Health Care Reform Still Making Waves

The health care industry continues to sail in a turbulent environment, rudderless, through a period of dramatic change. With the varied pressures of cost containment, little ability of the consumer to judge quality, Medicare funding problems, the powerful for-profit health care companies and insurers with the actuarial smarts to seek out and insure only the healthy and wealthy among us, you may not recognize your health care system in three years.

Catalysts for Change Three things catalyze all change in this country: 1) cost; 2) technology; and 3) politics (legislative issues). The forces driving health care are cost and legislative issues. In the future, technology will play a larger role in health care changes than it has in recent years. We are in the middle of a true revolution in how work gets done. First came the Agricultural Revolution that changed society. Instead of hunting for food, we started growing it. It lasted from about 8,000 B.C. to the late 1600s and was ended by the Industrial Revolution. Next, we started to depend on machines to get things done. Pulling levers and pushing buttons replaced much of the heavy lifting and manual labor that folks had become accustomed to. The third revolution-the Information Age-is in progress now. This revolution began about 1950, with the development of the computer and improvements in telecommunications. In essence, horsepower is being replaced by brainpower. Work is again being completely transformed. The situation, however, is confusing a lot of people and many are upset with the way the Information Age is affecting their careers. Modern telecommunications and computers are reshaping the work environment. You can work at home, in your car or almost anywhere as easily as in your office, thanks to laptop computers, modems, cellular phones, pagers and other technologies. This ability to work remotely means we can enjoy much more job freedom, but it also means that companies can go almost anywhere in the world to employ people with the best skills at the lowest salaries. We are in a situation where corporate America cannot guarantee our job future and government cannot deliver on what the politicians have promised. Welfare is being drastically reformed. We are in the paradigm shift from entitlement to earning and from rights to responsibilities. Globally, we are seeing a greater equality of opportunity. My prediction for the future: There will be more opportunities than we ever imagined, but with more competition for each opportunity than ever before. Your services will be needed in the future, but new skills will be required for these opportunities. There's a necessity to sharpen the tools already in your toolbox (and develop new tools now). Start figuring out now how your job and profession is changing and how tomorrow's tools and methods will alter the way you work. Don't try to defend old methods and ways of doing things-resisting change is a no-win battle. New tools that we will use will cause further change. The corporate ladder is disappearing with today's leaner, team-based organizations. Planning for Success It's critical that we reinvest our own money and time in skill development for the future. The new source of power in the Information Age is knowledge; the biggest challenge is not getting an education, but keeping one. Consider this fact: in three years, at least 50% of our skills will be outdated. When was the last time you did anything to change your behavior? You can't win tomorrow's game with yesterday's score. It used to be true that if you always do what you've always done, you will always get what you've always got. If you liked what you were getting, keep on doing what you always did. This is no longer true. Now and in the future if you only do what you used to do, you will get left out. Table 1 (posted at the end of this article) lists six steps for succeeding in the 21st century. The best supervisors, managers and leaders are masters of change. A manager's most important survival skill is the ability to anticipate change and identify new opportunities. There are paradigm shifts occurring in today's health care arena, and health care reform will continue for several more years. You can change yourself if you can change what goes into your mind. It's true that every improvement is the result of change, but not every change is an improvement. The past has (and will continue to have) value. At the same time, you should not let the past have a veto. Take the best from the past and best from the future to forge success for yourself (a process which means turmoil!). Steps to Managing Change We all go through the following four stages in responding to either a major or minor change: * Denial. It doesn't sink in right away that the change is occurring and that it will affect you. A typical response might be, "They can't be merging our my clinic with that hospital across town." We tend to focus on the past. When in the denial stage, we are in withdrawal and only focus on the past. * Resistance. Here, strong feelings about the change emerge. These feelings can include anger, blame, depression, anxiety, uncertainty, frustration and self-doubt. * Acceptance. During this phase we draw upon internal resources and creativity to figure out our new responsibilities and visualize our future. This can be an exciting time if we take on change as a new adventure and opportunity. In this stage, it is normal to have concern about details, confusion, new ideas and lack of focus. * Commitment to Change. At this point we are able to set new goals and make plans to reach them. We are cooperative, focused and ready to anticipate our next challenge. The longer we stay in the denial and resistance stages, the harder and more painful the change will be. Try to get through the denial and resistance stages quickly and go on to a commitment to change. Exchanging the familiar for the new, even if it's better, means the death of something familiar. We need to make certain that we allow for mourning and recovery. Table 2 addresses how to become a change agent and compete in the future. Managing change and becoming a change master is a process. When going through it, we first must understand the change and why it's occurring. Then we must understand the change and its significance. Next, we identify our feelings about the change and learn to accept it, which is one of the most difficult steps. We also must gain a new perspective with respect to the change and shed the old image. Then, we build on what's left, set new goals, develop new strategies and set up a support group. The key to implementing change is to give clear and direct communication. My recommendations for survival and winning strategies for workplace changes are: thrive with changes in the workplace, cope with feelings of uncertainty, overcome resistance to change by sharpening self-management skills and anticipate change by tracking trends. Suggestion: When you catch yourself being resistant to change, use a rubber band to snap out of it! Some of our clients wear a rubber band around their wrist as a self-motivator. The snap of the rubber band reminds them to take action toward getting out of the denial and resistance stages, so they can make the change happen in a positive way. Dr. Frings is a health care consultant, futurist, speaker and president of Chris Frings & Associates in Birmingham, AL. He is also a clinical professor in the Department of Pathology and Clinical Laboratory Sciences at the University of Alabama in Birmingham (UAB), and teaches time management in the UAB Leadership Institute. Suggested Readings Celente G. Trends 2000: How to Prepare and Profit from the Changes of the 21st Century. 1997, Warner Books, Inc., New York, NY 10020. Frings CS. The Hitchhiker's Guide to Self-Management & Leadership Strategies for Success: Seven Steps to Overachieving in Business and Life. AACC Press, Washington, DC, 1998. Frings CS. The Hitchhiker's Guide to Effective Time Management: The Only Time Management Book You Will Ever Need. AACC Press, Washington, DC (ISBN 0-915274-95-7), 1997. Frings, CS. Rethinking ourselves for success in the 21st century, Clinical Laboratory News, 1996;22(1):18-19. Table 1 HOW TO BE SUCCESSFUL IN THE 21ST CENTURY *STEP 1 Have written goals. *STEP 2 Have a plan to reach your goals and stick to it. *STEP 3 Expect the unexpected and have a plan for everything that can go wrong. Be receptive to change and learn to manage it effectively. *STEP 4 Don't make the same mistake twice. Learn from your mistakes and successes and those of others. *STEP 5 Get control of your bad stress. *STEP 6 Every day get a little better at what you do. tables/courtesy Christopher S. Frings, PhD Table 2 HOW TO BECOME A CHANGE AGENT * Keep a positive attitude. * Make managing change part of your job description. * Don't fight losing battles. * Be tolerant of management mistakes. * Keep a sense of humor-humor is healing! * Don't let your strengths turn into weaknesses. Refocus rapidly. * Practice good stress management. * Worry is the misuse of imagination. * Support upper management. * Invent the future instead of trying to redesign the past.