RWL #229
National Culture, 12 pairs of legs, the first female Army surgeon general
Greetings from the University of New Hampshire! Usually at this point I would say, “Greetings from Durham, NH” since I am officially done with the spring semester - yay! But I volunteered to teach a summer course - US Healthcare Systems - so I am a week into a five week course. I’m not sure what I was thinking back in January or February when I told my chair I was interested. If teaching a normal semester feels like a marathon, teaching a five week summer course feels like running the 800 meter dash. It’s too long to call it a sprint, but not long enough to call it long distance. It’s basically fast enough to make you want to puke, but slow enough to feel like it might last forever.
OK - I will tell you the truth about why I asked to teach it - I haven’t had the time to take a step back and think about my industry at the 30,000 foot level in a few years. Committing to teaching a class about the healthcare system I knew would force me to take that step back and even better, force me to articulate the current challenges in the industry. It is doing that, too, which is great. I hope I can teach it again next summer, because I’ll be able to build on the material I’ve been pulling together - a couple of the links this week are the direct result of my research for the course. The class is giving me the discipline I needed to spend some quality time with this material. I know I would have gone into the summer with good intentions of doing it on my own, but once the pressure was off, I would have found other projects to work on.
What I’m saying is I don’t do moderation well. I gained 30 pounds after I retired from the Army. After the pressure of having a physical fitness test and a weigh in was lifted, it didn’t take me long to slip into habits of eating a little more, exercising a little less. Since New Years I’ve implemented a relatively simple diet - I try to stay under 1800 calories a day, no booze, and try to get some exercise every day. On Saturdays I can eat anything I want. I’ve lost about 12 pounds and I don’t feel especially put out as a result of the program. My wife and I now do a meal plan for dinners on weekdays on Sunday and it’s kind of fun. I think it’s sustainable, but we’ll see. I still have a ways to go before I will feel good about my weight - I’m about half way there - but this discipline seems to work.
There’s solid research in psychology that tells us doing things through will power is hard to sustain. It’s important to come up with simple rules that don’t require a lot of thought if you want to sustain a discipline. Or it's important to put yourself in a situation where external forces will sustain the discipline for you. This was part of why I joined the Army many, many years ago. I knew I wanted to grow as a person, and I knew the Army would force me to do that. Once I signed the dotted line, the rest was out of my hands. When you literally can’t quit, it makes continuing on a lot easier. I use this technique fairly often in my life - often without really thinking it through. I know I’m not good at moderating on my own, so I outsource as much willpower as I can. Sometimes it works.
So speaking of the Army, tomorrow is Memorial Day. I hope you all have a pleasant holiday and take a few moments to reflect on those who have sacrificed for our country. Stay well and stay safe.
(Pic is from the funeral of a friend.)
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What: Hofstede Insights, National Culture
https://hi.hofstede-insights.com/national-culture
Why: I had read Hofstede’s work measuring cultural differences across countries way back in the 90’s and I was pleased to find he has a whole consulting business built around the concept. I was looking for this data because the text I am using to teach Health Systems talks quite a bit about cultural influences on how a country’s health system evolves. As it turns out, the UK, which has a fully-government run health system, has the culture closest to the US based on Hofstede’s measures. So I’m not sure that is quite right, but Hofstede’s model is still really interesting. I don’t know the literature in this area and I’m sure much has been done since he first did his research, but the lens Hofstede provides is interesting. You can compare countries using his tool by going here: https://www.hofstede-insights.com/country-comparison/the-uk,the-usa/
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Watch
What: TEDTalk, My 12 pairs of legs
https://www.ted.com/talks/aimee_mullins_my_12_pairs_of_legs
Why: I came across this talk while I was looking for material for my Health Systems class. Mullins talks about having two prosthetic legs in this short talk. Actually, she has 12 pairs of prosthetic legs that allow her to do a variety of unique things. The spirit of her talk reminds me of the energy I always feel when I visit my colleagues at Northeast Passage. Her mission in this video is to get people to look, rather than avert their eyes. By the end of the video, you can’t help but be a little jealous that she has 12 pairs of legs and you only have one. I loved this line:
"Poetry is what elevates the banal and neglected object to a realm of art. It can transform the thing that might have made people fearful into something that invites them to look, and look a little longer, and maybe even understand."
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What: No Turning Back Podcast, Patty Horoho: Lessons from the former Army Surgeon General
https://mgntb.libsyn.com/patty-horoho-lessons-from-the-former-army-surgeon-general-0
Why: I know many of you who read this newsletter know exactly who Patty Horoho is. But most of you probably do not. Lieutenant General (retired) Patty Horoho was the first female Army Surgeon General, and also the first nurse to fill that role. She led the Army Medical Department through a very difficult period following a profound loss of trust after the Walter Reed crisis, first being placed in command of Walter Reed and then being entrusted with leading the entire Army medical system. LTG(R) Horoho was my commander in 2005-2006 when I was the chief of resource management for the old Dewitt Army Community Hospital (and she was just Colonel Horoho back then). This interview is fun to listen to for me because I have followed her career at a distance since 2006. In this interview she gives General Stanley McChrystal some interesting insights into her leadership style - in particular she looks for a few words that encapsulate the “why” of the organization. She talks about it in her new role as CEO of Optum Serve, and I remember her taking the same approach at DeWitt and as the Surgeon General. I think this is a good example of leadership - finding a way to boil down the essence of the organization to a few words is a powerful technique. The whole interview is worth listening to.
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 .
If you’re looking for a searchable archive, you can see my draft folder here: https://drive.google.com/drive/folders/1jwGLdjsb1WKtgH_2C-_3VvrYCtqLplFO?usp=sharing
Finally, if you find these links interesting, won’t you tell a friend? They can subscribe here: https://markbonica.substack.com/welcome
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)