• Importance of Preparation—If nothing else, this crisis has highlighted the need for pre-planning and prevention. Although it seemed far-fetched to some, this type of pandemic had been predicted, and crisis management plans had been created. Yet, at the federal level, many of the warnings had been ignored or discounted. While the severity and impact of this crisis may have been beyond anyone’s expectations, organizations that had previously developed contingency plans, crisis communication guidelines, rapid response teams, etc., have been able to put policies and processes in place more quickly.  Companies who already had flexible, remote work arrangements for its employees and frequent use of videoconference technology seemed to come together more rapidly.  Of course, many organizations with workers who can’t work remotely—especially those in healthcare—have had to quickly manage their supply chain of goods/materials and put employment policies in place to ensure everyone’s safety.
• Coordinating the Management Team—Most organizations have pulled together their senior teams to coordinate a unified response to the pandemic.  These management teams have been meeting regularly to address the human impact—both physical and psychological—as well as the economic and operational issues that have been affected. The most effective management team meetings have emphasized the norm of psychological safety so that participants can speak freely without fear of retribution. They openly debate issues and work together to come up with the best path forward.  There is no finger-pointing or blaming others. They continue to come together to share their knowledge, listen to each other, and collectively decide on the best actions to take.
• Honest Communication—During this crisis, transparency of information has been critical. People want facts and a true understanding of the reality of the situation. The most credible leaders have provided brutal honesty, with no sugar-coating or false hope. They have built trust with the public and earned their respect by being straightforward about the issues.  At the same time, they have provided optimism and hope that we will get through this crisis if we all act responsibly. Leaders like Governor Larry Hogan of Maryland and Governor Andrew Cuomo of New York have acknowledged the fear that people feel yet have conveyed confidence and steadiness in their ability to manage through the situation.
• Flexibility and Accountability—This has been a time of great uncertainty; we don’t know when or how this crisis will end.  I have seen effective leaders learn as they go, be willing to admit mistakes and continue to course-correct. They have taken ownership for decisions that might have been wrong or misinformation that might have been given. They continue to learn what’s working and what’s not, adapt when new information is presented, and act thoughtfully about next steps.  The ability to be agile and to be accountable has validated their resilience and strength as leaders.  
• Compassion and Gratitude—In addition to being brutally honest, the most effective leaders have also conveyed their thanks for the dedication and commitment of others. Their call for unity in this effort has included an appreciation for the hardships that people are experiencing and gratitude for the many sacrifices and contributions that so many have made.  When expressed with sincerity, these words and actions have provided comfort and reassurance. The most revered leaders have acted as role models for the moral values that we all try to live by.    
• Caring for Oneself–As we’re told on an airplane to “put on our own mask first,” the most effective leaders have taken the appropriate actions themselves (e.g., social distancing) and are managing their own anxiety. Our leaders are not super-human, and like everyone else, must ensure their own safety despite the unending pressures that they feel.  As in the case of the British Prime Minister, people get worried when their leaders fall ill, whether they agree politically or not.

While we don’t know how long this crisis will last, we look to our leaders to guide us through this period of uncertainty with intelligence, transparency, courage and compassion.  We do not expect that they will have all the answers and, yes, mistakes will be made.  However, leaders who learn as they go, communicate regularly, and unite all of us, are best positioned to get us through this unprecedented time safely. 

Unemployment is high in this region, and most of the people that attended were either retired, disabled, or out of work. Because they can’t afford dental insurance–and Medicaid in the state only covers emergency extractions–many hadn’t seen a dentist in years.  And because they didn’t know when they’d see a dentist again, several attendees at the event preferred to get multiple teeth extracted rather than try to restore them.   Upon reviewing their cursory health assessments before seeing a dentist, we were not surprised to see a prevalence of multiple chronic conditions such as diabetes, high blood pressure, and depression.  And the opiate epidemic had hit this region hard.

I spoke to some people while they were waiting and found them to be very open and forthcoming about their problems.  One woman cried because she had been without any teeth for four years and couldn’t save enough money for a full set of dentures.  The need for dentures was overwhelming, and the best we could offer was to put her name on a waitlist for next year. 

Another woman, 71 years old, had a long talk with me.  She had a college education and had worked as a real estate agent in the community all her life.  Now that she was older and no longer employed, she couldn’t afford dental insurance.  All she needed was a cleaning, but the line was too long, and she had to be turned away.  She also mentioned that she couldn’t afford a hearing aid that was desperately needed. 

“We’re the people left behind,” she told me. “We’re the richest country in the world, and yet people in this community are hurting.  There aren’t enough doctors here, and I drive about an hour-and-a-half to Johnson City, Tennessee, to see my primary care physician.  God forbid if someone has to go to the hospital here with a serious condition. They may not make it out of the hospital alive.”  I asked her what she planned to do.  Her daughter had recently moved to Charlotte, NC, and she was reluctantly considering moving to Charlotte too so that she could have better access to medical and dental care. She left without any service but thanked me for listening.

Compared with other high-income nations in the world, the United States spends about twice as much on health care per capita, and, according to the Centers for Medicare and Medicaid Services, this will continue to increase. The high cost of prescription drugs in the U.S., compared to other high-income countries, is a big factor.  One would think that a higher cost of healthcare would correspond to a higher quality of care, but when compared with other high-income nations, the U.S. has a declining rate of life expectancy and one of the highest infant mortality rates. 

In addition, based on data from the last decade, a smaller number of applicants are being admitted to medical school. And fewer medical school graduates are choosing to be primary care physicians, instead pursuing higher-paying specialties.  The Association of American Medical Colleges predicts a shortage of between 21,000 and 55,200 primary care physicians in the U.S. by 2032.  Rural America has already been hit the hardest by the physician shortage, as a disproportionate number of physicians choose to practice in more urban areas. According to the Association of American Medical Colleges, “Increasing the number of U.S. doctors is necessary, but it will not be sufficient. In the coming years, the nation will need to transform the way health care is delivered, financed, and used.”

While the U.S. public believes our quality of care is the best in the world, for many people it is unaffordable, inaccessible, and too complicated. The solutions are not simple. Do we continue to maintain the wide economic disparity in healthcare that currently exists or try to find a way to provide affordable healthcare to all Americans? As we debate this issue, let’s not forget the urgent needs of the Americans right in our backyard.   

Whether you’re leaving a job voluntarily or involuntarily, this transition can often be bittersweet and fraught with a variety of emotions.  While the following tips may seem like common sense, it’s important to exit professionally to avoid “burning any bridges.”

• Stay Focused—As much as possible, tie up any unfinished business and remain engaged until you walk out the door.  You may feel relieved to be moving on or perhaps resentful that you were asked to leave. You may be tempted to say, “Not my problem anymore; I’m outta here!”  However, it behooves you to leave your work in good order so that your boss, your team, or whoever takes your place, can pick up the tasks after you’re gone. Prepare a status update of all current initiatives and who is responsible for each.  Let those who you do business with—inside and outside the company—know who the future contact(s) will be.  Ensure that others are aware of upcoming deadlines or issues that will need to be addressed in the future. Think about how you would want others to leave the work for you if the situation were reversed.

• No Disparagement—Above all, do not disparage the current manager or the organization to colleagues.  You may be leaving because of an unfair or uncaring boss; however, it’s best to refrain from sharing your negative thoughts and feelings openly.  Even your closest confidants at work tend to talk with others, and your disgruntlement will likely become fodder for the organization’s grapevine.  You do not want your complaints to promote the grievances of others. 

• Exit Interviews—If you are given an opportunity for an exit interview, think through what you want to say in an objective, fact-based way.  Be honest about a new opportunity or about the need for further career development.  Demonstrate accountability for any mistakes you may have made and refrain from blaming others.  As appropriate, offer constructive suggestions for improvement. If you feel that you have been treated unfairly, be sure that you have the facts and are not reacting to office gossip or speculation. State your case objectively and calmly. Perceptions can vary, and sometimes it may be best to simply let go and move on. If you suspect that there have been serious violations of policy—such as sexual harassment or other ethical issues—don’t wait for an exit interview.  These should be surfaced to the appropriate people immediately, so that they can be investigated and addressed.

• Review Your Benefits—If you’ve been given a severance or separation package, typically you are not permitted to share any details with co-workers; however, you can usually have an attorney review the terms. Take the time to ask questions for clarification about health care coverage, unemployment, or other benefits that you may need after you leave.

• Express Appreciation—It may be sad to say goodbye to colleagues, team members, and vendors/suppliers, that you have been used to seeing every day.  Convey gratitude to anyone that had been particularly helpful to you.  Share email addresses and phone numbers of those that you’d like to stay in touch with.  It is likely that your paths may cross again, perhaps in some other organization or venue. You may need help with a future job search, and you can offer support to others as well. 

Throughout my own career, I found that the transition from one position to another was always the hardest.  I learned that the work will go on with or without me; however, the relationships were the ones that I missed the most.  I cherish those friendships that have lasted for many years after leaving the job.  

So when leaving a company, it’s best to take the high road.  Keep in mind the words of Maya Angelou: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”  Good luck.

• You can influence people more effectively by being polite and respectful. Ruth Bader Ginsburg is a quiet person—not given to histrionics—and yet is resolute in her beliefs. She has argued her positions in front of and on the Supreme Court persuasively without drama, presenting her case with a calm demeanor and well-articulated logic. I am sure that many of us, who have been on one side of an issue and become exasperated by those who fail to see another point of view, are prone to show our frustration both verbally and nonverbally. It takes quite a bit of self-control and composure to, as they say, “disagree without being disagreeable.” We often forget that everyone is worthy of respect and dignity, even if we view the world very differently.
• You can hold distinctly different views with colleagues and still be friends. Ruth Bader Ginsburg and Antonin Scalia could not have been more opposite on many critical issues facing the Supreme Court, but they possessed a genuine friendship. They found a common bond in the opera and enjoyed each other’s company on many occasions. Often in life, we hold onto our anger and animosity so tightly that we lose sight of our humanity. And in our relationships, we frequently focus on our differences instead of the fundamental agreements that we share.
• Real change rarely occurs overnight and generally evolves over time. Ruth Bader Ginsburg has been a trailblazer in the women’s rights movement. She entered law school and worked in law firms when women were rare or non-existent. She successfully argued 5 out of 6 gender discrimination cases in front of the Supreme Court. Like the civil rights movement in the U.S., she recognized that real change is incremental, and requires patience and persistence. Those of us who work to change individual behavior or the culture of an organization, know that it takes time and constant reinforcement. Sometimes we take the proverbial “two steps forward and one step back,” but we keep nudging the change forward with steadfast perseverance.
• Women don’t have to give up having children and a family while pursuing a career…but having a supportive partner helps a lot. Ruth Bader Ginsburg was fortunate to have a husband who recognized her talents and was not afraid to put her career ahead of his. His sense of humor balanced her seriousness, and his willingness to assume many of the household and parenting duties while she worked late, clearly contributed to her success. Today, we probably know several working women with supportive partners but, sadly, it’s not a reality for everyone.
• Ruth Bader Ginsburg embodies the collective wisdom about healthy aging. At 85, she is still going strong—staying active and engaged. She has survived two bouts of cancer, works out regularly with a personal trainer, and still has an incredible work ethic, often spending late nights reading and writing. I was back in the gym the next day after seeing the movie!

Today’s political environment is very divisive, and the societal issues facing us are extremely polarizing. Yet, in the midst of the political fray, it’s refreshing to see someone who inspires and enlightens us with her intelligence, persistence, and steady dedication to the better nature in all of us.

Now, at this point in our lives, baby boomers are contemplating retirement, perhaps have already left a job (voluntarily or involuntarily) and are trying to figure out what to do next. While some people may not have enough money to retire and need to continue working, others mainly want to stay engaged and continue to be productive and vital.

At first, sleeping in, eliminating the daily commute, escaping the office politics, and working out at the gym every day is a welcome relief. But, after a while, the need to be more purposeful and relevant with one’s time becomes apparent. After the initial ‘honeymoon’ period, many retirees realize that they want to apply their wisdom, skills, and experience in ways that are meaningful and personally fulfilling, yet still have flexibility and balance in their lives.

So how do you figure out what to do next? Do you go back to school to learn new skills? Do you look for a similar job like the one you just left? Do you start your own business? The answer to all three questions is ‘maybe.’ I have found that the same self-awareness, exploration and discovery, and process of elimination, that I used earlier in life, still applies now.

If you are trying to figure out the next chapter of your life, here are a few questions to ask yourself:

• What are my strengths? What am I really good at? Often, we don’t recognize the qualities that we’re truly good at because they come so naturally, and we take them for granted. Playing to one’s strengths is key to finding satisfying and fulfilling opportunities.
• Looking back on your life, when have you performed at your best? What experience are you the proudest of? While it may be hard to replicate that point in time, what about the experience made it so memorable? Was it a particular person or group of people who supported you? Were you able to overcome unusually difficult obstacles? How can you find similar opportunities and apply your life’s lessons to a similar challenge?
• What do you value most? When we live our lives in alignment with our values, we find greater meaning and purpose. Think deeply about what really matters to you. Do you love learning? Do you love helping others learn? Do you value independence and freedom or do you value security and stability more? Identifying and acting in concert with your values can help provide greater clarity and focus.
• What are your unfulfilled hopes and dreams? Have you always wanted to run your own business, but the financial and personal responsibilities were too much of a deterrent? Have you always wanted an opportunity to travel? What would be the first step to investigating the possibilities? Is there some exploratory research you could do or make an inquiry to someone in the field that would jumpstart the process?
• How can you give back? Volunteering and serving others has proven to benefit one’s well-being and can be a wonderful way to apply a lifetime of acquired knowledge and skills. There are so many volunteer opportunities to explore; pick one that is important to you and try it.
• Who can else can help? There are resources around us who can act as sounding boards and provide helpful feedback. Is there a trusted friend or relative that can help you sort through your thoughts and figure out a path forward? Perhaps working with a professional coach can be a valuable resource as well.
• At a deeper level, who is your truly authentic self? We often go through life trying to please other people—our parents, our bosses, our spouses—and forcing a smile even when we don’t feel quite right inside. If you can, this may be the time to stop playing a ‘role’ and being authentic about how you want to live out the rest of your life. This self-reflection can be difficult but may lead to some personal insight and clearer direction.

Determining how to spend the next chapter of your life is an evolutionary process, and with patience and optimism, the right answer will emerge. Perfection is not the goal as there may be many right answers; however, through the process of reflection, exploration, reaching out for help—and some trial and error—the forward path can become clear.

Was this experience unusual?  I began to ask other patients if they hesitate to ask a doctor for a second opinion and, if so, why.

• “I don’t want the doctor to think that I don’t trust him/her. I don’t want the doctor to think that I’m challenging his/her judgment.” Patients put their faith and trust in their healthcare providers and don’t want to question their credibility or authority. Asking for a second opinion might be interpreted as a loss of confidence in the physician.
• “I don’t want to be perceived as a difficult patient or appear rude.” Patients want the doctor to feel good about them and don’t want to potentially damage the relationship. If they are about to undergo surgery, for example, patients want to make sure that the doctor “likes” them and will take special care of them throughout the entire process.
• “My doctor’s office is so busy. There are so many patients waiting to see him/her and there is so little time for me as it is. If I ask to have all my records sent, it’s just creating extra work for the entire staff.”  Again, some patients don’t want to seem difficult and are reluctant to ask for anything that might be perceived as an unnecessary inconvenience to the physician or the staff.
• “I’m embarrassed to tell the physician that I may not be able to afford it.  Also, English is not my native language and I don’t completely understand what he’s saying.  I probably should have seen a physician who can explain things to me in my own language.”  Patients may withhold personal information out of a feeling of confusion or embarrassment.
• “He/she is just going to give me the name of a friend or colleague. The second physician won’t want to throw my doctor under the bus.” Patients may not know who to contact and may believe that a second physician will not contradict his/her colleague out of respect or professional courtesy.
• “I know that there is no hope for a different outcome, so it would be a waste of time. Besides, I don’t have the time to travel far to get another opinion.” After a severe diagnosis from a physician, some patients are understandably sad and despondent. They may feel a sense of futility in seeking another solution to their health problem. They may also feel pressured by a sense of urgency to begin treatment and choose to forego other options.

So, what can a healthcare provider do to help patients be more comfortable asking for a second opinion? Here’s my wish list:

• Engage the Patient–Explain the treatment plan as clearly and understandably as possible and then discuss it with the patient–and family member(s)—to uncover any concerns. Patients have the right to fully understand what their treatment entails and what options are possible.  Ask, “What questions or concerns do you have about this plan?” If you sense that they may be holding back or reluctant to say what’s on their mind, state that you truly want them to be honest and to feel free to share any worries. Offer to let them think it over, and schedule a follow-up call or visit to review the alternatives further.
• Reach Out to Other Physicians–Confer with other specialists, particularly if it is a difficult or sensitive case.  Share with the patient that the treatment plan was discussed with others before providing the recommendation.
• Encourage Obtaining a Second Opinion–Discuss the value of a second opinion, especially in the case of major surgery or a severe diagnosis. Patients should seek peace of mind and feel confident that they’ve explored all possible options.  Express that it would be fine if they want to get a second opinion. “I would be happy to suggest a couple other providers–outside of this group practice–that you might contact, and we’d be happy to forward a copy of your medical records.” Offer to speak with the other physician(s) if needed.
• Be Open to Other Perspectives–If the second opinion is different, be open to hearing the patient’s perspective. Perhaps suggest a third opinion.  Shared decision-making is key to determining the right answer for the patient.

While I recognize that most physicians are very supportive of their patients seeking second opinions, there still may be intangible, and often emotional, reasons why patients are reluctant to ask for one. My hope is that healthcare providers will take the time to talk with their patients and listen to their concerns, particularly if there is reticence or discomfort in pursuing the proposed plan of treatment.

Staying composed under fire is something that requires a combination of self-awareness, courage, and a level of self-confidence that develops over time.  Admittedly, during my own career, I have been known to respond emotionally after an unexpected criticism or perceived unfair verbal assault. However, with greater maturity and experience, I’ve learned to keep the following in mind:

• You can’t control what the other person may say or do; you can only control your own reaction to it. Words can be hurtful, unfair, or misguided, and more often they speak volumes about the temperament of the speaker and less about you. Sometimes, that person is still angry about something that happened earlier in the day and may have nothing to do with you at all.
• Become aware of your body’s physical reaction. Can you sense your heart beating faster, your breath getting quicker and shallower, and your body temperature becoming more heated? These are signals that you’ve become emotionally hooked, and may cause you to say or do something that you’ll later regret.
• Disengage from the conversation if possible. You might try saying, “This conversation has become unproductive, and it doesn’t look like we’re going to resolve the matter now. I think it might be best if we come back when cooler heads can prevail.” Disengaging helps to collect one’s thoughts, gain perspective on the matter, and better appreciate another point of view. My preference is to go back to my desk and jot down my thoughts in a more logical, rational way to help regain my composure. If I decide to share my written thoughts later, I usually hold onto the document for at least 24 hours and reflect on it before sending.
• Apologize. If you did, in fact, do or say something wrong, admit it, and learn from the mistake. We’ve all said or done something that we’d like to take back, and a sincere apology can help bring reason and rationality back to the conversation. Even if you believe the speaker’s anger is unwarranted, apologizing doesn’t mean that you are wrong and the other person is right.  It means that you care about the relationship more. “I’m sorry that you and I see this matter very differently. Can we shift the conversation to how we can move forward and resolve the matter?”
• Listen for the underlying emotion behind the words and reflect back what you heard. “It sounds like this is a very frustrating issue for you.” You don’t have to agree with the person to recognize the intensity of emotion and show that you’ve heard him/her. Refrain from saying, “Just calm down” or “Relax.” From my experience, these admonishments exacerbate the situation and tend to make the other person more volatile.
• Avoid the resentment that can build up over time. As the saying goes, “Holding on to anger is like drinking poison and expecting the other person to die.” We often ruminate about the rude comment or insult, and our anger increases with each encounter so that the slightest remark triggers an emotional response. Focusing on negative comments can overshadow the positive aspects of your role and can sour your disposition. Letting go of anger and hurt feelings are important to maintaining personal well-being.
• And, finally, if you find yourself in a work environment with an impossible boss, unreasonable clients, or angry customers, you still have the power to choose. We often feel stuck because we need the money or it’s not practical to go elsewhere. But don’t be afraid to ask for help. Sometimes there can be other options that you’re not aware of. You do not have to become a victim or a cynic—your health and self-esteem are at stake.

You will likely face a harsh criticism or heated situation at some point in your career. The ability to stay composed when under fire can help you become a more effective leader and create a healthier and more productive environment for everyone around you.

• You can be strong and feminine. The traditional image of a leader is to be tough, assertive, and not back down.  However, when it comes to women, these adjectives are often seen as negatives.  The conventional view of women is to be softer, more nurturing, and typically to play a supportive role.  While there certainly has been progress, double standards still exist. If a man shouts, it’s bold and charismatic; when a woman shouts, it’s often perceived as shrill and strident. And women are judged much more harshly when it comes to appearance.  However, women don’t have to lead in the image of men; they can demonstrate their power by being both steadfast and caring, both persuasive and cooperative, both resolute and compassionate.  The ability to listen, empathize, and work collaboratively are strengths that you as a leader can provide.
• You don’t have to be perfect. Women tend to doubt their own competence even when they are more experienced and knowledgeable than their male counterparts. Much has been written about this lack of self-confidence and women’s imposter syndrome.  As you grow, you will begin to understand that leaders don’t have to have all the answers as long as they surround themselves with smart people and believe in their own problem-solving ability. Of course, we all make mistakes.  The key is to learn from them and keep moving on.  Don’t let failures or past errors in judgment undermine your confidence and hold you back.    Understand why the mistakes occurred and learn from the experience.
• You must persevere to succeed. Others may tell you that you’re not ready for the next level, or give you feedback about many of your shortcomings. They may even demonize you.  So, listen to the feedback, accept what fits, but don’t become a victim. Remember Eleanor Roosevelt’s quote, “No one can make you feel inferior without your consent.”  Find ways to grow, build on your strengths, and figure out how to compensate for your weaknesses.  And don’t be afraid to ask for help; no one can succeed alone.  You’ll need a few sponsors along the way who can be a vocal advocate for you, just like Barack Obama is for Hillary Clinton.  So be resourceful; there are others that would be happy to support you if you have supported them.
• You can operate from a position of hope and optimism, not fear or resentment. It’s easy to get cynical when you see others getting promotions or receiving more favorable treatment.   Talking negatively about others or showing anger about someone’s success reflects poorly on you and ultimately hinders your image as a leader.  Sure it’s tempting to grumble and wonder aloud how someone else could possibly be seen favorably or why the boss doesn’t recognize your hard work.  It’s better to make the case for your own leadership and bring to light your own optimism for the future.  As Michelle Obama said so simply, “When others go low, we go high.”

This presidential election brings a stark contrast of leadership styles.  No matter where you stand, I hope the young women—and men—in the country appreciate the significance of the first woman to be nominated for President and recognize some of the important leadership lessons for all of us.

Whether you’re contemplating how to get started growing the talent in your organization, or you’re a seasoned gardener, here are a few guiding principles to keep in mind:

1. Seeding the Garden—Before picking up a shovel of soil, first plan what you want.
   • Where are the biggest talent gaps in your organization? What areas of the company have seen the largest growth or expansion and have few ‘ready-now’ individuals to fill current vacancies?
   • What competencies are needed to be successful in your company? Some plants are heartier than others and more resistant to pests and the vagaries of the weather. You may be looking for individuals that are more resilient, can quickly grasp complex issues, and possess solid business judgment. Agree on what you’re looking for before beginning the recruitment and assessment process.
   • Are the individuals best grown internally or do you need to hire externally to find the right skill set? Your business may be growing so rapidly that you need to fill the talent pipeline with more outside hires. External hires can bring much-needed fresh perspectives, yet there’s always a risk that they don’t work as well with the company’s culture and values. While home-grown talent may have deeper ‘roots,’ sometimes they may have become more insular and less inclined to challenge the status quo. A balance of both internal promotions and outside hires is often best.

2. Feeding the Garden—Developing future leaders and establishing a robust garden of talent takes time and patience. Create the right environment for people to grow and thrive in your organization.
   • It begins with a belief that people can grow and develop. Leadership skills are best acquired through experience. Remember the 70-20-10 rule: 70% of leadership is learned from on-the-job experiences, 20% from coaching/mentoring, and 10% from training.
   • Individuals are responsible for their own career development. If they perform well in their current position, they can take on broader responsibilities and prepare themselves for other opportunities as they occur.
   • Management’s role is to conduct career development conversations with their direct reports, provide opportunities to address business challenges, support them through the learning process if they stumble, and recognize those who meet and exceed expectations. Managers who help employees recognize and build on their strengths, rather than focusing solely on their weaknesses, can produce greater employee engagement and productivity.
   • Conducting career development discussions, providing timely feedback, and checking in with associates is not just a once-a-year activity. Don’t start a garden without tending to it regularly; ongoing watering is needed to support employees’ growth.
3. Weeding the Garden—Assessing and reviewing the talent in the organization and its ability to meet the business’ needs is an ongoing process. Retaining the right individuals is an important element of this process
   • Some employees may have aspirations that can’t be met within the organization, while others may have grown complacent. You may want to move an incumbent to a new position in which he/she can thrive, or you may need to move out an individual to make room for someone else who can bring new energy to the role. Just as rotating and replanting crops can enrich the soil, sometimes this can work for the business as well.
   • Analyze your turnover. Do you know why good people are leaving?  You may think that it’s compensation-related, but more often it’s a result of poor management and a lack of professional growth.
   • How are your reward and recognition processes working? Do employees perceive that promotion opportunities are awarded fairly?  How do you recognize top performers and are their pay increases commensurate with their achievements? Are managers who do a good job developing others rewarded for their efforts?

Creating a healthy, robust garden of talent is not a one-year effort.  It’s a continuous process requiring focus, patience, and persistence. Great companies that have achieved sustained growth and are building their future leadership talent likely have solid talent management processes in place. With a continuous focus on growing the leadership skills of its employees, companies can begin to reap the benefits of a thriving culture, a dedicated and committed workforce, and strong returns on their human capital investments.  Enjoy the harvest!

In today’s changing healthcare environment, with greater consumerism and pressure to increase patient satisfaction scores, hospitals are trying to become more patient and family-centered. They are working to ensure that all staff members and their operations are focused on the needs and concerns of patients and their families.

Before becoming a patient, I assumed that all hospitals were naturally patient and family-centered. After all, isn’t their mission to serve and take care of the sick? But all hospitals do not operate that way, and hospital administrators are beginning to examine their people, processes, and systems from a patient’s perspective. Similar to a business striving to become more customer-centric, hospitals are beginning to listen to the input of their customers as they do business with the hospital.

Given the complexity of healthcare and the ever-increasing demands on providers, I recognize that there are no simple solutions for a hospital to become more patient and family-centered. However, here are a few basics to determine how well the hospital is doing:

1. Access—How easy is it to access the right provider in a timely way? Can you find the direct phone number or navigate the website easily to get to the right place? For those who call, do you reach a recording with multiple prompts or a live voice who can direct you effectively to the correct person or department? If English is not your primary language or you are hearing impaired, are there processes to assist?

When arriving at the hospital, is parking easily accessible and available? Is there wheelchair assistance? Are you and your family greeted warmly by the reception and admissions staff and welcomed to the hospital as valued ‘customers’ upon arrival? Or are you required to take a number, similar to renewing a driver’s license at the MVA? Are wait times reasonable and delays explained? If directed to another area of the hospital, is the wayfinding signage clear and helpful? If you get lost, does any employee of the hospital take the initiative to stop and give directions?

2. Building Patient-Friendly Systems—New systems are being created for scheduling appointments, patient education, communicating with physicians, and monitoring progress from home. With the proper time for implementing and upgrading software and training, these can be useful tools for communicating with you and your family members.

Hospitals are continuing to implement electronic recordkeeping systems. Sometimes these systems are met with resistance by providers because they take time to learn and adapt to the new technology. However, these new systems can help ensure documentation and improve communication that can benefit both you and the provider. Having access to the system from home–or from anywhere with a mobile device–can provide greater clarification and understanding of your condition after the visit. These systems can also help facilitate more straightforward tasks, such as prescription refills.

3. Cross-Functional Coordination—Frequently,multiple specialties and different departments are involved in a patient’s care. While many clinicians operate effectively within their own departments, sometimes communication across specialty areas is problematic. You may assume that the various members of your care team are all on the same page, but they may not be. Contradictory messages from different providers can lead to confusion and, at worst, conflicting treatment and possible medical error. The attending physician should take the lead in coordinating your care to ensure proper handoffs across departments and consistent communication among team members and with you. Your care team should consult with each other in person or by phone when there are differences of opinion or no clear solutions to a problem. Proper coordination with primary care physicians and other providers outside of the hospital is also critical so that the care can be followed up and monitored at home.

4. Dignity— Every individual working at the hospital—physicians, nurses, housekeeping staff, cafeteria and nutrition workers, administrative staff, etc.—has an important role in showing dignity, respect, and empathy to patients and family members. Working in a hospital environment can be difficult and stressful; hospital employees are often exhausted mentally and physically after a long shift. Yet healing others is a high calling and much is expected. You or your family members may be hearing a devastating diagnosis for the first time or be facing a high-risk surgery. And because a hospital is not your normal environment, you may feel especially intimidated and ‘out of your element.’ As you place your life in someone else’s hands, you deserve to be treated with respect and dignity at all times, even if the eventual outcome may not be positive. A kind word and a caring touch can be most welcome and appreciated.

5. Engagement—Patient engagement is a key element of patient and family-centered care. Patients and family members are often reluctant to ask questions and assume that the ‘doctor knows best.’ You may have concerns, such as “How am I going to pay for my medicine?” or “Who’s going to take care of my family while I’m in the hospital?” and providers should encourage you to share those concerns. Getting to know you as a person, in more depth, can help in the determination of the appropriate treatment, help make the hospital stay more comfortable, and ensure that the appropriate resources are provided to support your concerns. A simple question from a clinician, such as, “What do I need to know about you as a person in order to provide the best possible care?” can make a significant difference in the quality of care and your overall experience.

6. Follow Up—After a surgery or significant procedure, following up with you is essential to ensure compliance, to monitor the recovery process, and to help reduce readmissions. During the discharge process, many patients can’t wait to get out of the hospital and go home. You may be given all your prescriptions and sign papers, but not fully understand or remember the medications and the home care that is required. If you have family members or friends that can assist you, do they understand the home care that is needed? Does the attending physician provide a cell phone number and/or email address if necessary?

Medicine is as much an art as it is a science and all procedures don’t go as planned. When things happen that are unanticipated (which happens in every line of work), do the hospital and the provider(s) stand behind their service and work diligently to correct the problem? Are your problems acknowledged and addressed in a timely way? Do they openly explain to you what is being done to correct the situation and continue to engage you in the next steps?

Becoming patient and family-centered is an ongoing journey and requires an organization-wide effort. Many hospitals are doing an excellent job and going far beyond the ABC’s listed above. As a patient, I truly appreciate the dedication and commitment to this goal.