The Beginning
The beginning.
It’s ours. What a promising horizon.
We don’t get to decide when the end of the story happens. But then again, we don’t get to decide a lot of our life outline. The family we’re given, authorities and social norms that raise our minds, privileges and misfortunes of the government structures, the school funding that exercises our brain, whether or not social structure allows for access to healthcare.
We don’t get to decide these components that shape our lives. The energy of others that touches our own, forever altering the flow.
Sometimes the energy is kind. Sometimes it’s not. Often those others will affect in indirect ways, not realizing that all business is personal. Sometimes others’ anger and selfishness do create the unalterable change in stream. Then we'll decide to counter. We'll control our own additions. We grow older, we choose our friends, we choose which social norms to transform for the better.
We don’t get to choose if the bus takes us to school. We get to choose who we sit next to.
We don’t get to determine that a mistake against us will become a malicious intention only to be whitewashed. We get to determine how we can assure that maliciousness doesn’t become the new norm. Even if it means destruction and rebuild.
We don’t get to control who hurts us. We don’t get to decide if we’ll even understand it. And maybe some of you believe we control who to forgive, but that’s not really accurate either. We’re built to forgive not some but all.
We don’t get to decide who to forgive from a distance. We’re connected as humans. It's everyone.
We get to decide who to forgive as they stay wingmen at our side.
We don’t get to decide that we end.
We get to decide how we begin.
We decide how we begin, and we decide the hands that hold ours as we step into that new realm. It is the true secret of the equality of human life.
The beginning. It is beautiful and promising and ours.
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Beginnings in healthcare are radiant.
Broken components are dull, and for better or worse this is the backdrop in which beginnings illuminate.
We don’t get to decide that the broken components aren’t working. They just aren’t working, no matter what we do to try for otherwise. Broken healthcare components end.
And we get to decide new healthcare beginnings, along with the industry wingmen that accompany.
Not everyone will be on board when old becomes the end. Not everyone will be ready. That’s okay too.
Destruction may not have always been inevitable in order to rebuild, yet destructive insertions in healthcare have happened anyway.
New healthcare beginnings are coming either way. So with the uncontrollable end, let's look at what we can decide.
We have the advantage of the human heart. A heart that connects to the new beginning in radiance if done openly.
Just as we decide who stays our wingmen throughout life, through an end and over to a new beginning, we also control healthcare open hearts.
Healthcare rebuilds are happening now. Let’s make them as radiant.
Seven new beginnings, shining in brilliance, hand in hand with our wingmen.
- New healthcare beginnings are individual. The outdated, inappropriate hierarchy was always finite. New healthcare beginnings are individually experienced, for organizations and for individual people. Let this vivid illumination shine.
The wingmen, hand in hand
As we transition from an end, we must understand one another. The future of the healthcare workforce will be shaped by generational values. The future of healthcare will be represented in greater light of altruistic community good. And, the future of healthcare places not only customer service but patient advocacy in a new lead. The concept of physician decisions because that is the regulatory rule of law has met some ending with major challenge. Yet letting go of hierarchies will feel less intense in the illumination of new beginnings. Educational skill sets that do not match logic of customer service or evidence based best operational practices can be effectively transformed.
We can stay at the side of regulatory, local and global, as hierarchies are deconstructed. Anarchy and chaos need not be a risk; established regulation and operational processes can remain without medical director patriarchies, academic faculty dictatorships, pharmaceutical authoritarianism. We can harness clinical science knowledge for better practices in education, legislation, labor regulation and reimbursement.
As the end of ugly hierarchical acceptances nears, we are reminded of those times. Times when middle management demanded that, despite our expertise, we were not allowed to speak to, nor discuss operations in academic medicine, with the practicing physicians. Times when research and ideas have been thrown under the table because hierarchy decided the vivid new wasn’t in its favor. As we end raised decibels and tight fists and clenched jaws that we may face from poor administrations, we hold on to pharmaceutical, patient advocacy, academic, political and public service wingmen. We know one another’s expertise and collegiality rises above the inevitable hierarchical end. New transitions in healthcare decision making and leadership require attention to the individual, personally and individual organizations. And we can do this together. What happened in that past life is over. We cross into a vivid realm of equal voice and appreciation of expertise no longer constrained to traditional medicine nor traditional old management models.
2. New healthcare beginnings cannot be negotiated. They are going to happen. Healthcare is too costly, measured too imperfectly and continues to stand face to face with willing partners: the public, other industries and global peers. As we let go of the silos and broken systems, we are given a great gift. We needn’t stand face to face without direct touch anymore.
The wingmen, hand in hand
So the end is inevitable and we can decide to see the new beginning as a chance to model those rose-colored glasses. We can work with access, coverage, insurance and other models to truly measure best practices. We can agree with other industries on how to advance healthcare support. We have the opportunity to no longer see the global peer as the kid on the bus we’ve never met. We can extend a hand, introduce and acknowledge our inevitable human connection, in research, delivery, product regulation, labor regulation and training. We can control the benefit of including the public in decision making for healthcare. We can decide to give one another the benefit of the doubt.
As the end of old healthcare operations nears, we are reminded of those times. Times when change in healthcare was immediately met with stonewalling, anger, resentment over job security. Times when tears in a poorly managed major academic center took precedence over changing for operational improvement. In these former times, a quiet listening ear may have provided a buffer as leadership cried over resistance to mergers. Bitter insults thrown our way, insults that our suggestions of cooperation between hospitals, physician practices and academic institutions were naive, may have been insults accepted without protest. As the inevitably of new beginnings is accepted, we can happily display our gentle, lovely rose-colored glasses. Provide the positive aspects of cooperation, change, operational efficiencies in management and expertise outside of traditional clinical norms. Cherish the wonderful opportunities that global introductions bring. Comfort those bitter emotions of others by standing firm and unwavering on the bright light of inevitable healthcare beginnings.
3. New healthcare beginnings cannot be wholly predicted and planned for, so we embrace our creativity. In fact, new beginnings are indescribable. Just as no individual can fully capture another’s reality, no amount of planning or vision can ever capture what that new beginning will look like. That’s okay. Let’s work to understand that no stated vision should ever be accepted as true total reality. We will never fully understand what the new beginning will look like until we experience it. Still, we should work to understand this as we also work at creativity and imagination for the preparation.
The wingmen, hand in hand
What can we anticipate with new beginnings? Positivity. Movement. Unknown environment. Indescribable light. Communication that we can receive if we are perceptive, and communication that, if actual, shouldn’t be too difficult to recognize. Perhaps we needn’t stand at podiums or sit at conferences or force expert roundtables. Perhaps we can best move forward in humility of the unknown with new strategies in planning. We can design reimbursement that incentives positive approaches. We can incorporate health creativity in this flow. We might not be able to visualize healthcare delivery during work, research participation without daily disruption or oral healthcare incorporation in medical homes right now, but we can start with creative basics.
As we embrace the end of traditional planning and vision forecast, we are reminded of former times. Times when we were told to be prepared for our nurse managers to be unable to cope with change. Times when we were told to be prepared for ruthless nursing home administration, or nepotism in nursing home leadership. Times when we were told that hospital mergers are wrong, that mergers will only bring political persuasion in which physician-patient relationships will suffer. Time when we were told that incorporating Medicaid populations into an organization’s pay mix will bring marketability problems. We are reminded of the poor planning that spits out incorrect fire and brimstone visions. And as we leave these old reminders, we think to the future with positivity. Conversation, perspective and reception to new communication can lead to positive vision unlike any pre planning before. Mergers and acquisitions may bring efficiency, consistency in metrics and stronger voice. Nursing home management conversations could lead to transparent warmth and honesty in leadership. Change leadership should accompany concerns for management coping. The wonderful opportunities and unmatched strength of diversity should bring enthusiasm for health equity, regardless of payor.
With new beginnings, we must sit alongside our industry wingmen and accept two truths: basics in vision, accompanied by new strategies in healthcare planning, cannot ever fully prepare us for what the new beginnings will actually be. Yet there is no opportunity that prepares us better than creativity alongside basics.
4. New healthcare beginnings have a new speed. They do not operate on the same time that we have become accustomed to.
The wingmen, hand in hand
We must work toward new time perceptions and realities for new beginnings. The quality of healthcare delivery, quantity of delivery, reimbursement of such and how we plan for delivery to maximize one’s quality of life can and will be transformed. This may be with tech partners, this may be with stronger mixes of practitioners, this may be accompanied by creative products. Yet time will not be what it once was, for anyone.
As we accept that the old concept of time is no longer a reality, we can accept our new beginning with a full, adventurous heart. We may think back to a time when malice turned toward us, sneering that the new beginning is going to take a long time. Perhaps this malice directly stated that because connections to our partners and the end of the separations was going to be a long time, we ought to find new partners now. Perhaps they indirectly suggested that we ought to abandon the future we were planning because of old traditional time constraints. In our new beginning, we no longer need to concern ourselves with that healthcare malice, nor the disruption of good future because of poor time policies. We can smile and politely decline further connection to malice. Let that ending dissipate, stifling oxygen out of resentment until it accepts an uncontrollable new beginning marked with a new reality of time. Let that ending happen and know that new beginnings are beautifully represented with new concepts of time, Forgive the malice, stifle it immediately, remind it that we get to decide who stays as our wingmen, no matter old time models. Look to the new beginning with excitement as adventure in time perceptions take hold. Quality of personal care may transform with a slower pace. Faster speed may also shine through, in reimbursement efficiency, access efficiency, global harmony in research.
And no matter what, no matter who advises otherwise, our wingmen stay at our side.
5. New healthcare beginnings are not a destination finale. They are the beginning of a whole new world.
The wingmen, hand in hand
A new healthcare beginning is not a destination in which industry can shake hands, embrace and congratulate. A new healthcare beginning will be a new life and we live it in a world we’ve not yet experienced. Be prepared to for this and prepare industry for a continual movement. This can be done with sustainable funding, continuous measures and full international agreements in delivery and research. Those are the wingmen that will help see it through.
As we transition from the idea that new healthcare transformation is a cruise destination, we can begin to prepare for a whole new world. We may think back to a time when management condescendingly laughed at one’s distress, with a direct eye to eye proclamation that "there’s a light at the end of the tunnel". We may think back to when middle nursing management offered to take us on a cruise after the public mock we were being forced to endure would be over. We can think back to these statements and understand that while old management may envision every transformation to lead to a final destination, that concept is no longer productive. In fact, healthcare is forever with our human journey. The right to healthcare, the right to a quality of life are under constant threat. Access to care will remain a constant challenge, particularly with the transformation of credential, education and labor reimbursement. Expertise and knowledge will also transcend silos in industries. As changes occur, we can be grateful for our wingmen in industry and inter-industry. We can assure them and ask to be assured that new healthcare beginnings are forever in motion, forever evolving and will be a whole new world. We will not have accomplished a healthcare industry plan or deliverable and then sail into the Caribbean. No, a much better future awaits: a new healthcare beginning that leads to a new healthcare world in which we will forever live as a part of our connected system.
6. New healthcare beginnings are a new self, those this new self remains partly composed of who we always were. And, therefore, we can always partly transform now as well as embrace our individuality.
The wingmen, hand in hand
We may not like parts of ourselves or who were were. Good wingmen can help remind us of who we are in heart, who we want to be, all the layers that need to come off so we can be true. Our industry peers can do this, and we can do this in the workplace.
Keep good wingmen alongside, and recognize how to help those we choose to keep at a distance be good wingmen for their own peers. There may be times when we could have been more clear, or more truthful, or brought more compassion to the table. We may think back to the times when we warned others of impending negative outcomes and, as these outcomes occurred, we solely blamed those who didn’t listen. We may think back to the times when others hurt us intentionally, because we didn’t want to date our colleagues’ loved ones. We may think back to the times when others hurt us unintentionally, because they didn’t realize they were defensive. Perhaps they were embarrassed that staff remain untrained, despite healthcare standards requiring otherwise, and so they projected immaturely. Perhaps they accused your hiring to be based on your looks or your youth, and suggested that this appealed to a long term care administrator...because they didn’t want to admit a need for a skilled teammate. Perhaps all these experiences add up so hurtfully. Everyone knows these hurtful statements to be untrue. In fact, it is best to stand and model. Don't repeat gossip, don't be concerned with workplace drama, rumors of personal misdeeds or any unproductive darkness struggling to divide. Consider others and know the ugliness needn’t come along in new beginnings. With new beginnings, their good, respectful, compassionate hearts, the ones that decided to embrace healthcare in the first place, can shine through. Let's help workplaces from a distance shape their own wingmen. Let's help them be best.
As new healthcare beginnings take shape, all the petty, upsetting, prolonged battles - battles of power, battles of jealousy, battles of financial hierarchy, battles within ourselves that spill over to the workplace….all that can remain in the past. We are accountable to it, sure, yet we are always available to peel away the ugly layers and transform into who we always were. That old stuff needn’t contribute to our new selves. Workplace dynamics are perhaps one of the greatest components to the healthcare and medical industry.Observing, managing and bettering workplace dynamics through individual introspection can help usher in new healthcare beginnings. Observing, managing and bettering industry dynamics like public discourse with pharmaceutical companies, public confidence in reimbursement systems and public accountability in health can also usher these in.
We do not get to decide that healthcare beginnings are going to happen; they will. We get to decide that healthcare beginnings can be ushered in by leaving the characteristics not true to ourselves behind while polishing our beautiful hearts for the new world.
7) New healthcare beginnings are ever-present. They are not far away, not compartmentalized, not constrained by space. They are ever-present.
The wingmen, hand in hand
We always knew that healthcare endings were going to happen. We always prepared for this. That's okay; we have the wingmen we choose to remain hand in hand with. We may choose to think back to all the good and bad of our individual and collective moments in healthcare. Yet we must realize that all of these experiences helped shaped where we are going, and this design isn’t by accident. New healthcare beginnings are forged from all the experiences and priors and befores and histories, and the whispers that shaped the journey are the new beginnings ever-present. We haven’t stumbled upon holistic care concepts, alternative medicine, home health, socioeconomic determinants of health or spiritual care just because. We haven’t stumbled upon incidental findings in innovation because the odds were even in our favor. We haven't manipulated for success and actually realized it. Rather, new healthcare beginnings are a guiding presence, a force that we did not decide to invite nor may we seek reprieve from. They cannot be manipulated, nor should they be. And so, rather than say a long goodbye to all that is healthcare and medicine, we can choose to accept an end with a hello. We can stay with our wingmen in all aspects of care delivery, governments, pharmaceutical and biomedical companies, nonprofit organizations and academia. We can accept the new healthcare beginnings we have always felt to be present. We feel a force that isn’t documented, researched, outlined and marked up. We feel a force because we feel the presence, and this is in part how we go with our gut when we accept the ever-presence of new healthcare beginnings. These concepts didn’t say goodbye nor wait for some crossed over line for an introduction. New healthcare beginnings have been woven into our life by design, an ever-presence we are ready to fully realize.
New healthcare beginnings are radiant.
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We don’t get to decide that we forgive when it is built in. I have forgiven and hope it is built in to you, too. We are all connected and, in the end, we cannot help but choose to remain connected to one another. No matter what we prefer, the path becomes full forgiveness.
We don’t get to decide that there will be an end. We don’t get to decide when and how the ending happens.
We get to decide how we begin.
And like any other event in which our heart cannot hold the brilliance, we get to decide who will remain as our wingmen. We get to decide who we hold onto as we start our new beginnings. We get to decide who can come sit next to us on the bus.
The beginning. It is beautiful and promising and ours. We are an ever presence to one another.
It’s my new beginning, and as I step forward I choose to remain alongside you.
You can come sit here if you want.