Bathroom Stall Advertising…Why?

I don't know about you, but I prefer to visit the bathroom alone. Given that preference, I've felt, for over a decade now, like I've been under attack by advertising in public restrooms. The brain trusts who decided that ads on bathroom stall walls were a smokin' good way to get their message across have been pushing their products in my face, and I've been making note of companies NOT to buy from.

I mean, who wants to buy insurance from some dude who you first see smiling down at you in a bathroom stall? Larry Craig might find that compelling, but I most certainly don't. Besides, a strange guy in my bathroom means that he's in the ladies room, which adds another level of weirdness to an already weird scene.

Bathroom walls have long been used for commercial messages, but those have traditionally been along the lines of 'for a good time call' or 'Dwayne + Lola 4 Evah'. Why insurance brokers, day spas, or anyone else would think that bog walls would be an attractive, or even suitable, venue for their messages is beyond me. Well, beer might work, in a bar bog, but bars have notoriously uncontrollable bog walls, and ads posted there might find their messages being morphed by user-generated content. The beer company may find themselves appearing to participate in unnatural acts, or to agree with white supremacists.

Anyone who has any thoughts on why the bog-wall ad is a good idea, please share.

That's my story, and I'm stickin' to it…


The Story on Social Media: One Mouth, Two Ears

The always-full-of-great-information Sarah Evans, @PRSarahEvans on Twitter, and one of my favorite Tweeps, shared some really stunning stats today from Adam Singer's The Future Buzz blog. One mindblower of a statistic, among a buffet of them, is that there are 346,000,000 global citizens who read blogs. Wow, I'd be happy to have .1% of that number reading this blog!

I found myself thinking as I read Adam's post that there's a lot of talking going on out there on the Wild Wild Web. The really critical part of social media, however, is LISTENING.

It's tempting to think of one's web platform(s) as megaphones – Hey look! Over here! It's me! That's fairly par for the course in human interaction: we're all interrupting each other constantly, ususally about 20 seconds in to what the other person is saying. Reminds me of Gary Larson's classic "What Dogs Hear" cartoon – you're blathering away at your dog, all she hears is her name. Blah blah blah blah Ginger blah blah blah.

Same holds true with social media: people only listen if they hear something they want to hear, that their ears (eyes?) are tuned for. Everything else boils down to blah blah blah. Unless, of course, what you're saying is pitched to their tuned ears – their wants, needs, curiosity, value system, whatever you want to call it.

Which means you've got to listen. Listen at least twice at much as you talk. The web ain't a megaphone. It's a conversation.

I'm going back to listening now.

That's my story, and I'm stickin' to it…

The Story on Twitter and #daniela – Only Connect

Only connect.

When E.M. Forster wrote that in 'Howards End' in 1910, the first iteration of wireless – radio – was in its infancy.

We've come a long way, baby.

In many ways, the complexity and scope of modern communication – connection – mean that there's lots of the former, but not much, at least not in a meaningful way, of the latter.

'The more elaborate our means of communication, the less we communicate.' Joseph Priestly presciently said that in the late 18th century, and it holds even truer in today's communication-saturated world.

However, there are some stunning examples of how the complexity of 21st century communication can enable connections of the most human, and humane, kind.

Ladies and gentlemen, I give you the story behind the Twitter hashtag #daniela.

David Armano, a big noise in the complex web that is new media, is one of the people I follow on Twitter. If you don't know what Twitter is, go find out, but after you read this, OK?

I missed the kickoff of his conversation about Daniela yesterday, but my attention was snagged today when another of my connections – Tweeps – tweeted (Twitter has created an entire lexicon of its own) about @Armano's campaign to help out a woman with three kids who has just escaped a horrifically abusive marriage and is trying to get her life back.

All the pertinent details are on David's blog, so I won't give you the blow-by-blow. What I will tell you is that David started a ChipIn pass-the-hat to raise some chedda to help Daniela and her kids get back on track. He set a goal of $5,000.00. As of this afternoon, the total raised was approaching $13,000.00, and still rising.

In less than 48 hours.

THIS is the power of connection. THIS is why the internet is so powerful. It's not porn. It's real people, with real stories, making real connections.

David Armano is a mensch beyond words.

How many lives have you saved today?

Think about it.

Only connect.

That's my story, and I'm sticking to it…

Mistake? I Don’t Think So…

Ever hit 'send' and then screamed 'noooooooo!'

Come on, we've all done it. Gmail has even created a feature called 'Mail Goggles' to prevent what used to be called 'drink and dial' – initiate the feature, and Gmail will make you do math problems before you can send an email. Highly useful tool for those who hit 'send' while soused.

What about those moments when you're sitting at your desk, stone-cold sober, and you find yourself hitting 'send', after which you think you've just made a huuuuuge mistake?

Well, that might NOT have been a mistake.

A client of mine called me today in a panic. Apparently, while selecting some folks in Outlook to request LinkedIn connections with, this poor soul had inadvertently selected everyone in the database, and then hit 'send'.

And then screamed 'nooooooo!'

I asked, 'and this is bad news because….?' In the time since 'send', a dozen 'yes!' responses had come back from LinkedIn. Some of these connections were people my client hadn't been in touch with for years, and with whom she had some seriously good professional history.

Here's the moral of this particular story: you only get what you ask for. Being a 'private person' is laudable. Hiding your light under a bushel won't get you any attention at all. And it might set fire to the bushel, which has all sorts of other unpleasant consequences.

What are you doing to get some positive attention? Are there people you knew three businesses ago that would be great connections for your business today? The tools are there to reconnect.

Just hit 'send'!

That's my story, and I'm stickin' to it…

A Great Story On Healthcare IT

In today's Health Care Blog, David Kibbe MD and Brian Klepper PhD continue a discussion that they kicked off with an open letter to the incoming Obama administration in December about health care IT and electronic medical records (EMR/EHRs).

Patients think that EMR/EHRs are the answer to their prayers – no more forms to fill out, no referral slips to carry around, hey-presto, it's all on this flash drive. What Kibbe and Klepper point out is that's just the tip of the iceberg:

"…we are realistic about the problems that exist with health information technologies as they are currently constituted. As we described in our previous post (and contrary to some recent claims), most products are NOT interoperable, meaning licensees of different commercial systems – each using different proprietary formats – often find it difficult to exchange even basic health care information."

In other words, let's not create a tower of Babel just because IT tools exist that will let us. There's enough failure-to-launch across the medical-care sector now: forests of paper records that are a bear to manage, much less share; HIPAA standing like Colossus over every single one of those sheets of paper; and the rising tide of 'perfect EMR solutions' that have been developed in the last few years.

There is no 'perfect solution' – what's required is that healthcare realize that it's an IT business, just as every other commercial sector has come to realize over the last decade.

"…many health care professionals still think of health IT as a compartmentalized function within health care organizations. But health IT has increasingly become the glue between and across all health care supply chain, care delivery and financing enterprises. In the past, it was enough for health IT to facilitate information exchange inside organizations – in which case a proprietary system would do – but we now expect information to be sent and received seamlessly, independent of platform, including over the Internet. Most of the currently dominant EHR technologies don't even begin to get us there."

As someone who has recent experience as a patient managing cancer treatment, the idea of having my records securely available to any medical practitioner in the U.S. via the internet sounds like Utopia. An achievable Utopia, if the incoming administration listens to the rising chorus of voices asking for exactly that.

Add yours to the chorus.

That's my story, and I'm stickin' to it…

Cancer for Christmas – One Year Later


I had my annual mammogram this last Tuesday – remembering how last year’s formerly routine event wound up, to say I was a little nervous is a vast understatement.

Here’s the news: I’m now officially a survivor.

Looking back at the last 372 days, I have to say it’s been quite a ride. So many people have helped me, have lifted me up, have kept me from feeling that terrible aloneness that’s part of fighting a life-threatening disease.

‘Thank you’ sounds inadequate, but it comes from the deepest and most tender part of my heart.

I will finish the first draft of "Cancer for Christmas" by New Year’s Day. Then it’s on to finding an agent, a publisher, or – best of all possible worlds – both. I’ll be reaching out to Save the Tatas and the Susan G. Komen Foundation, offering them a piece of the cover price in exchange for helping promote the book once it’s published.

My goal is to help anyone in the fight – against cancer, or any other life-changing disease – navigate the medical car-wash and manage their medical care for their benefit.

Because if you don’t, no one else will.

2008 has been quite a journey. I’m in an incredibly wonderful place, which I don’t know that I would recognize had I not had my dance with the Cancer Troll.

2009 is already a mortal lock for my best year yet – I wish you the same!

Pay No Attention to the Man Behind the Curtain (If You’d Like to Stay Blissfully Ignorant)

I lost my health insurance the other day – and I'm not going to look for it.

I have reason to be very glad this didn't happen last year, given the cancer-for-Christmas gift I received at my mammogram last December.

Now that I'm in the self-pay column, I called the imaging practice where my next mammogram will take place to ask what the cost would be.

I have seen Explanation of Benefits (EOB) statements from my insurer – when I had one! – that listed the above-the-line cost as $600 to $1,000. Then there was the 'negotiated discount', and the other horse-trading hand signals that brought the cost down to around $350, which the insurer then paid the doctor.

Every EOB I've ever seen had this sort of dance on it – high initial cost, the insurer does a 'look what a great deal we got for you!' discount jig, and hey-presto, the final price is reduced by 50%-or-more.

So, when I called the imaging center, I was bracing myself for sticker shock.

I did get sticker shock, but in the other direction – a screening mammogram is $135, a diagnostic mammogram runs $120-$180, and ultrasound, if necessary, adds another $75.

Meaning the worst-case cost scenario is….$255.

Mention health care in any circle, and you'll hear cries about costs spiraling out of control, of doctors who lose money seeing HMO patients, of hospitals taking it in the shorts on equipment and supply costs, of patients paying $200 for an aspirin (I guess that's 'cause a nurse delivered it in a little paper cup?), of that last week of dad's life when his hospital bill hit $100K.

Here's a question – could it just be because of managed care that costs have managed to careen out of control?

I'm old enough to remember that, back inna day, you went to the doctor and paid for your visit on the way out. 

If you had a prescription, to went to the pharmacy and got it filled…and paid for it.

Needed lab work? You went to the lab, and paid the bill when it arrived.

You had insurance coverage against the day – which you hoped to avoid – when you'd have to go into the hospital.

Here's a suggestion for Tom Daschle, and the incoming Obama health care team: you don't need to invent a new system. Just go old-school, and add technology to it. Give consumers control not just over their care, but its cost.

When you're in the exam room with your doctor, thanks to managed care that's you, your doctor, and fifty people you can't see involved in decisions about your medical care.

That's fifty people who all want their 'taste', who add their cost – for administration, for oversight, for just taking up space in the transaction – to the cost of the actual visit.

That's the first way to attack cost – admit that the Great and Powerful Oz, the whole 'managed care' monolith, is really just a venal clerk behind a curtain who's inserted himself into the medical care system.

Putting patients back in control of their own medical care – really – would not just help control costs, but it might also drive actual patient ownership of their health. Now there's an idea.

So here's a suggestion – kill managed care. And don't have a funeral.

That's my story, and I'm stickin' to it…