Tuesday, August 16, 2016

Mind-blowing Lessons from the past 5 years

So today I celebrated 5 years working in my current organization, which means I have been doing this longer than anything I have ever done before, except elementary school.  As is our tradition, I wanted to share some of the mind-blowing lessons I've learned since starting work.

Mind-blowing: adj.: Anything that has fundamentally and irreversibly altered my experience of the world

  1. “Just because we think they are wrong, doesn’t mean we are right.” 
  2. There is no substitute for being there: get up early, get on the plane and be present
  3. Patterns keep repeating through medicine, software development, management, parenting
  4. The quality of technology reflects the quality of decision-making
  5. Decided is not Done, and Done is what matters
  6. Perfection is anathema to survival, and probably so to success 
  7. Help will only arrive after you have taken responsibility for solving your own problems
  8. When others try and convince you of your own ideas, smile, you have succeeded
  9. You must be your own harshest critic AND yet you must know your own true worth
  10. Perform first, negotiate second
  11. “You are too young to think you are bad at things yet.” 
  12. Get a life, your work depends on it

Tuesday, July 19, 2016

Stan Schutzbank Slide System

So I find myself presenting often these days, and making lots and lots of slide. My father, the eponymous Stan Schutzbank, warned me this would happen to me as it happened to him. Except he used to do it in the $3-per-physical-slide-better-get-it-right era.  I remember opening up our practice screen and gleefully helping him install the slide carousel as he would practice his most important presentations with his family.  In some ways, presentation is our family business.  Other people learn how to build tables, install furniture, mow the lawn.  I learned how to present in the...
Stan Schutzbank Slide System

What is the purpose of your talk?

Why are you presenting?  Are you there to teach or to guide a group to a decision?  Do you need to lead them to a specific decision (sales) or just ensure one is made? What must your audience know before they leave the room. Put your important points first, repeat them often and repeat them often.  

Remember your tortured audience.

No one really wants to hear your presentation, so remembering your audience matters. They aren’t really paying attention either, they are thinking about lunch, or if they left the stove on, or who they should be talking to, or a million other more interesting things than you.  Plus phones…
Are they forced to be in the room or there voluntarily? Large or small?  Are they visual, auditory, kinesthetic? Comfortable room, uncomfortable room? What time of day is your presentation?  Hungry? Sleepy? Tired? Bored? Overwhelmed? Keep this in mind as you craft your presentation and match your flow of ideas and energy to what you expect in the room.

You are the presentation, not the slides.

When it comes to the creation of any presentation, you should assume that they are designed to be presented. Your words, gestures and stories, should do more than half of the communication, leaving the slides to be light.  Let the slides guide the conversation, reinforce main concepts, provide figures, explanations of terms and acronyms.  No walls of text.

Note: If your presentation slide deck is meant to be a "leave behind" that has to be a self-sufficient document, consider making an actual handout as the flow works more seamlessly and you can take time and words to express ideas more completely.  Your audience may be handcuffed to slides, free them from this prison.

Now to the slides themselves:

  • If you have a background and color template to follow, use it.  If not, KISS (Keep it Simple Stupid)!  Simple is better-- busy logos, busy colors and busy slides distract from your message.
  • Avoid letting text wrap to the next line. It confuses your audience and will trip you up.
  • When in doubt... 
  • Break up sentences into bullets 
  • One idea per slide and be sure drive it home
  • Organize your points visually to convey this one point.
  • Limit abbreviations and always define them the first time with an asterisk and footnote.
  • Use animations sparingly, and only to convey motion and flow
  • Always consider how your animations will print-- overlays are unintelligible
  • Slide transitions are rarely called for and add little.
  • Video and Audio are unreliable, if you MUST, test, test, test.
  • Pictures are incredibly powerful, but only powerful to teach/instruct, not as art.
  • Never apologize for a chart being too small.  Either make it bigger, cut it up, or don't use it.
  • Appendix: Make slides you might need (usually with data), but save them for requests.  You will look incredibly well prepared.

Thursday, June 30, 2016

The Birth of Chirp: Why we built our own Electronic Health Record (x-Post from Iora Health)

Check out a post I did for our blog at Iora Health.  Once again answering the question of why we made the tough decision to build our own medical record.

Tuesday, June 21, 2016

Healthcare Badass? Guidewell interview from AHIP 2016 in Las Vegas

A quick interview from my recent trip to Las Vegas to speak at AHIP 2016.

Monday, January 11, 2016

So you wanna be a Powerballer?

Powerball, for those of you who are even more disciplined about news consumption, is an interstate American lottery that has not had a winner since November and currently has a jackpot of $806 million (reported confusingly as 1.3 billion).  It is literally all that anyone is talking about.

Like millions of other Americans, I have been roped into a pooled buying situation with some friends.  If anything, it allows us a new venue to insult and mock each other for the roughly the same reasons we have done so for the last 30 odd years.  To that end, I have been putting these tickets under the Recreation budget line, as opposed to Investment, as one friend advised.  We played on Saturday and shockingly, we failed to win anything.  So here we go again for Wednesday, slightly bigger pool, more intense discussions on exactly how to divide up and spend our winnings.

But here's the thing about all of lottery madness-- it is winning actually terrifies me.  All I can think about is some dystopian, Hunger-games-Victor-misery type situation. Enough to consider not playing again.  Seriously? Am I that risk averse?  Here are some issues going through my head:

Annuity or Lump Sum?

Classic question.  I have to go lump sum here.  Time value of money, don't trust the solvency of the lottery commission, better return on my own, etc.  About $480 million after taxes can buy a lot of things that can generate a return sufficient for today's expenses.

However, the major advantage of annuity would be that it is much easier to learn how to handle $26,000,000 (rough calculation) at a time than $480 million all at once.  Kind of like not taking out too much cash from the ATM, it is just less to lose.  That sad, after 1-2 years it would be really nice to take out the lump.  Is that an option?

How do I receive the money?

Simply put, where does one put half a million dollars received all at once?  Big mattress?  Several thousand savings accounts? Large brokerage?  I don't even mean an investment strategy, I mean, you get a check tomorrow, where the hell do you cash it?


So everyone complains about their huge tax bill on found money.  Honestly, this is found money, this is not where you complain about over taxation.  Taxing wages on labor is far more cruel than government taking a bite of money you didn't have yesterday and did almost nothing to earn.

Tax consequences of Splitting?

That said, how does splitting work, tax-wise?  If my friends and I do split, do we have to pay taxes on each successive transfer?  That is-- does the winner give Uncle Sam his 40% cut as does each subsequent recipient?  If so, taxes will eat a massive amount of winnings.  Do we incorporate before buying tickets?  How about gifts to friends and family (separate issue)?  Does the "lucky" winner just have to keep to the gift limit and start a bunch of 529s?

Keeping it?

How the hell does one hold on to that much money, acquired that quickly, without having developed any of the financial muscles to hold on to it.  How does one avoid the temptations of travel, frivolous or extravagant purchases, the claims of creditors (real or imagined), long lost relatives and old friends suddenly in need, sycophants, leeches, and hangers on?  How does one avoid the attention of thieves and con artists?

How does a winner spending wisely, take care of friends & family without ruining them?

The most conservative and thoughtful of us assume that we would make a series of rational purchases-- debt reduction, homes, set up financial products to assure the security of our loved ones.  But how does one do this without all of the potential pitfalls of found money-- how to not alienate friends and loved ones through too much or too little generosity?  How to avoid fueling drug, alcohol and gambling addictions in those around you?  How to make every interaction in your life, the way you process every conversation with every person, not entirely about this huge pot of money you effectively found?  How to raise children well, avoid the spoiled-sociopath continuum?  How to disprove the axiom that wealth never lasts more than 3 generations?

Growing it?

This has a little to do with how to receive the money, but one wonders how to effectively grow that much money.  I guess this is why we have really large financial institutions who would line up to "manage" that money for our lucky winners.  (See "Keeping it")

Giving it all (or some) away?

So then people think about to what charities or other causes they ought to contribute?  Whose student loans would you pay off?  For those of you in the Give it away camp, is it just because you don't have really good answers to the questions above?  Is there a responsibility that a lottery winner has to distribute found wealth?  To what end?

So that's what I am thinking about while everyone else is plotting their island escape.  Maybe I'm just boring, I don't know.  So I'll ask again, given all that-- You still wanna be a Powerballer?

UPDATE:  I did not win.