Everyone involved in budgeting knows the process includes reviewing past performance, determining how to use resources, and projecting future performance based on the outlined plans. In a steady state, or in environments where change is incremental, the outcome of this process can be straight-forward, predictable and similar from year to year. The process is more challenging in times of dramatic change when past performance can be a poor predictor of future success. Planning in such times is analogous to constructing a building on shifting ground.
Indeed, the ground on which we base clinical care for cancer patients is undergoing major shifts in not one, but two dimensions. Continue reading
Sometimes, I experience an internal conflict between the clinician/researcher in me, and the administrator in me. Indeed, because of this split existence, there are some phrases that make me cringe even when I use them myself. Taking a clue from the term in biology that means “self-activation,” one could call this an “autocringe loop.” For me, an autocringe loop tends to occur most often when the clinician/researcher in me is listening to the administrator in me talking. For example, I feel a very robust autocringe loop get activated when I hear myself say “no money, no mission.” Continue reading
Last month I attended a series of meetings at the National Cancer Institute (NCI) in Washington DC. As was the case many times this winter, weather created havoc with air travel. This disruption caused me considerable anxiety as I rode to the airport after my last meeting. I wondered if my flights would be delayed or cancelled. As it turned out, I scrambled and got on a flight as soon as I arrived at the airport. This flight was scheduled to leave earlier in the day but was delayed because of weather. So … I left Washington for home earlier than planned. In this case, the disruption in air traffic worked in my favor. Continue reading
I spent a fair amount of time this past week filling out what seemed like an endless string of forms. In addition, I was asked to review and approve some forms being developed by the Cancer Center. This effort, and the date of April 1, led me to consider an additional form that, if broadly implemented, would limit the growth of required forms everywhere and so have a huge and positive impact on the efficiency of complex organizations (including cancer centers!). Continue reading