From Seth Hazlitt’s Nephew: “Re: Sutter. The Sutter project situation reminded me of your Universal Rules for Big EMR Rollouts™, specifically number five: ‘All the executives who promised undying support to firmly hold the tiller through the inevitable choppy waters and [...] will vanish without a trace at the first sign of trouble, like when [...] the extent of the vendor’s exaggeration first sees the harsh light of day in some analyst’s cubicle.’ Is Jerry Padavano still with Sutter? How long until Jon Manis vanishes without a trace? A year and a half ago, Sutter said it had already spent $500 million, up from the original projection of $150 million. By early this year, it was up to $1 billion. As of this point, what exactly did Sutter get for their $1 billion+ investment?” My Universal Rules piece was a pretty big hit, I have to say. As for Sutter, it’s hard to say other than I was incredulous when they first announced how much they were planning to spend, which turned out to be a small fraction of the final estimate. What healthcare needs are small, specialized systems that interact, but that can be customized and managed locally and individually without making the whole enterprise-wide deployment as vulnerable and as unintelligent as the lowest common denominator of the systems that make it up.

From Pat Cremaster: “Re: Sutter. They couldn’t fund the EMR because of stock market losses and the decision to fully fund employee pensions (too bad other companies make similar promises to employees, but rely on government intervention when their pension goes belly up). It’s also a shame that our healthcare delivery industry requires investment income to fund it.”

From Ian Miller: “Re: e-prescribing. DICOM and HL7 standards are available as free downloads, but the specification of NCPDP SCRIPT Standard for e-prescribing medication costs $655. Wouldn’t it increase adoption to let anyone (like an open source developer) take a shot at creating the e-prescribing killer app by offering the NCPDP SCRIPT specification for free?” I’ve never understood why organizations charge for that kind of documentation when e-mailing out a PDF costs nothing. I admit I’m suspicious about non-profit motives when I see that.

From Lisa Lopes: “Re: HIMSS conference proposals. It is a shame that one must submit them so far in advance. You really have to be thinking about it. So much can change in a year. I always liked roundtables, but there aren’t as many of them anymore. Panel discussions allowing for interaction between panelists themselves and with the audience, I think, are superb vehicles for communication of issues that healthcare IT professionals are dealing with.”

From Lazlo Hollyfeld: “Re: ARRA. After all of the talk about ARRA boosting health IT purchases, clinical spending looks like it will be slowing since everybody is waiting to see what happens over the next 9-12 months. On the other hand, waiting to purchase an EMR system until next year is going to cause some potential difficulty in getting up and running to get paid. Talk about your unintended consequences. Meanwhile, the revenue cycle management vendors just keep humming and moving along as profit margins continued to get squeezed along the entire provider spectrum.” 

From Tom Servo: “Re: Pam Pure. I heard she got a hefty severance package, like $6 million, and new bedrooms and a security system for her horse farm. Meanwhile back at the employee ranch, merit increases were eliminated, profit sharing was eliminated, hours were increased, the fear mentality set in, and people were replaced by terrible Indian outsourcing. Shades of the finance industry.”

From The PACS Designer: “Re: HIStalk’s top 2% ranking. TPD found a website called /URLFAN that rates the popularity of Web sites. Happy to report to Mr. H, Inga, and HIStalk readers that our Web site is in the top 2% of over 3.7 million websites at #80,672. Thanks go to every one of you who contribute to HIStalk to make it the site to go to for the latest health care information and reader comments and writings!” Link.

To think we missed narrowcast content like this when there were just three networks and no Internet: this Web page deals exclusively with hospital food around the world. You will be shocked that most hospital food is dietician-approved, yet thoroughly unappetizing. Captive employees, of course, are shafted by their hospital employer on overpriced cafeteria meals (and the minuscule employee discount is one of the first budget cuts made). The most heinous act you can commit in a hospital, other than abducting a newborn, is daring to refill your $1.75 waxed paper cup from the soda dispenser like every fast food restaurant lets you do, thereby costing a billion-dollar hospital operation a budget-busting three cents. Boot camp recruits and prisoners eat the same prepackaged food from the same soulless food service outsourcers, so it’s about what you would expect (maybe openly rebellious employees and doctors should be punished with a Nutriloaf diet).

Since we’re on the “how fancy do your hospital buildings need to be” debate, this story from India is interesting: Lessons From a Frugal Innovator, subtitled “The rich world’s bloated health-care systems can learn from India’s entrepreneurs”. Example: heart bypasses are done under local anesthesia, but they have triple the IT adoption of US hospitals. Columbia Asia, a US company mentioned here before that operates hospitals in poor countries, is featured. “Columbia Asia … left America to escape over-regulation and the political power of the medical lobby. His model involves building no-frills hospitals using standardised designs, connected like spokes to a hub that can handle more complex ailments … Its small hospital on the fringes of Bangalore lacks a marble foyer and expensive imaging machines—but it does have fully integrated health information-technology (HIT) systems, including electronic health records (EHRs).”

I doubt Medsphere will include this quote in its marketing materials even though it’s coming from a high-profile OpenVista customer. Jordan’s technology minister, when asked about using open source, said this: “It will cost you more, by the way. We are working in the hospital sector, using open source. I think that in the beginning, the cost will be higher. In the long run it could be better. You have to develop software to interface with the open source, which will cost you more.”

Shareholders of IBA Health approve changing the company’s name to iSOFT Group, reflecting the brand name of the product and company it acquired awhile back.

A newspaper editorial observes the institutional nonsense that pervades every hospital. “Part of the problem is the computer. If the medication isn’t listed there, you don’t get it. It might just need to be renewed or re-entered, as meds have a sort of built-in renewal date. ‘Would you please call the doctor and check?’ you ask. ‘I will put a call in,’ is the reply, which is code for you won’t be getting that medication for a good long time. If you hear, ‘the pharmacy will have to be called,’ then you might want to call a friend and see if they can bring you some Tylenol … Something has taken a nurse’s good judgment away and has allowed a computer to trump it; has allowed her to look directly at a new IV line and conclude, beyond reason, that there is no IV medication prescribed. Something has forced doctors to have fewer firsthand conversations with their patients, for shorter periods of time, and to share less information.”

John Halamka got a ton of press that proclaimed him a visionary for having a VeriChip implanted in 2005, but he finally admits everyone who hooted and howled back then about the lack of utility in having under-the-skin medical data was right. “As a technology it’s dead. Use the network, use the cloud to store your personal health records. Or in a pinch, use a USB drive. But the implanted RFID chip is not as a society where we’re going.” One of my satirical news item on April Fool’s Day 2006 was this: “CIO Logs Full Year Without Showing Up at the Office. (BOSTON, MA) John Halamka, Chief Information Officer of CareGroup Health System, did not spend a single day at work in 2005, according to a Boston Globe review of expense records. Health system officials had no comment. ‘Check my vitae – I hold six positions in five organizations, plus I do a lot of speaking,’ Halamka stated in response to a reporter’s question. ‘I can’t say I started out planning to miss all of 2005 in that one job, but it just worked out that way. What I give them in quality more than makes up for any perceived shortfall in quantity.’ A CareGroup source told the Globe that discussions are underway to track Halamka’s location by the identity chip implanted in his arm last year. ‘I’d rig the damn thing up to a doggie fence and give him a few volts when he wanders, ‘ said the source.”

E-mail me.

HERtalk by Inga

Perot Systems releases its first quarter earnings: EPS $.24 vs. $.23 on $621 million in revenue, down from $680 million.

Harvard Medical School closes temporarily after a probable case is identified, an MIT student who picked up the virus while in Mexico and possibly shared it with colleagues at the Harvard Dental School.

SCI Solutions announces it has signed an agreement with Saint Thomas Health Services (TN) for SCI’s Schedule Maximizer and Order Facilitator solutions.

Medical transcription company Administrative Advantage selects the ZyDoc Medical Transcription platform.

Final attendance figures from HIMSS: 27,429 total registrants, down 6% from last year, and 907 exhibitors, down 4%. Over a fourth of attendees were first-timers, indicating a high churn rate.

The 60-bed Bates County Memorial Hospital (MO) selects the MedGenix financial and patient management system.

Authorities investigate a $10 million extortion demand for the safe return of over 8 million patient records and 35 million prescription records that were allegedly hacked from the Virginia Department of Health Professions computers. The FBI is assisting Virginia state officials investigate the incident that came after hackers infiltrated the Health Professions computers last week. They posted this boast on the home page: “I have your [expletive] In *my* possession, right now, are 8,257,378 patient records and a total of 35,548,087 prescriptions. Also, I made an encrypted backup and deleted the original. Unfortunately for Virginia, their backups seem to have gone missing, too. Uhoh For $10 million, I will gladly send along the password.” This fool is going to be so easy to catch that it isn’t even funny. Hey, we’ve got your $10 million – where can we meet you?

The Robert Wood Johnson Foundation awards Project HealthDesign $5.3 million. The project, whose mission is to support the creation of a new generation of personal health records, is based at the University of Wisconsin.

MEDITECH adds Vitalize Consulting Solutions to its list of approved advanced clinical consulting vendors.

Virtual Radiologic receives FDA clearance for vRAD RACS, Virtual Radiologic’s own PACS solution. The company will roll out the software to its affiliated radiologists over the next several months, replacing the commercial software it licenses.

Some news in honor of Cinco de Mayo: thieves in Mexico realize that everybody is wearing blue surgical masks because of H1N1 fears, so they’re donning their own to blend in with the crowd when making their getaway.

E-mail inga.

 View/Print Text Only

One of the greatest inventions of all time is the three-by-five card. Compact. Sturdy. Lightweight. Portable. Blank on one side. Lines on the other side. The three-by-five card has many uses.

The three-by-five card is at the core of my efforts to organize my work life. This card lists those things that I need to pay attention to, or ask about, or do in the next one to two weeks. If you were to look at my three-by-five card today, what would you see?

• Budget. I think this entry is permanently on the card since it seems we are always dealing with the budget – putting it together or monitoring it. Our operating and capital budgets have to be flat next year. At this time, our managers are making good progress on achieving this target. But our hospitals are not finished with their budgets, so they may cycle back in the next couple of weeks and ask us to make further cuts. Terrific.
• COMPASS. COMPASS is the name for our major revenue cycle initiative. We are working with Siemens and Accenture to standardize our revenue cycle processes and data and implement the systems needed to support that standardization and improvements. Like the budget entry, COMPASS will be on my card for years to come. We are moving well. Good progress is being made on the Newton Wellesley Hospital (our first implementation) plans. Progress continues on developing the governance and new management models that are integral to the project and are a big change for our hospitals that are used to autonomy. And outreach efforts are doing a nice job of helping people understand the capabilities of the Soarian system and the new processes. As is true for any large project, there are always issues and challenges that need attention from time to time.
• NWT Frm. I have no idea what this means. I apparently had something in mind when I wrote this, but I have forgotten what it was. If I haven’t figured it out in two weeks, I will presume that I took care of it and cross it off the list.
• Clin Ops Agenda. Clinical Systems Operations is a meeting of several IT leaders who discuss major clinical systems issues and strategies. We have a meeting in a couple of weeks and I’m trying to line up the agenda. While still in flux, it looks like we’ll have discussions about (a) the effort required to close the gap between our current clinical system features and the features we think we will need to qualify for Stimulus financial incentives; (b) an overview of our strategy to enable medical record coders to code entirely from the EHR and not need to pull the paper record; and (c) a discussion of the project demands for our Clinical Data Repository team – we need to help them prioritize.
• Common clinicals. It is time to return to the strategic conversation of how common should our clinical systems be and, given whatever degree of commonness we choose, how should we go about making that plan happen? We last had this conversation three years ago. In many ways we are making good progress towards that goal of commonality – our EMR implementation will be completed this calendar year, progressive adoption of services (in the SOA sense) continues, and the Brigham and Mass General are working together on Acute Care Documentation (ACD). However, we need to step back and broadly consider our current approach, which is best characterized as incremental and progressive homogeneity. We need to frame some overarching questions that need to be addressed, e.g., should we view this as a catalyst for broad transformation of care at Partners or will we focus largely on reducing the complexity of our portfolio of clinical systems? And we need to define the process for answering those questions. While we need to return to this discussion, we have to moderate the pace. The Brigham and Mass General will be consumed by the ACD and Medication Administration projects for a couple of years and we need to be careful that we don’t unnecessarily distract those efforts. And in many ways, the COMPASS project is plowing the ground for are still under developed organizational prowess at broad standardization of data and processes.I expect that FY10 will be spent developing and revisiting our common clinical systems plans with execution of the resulting plans beginning in FY11.
• Staff e-mail. Every month I write an e-mail to the IS department. This e-mail is a combination of news, strategic outlook, and overview of major initiatives. I have been doing this for nine years. I need to write this month’s e-mail. I haven’t figured out a topic. Presumably having this entry on the card will lead to a burst of inspiration at some point.
• Agility. We had an IS team look at improving our agility. They did a great job and I want to implement a number of their recommendations and advance the work that they started. But I haven’t gotten to it. This line has been on my three-by-five card for a long time. I need to get off my butt and do something about it.
• Jess – yard. Our middle kid Jessica lives in a condo (two units total) with two buddies in South Boston. My wife and I own the condo – rent more or less equals mortgage payment. But this does mean we are landlords, and as landlords, we need to deal with the tiny back yard. The plan is to turn the back yard from a sea of mud and weeds into somewhere young ladies and their boyfriends (assuming they pass the background checks) can hang out. Some yard plans have been developed. I need to let Jessica know which one we will go with. I’m OK with putting in a patio. The water fountain that spouts a 20-foot tall “geyser” every hour on the hour will get wacked from the plan.

There are other items on the three-by-five card, but I have probably bored you by now.

For those of you who have yet to discover the three-by-five card, I encourage you to check it out. No batteries. No worries about an operating system crash. Easy to read. You can drop it down the stairs and it doesn’t break. And you don’t need to stay in the lines when you write on it.

John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.

 View/Print Text Only

From Deborah Kohn: “Re: Kaiser’s PDF formatted PHR. PDF Healthcare is a Best Practices Guide (BPG) and Implementation Guide (IG), published in 2008 by two standards development organizations (ASTM and AIIM). PDF Healthcare is not a vendor, product, or service, nor is it another standard. PDF Healthcare describes little known attributes of the Portable Document Format, an international, open, ISO-ratified and published standard that is freely viewable on almost every laptop/desktop around the world, to facilitate the capture, exchange, preservation, and protection of health information, including but not limited to personal, handwritten documents, structured or unstructured clinical notes, structured laboratory test result reports, (unstructured) word processed reports, electronic forms, scanned document images, digital diagnostic images, photographs, and signal tracings. Until members of the PDF Healthcare Committee were told by HIMSS09 staff members that as an ‘unsanctioned HIMSS09 event’ our PDF Healthcare demonstration in the Hyatt Hotel McCormick Place had to ‘cease and desist’, PDF Healthcare was successfully demonstrated to an enthusiastic audience. One demonstration showed how clinicians in Southern California securely exchange patient health information with only a 3G phone, encrypted USB drive, and a printer.” I found the above participant slide on the AIIM site, so maybe someone can chime in as to whether it’s going anywhere.

It really bugs me that HIMSS locks up every possible meeting venue so that nobody can do anything without HIMSS approval anywhere near the conference site, the one time a year where people can connect without add-on travel costs (I’m pretty sure the most interesting events would be unsanctioned). I still say there needs to be a conference designed for the benefit of attendees, not exhibitors, with more and better educational sessions that are cutting edge, not submitted a year in advance with occasional unvetted conflicts of interest. A non-profit or small company shouldn’t have to spend GE-like dollars just to get a once-a-year audience in Neon Gulch.

From Curiously Underfunded: “Re: stimulus. Does anyone know how the physicians will go about collecting the stimulus funds? I keep reading about the qualifications, etc. but have not been able to find anything about how to apply!”

Jon Manis, CIO of Sutter Health, posted a comment in the HIStalk Forum about its Epic project. Not to be outdone, Neal Patterson (or so he says) posted the full text of Jon’s e-mail to staff (thanks to the readers who sent a copy of the e-mail to me as well). The original post by Francisco Respighi was a bit more speculative, inferring mass layoffs, which may or may not be the case. None of this is to cast judgment on Sutter, of course, but to call attention to what’s going on in the industry in general. Sutter has to run like a business, so if they are forced to make tough decisions that change long-term plans, then they probably aren’t the only one.

Speaking of Sutter, it signs a contract for Ingenix Impact Intelligence, giving doctors in the Sutter network access to metrics, utilization, and disease management information.

EHRtv posts its HIMSS interview with Jonathan Bush, conducted at the HIStalk reception. I’m really impressed with the video quality of what Dr. Eric Fishman has put together – it’s like watching TV, complete with high-quality titles, transitions, and great audio. Many people think YouTube is the standard for Internet video, not realizing how bad their proprietary compression and streaming technologies are (great for putting up cell phone video of a dog chasing its tail, but not great for anything you want to watch or listen to for more than 60 seconds). Some others of the many interviews he’s posted: David Winn of e-MDs, Tee Green of Greenway, and former Congressman Richard Gephardt. It’s really interesting to see and hear these folks directly. I saw Dr. Eric and he was working his butt off at HIMSS, seemingly everywhere with his camera crew. I think EHRtv is brilliant. I keep bugging him about how it works technically, so he’s probably pegged me as a fanboy stalker.

Thanks to everyone who completed my reader survey. I’ve already got a to-do list of reader-stimulated ideas that I’ll be putting in place. One expressed concern that the survey implied big HIStalk changes, even though it’s the same old survey I’ve been using for years. Not so — I’m not looking for new sponsors, planning to make any part of HIStalk a fee-based subscription, or adding new kinds of advertising (to answer specific speculation). I’ve been extremely fortunate that companies e-mail me saying they are interested in sponsoring, I e-mail back a rather primitive information sheet on page views and all that, and they either sign up or I never hear from them again. Probably 90% of those who get involved do so simply because they derive value from reading HIStalk and want to give something back (I know that sounds hokey, but I’m happy to report it’s absolutely true). Anyway, if you like HIStalk in its decidedly amateurish form, you will be pleased to know it’s not going to get any slicker (but you will like a few tweaks that were suggested, I think). I sent Inga the results Friday evening and got her “wow, they really like me!” reply minutes later, so she’s happy she scored well in the “what parts of HIStalk do you like” question (I rated her highly myself). And the question that had us both preening: “Over the past year, reading HIStalk has helped me perform my job better.” Those answering yes: 79%. That’s the ultimate metric and I’m really proud of it.

One other item from the survey. I’m surprised at how many industry newcomers read HIStalk to learn about healthcare IT (a third of readers have been in HIT for less than 10 years). I’m going to do whatever I can to better serve that audience. Some folks said they are ashamed to admit that they don’t know some of the acronyms or products I mention, while others said they would find great value in having HIStalk content segregated by topic (so if you wanted to see everything about Cerner, for instance, you could look in one place). I don’t know where I’ll find the time, but I may try to put together something like that in some kind of encyclopedic format, maybe with reader contributions (that screams Wiki, doesn’t it?)

People have asked about being able to view article comments easier. Options:

1. Click the Show Comments link at the bottom of an article to display the comments posted for it.
2. The Recent Comments list in the right column shows the most recent commenters and which post they commented on.
3. I just added a new Comments Page that shows the first few lines of the 30 most recently posted comments. If you see one you like, you can click the title to jump to the article, or click the commenter’s name (below the blue box) to jump directly to that comment (this is a new WordPress plugin that I installed to try to address the reader’s comment question).

Picis is offering a free Webinar called Best Practices to Help Improve Clinical and Financial Performance in the ED on May 12.

The local paper covers the ED computerization of A.O. Fox Memorial Hospital (NY). It’s McKesson, I believe.

Most of you (60%) don’t know or don’t care about Oracle’s acquisition of Sun, according to the last poll I ran. It will be a good thing for HIT, said 22% of respondents, while 18% said it will be bad. New poll to your right: if you are in hospital management, is the financial mood better or worse than it was in early winter when both the economy and the weather were bleak? Some say it’s looking up in general, so I’m interested in what’s going on at your place.

Someone posted a YouTube video of a demo of Cerner PowerChart using MPages at Lucile Packard Children’s Hospital at Stanford. MPages allow creating scripts or Web pages (including AJAX apps) that launch from tabs on the Millennium application screens. It’s pretty cool to see information widgets being dragged and dropped to create a custom Web page like iGoogle.

On HIStalk Practice: Dr. Lyle on information overload, Dr. Gregg Alexander on the creatively maladjusted, and our usual medical practice-related news and snark. If you want to be a guest author, either one-time or ongoing, let me know.

Markle Foundation releases its report (warning: PDF) on “meaningful use” and “certified or qualified” EHRs. Its seven principles: clear metrics are needed; use of information and not software alone should be the goal; use of existing electronic information such as medication lists and lab results should be rewarded first; ambitious goals should be phased in; EHR certification must include capability to achieve meaningful use and to also address security and privacy; ARRA support should include lightweight, network-enabled systems and not just big iron EMRs; and patients and families should be able to put their EHR information in whatever personal health record system they like. A bit different from the HIMSS “buy more stuff” approach, although both emphasized outcome metrics. The gripe with both: representation was heaviest from vendors and high-profile nonprofits whose people have the time to spend on non-revenue generating activities (unlike the average small-practice doc who’s trying to survive and, despite the preponderance of healthcare they deliver, who is also minimally represented by all these thought leader think tanks proposing their future).

Jay Parkinson gets more press than anybody else who’s running a three-doctor practice for primarily healthy, young, cash-paying patients, so it’s not surprising that Newsweek picks up his story, complete with the requisite hipster fawning (although at least omitting the usual GQ-like stubble-and-black-pants photo shoot), but also pointing out that his radical model benefits himself as a capitalist more than society in general. He follows the usual script, bashing insurance companies, EMR vendors, “old people” (meaning anyone on the wrong side of 40, apparently), and anyone who doesn’t spend their day on Facebook (“We’re starting with those who get it. Facebook started in 2004 at Harvard. It wouldn’t have started with old people. But you know what sucks? Now your mom is friending you.”) You know what sucks? Having a problem like a heart attack or chronic illness and learning that your franchised 2.0 photogenic IM-and-Facebook doctor doesn’t want anything to do with you. That’s where most of the value (and expense) of the healthcare system exists, not in having someone willing to bike over to your loft to prescribe sore throat ampicillin before your midnight poetry reading.

Hospital layoffs: Metrohealth Medical Center (OH), 270, Reading Hospital (PA), 106.

The former IT director of a Houston non-profit organ donation center pleads guilty to deleting its electronic data (including backups) after she was fired in 2005. She’s facing up to 10 years in jail.

Where will this fit in the PHR and financial responsibility market? Quicken Health Expense Tracker, a free, Web-based tool available for customers of a few insurance companies.

Number of hits Googling “swine flu”: 263 million. Number of deaths of US citizens from it: zero. Value to TV stations, newspapers, and J&J, the makers of Purell: priceless.

EMR vendor MedLink International says it has signed a deal with CBS Radio to develop what it seems to think will be a WebMD competitor, a revenue sharing portal tied to six New York affiliates of CBS (formerly Infinity Broadcasting, currently in near-collapse after Howard Stern left for Sirius). Unlikely. In the mean time, the one to beat might be Everyday Health, a mashup of several other sites that bought Revolution Health’s old site and draws more traffic than WebMD.

Odd: an illegal alien who gave up custody of her severely brain-damaged four-year-old daughter while fighting a drug charge and being evicted for not paying rent is fighting deportation and trying to regain custody. The daughter is a citizen since she was born here; at stake is the potential multi-million dollar proceeds of a lawsuit against Vanderbilt University Medical Center, which the mother claims caused her daughter’s problems by puncturing a vein.

E-mail me.

 View/Print Text Only

The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

Do You Have What it Takes?
By Ed Marx

I landed on the bottom of the ocean, staring up at the surface. Before I could process what happened to me, I was ripped out into the watery abyss. I paddled toward the light, broke through, and gasped for breath. Only seconds before, I’d been standing high upon a rocky outcropping along Kauai’s Na Pali coast

Spring Break of ’88 began well. Free tickets to Kauai to visit my in-laws and introduce them to our baby boy. During his grandparent cuddle time, my wife and I made our way down Kauai’s north shore to get an intimate look at the magnificent Pacific. We took advantage of a photo op before heading back up the lone path. I stood at the edge of the rock several meters above the ocean surf. I smiled, said “cheese,” and a second later, we were both overcome by a wave that took me out to sea.

Bloody knees, winter surf, rocky shoreline, I was in danger. Swimming parallel to the shore while outmaneuvering the breakers was not easy. Pummeling waves and the force of the undertow zapped my energy. I was scared. Gradually working my way closer to shore, I prayed the waves would not crush me against a wall of boulders lining the island. Three to four people met death that way every winter on Kauai. After much prayer, my feet touched solid ground. I scrambled up cliffs before the tide reclaimed me.

Although I’m an active tri-athlete, I’ve purposefully avoided the ocean. I’ve tackled lakes and rivers but never the open sea. I’m still afraid. Then an opportunity opened up for me to race in one of the sports foremost events, Escape from Alcatraz. I considered passing it up but instead said yes. If I didn’t face my fear, it would own me. On June 16, I hope to make swim way across the San Francisco Bay, avoiding all sharks and undertows.

I once feared public speaking, too. Now I love it. Despite a familiar nervousness that arises before each gig, I press on. To practice and hone the skill, I now look for speaking opportunities.

I feared challenging business peers, respectfully, of course. After I overcame that, I conquered a fear of challenging my managers. Iron sharpens iron, as they say. We experience growth by pushing each other onward toward a greater purpose.

Many who feel “stuck” in their careers are likely limiting themselves out of fear. Are you afraid to rock the boat? Do you comply dutifully with every request even though you know a better way? One way to accelerate your career is to continually pursue growth; second, is a willingness to combat fears—not letting the own you.

Do you fear getting fired for speaking up? How about being wrong or laughed at? I’ve been there, too. Others fear success and the additional performance expectations that come with it. Embrace your fears. Confront them. Then experience freedom.

One of my present fears is dancing an entire song with our Argentine Tango instructor. I can handle learning an individual move, but the pressure of a complete dance with an expert just kills me. I sweat. I forget how to speak. I even forget the move we just learned. But I’m smart enough to understand that unless I tackle this head on, my skills will not grow beyond what I know today. And that is unacceptable. I won’t tolerate complacency. You shouldn’t either.

Reflect and write down your fears. Be brutally honest with yourself. Then attack them one-by-one, with purpose. You will be amazed at the results. And I’ll bet you’ll find you’re not alone. Not only will you grow, but so will your family and employer.

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. (Use the “add a comment” function at the bottom of each post.) You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”

 View/Print Text Only