RWL #180 - Deploying to the Javits, future of nursing, injustice of excessive fines, & more.
Greetings from the University of New Hampshire - Forward Operating Base Last Homely House (FOB LHH)! What a beautiful week we had up here on the seacoast. It’s finally starting to feel like summer. Although I had a bunch of travel plans for this summer and they all fell apart, I feel like I’ve been very productive, and that has been satisfying. I’ve been working with several other researchers on some long term projects that should be moving toward generating their first products and I’m starting some exciting projects with old friends who are interested in trying their hand at research. I’m also still trying to place some students in internships and despite some success, that’s been really tough. I have had several organizations really step up and, despite the current challenges, recognized the importance of paying it forward. And I’ve been able to get out and paddle a few times as well, which makes the world such a happy place.
I hope you are feeling productive in this odd time and getting some time to enjoy the summer. Stay well and stay safe. And Happy Father’s Day to all the dads out there!
(pic above from the Oyster River in Durham, about a mile from UNH)
Read
What: McKinsey, Future of nursing: Supporting nurses across settings
Why: The nursing workforce is critical to the delivery of care across all healthcare settings - from academic medical centers to outpatient offices. This analysis focuses on the fact that care delivered in non-acute, ambulatory and long term care settings are growing at 2-3 times the rate of inpatient settings, and how this shift is likely to impact/be impacted by the nursing workforce. An interesting fact - the nursing workforce has a median age of 50, whereas the US workforce has a mean age of 42. Both are higher numbers than I realized, but given the physical requirements of nursing, aging has a real impact. Other topics covered include education and attitudes. Worth a quick read.
What: Bloomberg, The Crisis on Campus Is Here To Stay
Why: Subtitle: “A looming shortage of students will upend the business model of higher education. To survive, colleges need to do more with less.”
We are already seeing this here at UNH. We are expecting about a 10% shortfall in freshmen registrations which translates into a huge revenue deficit given the operating leverage of the university. Given fixed assets most brick and mortar universities systain, we’re a highly leveraged industry. The pandemic is cracking apart university education in the same way that the advent of file sharing cracked apart the music industry in the 90’s and early ‘00’s. “Going to college” used to be like buying an album: you wanted songs 3 and 4 on the A side, but you had to buy all 5 songs on the A side and all 5 songs on the B side, even though you would probably never listen to any of the songs on the B side. You can think of college like an album - songs 1 & 2 are education, songs 3 & 4 are communal living with lots of other young people, song 5 is dining hall eating, songs 6-10 is all the social stuff - frat parties, hanging out at the campus center, whatever. Online education has been growing for years, and now with most universities having been forced into the online space last spring, the legitimacy of the modality has really been validated. So if all you want is the education, songs 1 & 2, it’s become clear that online is the way to go. Certainly you do not want to pay for the whole album if you are likely to get kicked off campus half way through the semester and wind up getting 1 & 2, even though you paid for 3-10.
Southern New Hampshire University (SNHU - not part of the University of New Hampshire System, but a private university) has become an online juggernaut selling only songs 1 & 2. They do have a small campus in Manchester, about an hour from Durham where UNH is, and this year they have announced that students can choose to live on campus, but their classes will be online, not in person. Check their announcement here. When I read about this I thought, wow, this is the future. They are truly offering a decoupled college experience - everything is a la carte. It’s going to be an interesting future for education.
Watch
What: TEDxCollingwood, What Drug Dealers Taught Me About Trust
Why: Barnum, a former undercover narcotics police officer, talks about how to create trust. She has a bunch of interesting stories, from learning to listen from a bartender and part time drug dealer to learning how to build up self-confidence as she moves into a dangerous situation. She concludes with a discussion of the challenges of building trusting relationships in the online space. A very interesting talk.
Listen
What: Health Leader Forge, LTC Jarrod McGee, Commander, 11th Field Hospital
https://healthleaderforge.blogspot.com/2020/06/ltc-jarrod-mcgee-commander-11th-field.html
Why: If you were paying attention to the news about the COVID-19 pandemic in New York City you will remember that two Army field hospitals deployed to provide support to the beleaguered health system. Today’s guest is LTC Jarrod McGee, commander of the 11th Field Hospital. In this podcast we discuss what a field hospital is, what its capabilities are, and what it’s like to move one from Ft. Hood, Texas to New York City with only a few days’ notice. This interview focuses mostly on the logistics of the movement to give listeners a sense of what it takes to accomplish something this complex and make it look easy.
In the full length version of the interview we follow the discussion of the 11th Field Hospital’s mission with a discussion of LTC McGee’s career – he started out in the Army as a combat engineer “running around the woods and blowing things up” to later getting a commission as an Army Medical Service Corps officer and becoming a health services comptroller, so he has had a varied and interesting career. He is also the Army Regent for the American College of Healthcare Executives, so we talk about the importance of professional organizations, and how his ACHE contacts actually helped provide intelligence as he brought his unit into New York. We conclude with a discussion about leadership.
Jarrod was an Army-Baylor student when I was teaching in the program - we have stayed in touch since I retired and it was great to catch up with him after this major event.
What: The Tim Ferriss Show — Nick Kokonas on Resurrecting Restaurants, Skin in the Game, and Investing
https://tim.blog/2020/05/17/nick-kokonas-2-transcript/
Why: Kokonas is a high-end restaurateur and entrepreneur. In addition to his restaurants, he had reservation app called Tock. There are several interesting things in this podcast that are worth listening to. First, Tock had international clientele, in particular in Hong Kong, so he got early warning about the effects of the virus. He was able to see restaurant reservations plunge to zero in a matter of few days. This gave him early warning about what was coming to his US-based restaurants. I think that’s a great lesson about the importance of raising your head up above the fray to know what is coming down the pipeline at you, whether that is days, weeks, or years.
The second reason to listen to this podcast is restaurants are service organizations not unlike healthcare. Listening to how Kokonas modified and adjusted on the fly in the face of the pandemic is really inspiring - rethinking how to generate revenue.
The third reason is more economic philosophy - I’m a huge fan of Taleb’s work, and he talks about that and how to think about corporate control and investing.
What: Bound by Oath, Excessive Fines
https://ij.org/sc_long_podcast/excessive-fines/
Why: Long before #DefundThePolice swept social media, the Institute for Justice has been pressing for a more just world, fighting against incursions on the liberty of individual Americans, such as excessive use of no-knock raids, qualified immunity, and excessive fines, which is the subject of this episode of IJ’s Bound by Oath podcast. When the Obama administration investigated the activities of the Ferguson police department, what they uncovered was something IJ has been fighting against for years - policing for profit - which refers to police departments that use their ability to impose fines to raise money for the department itself or for the municipality. If you feel like the intent behind #DefundthePolice is important, then you should support IJ. I’ve been donating to them for years once I learned about things like policing for profit. Check out this podcast and learn more about how local governments abuse their power and make the lives of lower SES citizens miserable.
Thanks for reading and see you next week! If you come across any interesting stories, won't you send them my way? I'd love to hear what you think of these suggestions, and I'd love to get suggestions from you. Feel free to drop me a line at mark.bonica@unh.edu , or you can tweet to me at @mbonica .
Also, if you find these links interesting, won’t you tell a friend? They can subscribe here: https://tinyletter.com/markbonica
See you next Friday!
Mark
Mark J. Bonica, Ph.D., MBA, MS
Assistant Professor
Department of Health Management and Policy
University of New Hampshire
(603) 862-0598
mark.bonica@unh.edu
Health Leader Forge Podcast: http://healthleaderforge.org
'It is the small things, everyday deeds of ordinary folk, that keep the darkness at bay. Simple acts of kindness and love.' - Gandalf (The Hobbit: An Unexpected Journey)