NYTimes Magazine travelogue photos (Shinrin-yoku, and take a breath)

from NYTimes

Is this goofing off, or is this about personal resilience? Like the idea of “forest bathing” (youtube) or shinrin-yoku, I seek out opportunities during the day to pause and reflect, and walk where there are trees. Sometimes this ends up being an online article with lots of nature photos 😦 .

Hey, you do what you can.

The photos from this travelogue are pretty amazing.

And, did any of you watch the movie “Crazy Rich Asians”? The skyscraper-top boat-like structure in Singapore is apparently an Infinity Pool and is REAL (see the background in the photo at the top). Gotta put this on my bucket list.

CMIO’s take? Harken back to the tripartite model of physician burnout and resilience: a) develop a culture of wellness, b) work on improving practice efficiency and c) work on personal resilience. And ‘forest bathing’ belongs firmly on this list. Take a moment.

I’m excited to for 50th grade! (Re-inventing myself, via NYTimes article)

This is brilliant. Kids re-invent themselves each school year.

As a parent, I see my kids reinventing themselves every school year. They’ve gone through their Lego phases, their sporty phases, their drama phases, their communicating-only-via-eyerolls phases. 

Mary Laura Philpott, NYTimes

Why not, us, as adults? What a great way to encapsulate the neuroplasticity of our minds; we do know that our brains do not stagnate in adulthood, but continue to mold and change:

https://blogs.scientificamerican.com/talking-back/new-clues-to-just-how-much-the-adult-brain-can-change/

So, why do we continue on in our jobs without considering the annual-beginning-of-school-year re-invention? Remember in medical school learning Prochazka’s Stages of Change model: how our patients who smoke would go from Pre-contemplative to Contemplative to Preparation to Action to Maintenance? We see this in EHR adoption. Or perhap some go through Kubler-Ross’s stages of grief. OK, however you slice it, perhaps we do each need time and space and permission to “start fresh.”

CMIO’s take? I’m excited to be starting 50th grade! How about you?

Time management regret? (NYTimes) Work-life (im)balance? Start now.


We can all benefit from reminders. And self-forgiveness. And taking a single step, (or creating the “next action”) as David Allen says in his book “Getting things Done (book summarizing video).” Atomic Habits (book summarizing video) is another book with similar suggestions. There are a growing number of books, articles, videos dedicated to this topic; go ahead and explore. After all, the ancient Chinese saying is: “The journey of 1000 miles begins with a single step.”

We are all burdened with too much work and too little time. If we are not careful, our work overwhelms other parts of our lives and we lose balance. I struggle with this myself. It is helpful, then, to have a quiver of tools to deploy in the moments when your self-awareness kicks in: “whoa, I’m out of balance; I missed my kid’s field hockey game, or that school event, or the dinner with my family.” Or maybe all of the above. 😦

In these moments, as the article suggests, break it down to ONE action.

  • Forgive yourself. Move past it and commit to behaving differently NOW.
    Self-disappointment gets in the way of personal progress.
  • Do ONE thing. Leave today, early enough to go exercise, for example.
  • Find a SMALL thing to change. “Managing time” is a huge monster, but getting THIS particular project started involves finding THAT one phone number. There. That’s progress.
  • Read a book about process (This works for me, instead of doing better, read about doing better, maybe implement ONE idea from it, and rejoice. As you read more and pause and reflect more often, you WILL find more opportunities to change or establish a new habit. It is okay if this takes weeks, months, years, decades. We are all works-in-progress.)
  • Set yourself a task for teaching Work-Life balance. Nothing like see one, do one, teach one, like we did in medical school. Or worse yet, don’t even see one or do one, but figure out how to TEACH one, and that forces you to examine yourself and pay attention. (Speaking of which, come to the CMIO Leadership Academy where I’m going to be teaching … Work Life Balance). Hilarious!

CMIO’s take? Having trouble managing time or really getting started changing yourself? Break it down into a small “next” action. Read the article. Watch a YouTube video. I’m surprised at home many authors now offer their best ideas on video or in short articles. Are Books “so last century”? Maybe so.

Why we still love tech… (WIRED)

Detail of a Monet. Captures the wistfulness of this post…

https://www.wired.com/story/why-we-love-tech-defense-difficult-industry

Paul Ford is CEO at PostLight and recently wrote an impassioned “Proudshamed” reflection on his career growing up with tech. I resonated with a lot of it, as CMIO with responsibility to improve the digital lives of our patients and our physicians.

737 Max software lessons – a critique for EHR (IEEE news)

https://spectrum.ieee.org/aerospace/aviation/how-the-boeing-737-max-disaster-looks-to-a-software-developer

Photo: Jemal Countess/Getty Images from original article above

I watch the airline industry as both a beacon towards safety culture, and also as a cautionary tale of “there but for the grace of God, go I.”

This article from a software developer with intimate knowledge of engineering, software and design principles, rips the 737-Max experience apart in a way I have not read in the broader press.

CMIO’s take? As a CMIO with responsibility to improve the implementation and design of an EHR that influences the lives of millions of patients, such lessons are humbling, and instructive. Read the article. Think of how each of us plays a role.

Are you pro-friction or anti-friction? (NYtimes: Is Tech Too Easy to Use?)

I love articles like this that challenge long-held assumptions. For decades, “everyone knows” that technology is too hard to use, and we have spent countless hours designing “frictionless” interactions. Look at books like “Don’t Make Me Think.” As a result, we’re so enamored of our devices, that we prefer to answer the ‘buzz’ of a notification or spend hours developing neck cramps looking down, instead of interacting with our fellow humans, our friends, our loved ones. The pendulum has swung too far. But does this hold true in healthcare? After all, the article states

“No one wants a doctor who prioritizes speed over safety.”

I think our answer must be more nuanced, and less of an epigram.

  • When EHR’s are hard to use, YES, frictionless is an important goal, so that doctors’ intent can easily translate to correct action (order the right prescription, the right test, assemble the important medical data for good decision-making)
  • When computer-generated alerts are important, frictionless MIGHT be a problem: in some parts of our EHR, doctors have learned that pressing “escape button” twice, will bypass the alert, without having to read and respond. In this case, frictionless is NOT good.
  • In those borderline cases, where SOME thought is necessary, but there appears to be a BETTER choice in the vast majority of cases (we use the 80/20 rule, so-called the Pareto Principle), we design the alert so that the EASIEST thing to do is also the right thing (something that Staples made famous with their EASY button)

CMIO’s take: Friction, frictionless, Easy Button. Do you have any stories about designing the future of healthcare IT?

Seeing a black hole (NYTimes) is astounding

We are all involved in our little lives, our noses at the grindstone, making a living, trying to make a difference. Sometimes it is worth looking up … wayyyyy up, and see that fellow scientists are hard at work expanding the edges of our knowledge. We have known, based on Einstein’s theories, about black holes, believed in their existence based on indirect evidence from light bent around massively heavy objects. I had never heard of Sagittarius A*, the name applied to the mysterious unseen object at the center of Milky Way, but apparently we’ve been able to track large stars that slingshot around an unseen object with the mass of 4 billion suns(!) and have named that entity Sagittarius A*, and believed it to be a supermassive black hole. Wow, the theories we can craft with the puzzling evidence from our telescopes.

Of course, we still have NO IDEA about such things as Dark Matter, a theoretical construct we need in our understanding of how galaxies stay together (there is not enough matter in the ,mutual gravitational attraction of visible stars to explain why a galaxy spirals and stays together), or Dark Energy, another theoretical construct we need to explain why galaxies are moving moving away from each other at an ACCELERATING rate, when they should be decelerating due to gravitational attraction? Is it like Dark Fiber, those unused cables of internet connectivity? (No) or Dark Mode in the Mac operating system? (No)

And now, this, an actual image of a massive black hole at the center of galaxy M87. We finally see what Einstein saw in his equations half a century ago. Cool beans. Einstein rocks.

CMIO’s take?