has created a zen-like setting compared to the institutional feel of my doctor’s practice. I know nothing about dentistry, but it could be that there are much better margins in that business that allow for investments in modern facilities and communication technologies. (More direct pay has to be a good thing.) Certainly I know that PCPs are being squeezed very hard right now and it is difficult to run a successful practice in the current environment.

The moral of the story (multiple choice): a) Avoid medical facilities with water walls b) Don’t spend time on Twitter before going to the dentist c) There is power in knowledge d) All of the above.

The conference kicks off officially at noon on April 29th. And right out of the gate (1pm) there is a presentation by Karen Corrigan and a panel of experienced marketers discussing how we can position healthcare marketing departments (and marketers) for the future.  To show you just how good this conference promises to be, at the same time my friend Jesse Stremcha and his colleague Bjorn Gunnerud are presenting on philanthropy and the importance of collaboration between marketing and fundraising. Jesse is an expert in ePhilanthropy at Children’s Hospitals and Clinics of Minnesota. He is a terrific presenter and will share solid information. So you can see, right off the bat I am conflicted between two promising sessions.

On Monday, April 30, there’s a session at 11:15am where Marc Beaumont, Daniel Fell and Linda MacCracken are speaking about using marketing analytics to help drive results for your hospital. Daniel and Linda are two of my favorite healthcare marketers. They are both incredibly smart and deeply immersed in our industry (lots of experience). Their session should be a good one!

There are so many other presentations worth noting. My friends Chris Bevolo and Chris Boyer are presenting on “Breaking the Rules of Website Design.” They are great presenters – very entertaining. I am presenting with Jill Lawlor (Cooper University Hospital) and Lyle Green (MD Anderson) on “Integrating New Media into Physician Marketing.” We’ve got a good story to tell. Bill Gombeski from UK HealthCare is presenting on growing new business via word of mouth marketing. Carla Bryant (Corrigan Partners) and a team of presenters will address aligning brands across digital channels – a really important topic that most organizations have not fully addressed. My colleague Gabrielle DeTora is taking on the controversial subject of hospital rankings with her presentation – “Hospital Ranking Matters!” She is presenting with Sean Young of Penn State Hershey Medical Center and Health System.

You can see, this promises to be a terrific conference. Lots of good learning and great people with whom to network. If you haven’t already signed up for the conference, you can check it out online by clicking on this link and download the conference brochure.  I hope to see you there!

Jonathan Gruber, the author of the Healthcare Reform: What It Is, Why It’s Necessary, How It Works, is the Director of the Health Care Program at the National Bureau of Economic Research, where he is a Research Associate. He is a co-editor of the Journal of Public Economics, and an Associate Editor of the Journal of Health Economics. All of this in addition to serving on the faculty of MIT.

According to his bio, Gruber was a key architect of Massachusetts’ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. In that year, he was named the 19th most powerful person in health care in the United States by Modern Healthcare Magazine. He was a consultant to the Clinton, Edwards and Obama Presidential campaigns and was called by the Washington Post, “possibly the [Democratic] party’s most influential health-care expert.”

Gruber’s comic book is illustrated by Nathan Schreiber, writer and artist of the Xeric award-winning independent comic series and graphic novel, Power Out.

One of the really cool parts of this story is that Gruber did not set out to create a comic book. It was his publisher’s idea to deliver this message via a graphic format. Gruber wasn’t sold on the idea but spoke with his 17-year-old son who is a reader of graphic novels. It was the conversation with his son helped persuade him to try this medium.

The reviews for Gruber and Schreiber’s collaboration have been glowing. Here’s one example from renowned economist, David Cutler:

“If you want to learn about health care reform, you can do no better than to learn from the master. Jonathan Gruber shows how health care reform works in a way that everyone can understand. Read this book. You will not regret it.” — David Cutler, Professor, Department of Economics and Kennedy School of Government, Harvard University

You can learn more about Healthcare Reform: What It Is, Why It’s Necessary, How It Works and order a copy for yourself, by clicking on this link. I just ordered my copy from Amazon.

Of course, now the challenge is getting home this evening. The snow is back, and coming down in full force. It is beautiful and I have no problem spending another night in Bennington, if that is what it takes, but I’d much rather get home and enjoy the weekend with my family. Below are a few photos I’ve taken with my iPhone when I’ve had breaks between meetings. Enjoy!

• Aster Awards (11th annual) – Early submission deadline, February 29, 2012. Late deadline, March 16, 2012. Go to www.AsterAwards.com for more information. This is one of the national healthcare advertising and marketing competitions we make a point of participating in each year. It is sponsored by Marketing Healthcare Today magazine.
• Healthcare Advertising Awards (29th Annual) – Early submission deadline, February 17, 2012. Late deadline, March 7, 2012. Click on this link for more information. This is really the grandfather of all healthcare advertising awards competitions. It is sponsored by Healthcare Marketing Report magazine.
• Lamplighter Awards – For those of you with hospitals in New England, the Lamplighter Awards is the annual competition sponsored by the New England Society for Healthcare Communications.  The early deadline is January 27, 2012. The late deadline is February 10, 2012.