Enabling Healthy Decisions | Category Archive

Scary Healthcare Realities

October 29, 2010 by George Van Antwerp 1 Comment

Thinking about Halloween got me to thinking about what “scares” me about healthcare…

We have 10′s of millions of uninsured and underinsured people in the US while being one of the most prosperous nations.
People can and do actually go bankrupt due to trying to medical costs.
Health literacy is a huge problem and isn’t being addressed at a systemic level.
Surgery on the wrong body part still happens.
You can get sicker going to the hospital than you were before you went.
People who work in healthcare can’t figure out the system (much less the people outside the system).
Over 20% of kids need medication.
Obesity, diabetes, depression, and other conditions are all related and growing quickly.
Health and wealth are correlated yet the financial payment system rewards sick care and short term ROI.
People don’t want to be PCPs due to the risk, the pay, and other challenges.

What scares you about our healthcare system or health in general?

Your Personal Brand

October 12, 2010 by George Van Antwerp 1 Comment

Years ago, one of the articles that changed my approach was by Tom Peters called The Brand Called You. It’s a great article if you haven’t read it.

Here’s a good presentation I just stumbled upon with some similar messaging…

General Thoughts, Leadership

Decisions When Running A Race

October 4, 2010 by George Van Antwerp 0 Comments

For the first time in a year, I ran a race yesterday. It was a half-marathon. I didn’t train that hard so I didn’t have huge expectations.

But, as I was preparing and running, I thought about all the things that go thru my mind and figured I’d share that.

When do I buy a new pair of shoes? I’ve had the same style of New Balance for years. But, I make sure I don’t end up running a pair into the ground right before a race and have to switch to a new pair.
Do I carry a drink or use the race drinks? I prefer to carry a drink and save the time of slowing down during the drink stations.
Should I walk to drink or run through the drink? I’ve tried both. I like to walk on the full marathon, but run through in all the other races.
Should I listen to my iPod? Yes for me since that’s how I train.
Should I run with someone? I’ve tried it a few times. It works well if you have a similar pace and goal. I think it’s important to do training especially long runs with people. My old training group helped me get a lot faster in the past.
What should I eat the night before? Pasta and carbs.
Where should I start? I’ve started at the frontline (for a 5K) with my average pace group and with other groups. I think this is somewhat mental. If I start with people that are too fast, I run the risk of trying to keep up and burning out. If you start too fast, you also have people passing you which can be psychologically frustrating. If you start with a slower group, you might have to do more navigating to get to run fast, BUT I do like being able to pass people. It’s a good feeling.
What types of splits should I do? The debate is whether to start fast, run all your miles at the same rate, or start slow and get faster. I personally like to start slower and keep getting faster.
Do I wear clothes to shed or start the race cold? I always try to wear shorts (although yesterday was under 40 degrees), and I put Icy Hot on my legs which seems to keep them warm early in the race. I’ve worn a long sleeve shirt to toss away, but yesterday, I wore a light coat the whole time.
Do I bring gel (or beans) or take what they give you? I always bring my own because you know the flavor you like.
How much sleep should I get? I try to get two good nights of sleep before I race (7 hours).
When do I go to the bathroom? Believe it or not, this is important. You’ll wait 20+ minutes in line for a portapotty, but you want to hydrate before the race. I hear that the hard core people just pee down their leg while they run, but I’m just not there. If I really have to go, I stop during the race.
Do I wear the race shirt? I personally don’t like to wear the race shirt for the race. It feels amateur to me (as if you don’t have any other shirt to wear).
Where should I put my race number? My friends (who run a lot) told me to put it on the front of your shirt and to put it low so it’s basically just above your waist.

That’s a quick list. I’m sure there’s more. What amazed me was the amount of planning for this. I know I do a lot of planning for presentations (logistics, clothes, sleep, run in the am, etc), but I’m sure that others plan a lot more for their recreation than they do for work.

exercise, General Thoughts, Methodology

Sleeping With Your Mobile Phone

September 3, 2010 by George Van Antwerp 3 Comments

There is lots of good data in the new Pew report on “Cell Phones And American Adults“. It shows that people who text a lot also talk on the phone a lot. It shows how adults use text messaging compared to teens. The one that stuck out at me was that 65% of people had slept with their phone.

Why do people do this? I do it if I’m using the phone as an alarm at a hotel, but otherwise, I don’t want the phone beeping at me at night with e-mails (legitimate or spam).

General Thoughts, Research, Technology

Does Playing An Instrument Increases Odds Of Being An MD?

September 2, 2010 by George Van Antwerp 0 Comments

I’m skeptical. My kid wants to be a physician so she was all upset yesterday when they played a video at school saying that 52% of kids that are in band in grade school go to medical school. There’s no time for her to play multiple sports, study, and be in the band so of course we said no.

I was in the band when I was a kid so it’s not an issue with the band. There are plenty of studies around music and academics. Not that I’m going to call the school out on the video, but I’d like to see the research. A quick Google search didn’t find anything on this correlation. I’d more importantly ask the question of what percentage of physicians played an instrument, at what age, and for how long. Did they play piano? Did they play the recorder? Did they play in marching band in college? Did they play in a heavy metal band? There is a difference.

I hate when groups “market” themselves hard to the kids. My son was all worked up a few weeks ago when the boy scouts talked about shooting guns and bows and arrows (neither of which I intend to let him touch for a while). He thought this was a way around me by joining boy scouts.

Anyways, if anyone knows about research on band (or other activities) and the correlation with being an MD (I prefer causality), please comment. Thanks.

General Thoughts, Healthcare, Research

The Power Of A Name

August 6, 2010 by George Van Antwerp 0 Comments

Believe it or not…Cows with names produce 68 more gallons of milk a year (according to Newcastle University in the UK).

So what does that mean for you? Imagine how important it is to treat your customers as people…or your employees. Think about that personal experience when you interact with a member. If you’re the consumer, think about how it makes you feel when you get a general message from your healthcare provider. Isn’t it better when it’s personalized to you?

Books / Articles, General Thoughts, Marketing / Communications, Research

Bullets Do Come Down

July 5, 2010 by George Van Antwerp 0 Comments

Growing up in and around Detroit, I often think of glorious holidays like Devil’s Night or activities where people shoot off guns into the sky (not to stereotype the city too much). People seem to forget that the bullets come back to earth to either injure people or put holes in roofs that become leaky.

But, I have similar thoughts about 4th of July celebrations. I heard a radio host say this morning that you can tell the smart people on the 4th because they print out the map to the local urgent care before they start drinking and lighting off fireworks.

Nationally, 9,000 people were injured and 2 were killed last year from fireworks. Additionally, the 4th of July has more fires than any other holiday with about 50% being started by fireworks (source). How would you feel about lighting your neighbor’s house on fire and watching it burn to the ground?

Fireworks are great. I enjoy watching them, but I always have some concerns about people putting on their own displays in the middle of a subdivision. We had a house burn down in our old neighborhood, and I saw one catch on fire when I was a kid.

General Thoughts

Innovation Has To Respect The Past

July 2, 2010 by George Van Antwerp 1 Comment

Cars provide us with some interesting examples of innovation which has had to adapt to fit our norms.

For example, we have keyless cars, but if you notice, several of them have places for you to put the key in. It’s really just a holder for the key since it doesn’t activate anything, but otherwise, we don’t know what to do with the key once we get in the car. [This may be more of an issue for me since I use this when I rent cars and don't have such a car everyday.]

Another example is the silence of hybrid cars. US lawmakers are considering making manufacturers put sound back into the electric cars so that the visually impared who rely on sound to help them navigate can tell when a car is coming.

I’m sure there are other examples.

Consumerism, General Thoughts, Innovation, Value Propositions

Should Restaurants Use Characters To Promote Unhealthy Foods?

June 26, 2010 by George Van Antwerp 0 Comments

I find this to be an interesting debate similar to should companies be able to promote smoking. On the one hand, kids are obviously motivated to go to a fast food restaurant to get the latest toy that comes with the kids meal. On the other hand, they can’t do it unless their parents take them there.

Additionally, you have to think about what the consumption of these fast foods are by the general population to understand if kids are eating the food at a higher rate than their parents. I’m not sure you could look at families versus couples because by the nature of families being busier and more scheduled they are less likely to eat prepared meals at home.

These high level issues are important because if kids are likely to eat the meals anyways than why not give them a free toy because you are essentially using marketing to get them to choose one restaurant over another based on the toy. If it is the toy that is changing their eating habits then we have a different issue – commercials, over-scheduling, parental control, access to healthy meals and snacks, and general eating habits of the population. I struggle with the argument that the companies themselves shouldn’t be allowed to advertise.

But, I do think there is comparative research which has been done on tobacco and alcohol advertising (i.e., the Marlboro Man).

A factoid I saw in Time this morning was that

“Celebrity sells…kids think food tastes better when a popular carton character appears on the packaging…But, the flavor boost occurs only with junk food, not healthy snacks like vegetables.”

Even with that data, 47% of the child-marketing budgets for fruits and vegetables are on licensed characters compared to 29% of the dairy budgets, 15% of the junk food budgets, and 7% of the candy and ice cream budgets.

Blogroll, Consumerism, General Thoughts, Marketing / Communications, Politics

Little Improvements To Healthcare Process

May 12, 2010 by George Van Antwerp 0 Comments

I saw an advertisement for a site where you could share your thoughts on improving the healthcare system. I went to the website, but I was disappointed. It didn’t seem to have many patient inputs. There are huge issues for us to deal with around this many of which are wrapped up in reform (whether that’s the right answer or not).

But, if I put my re-engineering hat on from the 90′s, I think there are lots of little improvements that I would make. Here are some thoughts:

Online appointment scheduling for physician’s offices. It would be great to do this outside of normal business hours or understand the open time slots.
Real-time updates if the physician is behind schedule – text message alerts.
Kiosks at the pharmacy for picking up refills so that pharmacists could spend their time on first-fills and counseling.
A forum to allow consumers to create a profile about communications preferences and relevant behavioral profiling that would help healthcare companies provide them with relevant information…and allow this profile to follow them as they moved from company to company.
Some type of online certification for health information websites so that we knew which sites to trust for information.
Simpler plan information so I really knew what was covered and what my costs would be.
A virtual coach to help me interpret information, guide me to content, decide when to get a second opinion, provide me with pre-screening, and manage worries (i.e., do I have the flu or just a cold).
Online portals and PHRs that were engaging, portable, and learning systems.
Better communications design and literacy considerations.
Full genomic profiles that not only told me what I was genetically pre-disposed to but what I can do about it.
Aggregation of all the cool tools into a front-end where I could manage a condition thru without having to have multiple logins and different pieces of content to put together.
Easy to understand billing.
A way to stop having to repeat myself on the phone, in the office, at the pharmacy, at the clinic, etc.
No waiting in line – ER, Urgent Care, pharmacy.
Automatic, real-time suggestions (did you know there’s a generic alternative to that? did you know the urgent care down the road 2.3 miles is open and will save you $50 compared to your ER copay?).

I’m sure I could go on, and each of these has implications. For example, to have no waiting in line means creating more locations which creates more costs which ultimately requires them to create more demand to stay business. A vicious cycle.

General Thoughts, Healthcare

Pediatricians To Discourage Teen Drinking?

April 12, 2010 by George Van Antwerp 0 Comments

I was reading the USA Today earlier (now that I’m back from vacation) and it has this whole article about “pediatricians need to work hard to discourage children and teens from drinking alcohol.” Really?

That seems like a role for people other than the pediatrician. Unresponsible drinking is certainly a problem:

Major contributor to the leading causes of teen deaths – accidents, homicide, suicide.
Increases the chances that teens engage in other risky behaviors.
Affects developing brains and general health.

Their statistics are:

>90% of high school seniors and 60% of 8th graders say alcohol is easy to get.
29% of high school students report riding in a car 1+ times in the past month with someone who had been drinking.
10.5% had driven a car in the past month after they had been drinking.

I always thought the most effective way to discourage drinking and driving was to park that crashed up car in front of the schools to serve as a visual reminder. Probably today, you could create a virtual reality drinking experience that shows how bad your responses are and your likelihood to impact your life.

But, I can’t see pediatricians having enough access to students in their influential years (which I would consider grade 6 and above) and making a convincing arguement by taking about the damage to the developing brain.

This is an issue which requires parential guidance and is massively impacted by social norms. Do their friends drink? Do their parents drink? When? How much? Why? Are they allowed to drink responsibly at home (like Europeans for example)?

We have to culturally teach our kids the right view of alcohol. If we paint it in the wrong light, it will be abused.

Now, if you’re interested in why many of the facts about drinking are overstated and the agenda behind that, you can go to alcoholfacts.org or alcoholinformation.org. [Note: I've only skimmed these pages which seem someone opinionated and counter to much of what I've seen. I did see a few points I agreed with, but I'm only presenting a counter-opinion.]

General Thoughts

Sleep, Work Hours, and Career Choices

April 10, 2010 by George Van Antwerp 0 Comments

I know there are limits on how many hours a trucker can drive per day and limits on how many hours an airline pilot can fly per day. I even think there are some limits on hours that a resident can work in a day. These are all within the past decade.

It struck me as interesting earlier today when I thought about the fact that it is the jobs to which we trust our lives and/or have the highest likelihood of harming us where people are most likely to have worked the most hours and slept the least. Given all the research on the impact of sleep on our health and our decision making ability, shouldn’t this be a bigger concern for us?

People with weapons – police and military – are highly likely to work in stressful positions with long days.
People in the healthcare field – pharmacists, nurses, physicians – are highly likely to work in stressful positions with long days.
People who provide transportation – taxi drivers, bus drivers, airline drivers, truckers – are highly likely to work long hours (at least historically). [I assume these may be stressful jobs, but I don't know.]

I’m sure there are more, but these were the 3 buckets that jumped out at me.

General Thoughts, Healthcare

The “Toyota Effect”

March 21, 2010 by George Van Antwerp 0 Comments

While I’m not an expert, all these stories about Toyota get me thinking about prescriptions. Is the rapid acceleration caused by the car or the driver? Is the perception that it could happen contributing to it happening?

From an outside perspective, it seems to be a mix of correlation, causation, and the placebo effect. Here are some definitions from dictionary.com:

Correlation = the degree to which two or more attributes or measurements on the same group of elements show a tendency to vary together.

Placebo Effect = The beneficial effect in a patient following a particular treatment that arises from the patient’s expectations concerning the treatment rather than from the treatment itself.

In the medical world, it’s important to understand the differences between these three. Let’s say you start taking a new medication and feel sick to your stomach. Is it caused by the medication? Does it happen every time you take the medication but not related? Or did you expect to feel sick and therefore do?

People often don’t pause to think about this and test the hypothesis.

[See older post on price and placebo effect.]

Causation = anything that produces an effect.

General Thoughts, Healthcare

The Stress Of The Healthcare Vote

March 20, 2010 by George Van Antwerp 1 Comment

I don’t spend a lot of time around politicians, but I had the chance this week to spend some time with lobbyists and people working with the lobbyists. One of the interesting things I heard about the healthcare vote is that politicians (especially the Democrats) were unusually stressed out about having to vote.

Basically, they’ve been told that they’ll be blackballed and unable to get any of their own initiatives pushed thru if they don’t vote for the bill.

And, many of them are seeing numbers that show only 50% of their constituents (at best) support the bill.

Therefore, it’s a lose-lose proposition. You’ve been elected to represent the people so you should do what they want. At the same time, we know that consumers are swayed by all the propaganda by both parties and multiple other groups. Do you know better?

It’s a great question. I haven’t been a big supporter of this reform while I 100% agree that our system is messed up. My recommendation continues to be to parse it up. First, solve coverage for the uninsured. Second, begin to address things like previous conditions. Third, focus on prevention and the payment / incentive systems.

And, I’m in the industry and don’t have time to keep up with all the changes and nuances to the legislation. I had finally resolved myself to reform and thought the bill(s) on the table right before the MA vote were probably ok (not great). But, I don’t know what’s changed since then and the meaning of those changes.

I saw some article about all the pork being put back in to the bills to get the vote. That makes me annoyed as a taxpayer.

General Thoughts, Healthcare, Politics

Are You Using A Mystery Shopper / Caller Progam?

March 3, 2010 by George Van Antwerp 1 Comment

One of the programs we used very effectively at Express Scripts to test our call center was a “mystery shopper” program. Much like the name implies and has been used in retail for years, this process had a person calling into the call center and asking a series of questions about plan design or other aspects. This was a great way to see if training had worked and understand the experience that our members had.

I honestly don’t remember exactly how we set this up to pass the authentication process, but I believe we probably created “dummy” members in the eligibility file with a name and member ID that could be used by the mystery shopper.

Those calls were then ranked based on quality of response, consistency of response, first call resolution, and other aspects. This testing process was continued until the quality scorecard passed a certain level.

With the increasing complexity of plan design, this is something that everyone should look at.

BPM / Process, General Thoughts, Healthcare, PBM / Pharmacy

Pottery Barn Example Of What Not To Do

February 28, 2010 by George Van Antwerp 1 Comment

One of the things that I’ve long talked about is the fact that loyalty of customers is not simply attributed to perfect service. You can make a mistake as long as you quickly respond and fix the issue. Last year, I was singing the praises of Pottery Barn for doing just that. But, now they’ve blown it again. [BTW - Pottery Barn is owned by William Sonoma.]

In 2008, I bought a couch from them. Love the couch. Loved the store. Felt it was over-priced, but I was okay with that for the quality and service. But, when it was delivered, there were a few issues. Honestly, pretty small, but I had high expectations. I sent a few messages and got a flurry of activity leading to a 10% discount on my purchase. I was happy.

A year later, I decided that I was going to buy another couch and went back to Pottery Barn. This time, it was a comedy of errors. The 6-week delivery took 16-weeks. The deferred payment terms which were supposed to be 12-months from delivery started immediately. So, again I raised the issue, saw a flurry of activity, felt it was fixed, and received a discount (credit) on my purchase price. I felt happy until after getting my next month’s bill only to find out that everything was still messed up. They had simply gotten me to go away without fixing anything. And, I also found out from the new installers that the original installation on my couch from last year was messed up and that was the reason why it constantly was disconnected (it’s a sectional).

So, this time, my anticipation was another discount. Would that have really made me feel better? I’m not sure this time. Now, I’ve actually spent time and been frustrated dealing with lots of credit people and customer service people. It’s actually cost me money (in time). But, I didn’t get another discount. For a company that offers it’s employees a 40% discount, I know there’s lots of room to “reimburse” me for my time.

Yes, I know this isn’t at all about healthcare, but it is about communications and customer service which are important. [And, yes...I'm using my "bully pulpit" to voice my frustration.]

General Thoughts, Marketing / Communications

Implied Preferences / Educated Preferences

February 3, 2010 by George Van Antwerp 0 Comments

A few weeks ago, I was staying at a very nice hotel and was shocked to find out that they had cleaned my room while I had a do not disturb sign on the door. [My general mode when I travel is to just leave everything out in my room and not have them clean until I check out.] I immediately called downstairs to ask what the heck happened. They told me that they just assumed that I’d made a mistake and keyed themselves in.

I was honestly shocked. I’ve spent a lot of nights in hotels and never had this happen. They said that if the sign is up both in the morning and afternoon they assume that the guest had forgotten about it. They then offered to put me on the “honor the do not disturb sign list”. Are you kidding me?

I guess my argument (linking it back to healthcare and communications) is that aren’t there some implied preferences. Unless you tell me different, shouldn’t you honor my requests? If I sign up for e-mails, you should send me e-mails.

For example, if a consumer (member / patient) gives a company their mobile phone number, don’t they expect to receive calls on that phone? I think so. Now, I don’t think that giving a mobile phone number as a “phone number” implies that the consumer is saying it’s okay to send them text messages.

The other issue here is around “educated preferences”. If a company knows that the best way to get someone to stay adherent with their medications is to remind them to refill them, should they make it easy for consumers to opt-out of that program? I don’t think so. I think they have to offer that option, but why make it easy. Patients think they will be adherent. Heck, a lot of patients think they ARE adherent.

Don’t corporate entities have a role in leveraging their data and experience to help people even if people don’t know they need help.

Consumerism, General Thoughts, Healthcare, Marketing / Communications

Sleep Deprivation No Longer A “Badge of Honor”

January 16, 2010 by George Van Antwerp 0 Comments

I would argue that for years many people bragged about how little sleep they got (as a proxy to show how hard they work). Has that changed or will that change? I’m not sure. The whole concept of face time is often more normal than the work smarter not harder concept.

The question of course is whether research on the impact of sleep deprivation will change anyone’s mind. In an article I just read, it has several key points from a recent study [by Daniel Cohen, Harvard Medical School, Science Translational Medicine journal]:

Studies estimate that almost 30% of Americans get less than 6 hours of sleep per night.
The circadian rhythm hides the effects of chronic sleep loss and gives people a second wind btwn 3-7 pm (before they fall off a cliff in terms of attention).
If you stay up all-night on top of sleeping less than 6 hours a night for the past 2-3 weeks, your reaction times are 10x worse than they would have been if you just pulled an all-nighter.

“A large segment of the population may be at a high risk of committing catastrophic errors” (Eve Van Cauter, sleep researcher at the University of Chicago)

Given the risks of error, the impact on health, and other issues, it would seem like companies would want to discourage this “badge of honor” and encourage people to get appropriate sleep.

Books / Articles, General Thoughts, Healthcare, Research

New Respect For Swimmers

January 11, 2010 by George Van Antwerp 0 Comments

I’ve never been a swimmer and hence, whenever anyone asks me about doing a triathlon, I just laugh. But, now my 8-year old has gotten into swimming. They run a mile then swim for 90-minutes 3x per week. I figured if she could do it than I could. Big mistake.

I tried to swim for 30-minutes that other day and felt like I was going to pass out. I’m sure it was a good workout, but I realized that like running I need to manage my expectations and start small. This may be a good new years resolution…make it one hour swimming.

exercise, General Thoughts

Why Can’t I Text My [Application]

January 6, 2010 by George Van Antwerp 0 Comments

I forgot to grab a receipt earlier today when I used my debit card. Since I keep a record of all my transactions in Quicken, I quickly realized that I needed to e-mail myself the amount so I could enter it when I got home. That got me thinking…why couldn’t I just text it to home home PC. The PC is on the web. It could “listen” for my message; receive it; and integrate it.

I’m sure there’s more to it, but this could work for healthcare updates – weigh, blood sugar, blood pressure. Sure, ideally my bank would update my Quicken and my bluetooth connected WiFi health monitoring devices would do it for me. BUT, in the interim…

General Thoughts, Healthcare, Innovation, Marketing / Communications, Technology

Dog or Kids (fun)

January 3, 2010 by George Van Antwerp 0 Comments

I usually don’t stray too off topic, but I thought this was funny enough to share.

Which would you choose? [Of course the only one that believes this is reality are those without either... at least most of the time]

General Thoughts

Does Technology Make You More Efficient?

January 3, 2010 by George Van Antwerp 0 Comments

If you’re like me the answer is “of course”, but I realize that it isn’t always true for people. Look at the people who get sucked into things like SecondLife or people who play games for hours on Facebook. That certainly isn’t efficient time.

An article “The Internet Ruined My Life” by Pat Regnier in Money Magazine (Jan/Feb 2010) makes some good suggestions.

“When work got stressful – pretty often in this economy – it was all to easy to click over to Facebook.”

He points out that for Americans working over 50 hours per week:

56% say technology has increased their job stress (27% by a lot).
47% say technology has made it harder to focus at work (14% by a lot).
66% say technology has made it harder to forget about work at home and on the weekends (37% by a lot).

I’d say what about the fact that it’s easier to multi-task and watch your kids soccer game during the week and stay in touch.

He makes a few suggestions (all relevant for getting into the new year):

Check out the 43folders.com blog.
Break the circuit – stop checking Facebook for a week and see if it’s still that important.
Be smarter about e-mail. The more you send; the more you get. Create better subject lines. He suggests the book “The Tyranny of E-mail”.
Focus on your job (which isn’t to check e-mail…by the way). He suggests checking e-mail just a few times a day [which is very hard but very efficient].
Stay offline in front of the kids [which is hard to do when you work from home].

Books / Articles, General Thoughts, Marketing / Communications, Social Media

Looking Back 10 Years Ago

January 1, 2010 by George Van Antwerp 0 Comments

I usually try to spend some time reflecting at the new year looking backwards on what’s been accomplished, what I’ve learned, and how I’ve changed while also setting some goals for the next 1, 5, and 10 years. Given that it’s the changing of a decade, I’m first going to look back 10 years to see where I was.

1999:

Living in St. Louis [I've moved about a mile down the road.]
Working at Ernst & Young LLP [I've had 5 different jobs since then... although all of them with people from E&Y.]
Wondering if the Y2K work I did would matter [still not sure but the world didn't crash].
Working with managed care companies trying to convince them to build member portals and how the Internet would change their business. [I think we know where that went although they are still trying to drive traffic there.]
Married with no kids and a dog [We now have 2 kids and a new dog.]
Never worked out [I've since ran 3 marathons and try to work out several times a week.]
There was no social media [Now, I've got Twitter, blogging, Facebook, LinkedIn, and Plaxo.]
Same mobile phone number and carrier although I paid several hundred dollars a month for many less minutes and features.

The decade itself seems full of big events:

My kids being born and watching them grow – Amazing! [I could talk about them and my amazing wife forever, but that's probably not for this blog.]
The dotcom bubble bursting [which impacted the company I was then working for].
9/11 – I can still remember driving to work that morning and sitting at work in sort of a daze [even out in the midwest].
Iraq and Afghanistan.
New Orleans.
The Red Wings domination in hockey.
The St. Louis Cardinals and the Boston Red Sox winning World Series.
Running my first marathon [and later running with my little brother].
Trying to start my own company.
Golfing with my wife [our weekly date] … but never seeming to significantly improve.
Tsunami.
Recession and seeing people I know lose their jobs and have to adjust lifestyles. [I was glad I experienced this early in the decade and had an appreciation for this.]
Seeing my parents really begin to age.
Watching my brother and sister get married and have kids.
Learning more and more about what I like to do and what I’m good at.
Appreciate the power of networking.
Actually using the healthcare system – first for the kids and second for myself.
Learning a lot about stock markets and IPOs and caring about saving for retirement and college.
Seeing the frustrating challenge of changing behavior with physicians (eRx, generic sampling) and later with patients.
Getting to do more and more selling.
Continued reinforcement of my Renaissance Man philosophy that broad is still a valuable strategy.
Learning what doesn’t work and how not to act. [that could be a whole book]
McMansions.
Disney.
Learning about corporate politics [you could avoid that as a consultant... generally].
Learning to play Texas Hold’Em with my friends.
Building two houses, finishing two basements, doing remodeling.

I guess in general it’s been a good decade for me. I’m better off. I have a great family. I’ve learned a lot. I’ve grown in my career. I’ve made lots of new friends.

At the same time, the world’s been pretty crazy, and I appreciate the sacrifices that many have made in the Armed Forces during this time. I hope that the next decade will be much better for everyone.

General Thoughts

You Know You’ve Had A Good Workout When

December 23, 2009 by George Van Antwerp 0 Comments

Every once in a while you have that great workout. As we get ready for the 60% surge in gym memberships that occur with 1/1, I started thinking about what criteria I use to know this.

An inability to walk up stairs without pain. I even had one workout years ago (kickboxing plus spinning) where I had to crawl up my stairs at home for day.
You have to take Advil before you workout again since you’re still sore.
You have to use IcyHot before you workout again to try to relax your muscles.
An inability to lift light objects (such as kids) since your arms are too sore.
An ability to wring the sweat from your clothes as if you had just jumped in a pool.
Throwing up from a workout. (I have to trust this. I’ve come close, but my body seems to stop before I get there.)
Totally physical collapse. (I also have to trust this. You often see this with marathoners or people doing the IronMan, but my body seems to stop before I get to this point.)

Of course, you can’t do this everyday or you can’t recover (and you probably aren’t very comfortable). But, I often find that the best way to get this is to try a new routine or new workout. I’ve done this new core workout a few times at the Lifetime Fitness in Chesterfield, MO which seems pretty easy but is really hard. I have trouble with certain movements the next day for sure.

exercise, General Thoughts

Because People Are Different

December 22, 2009 by George Van Antwerp 0 Comments

I’ll borrow our tagline from Silverlink Communications - Because People Are Different – to follow-up on my post on direct mail from yesterday. The first commentor makes a good point. Certainly e-mail doesn’t work for everyone. Nor does the phone (although it is generally ubiquitous today).

The reality is that different segments require different modes of communication. The question is how to figure that out.

Do you ask people for their preferences…realizing that many times people don’t know what they want or need?
Do you look at historical behavior to predict what will work best for people like them…realizing that healthcare is intensely personal and while predictive may not be indicative…and people’s healthcare behaviors change over time?
Do you pursue a cluster approach – i.e., send multiple modes simultaneously…realizing that this isn’t very cost effective?
Do you pursue a strategy of sequencing – i.e., call then e-mail then letter – and which pattern works best…and what spacing between modes works best? (This will vary by message, objective, and audience.)

And, the question that I surprisingly don’t hear many people ask is why is there so much direct mail when we as a culture are generally more interested in being environmentally aware than ever (although we still have a long way to go). Why kill a tree when other modes are more effective, less expensive, and offer better consumer insights?

General Thoughts, Healthcare, Marketing / Communications, Silverlink, Value Propositions

Should Rx Data Be Used By Pharma?

December 16, 2009 by George Van Antwerp 0 Comments

This is a great question as posed by numerous people (see WSJ blog). Now, the one reality that most people don’t realize is that the data is only directionally correct. Not everyone sells their data to the aggregators so depending on pharmacy (or PBM) marketshare the data could be close to significantly off.

Perhaps, that’s not the issue. The question is whether pharma should have a right to see prescription data by physician to understand their behavior. It’s not patient specific data so that alleviates what I think should be the big issue.

Between patients visiting healthcare sites, registering for coupons, buying disease specific publications or supplies, the individual data is probably a lot easier to get and use…and probably more accurate (at least at the household level).

Assuming no one says that pharma can’t communicate with physicians, I think the data is relevant. Certainly, they have an agenda – drive marketshare of their drugs. I think we have to assume that physicians aren’t just guppies that hear the pharma rep talk and do whatever they say. Physicians are smart, well-trained professionals that should be able to hear messaging about drug pros and cons; look at the research; talk to their peers; talk to their patients; and appropriately prescribe.

I think the prescription data probably creates a more efficient system. Physicians that use a drug frequently are visited less often by the rep and don’t spend time away from patients. Physicians that don’t prescribe a drug frequently (and prescribe a high volume of competitive drugs) probably get more visits…BUT they have the choice of saying don’t come.

[I'm taking a little extreme of a view here since nothing is black and white, but I'm not sure I see the privacy issue here.]

General Thoughts, Healthcare, Marketing / Communications, PBM / Pharmacy, Politics, Value Propositions

Phones On The Planes – Please No

December 10, 2009 by George Van Antwerp 0 Comments

The fact that there is even a coalition called the Inflight Passenger Communications Coalition which is focused on getting passengers the “right” to use their mobile phones on planes in the US is crazy. I don’t care what they do in other countries. This would drive me insane. As someone who spends a significant amount of time on planes, the last thing I want to hear is some person talking the whole flight. This is great downtime and work time for me.

I completely agree with having Internet access. People can stay connect via SMS (text messaging), e-mail, web chats, or other written modes. Having dozens of people talking out loud in a confined space would be unpleasant for everyone.

General Thoughts

Can Un-Athletic Coaches Be Role Models?

December 1, 2009 by George Van Antwerp 2 Comments

As a parent, I always think about setting examples for my kids. Since I do believe that playing sports is important to teach kids teamwork, coordination, social skills, and competitive skills, I think this is a key question. Sports is an integral part of our society. I see three potential role models for kids around sports: [Also, over time, I think that kids peers can become role models or certainly older kids.]

Parents
Coaches
Professional Athletes

While I think there are some great professional athletes who can serve as role models (e.g., Michael Jordan, Tiger Woods), there are a lot that aren’t due to drugs, violence, unsportsmanlike conduct, gambling, cheating, and financial mismanagement. And, that’s a very hard thing to control. We’re always (IMHO – in my humble opinion) going to pay to see the best even if they’ve used steriods or have control issues.

As parents, we have the most control over ourselves. We can make sure our children see us play sports and exercise. We can stress the importance of this. We can help them learn sports and make sure they take away lessons from their playing – e.g., winning isn’t everything. [One interesting observation that I've had is that athletes make good sales people because they know how to keep trying and get focused even after a loss.]

But, the one I struggle with is coaches. Sometimes you may have control over the coach, but they can be a very powerful influence on your kids. They spend hours with them and provide guidance. There are some things that you obviously don’t want in a coach – too demanding, not demanding enough, someone who encourages winning at any cost. But, what do you do about the coach that is very smart and understands how to play, but isn’t in shape at all? They can’t even run down the field with the kids. What type of image does that give the kids? It seems mixed to me, but maybe I’m wrong.

[Note: I was originally going to call this "Fat Coaches", but I think there are plently of overweight people who are athletic. But, I'm not so sure about this guy above or some other coaches I've seen.]

exercise, General Thoughts

RoadID for your athlete

December 1, 2009 by George Van Antwerp 2 Comments

Here’s a simple, yet valuable gift for your athletic spouse, friend, co-worker – RoadID.

This is something you can wear or put on your shoes so that if you get into an accident while you’re working out (i.e., road running, biking, hiking) people can contact someone for you. I think it’s great. I was skeptical of the need for it for a while, but I realize that accidents do happen.

They’ve now come out with RoadID interactive. I have mixed impressions. It’s great in that you can log information into an online profile – addresses, contacts, physicians, medical information, insurance coverage, etc. If you’re in a horrible accident, all of that would be good to have. And, the reality is that you control how much is there. But, I’m still a generally paranoid person so I would worry about someone stealing my shoes and all of a sudden having access to my information.

[Too bad you couldn't make it so that it was only enabled if some of your vitals signs were off and transmitted via a sensor to the site to unlock the information. That would be cool!]

exercise, General Thoughts, Technology, Value Propositions

Samples In The Age Of H1N1

November 19, 2009 by George Van Antwerp 0 Comments

One of my first jobs was at Krogers. That changed my view of sampling food forever. I’ll never forget watching a woman sample the spinach dip at the deli. She dipped her fingers in; licked them; and then dipped them back in to get more. (Discusting!)

Now, with all the flu, I’m even hesitant to even eat from a bowl of nuts. Who knows who’s been eating out of the bowl.