Healthcare Reform: Things they should teach our doctors in med school.

 

Foreword: This article was kept back for quite some time until today for the reason that it might cause a stir among many of our business partners, affiliates and a handful of close friends. I do not intend to discredit the medical profession in general nor embarrass anyone. My sole intention is to let them know that they should put people first above all before themselves.

 

Quality healthcare is one of the very basic benefit every Filipino should and always have. Yet, even those who have and can afford, cannot truly appreciate health care in its true sense of the word. I'd say, much of the problems in service delivery  lies entirely not our government or the system but from the principal drivers of health care - the doctors.

I have listed some common and very annoying habits that doctors do or doesn't do in the practice of their profession and what med schools should teach to our young graduates.

 

1. Respect other people's time.

Have you ever seen a doctor who came in for work on time? Probably there are but in my experience 9 out of 10 doctors never make it on time. What's even more disheartening is the fact that people graciously accept doctors' tardiness. No one expresses anger or disappointment whenever the doctor come in late for work. Instead, they are greeted with respect and reverence much like greeting a priest in a confessional. Also, our chronically tardy doctors were given 'safe passes' or 'blanket' acceptance for such socially unacceptable behavior. It's high time that we should express to our doctors that our time is equally important as their time and that there are no excuse good enough for disrespecting our covenant of properly keeping time.

 

2. Always consider patient's financial capacity.

The cost of health care including diagnostic tests and medicines are steep these days most specially with the advancement of very modern medical technology. Ever wonder why doctors prescribe too many lab tests and not even ask if we can afford to pay for it? In retrospect, doctors should always qualify the financial capacity of the patient to pay for medical bills and that procedures should be conservative and given in accordance to patients' economic status. In other words, before an expensive procedure is to be given to a patient, a low cost alternative must first be considered unless extremely necessary.

If it may help to understand, doctors get as much as 15% to 30% percent (commission) for every laboratory referrals they make to private laboratories. The more referrals they make, the more income they generate - that is how the 'game' is played. Sad but true, there are no prevailing health care standards placed by our Government to better monitor and manage medical practice, much like an ISO for the manufacturing industry, and so doctors are left to do basically anything they want without being accountable for anything.

 

3. Give what is due to the Government.

Doctors make poor businessmen. A dishonest businessmen at that. In fact, they don't consider their practice a business at all; probably another excuse not to give official receipts and being chronically tardy. Doctors don't declare how much patients and money they earn for medical consultations. Doctors don't declare their commissions or referral fees they get from private laboratories and hospitals. Doctors don't declare cash gifts and bonuses. And, doctor's refuse to deduct taxes from services rendered to insurance holders. Well, if there is anything these doctors want to deduct from, it probably is their obligation of service and charity to their countrymen.

 

4. Stop asking favors.

We are in the business of health care and, part from being that, we hire doctors to manage our clinics. If there is truth to what our medical director once said that: "doctors need medical reps for conference sponsorships". Is it really a need or just merely a want? I pity the medical reps these days for they are reduced by these doctors to become their personal sponsors for conferences and even their dinner parties. This is one major reason why our medicines are among the most expensive in Asia because of the representation costs incurred by drug companies to these doctors. Yes, your doctor is the reason why they are expensive.

 

5. Work with the system.

Many doctors always seems to feel that they are always a cut above the rest. This probably stemmed from long and expensive education that they feel they should be given special treatment. Thus, being socially placed above the pedestal, they feel that they can work their best if there are less rules to follow. Rules that particularly govern their professional practice.

I can vividly remember when we first installed our first medical director to our chain of medical clinics and discussed on house rules and policies, they (the doctors) started feeling very uncomfortable.

 

The practice of medicine has changed dramatically over the years most specially with the advent of modern medical technology. We were able to probe deeper and understand primary causes of diseases and how we can protect ourselves from them. But, despite all the advancements, some basic yet very important things hasn't changed and that is how our modern shamans (doctors) practice their profession for the sake of science?

That Crazy Horse

That crazy horse! I think about it a lot these days.
Missing the sulky and misguided adventures, that
brought me in countless pits of dangers and mindful follies.
She was a foolish ride no doubt, but fun nonetheless.

Since that dusky hour of our depart,
immediately I felt the weight around my waist.
Dragged and lost into lands unfamiliar;
land of virtual peace and love. So they say.

That crazy horse may be truly crazy.
yet brings the warm glow of youth and,
the liberating but wondrous joy of unpretentious mind.
With this I say, I want to break lose and find my crazy horse.

Physician House Calls : Reviving an Old Practice to Modern Communities.

When was the last time you remembered a doctor visiting you in your home and see how you are doing? I was fortunate enough to have such personal care when I was still a young lad, that kind doctor was our neighbor. From that time forward, going to the doctor's office was really somewhat a luxury. It is since I don't have much time to spend and wait in line for doctors that always come in late for work .

In cases of medical conditions where you need to urgently see a doctor at wee hours of the night, where do you go? I cannot go to OPD section since they close at night. So I am left with no choice but to endure the steep cost of medical care in the Emergency Room, even if my case isn't an emergency.

We in the health care insurance business recognize the this serious flaw in the delivery of health care services to our countrymen. More often than not, the HMOs shoulder most of these unnecessary expenses incurred thereby increasing their utilization.

Being fully aware of this situation, KAINOS Health Management, Inc (our company) has come up with a simple plan that isn't really new at all; but a long gone practice - physician house call.

Yes, we believe that genuine health care should be patient centric and that, a personal and convenient approach is necessary at all times - even at night. Providing house calls is a very welcome convenience most specially for parents who have not enough resources to visit the nearest hospital or can't wait until morning to consult a very tardy doctor.

Visit our new program on our company website at www.kainoshealth.net to learn more.

The Folly Of Action Group Meetings

I was the host tonight of a BCBP Action Group Meeting which we hold once every week to different households of each member couple. It is a fellowship community where my wife and I recently joined to worship Christ and commune with other members as well. Yes we had the usual stuff of studying the Bible and of course the personal sharing.

When the sharing started based on the reflections we had on a verse from the Bible, my wife and I had only a little over five minutes to say our part because the other couple took almost an hour to say their piece!

After the session, the host will normally serve food for the guest and we did. Since I am the host, I thought I will have the opportunity to share more and run the group's conversation. Unfortunately, that didn't happen. I was almost quiet that evening because their 'chit-chats' never seem to cut and it's difficult getting in between their conversations. I however tried to manage my way twice to get through and start to say my piece. Yes, they stopped and listened for a few seconds then they just smiled back. Immediately after that, they shot back and continued on  as if I did not talk at all or I wasn't there. I was not even asked for my opinion.

Sensing that it was hopeless for me to join their conversation, I just retracted and kept silent the whole night. Now, how is that for a group sharing?!

My advice:

I have only few advices to give to these people and I know it's not that difficult...

1. that they should listen more than they talk,
2. give time for others to talk,
3. and, be kind to the host to run the show - it's their house anyway!

I'd say that this is complete disregard and therefore disrespectful to my authority as a host. I felt that my house was turned into a cheap restaurant and I am the waiter!

With this, I am very,very disappointed. Sorry guys.

Half Past Eleven

One day got infuriated by something and someone who isn't worth mentioning about now. These words just came spewing out like a dormant volcano rumbling and throwing rocks of angry words. Nope that volcano hasn't erupted yet, it will soon be and pressure is building up fast.

These I write ...

 

A self-righteous man is a self-centered one who

thinks of himself as all knowing and blameless in all his

hideous acts.

~~

He who does not accept personal shortcomings

has a very short memory and lives a life as short

as what he can only remember

~~

An agitated man never seeks the

company of peace, but rather digs

himself in the graveyard of loneliness.

~~

A man who claims perfection is

himself living a less-idyllic life.

~~

Anger only reaps resentment. It's perilous

path leads to unfathomable depths of destruction,

loneliness and regret.

~~

A leader with a broken moral  compass,

leads a pack of sheep into a rocky cliff of

what he claims a promise land.

~~

A well guarded thought and tongue is more

respectable than one who speaks

folly and vile words.

~~

When do you say it's over?

When do you say it's enough?

When do you say you can't?

A quiet man never speaks a word about it,

nor moves a hair but

shows when he disappears.

~~

A true man's value can be appreciated

only abundantly when there is

less of him available.

~~

Great destruction can only come from

the least of them all.

~~

A proud man never learns to accept defeat

but when defeat is inevitable, he in turn blames the

world for his miseries.

~~

In the eyes of a proud man, he is blameless

and remains that way until all sight is lost.

Initiating an Almost 'Paper-less' Office

I work in a health care insurance industry and in this business, paper works are undeniably enormous and quite unsightly too. Though the initiative of doing 'paper-less' has been floated before, no real plans were laid out and no real participation by the management has been committed.

We all clearly say that doing 'paper-less' provides many potential benefits, and cost is one of them. Whenever people encounters challenges on implementing this program, all of a sudden they withdraw and not talk about it. True enough, it is very challenging - so this is where the fun and excitement begins!

When we talk about a 'paper-less' program, it is synonymous to using a special software to manage all paper works for distribution and storage. There are many softwares (aka Document Management Softwares - DMS) available in the market but many of which are insanely expensive and will surely make you lock-in to their service - that is something we do not want of course.

For several years, I have had the opportunity to work on several different DMS's and I would say there are many good ones out there as there are many bad ones too. One thing to consider as well is the company that makes these software and we wanted to make sure that they will still be there even after two decades of use.

What are the qualities of a good DMS?

A good DMS must atleast have the following properties:

• Easily accessible: All employees must have a ready access the uploaded documents for retrieval and review so there will be no physical distribution of documents that will eat up their desktops.
  
• Sharing: Uploaded documents must have the capability to share it with others based on the privileges provided by the owner of the document.
  
• Accountability: This is done in two ways: 1) version control to monitor all changes made by every single user and, 2) document permission to set security restrictions to every document.
  

GoogleDocs & Spreadsheet - A good way to start.

To give you an idea on how our office is setup, we have 60 plus employees both in our insurance business and medical clinics which are located in other parts of the city. Yes, papers are used a lot so my challenge here is to significantly minimize paper usage as much as possible if it cannot be remove at all. Since we are using GoogleApps platform anyway (thank goodness for that), for our email, calendar and instant messaging service; we might as well maximize all other services like using GoogleDocs & Spreadsheets as our Document Management System (DMS).

Implementation Plan

Sometimes, the only best option to make a plan like this successful is not to give your employees any other option. ;) Really! Believe me it works all the time. Below is my way of implementing an almost 'paper-less' office:

1. Make a memo to everyone concerned telling them about your plan and when it will be effective. The schedules of training, transition and implementation must be clearly stated to avoid potential conflicts in the future.
   
2. Create a simplified guideline and policy regarding this initiative. This will help the transition to paper-less easy for everyone to follow.
   
3. Provide training sessions and learning resources. Since most of the things they need to know can be found on the Internet. I provided our employees links to videos and interactive tutorials for them to study. training sessions are provided only if there are some advanced questions to be asked. Doing this saves time and effort on my part.
   
4. Remove all MS Office or Open Office applications installed on every desktop. This will ensure that all employees will be forced to use Google Docs and Spreadsheets and that these documents will be saved in Google servers.
   
5. Disallow document saving in any local hard drives or USB drives. This ensures better security and protection in cases of theft, calamity or virus attacks.
   
6. Provide regular review and feedback sessions to measure success of the project plan.
   

I have given my staff relatively three(3) weeks for the transition. With that, I think that is ample time for them to adopt to the new system.

How are you implementing yours?

Me, My beer and the Sinulog Festival.

Oh yes, it's that time of the year once again where people flock and stroll around the City 'til early morning the following day - the Sinulog Festival. Quite honestly, I have outgrown this event and wanted to stay as far as possible from loud noises and heavy traffic. However, I've got two 'jumpy' kids who are very excited to get a tattoo and watch the street dancing.

So in preparation, we got all our things packed for a sleep over at our office (Jones Avenue) so we won't need to worry about waking-up very early in the morning for the Sinulog.  We also went out for a dinner with a couple who has been my long time buddy since high school and shared a nice chat and laugh with his wife this evening.

I guess, I would probably enjoy Sinulog more if my wife isn't with me all the time. If given the chance, I would probably sit on some small bar and drink, get to know people and have a good and nice chat. Or probably sit on one corner and just watch the parade pass by and enjoy my quite time alone. But then again, it's just me wanting some time off alone sometime.

;)

The Troubled Global Economy: "In Greed We Trust"

 

The year 2008 as many of us are aware, unless you are living in some remote timbuktu, that we are in a very serious global economic crisis. Banks failing and closing down, unprecedented job losses, and fear of uncertain future is slowly becoming a reality. Many says, it stemmed from too many bad loans from the housing and banking industry thus, the credit crunch. To add more insult to injury, Bernie Madof (once called an investment guru) has successfully built the largest Ponzie scheme probably in the entire history of humankind. He made people believe that their money was safe and growing but, wasn't really there.

Fifty billion dollars, all gone by just ONE man!

With this we asked ourselves, how can a very strong economy like the US, likened to titanic in pride, strength and might; be sinking in deep, cold and lonely waters of debt? Haven't they learned from their 1929 experience or do they just have a very short memory? Complex as their economy may be to balance their worksheet, their economy will even become more sour unless people start changing their mindset about themselves - that the world does not revolve around them!

The American economy is built on the capitalist principles of buying and wanting more. For them, the seed of economic growth is not providing the needs, but feeding every individual's urge of wanting more. You wake up everyday and you see endless ads and commercials on the roads, radio, TV, internet and virtually everywhere. Capitalism has successfully found and capitalized one resource that is virtually unlimited in supply, and that is GREED!

And also because of greed, the capitalists invented a tool to suffice their endless wants - credit. People started buying on credit more than what they can pay for and splurging to their hearts desire until more credit is needed. This went on for years until the bubble has finally bursts.

Such misfortune is very embarrassing to many Americans, it simply blows their PRIDE and cannot accept the fact that they are in deep, deep trouble. To save face, they are minting more money out than ever before in the hopes it will stimulate their economy once again. The sad reality is, they are just passing the buck to their children and their grand children so they don't have to worry about it now.

If I am to put a mathematical formula on how we all got into this mess, I would simply expound it into this very simple notation:

                          (Capitalism + Greed) * Pride = Trouble

From this point forward we ask ourselves, where will it stop and when will it end? Is Capitalism the culprit of all these? Is it all the fault of Allan Greenspan? I say, this is all a case of GREED and PRIDE. Since we are all in it together, I guess it is but prudent to "grab the bull by its horns" , accept the consequences and not pass the buck to their children.

This is where I leave my message for you to reflect and understand how we can fix the problem and prevent it in the future. There is no quick and easy fix to this. So we all better brace ourselves for the very rough road ahead and pray to God for forgiveness and comfort.

A message to all Americans around the globe.

Today, November 5 2008, mark a very historic day not only to Americans but to humanity as well. A moment where all of us join hands to celebrate the triumph not only of one person but to all who to fought for a real change in American politics and governance. People who fought that every single individual is important no matter what family, racial or economic background one came from - every single individual can make a difference.

I am not an American but this is what President Obama , for me, came to represent - hope, patience and equality. This changes my views on the Americans in general and the Americans of the future.

Congratulations to President Barack Obama. Congratulations to all the Americans around the globe!.

From Cebu, Philipines - we care!

Would you buy anything made in China?

I wouldn't, if I have a choice. Almost everything we use on a daily basis are now made in China. From toiletries, car accessories, office supplies, computer parts, children's toys to a whole lot more - everything is made in China. I wouldn't have a problem if it is made in some Timbuktu as long as they are of high quality products and manufacturers are trustworthy.

What is this new controversy (see news) where milk formula made in China are tainted with melamine? Melamine on milk formula for babies? Melamine are organic compounds use to manufacture floor tiles, fertilizers, white boards, retardant fabrics and commercial filters. Several hundreds of babies (reported so far) who fed their babies with milk formula Supplied by Sanlu Group Co., have dies because of this. Many of their milk are now exported to several countries namely Taiwan and some other unnamed countries.

Protect your babies. Protect your family. Never trust and buy again products made in China.

LHC: The Ultimate "Killer App"?

  

Yesterday marked a very historic moment to mankind. We finally have THE machine to understand how the stuff of everything are made of and how it all began. It's the grandest celebration not on what we have built, but our CAPACITY to seek higher learning on the very fundamental laws of nature and build things to achieve such knowledge.

We have built the most expensive experiment that requires the very brightest minds around the globe to answer the very basic question. Many doomsayers  says this will definitely be the 'killer app' that will bring mankind to extinction or that mankind will destroy our galaxy by creating an uncontrollable blackhole. Is this the end of the world? I'd say it is not!

The end of the world will dawn upon mankind if our quest for learning dusks. This is precisely the reason why we as mankind evolved to be a superior being and ruled over for thousand of years. Our quest for learning is what makes us human everyday.

JCAHO: The "Big Brother" of Medical Practice

I remembered a few months back when my brother told me that one of the major hospital in the city here in Cebu was threatened by an immediate drop in hospital admissions. Something very unusual for them since they are always flooded with patients at any given time. All of a sudden, as what my brother described the phenomenon, the emergency receiving area became a "ghost town". Orderlies are lining up outside waiting for patients!

What brought about this phenomenon? As it turns out, many of their hospital doctors has somewhat "unionized" and started referring their patients to other hospitals of their affiliation. What sparked the sudden outrage of these doctors was due to the hospital's initiative to adopt JCAHO practices. As a consequence, other hospitals within the city suddenly had an unexpected surge of patients while the said hospital had very few. So what is JCAHO? Why are doctors in that hospital intimidated and even caused outrage to move their patients out?

 

What is JCAHO?

JCAHO is an independent, not-for-profit organization, The Joint Commission accredits and certifies more than 15,000 health care organizations and programs in the United States alone. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

What is JCAHO's Mission?

To continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations.

What is the scope of JCAHO?

The accreditation programs of JCAHO includes: Ambulatory Care, Assisted Living, Behavioral Healthcare, Critical Access Hospitals, Home Care, Hospitals, Laboratory Services, Long Term Care, Networks, and Office-Based Surgery.

 

Isn't this good for all of us?

The answer is a resounding yes! However, (in my opinion) doctors are threatened because of the following reasons:

1. Standards: When doctors work in a JCAHO accredited hospitals, part of the policies that they are expected to adhere is the set standards by JCAHO. This means that doctors cannot just confine patients, request lab workups or procedures unnecessarily. Thereby, controlling healthcare cost incurred by he patients. This significantly controls the doctor from having malicious agenda of giving so many procedures and confining them unnecessarily just to earn more. This is true and this is rampant.

2. Peer Review: This time around, doctors practices are meticulously reviewed for proper patient management. They are under a watchful eye of hospital appointed committee (like the "Big Brother") and reprimand if any violations are made, be it procedurally or behaviorally.

3. Performance Evaluation: With our current healthcare practice, who determines if the doctor is effective in patient management? Does the doctor himself even know he/she is efficient and effective in delivering healthcare? I bet he doesn't. We consider doctors as modern day Shamans and would want to remain that way! JCAHO has toolkit for medical practitioners in the form of performance indicators. It is performance metrics program where all their patient management activities are measured, quantified and analyzed. The output of the report provides a grade. Just like how hospitals under JCAHO are graded from 0 to 100.

4. Full disclosure: Doctors are also expected to fully inform and disclose all activities that will be done to the patient, its outcome, and medical errors (if any) - blag! Doctors are human and they commit mistakes but they are not honest enough to tell you they made a mistake for fear of litigation.

My thoughts:

We don't anymore live in the middle ages where the Shamans are the only people in the know and not even question their authority. Doctors have enjoyed that position for a long time and at most at the expense of patient safety. JCAHO's basic tenet is patient's safety. Nothing more and there are no hidden agenda to this. Bottom line here is, doctors don't want to be controlled or a "big brother" watching over their shoulders. It just annoys them to think that they can be kicked-out of the JCAHO accredited hospitals or worse, sued for medical errors by their patients.

The "Kung-Fu Panda" Wisdom

One Sunday morning, I turned to watch a DVD movie with my kids and they were all very ecstatic when I flipped open the case entitled Kung-Fu Panda. We all gathered around as we watched.

I never expected that I will be having so much fun watching. My two kids were so glad to see me had a wonderful time time as I laughed and laughed until the movie ended. Yes, it was somewhat a rare sight for my kids to see me like that - laughing aloud. What came so surprising to me was that the movie wasn't just an action-flick "eye candy" animation, it has some real lessons that made me stop for a while and think. Let me quote some nuggets of wisdom I took from that movie:

"One cannot see beneath an agitated water, let it calm for a while to see through it clearly..."

My interpretation: Man cannot make sound judgement when his mind is clouded with emotions. It is always wise to step back, take a breather and and confront when all is calm and cleared out. It is always easy to get agitated most specially when you are most responsible, but it is even more easier to make mistakes when decisions are made on such state.

"There is no such thing as a sacred scroll. There is only you."

My interpretation: When our minds are made to believe on something that isn't true, and we work and focus our energies towards something we believe is true. We eventually become the truth.

In summary: Our mind is truly a wonderful thing. It is a jewel and the seat of all emotions, ideas, reasoning, and spiritualism. We hold the power to make all things possible if we will it to be. Find inner peace, if we search for it. And believe that there is nothing "out there" but just us and our infinite mind. (not sure about that)

The psychology of rumors and how it starts.

Let me quote a scholarly definition of what rumor is based on on a research entitled: Rumor and Gossip Research by American Psychological Association.

Rumors have been described as public communications that are infused with private hypotheses about how the world works (Rosnow, 1991), or more specifically, ways of making sense to help us cope with our anxieties and uncertainties (Rosnow, 1988, 2001).

Rumors are unsupported claim for certain occurrences and it is brought about by our mind's ability and eagerness to understand incomplete information. To make sense of things, we tend to "fill-in" the missing pieces and draw a picture from those.
To give this theory a test, say for example I ask you to fill-in the missing letters below to form a word. I will not say how many letters you need to "fill-in", or even if the words are related. Just fill-in and make sense of the following words based on your own understanding. Go ahead and give it a try and see if you can guess what I intend the word to be.

red, exciting, hot, f___k

I know what you're thinking but it's not what you think it is. Ninety percent (90%) of all people I asked answered UC between the letters given above and this has just proven my point. So what's is the answer? Read on.


So how does rumors start in the office?

Rumors can come only in two ways. One, from speculation (as with the exercise above) and two; intentionally manufactured stories often with ill intent. In most cases, it start with the former.
Rumors starts from an office employee seeing or over-hearing information that is incomplete and "fills in the blanks" according to what he or she thinks.
An office employee seeing someone on the records room (like the one pictured above) may understand the scenario differently, puts malice to it and spreads the wrong information around. So, before the day ends, the two staff who came from the records room suddenly gets the full attention of the entire company. Halaka!


My Advice: Rumors is as old and part of the human psyche. There is no way you can stop people from making wrongful speculations however, you can always stop and think first before believing. Remember, ninety percent (90%) of rumors are all wrong and are downright malicious.

ANSWER: f iretruc k (Gotcha didn't I?)

A Drive-In Church? What would they think of next?

This is something we don't see everyday - people going to church in their cars. But this isn't something very surprising nowadays since a lot of Catholics now attend churches in the malls and even in movies houses.

"take this cup as the blood of Christ..." in your Ferrari? These two couples doesn't look like lazy people to me, but they sure look very comfortable.

If you can spend for gas going to the church - surely you can tithe a little more than a dime. Clearly, America is still blessed even with high gas prices.

Until next Sunday pastor, how about Sunday school for my kids?

In closing, I just don't know what to say. Either people are getting lazier each day or becoming more anti-social. But it's definitely cool to have one like this here in Cebu! Hoorah!

What leaders ought not to be.

Having served the company for four years now, I had the chance to work with a colleague who has become an epitome of failed leadership. This experience has taught me a valuable lesson on what not to be when I take a shot as the 'main' man - the CEO.

This colleague has been like my shadow and knew him like the creases on the palm of my hand. I guess success has got in to him that much, and has become what he abhors the most - an elusive and misguided dictator.

I have outlined the qualities of this chronically doomed leader so it will be my heuristics on what leaders ought not to be.

Leaders ought not to be:

• a 'flip-flopper'. This is a quality of a person who cannot seem to make up his own mind much less, stick to the company's objectives. He seems to go in endless circles and people are tired on following his path. I don't know if he can see clearly that his men are very much frustrated on keeping up with standards, policies, and objectives of the company when he himself does not even recognize its value and keeps on bypassing them. For him there is only one and only one rule - his rule of thumb.

 

• self-centered and arrogant. He seems to enjoy a lot sitting on his laurels and continually strokes his ego by saying that the company and its people will be nowhere without him. While it may be true somewhat, but its just a small fraction of the effort. It's the people who support at the 'back door' that made the four corners of the business stable - not by an arrogant salesman with a tricky sales pitch up his sleeve.

 

• an all talk, but walking the talk. This guys talks a lot, and I really mean a lot! This self-righteous individual preaches like the Pope, and poaches like pimp at sunset. He always makes it clear and very adamant with all executives like me not to 'screw' around with any employees and yet he was the first to break the rule. Talk about true leadership.

 

• a coward. False leaders come in different forms and sizes. Many come in shining armors with the fiercest look and the sharpest swords. But when  the charging comes to confront the enemy he will sit at the back and let others cover for his sorry ass. At peacetime, his inspiring words are the only voice you'll here, but dead silent and non-existent on war time - probably hiding in the bunker you say?

 

• disrespectful. An arrogant man never learns to respect others, even of the same cloth. This is very evident on many of our corporate meetings when he tramples on the decisions of the CEO and discredits his capability as a leader in front of his subjects! Who now is more apathetic ?

 

• false sense of direction. His true 'north' is different from what is commonly accepted and wants everybody to follow his broken compass. I remember quite vividly saying that his 'barometer' for identifying  if the company is doing fine is if his one of his long time employee isn't making complains. If SHE complains, then that means there is deep trouble. This is like believing to a superstition - unbelievable!

 

• emotionally unstable. A mark of a true leader never gets 'budged' by emotions when making decisions. Leaders decides very objectively and squarely even at the highest tides of emotional situations. Yes, many and costly mistakes are made because of emotional instability.

This ominous character is what brought him down in the beginning and the same shall be his fate on the very last if he continually disregard the signs.

As for me, I have had it up to here - my brow line, and don't know how long I can take this. Honestly, I don't share his vision anymore because it's clouded. I don't share his vision because it's misguided. I don't share his vision because it's self-centered. What is keeping me afloat all these years is the people at stake. Much will be lost if I jump ship. I say, to whom I serve is not the driver that stirs the wheel, but the man who paves the road.

My Google Apps Wishlist for 2008

1. A better looking user interface.
2. Google Docs supports more formatting tools
3. Provides online storage facility
4. Webpage designer supports php scrips
5. Gmail tasks manager
6. Release JotSpot Wiki by early February
7. Has workflow manager
8. Has simple forms designer
9. A better start page
10. SMS messaging capability between Google Apps user
11. Offline mail, calendar, document and rss reader
12. Synchronize local files with remote Google Documents
13. Google docs can publish blog posts directly to Blogger and Wordpress
14. GMail signature is in html format
15. Has database designer. Default is postgresql or mysql
16. Has report designer.
17. Sales CRM is built-in to standard edition.
18. Lower user fees for developing countries. Like $US 12.00 per user.
19. Free 2GB hosting service.
20. Google Talk can broadcast message on selected group.
21. Google Apps has installable client software for Linux and Windows that can sync online.
22. APIs for email and calendar is provided for free.
23. A downloadable User's Guide Manual in pdf format.
24. Provide encryption capability on all data uploaded to Google 'cloud'
25. Google calendar can attach files as supporting documents.

KAINOS’ Managed Care Rules, Rights, and Responsibilities

Knowing your plan’s rules – and your rights and responsibilities under those rules – can help you make the best use of your KAINOS Healthcare Plan. It also can save you money and help you get the right care you need.

You get a lot of information about your managed care plan when you enroll. The member handbook explain the benefits – the kinds of treatments and services your plan pays for. Keep this material handy so you can refer to them when you have questions. Read the plan newsletter or our blogs, like this one. It keeps you up to date on any changes in your plan.

A health plan contract provides a legal definition of plan benefits. If you are in a managed care plan through your job, the contract may be between your employer and the health plan. You may need this if you have a serious problem with the care or services you get from your health plan.

The Rules

Your membership materials provide information about:

• Costs and Benefits

Find out which benefits your plan pays for and which it will not. Find out how much you need to pay (on programs requiring co-payment) for each doctor visit, for prescription drugs, and for medical equipment.

• Member Services

Find the telephone number for the member services department of your health plan. Call this number (1-800-1-888-6300) with questions about how to file a complaint, the health plan rules, costs, and benefits. Be sure to tell the member services department of any changes in your address, phone number, job or family life that may affect your coverage.

• Practice Protocols
  

See if your plan recommends doctors follow “practice protocols” or “treatment guidelines” for certain chronic diseases and other illnesses. These guidelines usually are based on standards of care set by medical experts. You are more likely to get good quality care if your doctor follows these guidelines.

• Out of Network Care
  

Know if and when your plan pays for visits to doctors and hospitals that are not part of your plan’s network. This is sometimes called going “outside the network.” You might need to pay all or a percentage of the doctor’s or hospital’s fee if you go out-of-network for care. Costs incurred during “outside the network” services are reimbursable only if it conforms to your subscribed healthcare plan.

Your Rights

If you know your rights, you can stand up for yourself and protect yourself from an unfair plan decision.

• Read through the plan materials for information about what you can do when your plan or your doctor makes a decision you don’t agree with.
• Talk with someone in the member services department to find out how to appeal a plan decision you feel is unfair. For example, how to appeal your plan’s decision to stop paying for your medical treatment.
• Your insurance/human resource department can tell you about laws that protect your right to health care in managed care plans. Your insurance/human resource department may help you file an appeal or reconsideration.

Your Responsibilities

People today take more responsibility for their health than they did 20 years ago. They are more active, eat better, and work as partners with their doctors. Taking responsibility for your health can mean a healthier and happier life. Here are some ways to do that:

• Learn healthy habits. You are responsible for what you eat, how much exercise you get, whether you smoke and following your doctor’s advice when you are healthy and when you are sick.
• Call any KAINOS affiliated doctors or your plan’s help line (1-800-1-888-6300) if you need advice about medical problems.
• Go to the nearest hospital emergency room if you have a life-threatening or very serious health problem. Be sure to call your health plan as soon as possible.
• Attend Health & Wellness Seminars sponsored by KAINOS. It’s a free service provided for members so take advantage of all the amenities available as much as possible.