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Dr. Maurice A. Ramirez is the founder and president of the consulting firm High Alert, LLC.. He serves on expert panels for pandemic preparedness and healthcare surge planning with Congressional and Cabinet Members. Board certified in multiple specialties, Dr. Ramirez is Founding Chairperson of the American Board of Disaster Medicine and serves the nation as a Senior Physician-Federal Medical Officer in the National Disaster Medical System. Dr. Ramirez has a new book: You Can ... [More]

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SAM - The Three-Part Process of Social Media Marketing
[Internet-and-Businesses-Online:Social-Media] Online social networking and social media marketing are the hottest new tools in the business promotion armamentarium. These tools are not only extremely effective for "growing the brand," but for advancing the reputations and careers of executives alike.

The 5 Steps of Social Media Marketing
[Internet-and-Businesses-Online:Social-Media] Entrepreneurs are using the newest internet trend, professional social networks. Services like LinkedIn, Konnects, Ecademy, Plaxo and even Facebook provide professionals the opportunity to meet and collaborate with colleagues worldwide. These professionals fall into two distinct groups who utilize social networks.

What Would They Say Today?
[Health-and-Fitness:Healthcare-Systems] Since 2003, multiple independent evaluations of hospital preparedness and hospital disaster planning have found the reality in each successive year to be far below that purported in 2003. A brief survey three reports by the Institutes of Medicine in June, 2006 serve as proof that any hint of hospital preparedness is false and that momentum towards preparedness has been lost. These reports, Hospital-Based Emergency Care: At the Breaking Point, Emergency Care for Children: Growing Pains, and Emergency Medical Services at the Crossroads found a disparity between self reported preparedness on multiple association and government surveys compared to actual preparedness measured across the five core indicators of hospital preparedness.

Where Did All the Doctors Go?
[Health-and-Fitness:Healthcare-Systems] In the fall of 2010, the gulf coast of the United States is again struck by a category four hurricane. Five years of planning and preparation swing into action. Hospitals, structurally reinforced to survive such storms, remain open and operational, serving their communities during and after the storm. State and Federal recovery plans assist displaced people return to home and even find jobs.

Fresh Eyes For Companies That Are All Heart
[Business:Management] Business consultants, financial consultants, business professionals, and even human resource professionals are well versed in streamlining day to day operation, supporting business processes in the face of internal and external adversities, and even in dealing with leadership issues. However when the issue is medically related and decisions regarding fitness for duty at the highest level of a corporation will may involve the review of highly sensitive personal and even devastating medical information, the most stalwart business people begin to shy away from the issue.

What is Your Safety Worth?
[Health-and-Fitness:Healthcare-Systems] In 1999, the Institutes of Medicine asked a simple yet profound question, "If you would not ride in an airplane flown by a pilot who had not qualified on a flight simulator, why would you allow a healthcare Professional to treat you who had not qualified on a patient simulator?" This question went virtually unanswered despite the fact that the healthcare community paid significant attention to other questions raised in the same Institute of Medicine report. It was almost as if by diverting attention to other issues and finding less expensive problems to blame.

Did We Ever REALLY Ask?
[Business:Customer-Service] Hospitals and their corporate officers live and die by customer satisfaction scores such as the Press/Ganey Survey and Harris Poll. The problem is that these "surveys" & "polls" are little more than "opt-in" commentaries. Scientific data shows that, regardless of industry, a dissatisfied customer is three times more likely to express their opinion than a satisfied customer. Given this fact, the healthcare industry standard "opt-in" model, by its very nature, should yield a 3 to 1 dissatisfaction bias. Given that this bias is not seen indicates that other, unaccounted for factors, are skewing the data.

Globalization and Generation Y
[News-and-Society] The international marketing firm Youngster recently reported that for the first time in history, the market group known as Generation Y, those ages 10 to 25, is evenly divided across each of its five age based subgroups. A short to ten years ago when Generation Y first burst on to the scene, the vast majority of Generation Y was age 10 to 14. This first wave of Generation Y influenced popular culture giving us nSync and Brittney Spears. The youngest segment of Generation Y represented over 50% of the group and they controlled the mass media market. In the 10 years that have followed, the early 10-year-olds of Generation Y became 20-year-olds filling out the top ranks of Generation Y. The relatively constant birth rate in the Western World resulted in an even distribution across all stages of the Generation Y. The expanding size of Generation Y has resulted in the dissemination of their influence not only through popular culture as determined by those younger than 18, but also the business culture that is determined by the most innovative in the technology field, those age 18 to 25. But, what impact will this have on globalization?

Entrepreneur Heal Thyself
[Business:Entrepreneurialism] As the practice of medicine becomes more and more the business of medicine physicians find themselves with an ever widening view of the market based world. Some physicians retreat into practices where they need "only practice medicine" and allow others to "deal with the business side." Other physicians choose to "take the bull by the horns" and manage their own enterprise. Others choose to diversify their entrepreneurial interests. The entrepreneurial life of running a medical practice is much the same as that of running a start-up business. The only significant difference is that a medical practice runs on a larger budget initially, but a smaller budget and profit margin later on. Non-medical start-ups usually begin with marginal funding and, if successful, grow as their income grows eventually reaching a point where their budget and profit margins are both quite respectable.

InstaDecision - 4 Steps to a "Blink" Moment
[Business:Strategic-Planning] The past months have seen a resurgence of interest in the ideals of "gut reactions," intuition and other versions of the insight methods described by Malcolm Gladwell in "Blink!" Business leaders, CEO's, physicians, disaster field responders, professional speakers and a business consultants use both linear and non-linear decision making (logic & intuition) to create "Blink" moments daily. Most people know the linear decision making process because it is cultivated by our educational system. It is a system based on the collection of data to support a decision (If A and B then C, but if A and not B then D). Few people realize that we are all born as innately non-linear thinkers.

Outrage or Enthusiasm - The Choice is Yours
[Business:Customer-Service] Businesses large and small want happy customers, happy employees and happy vendors. Regardless of whether a multinational corporation or a "Mom & Pop" store, enthusiastic supporters are a marketing asset while a single outraged person is a liability. Studies have shown that the average "satisfied customer" refers five people while the average "dissatisfied customer" finds 11 people to chase away.

xBox Education & PlayStation Process Enhancement
[Gaming:Console-Systems] Futurist and technology guru Dan Burres once observed that to play the average video game such as Halo or Sonic the Hedgehog, a child must learn and master no less than 70 new rules or skills. These 70 skills do not increase the player’s likelihood of success in the game, rather these 70 skills are the bare minimum to negotiate the first level of the game. What would happen if the much ballyhooed No Child Left Behind curriculum handed over to video game programmers and utilized as the rules, processes and systems of a series of role playing adventure video games? What if the same level of mastery of scholastic skills were required achieve success within the various levels of these games?

Death of the Dinosaur, the New Economy of Information and Process
[Business:Management] Since the inception of the industrial era, business has moved in what Bhatt has referred to as the "sell/buy" approach. In other words a business, corporation, or even street vendor offers products for sale and the consumer purchased them.

Katrina - Have We Learned Anything at All?
[News-and-Society:Weather] On this second anniversary of the disaster now known by a single word - "Katrina" all of us in disaster response look around and shake our heads. One year ago we saw misstep after misstep, failure after failure. As we look back over a landscape that is still scarred by the aftermath of flooding and looting to see both despair and rebirth we ask ourselves: Are we any better prepared today?

Another Anniversary Of 9-11
[News-and-Society:Pure-Opinion] The National Academies of Science recently concluded that hospitals fail to plan, fail to train and fail to integrate themselves into the community response plan. Terrorism can be mitigated, sometimes; but what happens when there is an unstoppable disaster?

Another Inconvenient Truth
[News-and-Society:Weather] The National Oceanographic and Atmospheric Administration (NOAA) has made several determinations of late confirming what most of us already knew, 2006 was the hottest year on record and 2007 is proving to be hotter yet. Global Warming activists and environmental groups have latched onto he sudden climate change since 2004 as proof that global warming is accelerating and that human generated greenhouse gases are the cause.

Another Season - Another Storm
[News-and-Society:Weather] We've all heard the predictions - Fifteen major Atlantic hurricanes are expected for 2007, five of which are predicted to impact Central Florida. Certainly, nobody yet has forgotten the four hurricanes that inconvenienced us in 2004, nor can we forget the three storms of 2005. But before we look ahead to this coming season, let's stop and take stock of the lessons we've learned from our most recent experiences and prepare our children for this year.

When Disaster Strikes - Are We Really Prepared?
[Health-and-Fitness] While no one enjoys disasters, they're a fact of modern life. If you think that you can't initiate such disaster planning in your community or company, think again. If average citizens start to demand disaster planning in their community, politicians will listen and will act. Hospitals will listen and will act. And companies of all sizes will listen and will act. So yes, one person can make a difference. And even though you can't stop a disaster from occurring, you can help lead the way for getting the planning in place that makes the disaster less disastrous for all.

Resilience, Communications and The Talking Dog
[Business:Workplace-Communication] Choke points in communications develop between organizations because information must funnel through the top to the bottom of the silo before it could be disseminated to the other members of each organization. Gergen and Marcus recommended that in business the silos be removed. By doing this, organizations could communicate risk, benefit and opportunity, relying on their unique capability to insure customer loyalty and market success.

Not If, But When
[Health-and-Fitness:Medicine] Given that the last major pandemic was the 1917/1918 Spanish flu this means that we can expect a pandemic flu outbreak between 2006 and 2013. It is a mathematical certainty.

The Greatest Show On Earth
[Arts-and-Entertainment] The audience was hushed as a humble ringmaster stood and announced that he would like to thank the troops, those serving in foreign lands, those serving here at home and those in the Orlando audience. Without fanfare the curtains parted and hoof beats could be heard. Like the Calvary of old, the single rider, galloped into the arena carrying our nation's flag.

Hunker Down Again!
[News-and-Society:Weather] It is 2007. It is summer. The sky is blue. The sun is shining again over central Florida and you are enjoying one of Orlando's beautiful spa and resorts. The kids have met Mickey and Minnie, Pluto and Donald, Shamus and every character in Universal Studios. You know because you have had to walk every inch of every park. As you nestle in for a much deserved evenings rest you turn on the Weather Channel and there before you are the two red flags with those ominous black squares. Hurricane!

Avoiding An Investment Disaster - Investment Triage
[Business:Venture-Capital] The question of feasibility is often couched in such phrases as ROI - Return on Investment; profit and loss analysis; and risk benefit ratios. Regardless of how we phrase it the question still comes down to feasibility. If the investor is fortunate enough to be well versed in the technology, language, processes, practices and preferences of the market then they are often able to make a reliable prediction of the feasibility of a venture seeking capital. However, if an investor takes a diverse approach to their investment portfolio then they must learn to analyze business plans in a fashion that allows them to determine if the conclusions drawn are applicable within the market of that venture.

One Great Solution For Improving Healthcare Preparedness
[Health-and-Fitness:Medicine] Our nation faces two interesting challenges when it comes to the healthcare response to disasters. The first is that according to an Institute of Medicine report published in June 2006, hospitals have by and large failed to meet even the most basic standards for disaster preparedness. In other words, they have failed to develop the relationships within their own communities, ignoring even EMS and community-wide Emergency Response Services thus failing to integrate these critical services into the hospital disaster plan.

Volunteering In Times Of Disaster, The Time Is Now!
[Health-and-Fitness:Medicine] Physicians come to their profession with a high sense of personal honor and a high sense of personal duty. It is these two characteristics that spur physicians to contribute time, energy, talent and resources in times of local, regional or even national disaster. Whether hurricane Andrew, hurricane Charlie, hurricane Katrina, hurricane Rita, hurricane Wilma, the terrorist attacks on the Murrah federal building, the World Trade Centers or the Pentagon, whether forest fires or large automobile accidents whenever the healthcare system appears to be overwhelmed physicians and other health care professionals find themselves spurred to action.

Redundancy, Business Continuity And Lessons For Healthcare From The Disaster Field Office
[Business:Continuity-Disaster-Recovery] The business world has learned several hard lessons over the past decade when it has come to the need to preserve business critical data. Words like "redundancy" and "continuity" have become the watch words of the Information Technology professional and the corporate CFO. The time taken to perform daily and even hourly computer back-ups is no longer perceived as a waste, but rather as time well spent. Where once computer sales people had to argue the benefits of off site storage, now corporate buyers demand such service compatibility.

Our "Sicko" Society
[News-and-Society:Pure-Opinion] Socialized medical systems certainly have their advantages for citizens of countries willing to live with different freedoms and different lifestyles than we prefer in America. A better system is out there, we need only have the resolve to find it.

Implications of NIMS Integration Plan For Hospitals and Healthcare
[Legal:National-State-Local] The Homeland Security Act of 2002 provided the authority for the creation of the Department of Homeland Security (DHS). It also directed the Director of DHS to create a National Incident Management System (NIMS). Published in 2004, NIMS formed the framework for detection, mitigation, response and recovery from manmade and natural occurring disasters, events and incidents of national significance within the United States, its territories, protectorates and Indian Tribal nations. NIMS provided the framework for the creation of the National Response Plan (NRP), also published in 2004. The National Response Plan is an all-hazards, all-agencies approach to the detection, mitigation, response and recovery from disasters, whether natural or manmade events and incidents of national significance. A little known provision of NIMS created a classification system for all disaster-related resources. This classification system, the National Resource Typing System (NRTS) provides a unified cross-agency, cross-jurisdictional means of classifying all resources that are or could be used in response to a NRP/NIMS event, whether these resources are equipment or personnel.

The Edge of Disaster - Managing Expectations
[Book-Reviews:Non-Fiction] Steven Flynn's recent book The Edge of Disaster has garnered the expected "inside the beltway" Washington response. Finally today a senior official at the Department of Homeland Security (no doubt in the Public Information Office) began to spout the company line and tie it to Mr. Flynn's book. Point by point the Department of Homeland Security and the Federal Emergency Management Agency (FEMA) again remind the American public that a federal response is always more than 24 hours away, in fact, usually 48 to 72 hours.

The Edge of Disaster and Modern Health Care
[Book-Reviews:Health-Mind-Body] Stephen Flynn's recent book The Edge of Disaster, featured on national public radio this week, describes a number of large scale vulnerabilities across the United States. His thoughts on pandemic flu, while certainly concerning, pale in comparison to the real numbers. Mr. Flynn describes 80 million infected with as many as 800,000 dying of the disease. However, a review of Avian flu pandemic over the last 300 years shows that one-third of the U.S. population or 100 million people will be infected.

The Implication Of Another Round Of Bombings
[News-and-Society] July, 2006, many awoke this morning to the news of a major Counter terrorism success. Conspirators in London were arrested for alleged participation in an apparent plot to blow-up an unknown number of American aircraft at an uncertain date in the not too distant future, perhaps even on the anniversary of September 11th.

The National Resource Typing System
[News-and-Society] The Homeland Security Act of 2002 provided the authority for the creation of the Department of Homeland Security (DHS). It also directed the Director of DHS to create a National Incident Management System (NIMS). Published in 2004, NIMS formed the framework for detection, mitigation, response and recovery from manmade and natural occurring disasters, events and incidents of national significance within the United States, its territories, protectorates and Indian Tribal nations. NIMS provided the framework for the creation of the National Response Plan (NRP), also published in 2004.

What Is Wrong With Continuing Medical Education?
[Reference-and-Education] Through any one or all of these opportunities, the physician who "dabbles" in speaking can be as good on the platform as the family practitioner who "dabbles" in office surgery. They will be competent. They will be self assured. They will have great outcome and they will know when they are getting in over their head. . . . When to ask for help.

The Gift of Resilience
[Self-Improvement:Stress-Management] December 29, 2006 was an amazing, exhausting 45 hour day. In the aftermath I had the opportunity first to take stock of everything that had happened, of how the corporations, companies, people and professionals and the resources of a nation come together to save one life. After the euphoria had dimmed the fatigue set in.

Bridge Collapse!
[News-and-Society] Last night's tragic collapse of 500 feet of road deck crossing the Mississippi river in Minneapolis, Minnesota at rush hour is yet another example of the fact that "All Hazards" includes more than just the natural disasters of hurricanes, earthquakes, floods, and tornadoes and it goes far beyond the manmade disaster of terrorism. With night falling and bumper-to-bumper rush hour traffic, the bridge gave only a momentary creak as warning before suffering structural failure and sending more than 50 cars into the murky waters of the muddy Mississippi.

Blink or Slight of Hand - Hospitals Beware!
[Health-and-Fitness:Medicine] The recent NIMS Integration Center alert and its associated FAQ document may allay the fears of hospitals as they move forward quickly to meet the September 30 implementation deadline. However, those facilities who view this document as reassurance that there are no significant repercussions for failure to be NIMS compliant may find that the copies of the High Alert document circulated at the Department of Homeland Security, FEMA, the NIMS Implementation Center and CMS served as a template for NIMS enforcement.

London Gets Lucky - The World is Not a Safe Place
[News-and-Society] This morning's announcement by London Police that their "ordinance division" (bomb squad) had defused a "viable device" near Piccadilly Circus demonstrates yet again that the world is not yet a safe place. While, no organization has claimed responsibility for this bomb, reports indicate that the device was of sufficient sophistication as to include vehicle fuel tanks, propane gas cylinders as part of the incendiary charge as well as nails for shrapnel. All this just 7 days before the second anniversary of the bombing of the London Undergraound and only 2 days after the new Prime Minsiter took office.

The Unsung Heroes
[News-and-Society] Despite the hardships and the lack of personal benefits beyond that satisfaction of having served their fellow American, an increasing number of healthcare professionals from all areas of healthcare, both clinical and nonclinical are seeking to join not just NDMS but the state equivalent medical response teams in all 50 states and US Protectorates. Those not willing to leave their homes are joining Medical Reserve Corps Teams in order to afford themselves an opportunity to assist their own communities in the event of disaster.

Know How to Stop, Drop, & Roll? Then It’s Time to Rinse, Lather, & Repeat
[Kids-and-Teens] Over the past 2 decades, who has saved more lives in home fire? You may be surprised to learn that more children have saved their parents than parents have saved children.

Healthcare Recovery for the Gulf Coast
[Health-and-Fitness:Medicine] Healthcare professionals regularly find themselves mandated to choose between maximizing patient flow and maximizing patient safety. They are often forced to forego important family events under threat of suspension, retaliation or termination. When the healthcare professional finds a home where they can achieve a level of work/life balance, it is difficult if not impossible to dislodge them again. It took a hurricane to dislodge these professionals from the Gulf Coast and nothing short of another force of nature, perhaps this one favorable, will move them back.

A Homeland Security Role for Vitamin B12
[Health-and-Fitness:Nutrition] The utilization of high dose Vitamin B12 intra-rectal gel in the treatment of cyanide toxicity would be required before a definitive recommendation could be made for this route of administration- the potential of this route is clearly supported by the literature. Transmucosal Vitamin B12 may represent the missing link in the care of cyanide related toxicity both in the industrial and the tourism related exposures.

Three Simple Rules for Media Relations
[Business:PR] In the disaster field office there are three simple yet absolute rules to managing media relations. Businesses, celebrities, and even hospitals have created for themselves foibles and catastrophes due to a basic lack in the ability to manage media relations and the press. These problems stem from the fact that most failed to understand that the press serves the same people that they serve. Whether you are a corporation, a small business, a healthcare facility, or a movie star the press speaks at one time en masse to your public. If you remember this simple fact it is then no great intellectual stretch to understand that by partnering with the press and the media you can communicate vital information to your entire market simultaneously.

Disaster Medicine- Beyond the ER
[Health-and-Fitness:Medicine] In the year since 9/11 disaster medicine has come into its own. Now a recognized specialty the practice of disaster preparedness, disaster planning, disaster response and disaster recovery as it relates to the practice of medicine and the function of healthcare and healthcare institutions has moved from the realm of the emergency manager and hospital safety officer and into the realm of the healthcare professional. But in this expanding universe of knowledge the hospital floor and the Intensive Care Unit were all but forgotten.

The Choice to Love
[Business:Customer-Service] Love has been described a basic building block of resilience, the foundation of the family, and in the goal of marriage. But does love have a place in business?

How to Think Like Einstein
[Self-Improvement:Leadership] Training yourself to think like Einstein-to see the patterns and processes behind everything you do-will enable you to reach your full potential and bring new and innovative ideas to market. Remember that those with the greatest potential are those who are the most adaptable to any circumstance. They innately understand the process that underlies any other person's success and can replicate it with ease.

Epidemic Enthusiasm and Pandemic Pride
[Business:Customer-Service] Every businessman knows that the key to turning customers into raving fans is to give exceptional customer service, to provide not only for the customer's needs but for their every want and desire even before they know that they have a want or desire. What eludes many business owners is how to provide that level of customer service. Literally hundreds of books have been written and seminars sold on how to improve customer service. Experts have employees imagining everything from mailboxes to Caribbean beaches all in the hope of improving customer service.

The One Best Step to Mazimize Your Disaster Plan
[Business:Continuity-Disaster-Recovery] There are as many ways to write an after action report as there are hospitals that are now required to perform disaster drills and write after action reports analyzing the performance of the institution following a disaster or a disaster exercise. In the last year, however, a new recommendation for a more effective after action review process has come to light. This article explores the one best step to maximize your disaster plan.

Love - The Basic Building Block of Resilience
[Self-Improvement:Positive-Attitude] The four forms of resilience are all based on this simple emotion, love. Whether it is our physical resilience, our emotional resilience, our relationship resilience, or our spiritual resilience each requires that we make the active decision to love in order to build that resilience; to fill that canteen. Similarly, we thus fill our 40,000-gallon bathtub of resilience with this basic element of resilience, love.

Business Continuity and Healthcare Disaster Planning
[Business:Continuity-Disaster-Recovery] Healthcare desperately needs a planning professional who can combine the healthcare vulnerability analysis with the business process vulnerability analysis.

Qui Tam - Sarbanes Oxley and Disaster Preparedness
[News-and-Society:Pure-Opinion] Last year a High Alert, LLC white paper had raised the specter of NRP/NIMS compliance being linked to CMS (Medicare, Medicaid and Tricare) billing, the discussion had been strictly theoretical. Several federally funded training programs have now brought to the table a new and ominous implication of the NIMS Integration Center Implementation Plan for Hospitals and Healthcare. Additionally, hospitals have reported being informed that disaster preparedness will be linked to CMS reimbursement (Medicare, Medicaid and Tricare payments).

When Worlds Collide
[Health-and-Fitness] These worlds collide in the modern era of disaster preparation and response. By mandate, hospitals and healthcare facilities are now required to use the same incident command system that Fire-Rescue has used for decades. The relationship is further complicated by the fact that this mandate reverses the traditional lines of authority and knowledge in which Fire-Rescue has always taken instruction and guidance from healthcare as regards Fire-Rescue's medical operations. Now healthcare must take instruction and guidance from Fire-Rescue.

Who Will Fill Their Shoes?
[Health-and-Fitness:Medicine] Healthcare professionals are leaving because they are tired of being cannon fodder. With the coming pandemic those of us in healthcare know we will die in the line of duty just as our colleagues did in Toronto with SARS. We simply won’t sacrifice our lives for a system that no longer values us, our positions, our education or our experience.

Relationship Leadership
[Business:Management] Relationship Leadership is the use of interpersonal skills beginning long before a disaster looms to create an environment of mutual trust and respect to influence others to work towards common organizational goals. This means permanently abandoning healthcare's current dependence on the power and control (demand and threat) method of leadership.

No More Wrong Site Surgery
[Health-and-Fitness:Medicine] Perhaps, imagine if you could mark the surgical site days or even weeks before surgery without risk of changing the marking. Imagine a pre-operative marking system that provided a unique identifier for the surgical site that is not affected by the process of washing, prepping and draping.

Marketing Triage
[Business:Marketing] The role of Business Triage has never been more important than in the world of marketing. Many authors, speakers and consultants will tell you to feed your business money, lots of money. While money is needed to start a new business and make a business grow, in a resource-limited environment, undirected money is NOT the food your business needs.

There is No Nursing Shortage
[Health-and-Fitness:Medicine] An interesting conversation took place recently between a 45 year nursing veteran and her family. The topic of the day was the nursing shortage and the veteran nurse surprised all by announcing, "There is no nursing shortage, there is a hospital nursing shortage."

I Will Watch My Friends Die
[Health-and-Fitness:Medicine] The most ominous words ever uttered by a disaster preparedness expert stated simply that given the current state of hospital preparedness and the current rate at which facilities are becoming disaster ready, there will be no meaningful level of preparedness in this decade unless someone blows up a hospital. This may seem a bit extreme, but declassified documents show that Al Qaeda seeks to steal an ambulance and blow it up at a major American trauma center.

The Other Side of the Stethescope
[Health-and-Fitness:Medicine] Workplace safety has become as much a component of "All Hazards" preparedness and patient safety initiatives. Facilities that have instituted this expanded approach to preparedness have found that patient safety initiative, employee safety programs and...

Making Lemonade
[Self-Improvement:Grief-Loss] I spent the late hours of this evening with an old friend. My friend and I had gone to medical school together. His wife of 25 years died 3 months ago. I spent four hours reminiscing with my friend, reliving their last vacation together and their last days. Before I picked him up I contemplated how to tell him that after loving her so completely for so many years that it was OK to move on with his life, to be a father, to be a doctor, to be single and perhaps even to find someone new to love.

Another "All Hazards" Risk
[News-and-Society:Pure-Opinion] Einstein is credited with saying: "The ultimate insanity is to continue to do the same thing and expect a different result". Einstein obviously met the people who direct our healthcare disaster preparedness in America.

"All Hazards" - More than Disaster Preparedness
[Health-and-Fitness:Medicine] In the years since 9/11, those in disaster planning, preparation, education, response and recovery have concentrated all their effort on convincing private healthcare corporations and non-healthcare corporations alike to adopt an all hazards approach to adversity and disaster. But "All Hazards" is more than just disaster preparedness and it is time for healthcare to face this reality.

The Unprepared Beware
[Health-and-Fitness:Medicine] The first step in a progression that, if followed by CMS, DHHS, DHS and DoJ, will put the full weight and power of the federal government behind an unfunded mandate for hospital preparedness has occurred. An appreciation how CMS and DoJ have handled dealt with healthcare providers who have run afoul of these agencies in the past 18 months may portend the future.

General Honore Leads the Charge Tor Preparedness
[News-and-Society:Military] Lt. General Russel Honore (for those of you who are not familiar with military ranks, that is a three star general) has a new mission. In addition to training new recruits for the urban combat environment of Iraq and Afghanistan, General Honore is now touring the country, speaking to churches and Rotaries, in town halls and community government auditoriums not as an ambassador for the United States military but rather as an evangelist preaching the gospel of preparedness.

Where Should NDMS Reside?
[News-and-Society:Pure-Opinion] The National Disaster Medical System, the nation's medical rapid response force has beginnings in the mid 1986 as a small civilian division of the Uniformed Public Health Service in conjunction with the U.S. Department of Health, Washington, D.C. office. From those humble beginnings, NDMS has expanded to a nationwide program with volunteer reservists in almost all 50 states. NDMS has served in terrorism related disasters as well at the Murrah Federal Building, the World Trade Center, the Pentagon and other events. NDMS is the nation's "ready team" deploying on a stand by basis at events of national significance including the Presidential Inauguration, the rededication of the Statue of Liberty, the Republican and Democratic National Conventions and even at the Super Bowl. So why can nobody find NDMS a permanent home?

The Tornado in Your Business
[Business:Strategic-Planning] The recent tragic news from Florida points out the vulnerability to the unexpected that we all face in life and in business. In the disaster field office we have learned that the only safeguard against uncertainly is preparedness. But when do you prepare?

Even in Our Own Backyards
[News-and-Society:Weather] The tragic events in Florida point up again the fact that adverse events, whether weather related or manmade are an unavoidable part of life for individuals and communities. However, it is through planning, preparation, practice and unfortunately experience that the communities of Lake, Brevard and Volusia County turn tragedy into triumph with their rapid response, their professional caring and their ability to keep needs from exceeding resources, in short, they diverted large scale disaster.

A Fuel Gauge for Resilience
[Self-Improvement:Stress-Management] The concept of avoiding disaster and catastrophe relates directly to the ability to maintain sufficient resilience that needs never exceed resources and that needs never exceed the ability to respond. Physical, emotional, relationship and spiritual resilience are well known as the four categories in which resources are mapped to ensure survival through adversity in business and in life. But how can we measure our resilience when we are not facing an adversity?

And the Greatest of These is Love
[Business:Customer-Service] It seems that American business loves everyone and everything. Perhaps it is the fact that most of today's business leaders were born or grew up in the 1960's and 1970's, the decade of love. But more likely it is a semantic error, or a marketer's ploy.

Who Will Run Our Prisons?
[News-and-Society:Crime] When pendemic flu strikes, and it will, 50% to 80% of the work force will be home sick. Half of these people will die. Pandemic planning world wide is only beginning to consider such issues as food delivery and electricity. With the rising prison population in the United States, who will run our prisons when half the guards are sick?

Even in Hometown Kissimmee
[News-and-Society] This morning's news that the threats to bomb various targets in Kissimmee, Florida and Greater Osceola County are tied to the discovery of actual bombs and bomb making materials proves yet again that the Kissimmee and Osceola County are not as safe as many would have us and our county government believe. Even more concerning is that much of the critical equipment needed to respond to a Chemical, Biological, Radiological, Nuclear, Explosive (CBRNE) event are kept in Orlando. This equipment, known as a "Push-Pack" is stored with other interagency response equipment and may only be release with the consent of Orange County’s Emergency Operations Center.

It Finally Happened! The Cold War is Back-With a Twist
[News-and-Society] Russian officials today announced that the arrest of a man attempting to sell weapons grade uranium. That's right, the type of uranium used in a nuclear bomb. In reply, American officials attempted to reassure the public by stating that the amount of uranium offered for sale was less than that required to create a nuclear warhead. It is of note that they did not deny that this was in fact weapons grade uranium.

If Quarantine Works for Horses-Why Won’t It Work for Avian Flu
[Health-and-Fitness:Medicine] The State of Florida, Department of Agriculture, this week lifted the quarantine on horses in South Florida. This was welcome news to the competitive horse breeding industry which has spawned many of the recent champions of horse racing. Equine herpes virus, a disease fatal in horses, was the cause for the quarantine and officials lifted the quarantine because this it had stopped the progression of the disease through the horse-racing community. But if quarantine is so effective in animal diseases, not just equine herpes but mad cow and other diseases, then why will it be ineffective when the avian flu pandemic strikes?

Bipartisanism and Silos of Authority
[News-and-Society:Politics] The new balance of power in Washington, DC, has sent pundits scrambling to predict how the Republican Party and the Democratic Party will interact. Conservative pundits tout theories that the Democrats will be forced to the political center, if not slightly to the political right by a conservative President Bush. Simultaneously, liberal pundits are celebrating the projected migration of a hawkish Executive Branch from the radical right to the conservative left. All this while our elected officials go to great pains to promise they will work in the 'spirit of bipartisanism' and that there will not be 'gridlock' in Washington, DC.

40,000 Gallons of Resilience
[Self-Improvement:Stress-Management] Like filling a bath tub with water before a disaster, developing resilience is the key to your survival. How big is your bath tub?

Drinking Deeply of Resilience
[Business:Change-Management] When you drink deeply from your canteens of resilience you learn not only how well you prepared, but how well you planned for refilling your reserve.

Fiddling as America Burns
[News-and-Society:Pure-Opinion] Irwin Redlinger's book America at Risk reignites the controversy surrounding America's preparedness, but is the news all bad?

Filling the Canteen of Emotional Resilience
[Self-Improvement:Happiness] Emotional Resilience is the antidote for stress, but how do you never run lout?

Filling the Canteen of Physical Resilience
[Health-and-Fitness:Exercise] Building Resilience starts with physical preparedness, but "physical" means much more than just exercise.

Filling the Canteen of Relationship Resilience
[Self-Improvement] Relationships are a source of strength and stress, which will they be for you

Filling The Canteen Of Spiritual Resilience
[Self-Improvement:Spirituality] It is not what you believe, but that you believe. What do your beliefs lend to your resilience?

The Four Canteens of Resilience
[Self-Improvement:Success] When you face adversity do you draw your resilience from a thimble or a 40000 gallon bathtub?

2007- The Year of Resilience
[Self-Improvement:Inspirational] The Founding Chairperson of the American Board of Disaster Medicine declares 2007 as The Year of Resilience

In the Kill Zone
[Business:Strategic-Planning] What does a future pandemic mean to American employers? Dr. Ramirez discusses the possible impact of pandemic avian flu on the workforce.

How to Instill the MFA Mentality in Your Company
[Business:Management] To truly reach your customers, you need to understand where they're coming from- what they want and need in your product or service. But you don't need to shell out a bunch of money on focus groups and marketing research. You can do the research yourself for much less by adopting an MFA mindset.

Disaster Medicine: A History
[Health-and-Fitness:Medicine] The medical response to disasters is becoming an increasingly complex and specialized branch of medicine. The new specialty of Disaster Medicine has roots dating back almost 2 centuries. Geoff Williams and Dr. Maurice explore the depth of these beginnings.

Is the Stock Market "Disaster Drop" Really Inevitable?
[Investing:Stocks] The newest James Bond movie "Casino Royale" is in part based on the theory that Osama Ben Laden and other terrorist groups profited from the down turn in the stock market following September 11, 2001 and other disasters. The movie suggests that a terrorist organization heavily invested in puts could cause a wholesale sell of stocks in an entire industry and profit from the ensuing options rush.

Want Business Success? Think a Little Differently
[Business:Entrepreneurialism] While many jobs for American MBA graduates are going overseas, those who have MFA's will be in great demand. According to Gartner Inc, by 2008, 40 percent of IT jobs for MBA's will be outsourced to workers overseas.

New Orleans' Ninth Ward: Rehabilitation or Recovery
[News-and-Society:Pure-Opinion] The press has recently focused attention yet again on New Orleans and the process of rebuilding. But this debate now entering its second year is more monologue than dialogue. The emphasis has been on rebuilding and rehabilitating and not on true recovery.

Profiting from Disaster: How to Ethically Make Money During Times of Crisis
[Business:Entrepreneurialism] When a disaster strikes- whether it be a hurricane, earthquake, flood, terrorist attack, or some other devastating event- many businesses are eager to volunteer and assist those in need. They want to help rebuild the damaged homes and businesses, and they often donate the necessary materials and manpower to do so. Unfortunately, the resources that are brought in on a volunteer and donation basis typically run out much sooner than expected. And very often, those businesses who gladly gave their time and resources to those in need feel guilty charging for additional services, so they pack up and leave the area, proud of their good deed, yet leaving those in the disaster area with few recovery options.

Get Out of Crisis Mode and Stay Out: Utilizing Resource-Based Decision-Making in Your Organization
[Business:Sales-Management] Two economic sectors dominate the field when it comes to decision-making: one operates on a resource-based model and the other runs on a continuous crisis model. Many organizations choose the latter model because they place tremendous emphasis on saving money minute to minute, not on investing in future need. But resource-based decision-making offers a process that helps you make instant decisions, and more important, introduces small changes that, over time, prevent your organization from getting into future bad situations.

Expand Your Business Horizons with Pattern Recognition
[Business:Entrepreneurialism] If you want to see new opportunities for your business and increase your decision-making speed and accuracy, begin by looking outside your own business- even outside your industry- at trends and patterns that you can apply to your own organization.

Where's the Technology?
[Internet-and-Businesses-Online:Product-Creation] Telecommunications, the Internet and home commuting have grown explosively in the past 5 years, but medicine is still a face to face venture. With the coming pandemic when will telemedicine catch up?

The Industrialized World Isn't Safe From Pandemic
[Business:Strategic-Planning] The coming avian flu pandemic holds more secrets than most in the industrialized world realize.

The Race to a Paperless Society
[Health-and-Fitness:Medicine] As medicine is forced to "go paperless" a new generation of personal portable medical records may be poised to take these devices from "novelty" to necessity.

For the Record- Thank You for My Resilience
[Kids-and-Teens] My father died a number of years ago. Our last years were strained and distant because when I became a single parent, he was quite vocal about the fact that my children would be better off if I concentrated on my career rather than changing my goals to raise them. By the time I have learned to understand and forgive, he was gone. Now I have adult children and I look at the resilience they draw from our relationship. Like my father, I brag daily about the accomplishments of each one of them. I want those I love to know I am proud of them now. I want them to have the emotional resilience and relationship resilience that comes from this knowledge.

Tamiflu Psychosis
[Health-and-Fitness:Medicine] Just when AARP magazine, and so many other well respected and widely read publications, are carrying articles about pandemic flu planning for personal homes, more bad news.

Mechanisms of Injury and the All Hazards Approach
[Health-and-Fitness:Medicine] The "all hazards" approach to disaster preparedness is based on the concept that while adverse events can not be predicted in their timing, location or type there are limited ways in which they can impact a community, business, or individual. In disaster medicine we call these limited "mechanisms of injury."

One Life
[News-and-Society:Military] It is a common misconception that only a large-scale disaster or thousands of protesters will get the immediate attention of government or large corporations. On December 29, 2006, I saw this misconception proven wrong.

Don't Let Your Business Become a Wounded Dog
[Business:Strategic-Planning] Businesses become wounded dogs when they fail to ensure that an adversity does not evolve into a disaster. In two decades of disaster field work and consulting to companies large and small I have seen and helped more than my share of wounded dogs. The problem is that most wounded dogs suffer adversity of their own making and fail to provide the resources to cope with that adversity. Is your business about to become a wounded dog?

The "Choke Point" is Management
[Business:Change-Management] Decades of experience have taught us that even the most experienced project manager, leader, CEO or company president can only effectively lead a breadth of three to seven subordinate divisions and ideally the number is five. That same experience has also taught us that a leader becomes detached if the organization they oversee grows greater than five to seven layers deep with, again, the ideal number being five for efficacy. But why does this occur? Why should your organization be no more divisions wide under any one leader than the number of fingers on their hand and no more layers deep in that organization than the number of toes on one foot?

Continuous Integrated Triage
[Health-and-Fitness:Medicine] The concept of resource-based decision making would seem to be basic to the practice of medicine and especially emergency medicine and disaster medicine. Unfortunately the reality is that in the United States of America and, actually in most industrialized nations, medical care decisions are not resourced-based, they are emotionally-based. And this works in all but the most dire of circumstances.

The Missing Link
[Computers-and-Technology] The medical profession is being dragged kicking and screaming out of the Nineteenth century and into the Information Age.

Pandemic Flu – Why Do the Good Die Young?
[Health-and-Fitness:Diseases] The recent medical publications on the reasons why Pandemic Flu is and has been so deadly are key information not only for scientists and physicians, but for the general public as well. May people rely on their belief that they are NOT at risk when Pandemic Flu strikes because they are young and healthy.

A Date That Will Last in Infamy
[News-and-Society:Military] 65 years after the surprise attack on Pearl Harbor it is becoming all too easy to forget the lessons learned on that horrific Sunday morning. As with any historical lesson we must start with an appreciation of the sentiments of the times.

DISASTER MEDICINE: A View from the Trenches
[Health-and-Fitness:Medicine] From earthquakes to wars to floods and hurricanes, the history of disaster medicine is replete with success and failure when it comes to the results of the physicians and nurses and medical administrators who assist during and in the aftermath of a crisis. And it’s a long history.

An Angel Blowin' By
[Self-Improvement:Inspirational] The rescuer is sometimes the one rescued and in surprising ways.

Business Triage
[Business:Strategic-Planning] What do Tylenol, New Coke, Jack-in-the-Box, Bag Leaf Spinach, Katrina and the World Trade Center have in common? They were all disasters.

Are We Ready? Five Questions to Ask Your Hospital Before Disaster Strikes
[Health-and-Fitness] In an age of uncertainty, risk and threat is your hospital prepared to care for you and your family in the event of the unthinkable?

Disaster Life Support: The 21st Century’s CPR
[Health-and-Fitness] In the new millennium, a heightened awareness of both terrorism and the impact of natural disasters has created a need for a “new CPR”; core skills that will help both laypeople and medical professionals meet the challenges of man-made and natural disasters.