The trials and tribulations of a middle-aged PACS consultant,
father, and garage sale junkie as he engages in his
never-ending search for sanity in an insane world.

Tuesday, July 19, 2011

Now It Can Be Told....

Almost everyone I know has heard either the bible verse from Ecclesiastes 3 or the lyrics to the old Byrds song “Turn! Turn! Turn!”. You know how it goes….

1 There is a time for everything,
and a season for every activity under the heavens:
2 a time to be born and a time to die….

Not everyone knows what is beyond those first few lines though so here it is…

9 What do workers gain from their toil? 10 I have seen the burden God has laid on the human race. 11 He has made everything beautiful in its time. He has also set eternity in the human heart; yet[a] no one can fathom what God has done from beginning to end. 12 I know that there is nothing better for people than to be happy and to do good while they live. 13 That each of them may eat and drink, and find satisfaction in all their toil—this is the gift of God. 14 I know that everything God does will endure forever; nothing can be added to it and nothing taken from it. God does it so that people will fear him…. 22 So I saw that there is nothing better for a person than to enjoy their work, because that is their lot. For who can bring them to see what will happen after them?

For the past 28 years I have thoroughly enjoyed my work as the PACSMan. I have met some incredible people, developed longstanding friendships, worked with some incredible vendors and basically have been having a blast. Through it all, though, being on my own for the past three decades has allowed me to fulfill my most rewarding task- that of being a dad. Were I to have worked for a big company instead of myself I would have no doubt missed parts of my kids growing up and, to me, that would have been a travesty. Please note that this statement is not intended as a hit against people who work for big companies either. I have seen many individuals who have struck the proper balance between their work and personal lives and done a wonderful job as a father, husband, and employee. I have also seen those who haven’t as well, whose chase to make the almighty dollar has clouded their judgment and rearranged their priorities in life away from where they should be in my not so humble opinion.

My dad was an incredible man but he worked four jobs to support us- his full time job at Fort Monmouth as a supply clerk, at Tomanio Brothers paper store at nights, at Shadowbrook parking cars for $0.25 each, and caddying at Rumson Country Club on weekends. All in all if my high school-educated dad brought in $20,000 between all four jobs it was a good year.

Because he worked so much I never really got to know my dad until several years after my mom passed away. By then he was in his early 70’s and I was almost 40 and I moved him down to Florida. I missed knowing my dad as a child and vowed never to let that happen to me with my own kids. In what many might call a knee-jerk reaction I became the Supermom of dads and can honestly say with that one exception that still haunts me to this day when I simply couldn’t make it home in time, I never missed a single thing my kids did, large or small. And to me that is what has made my life oh so special.

Was it without sacrifice? That depends on how you define sacrifice. Financially I could have literally been a multi-millionaire like so many others I know and been living la vida loca. Over the years I have had several job offers with monetary guarantees that were mind-boggling but I always kept asking myself- to what end? Would it be worth giving up being a key part of my son’s lives to give them financial stability? Do I want my kids finally learning about their dad at age 40 like I did? Every time I heard Harry Chapin’s song Cats in the Cradle playing it made me pause and think. Nah….just not worth it. I also reflect back to a passage in Mark 8:36- “What good is it for a man to gain the whole world, yet forfeit his soul?” Is money the end-all be-all that so many make it out to be? Once again the answer is no.

As with all businesses I had some very good years consulting and a few years that would redefine challenging. But the one constant is that I always had my kids and they me, for better or worse, richer or poorer.

So it’s on to the next journey in life- a different one with my kids as adults and a new life with an amazing company. So far it’s been fun. Despite my having to get 10,000 things done by this coming Friday so I can have a clean slate when I start next Monday, the boys asked if I wanted to have lunch with them yesterday and....well….I’m sure you know what the answer was. The pizza was great but the company even better. After all, how many dad’s can have their 18 and 19.5 year old sons invite them out to lunch and even offer to pick up the tab? Life is good indeed.

When my dad passed away at age 84 I wasn’t the 48 year old son mourning his father’s passing but instead a 10 year old boy who had only gotten to know his dad for a few years. I walked into St Anthony’s, the same church I was an altar boy at from age 6 till 13, and the flashbacks were immediate and intense, the only difference now my being that the funeral I was at now was that of my own father. You have no idea how that impacts you. I looked over at my boys, then ages 10 and 12, and then looked at dad’s coffin and felt an immediate peace. Dad always said to me “Take care of my boys” because he never had the chance to do that the way he really wanted to for my brother and I. He took care of us as best he could but at the sacrifice of actually being there. I chose not to make that same sacrifice and did all I could to “take care of (my) boys” then, now, and forever more. They are my reason for living.

Now that my job as a dad has changed over the passage of time it’s my turn to enjoy what life has to offer and I will. My new “job”, if you will, is anything but a job but instead something I am excited to embark upon. It’s a position that is custom tailored to many of the strengths I have developed over the years. It’s also with an amazing company with amazing leadership and an amazing product line. Most importantly it provides me with the chance to be on a team again doing what I do best which is helping people. I love it.

The PACSman will be around for a long time, just not as the PACSMan. My blog will exist in a different form, probably under the name “Confessions of an Ex Altar Boy” and deal with mainly with my personal life, avoiding the controversy that sometimes accompanies PACSMan posts. But I’ll be around So bookmark it- I guarantee you it will be a blast.

So I’ll end it this blog the way it started-
Dominus vobiscum- (The Lord be with you).
Et cum spiritu tuo. (And also with you).

The best is yet to come…

Sunday, June 19, 2011

Father's Day Thoughts

Left To Right: Nick, my brother Frank, Me, Matt

I’ve easily written 10,000 words in 6-7 different posts the past 7 weeks, none which has ever seen the light of day for a variety of reasons. But here it is, just after 9:30 p.m. on Fathers Day, and I’m writing again after just coming back with wonderful dinner at Olive Garden with my oldest son Nick.

Nick has developed into an incredible young man. I always commented that Nick was my minimalist- doing the absolute minimum to get by in life- and I guess it always upset me because I try and do the opposite. In the past year he has shown a side of him that I never saw before. He has become a driven individual who embraces his work, school, and life with a passion doing the very best he can and being the very best he can be. He is close to converting me to become a Mac-aholic like he is, but when your life is spent in the Apple store it tends to do it to you. He is one of the chosen few who got to enjoy his passion for all things Apple by actually securing a job at the Apple store. He is the second youngest employee (by just a few months) at the store with nearly 100 people in it and is doing great at it, slowly but surely climbing the Apple tree yet making sure he doesn’t piss off dear old dad by making work second and school first.

Truth be known I’ve been going through a bad case of pre-empty nest syndrome with my youngest son Matt graduating high school last month. A week after he walked off the graduating stage wearing more robes and honors than half the faculty (Summa Cum Laude, officer in National Honor Society, International Baccalaureate degree, etc.) I was both proud and confused. Proud that my son did so well in school yet confused as to what’s next. Last year when Nick graduated and I felt the same degree of pride in him as I did with Matt but not as much confusion because I still had one of my babies at home to take care of. Soon I may have none….

Five days after Matt graduated high school he was off to Europe visiting eight countries and 11 cities in 31 days with nothing more than a backpack on his back and his best friend Amelia by his side. Ah but to be young and carefree again. This kid planned this trip out better than the invasion of Normandy. He’s been gone 20 days now, and has 11 more to go until he comes back, yet this it’s enough to give me a taste of what my future holds. While I’m excited about having more “me time” I also miss being the dad who was always there. Always. Just ask anyone. They were- and are- are my life. But now…who knows?

Matt called me this morning from Rome to wish me Happy Fathers Day. That's Rome, Italy, not Rome Georgia. My kid remembers to call me on Father’s Day…..from Rome, Italy no less. Amazing.

And Nick. Not only did he take the day off to be with me today and take me to dinner as well but he also gave me a card I’ll always cherish. It simply said:

I listened more than you think.
I remember more than you realize.
I love you more than you know.
Thank you for being my dad.

With a personal message:
Almost 20 years together my how time flies….Thank you for always doing your best in spite of me.

Has it been 20 years already? It seems like only yesterday.

In spite of me? Not hardly. I did my best because of you, Nick…

As I read the cards I got, listened to Matt’s voice from halfway around the globe, spent time with Nick and reflected over the past few decades, five words kept going through my mind over and over again- ”It was all worth it.”

Despite all my shortcomings- and they are oh so many- I guess my kids feel lucky to have me. If they only knew how lucky I am to have them as well, because so few dads have kids as incredible as mine…

Lucky kids, luckier dad. Life is good indeed….

Monday, April 18, 2011

Fava Beans and A Nice Chianti

Call me the sick puppy I am but I enjoyed the movie The Silence of the Lambs. The psycho-drama kept you on the edge of your seat until the very end and no one but no one comes close to Anthony Hopkins in his portrayal of Dr. Hannibal Lector.

There was an event that happened in our industry a week or so back where a press release went out over the newswires and basically said one of the biggies in our industry- Iron Mountain- was getting out of the cloud storage market. Now my ear is usually pretty close to the ground with events like this so it took me completely by surprise. Apparently the Gartner Group put out a press release with the heading "Iron Mountain to shutter cloud storage service" and I questioned if this had any impact IM’s healthcare segment. Since the event was reported in at least 20 trade journals on Monday and numerous others since then I reprinted one of the stories from one of the journals (ComputerWorld®) on AuntMinnie’s® PACS Discussion Forum and asked the question, quite responsibly I might add, " So...what does all this mean for IM healthcare clients? Virtual File Store® and Archive Service Platform® were directly addressed but the DRC (Digital Record Center®) that addresses healthcare was not even though this too is an IM digital cloud solution that should fall under this "cloud". Very weird that this market sector wasn't directly addressed one way or the other in the release through Gartner so it makes me wonder...IM- is you in or is you out? Inquiring minds want to know... “

I expected a response like this :

Thank you very much for your concern.

Despite a headline that makes it sound to the contrary, IM’s digital healthcare solution is very much alive and well. While the post erroneously made it sound like all of IM’s cloud storage services were closing, this closing only affected two small divisions of IM that were not profitable. The DRC (Digital Record Center) for Medical Imaging is not affected by this and continues to do enjoy a strong presence in the medical imaging marketplace.

Should you or any of AM’s readership have any questions please don’t hesitate to contact me at …….
The Big Kahuna at IM

That would have cleared it up for me and everyone else and the company could have put this PR nightmare behind it. Instead I, and the industry, got absolutely nothing publicly while behind the scenes I was made out to make Dr Lector look like Tinky Winky.

I loved initial call I got 15 minutes after the initial posting hit the PDF asking me who my sources were for some of the broad comments made - “they are- and will remain- confidential” - but even Stevie Wonder could read the rest of the stuff which was all public. So out of courtesy I revised my initial post to reflect the company’s posture (which they should have done, not me) slapping them on the hands only for allowing this release to get out but otherwise doing no harm- or so I thought. The next thing I know I get a voice mail on my cell phone at 9:30 p.m. that starts out “You have got to be kidding me…” then TELLS me in a demanding manner (not politely asking) what I MUST say to make this right. I also had comments made about how I was embarrassing myself through this post, yaddi yadi yada as if I was the reason for it hitting 30 journals. Um..no. Apparently winning through intimidation may work well in certain organizations but it doesn’t work with me. So I sent this e-mail to the big Kahuna there:

“I made the modification to my original post and it stands. I am not IM's mouthpiece nor do I represent IM's position or any other vendors position in this industry for that matter. I also made this post as an individual and not as someone representing AM or anyone else so please don't try and make that connection either.

This was a valid press release published in several trade journals, one that lead to the question I asked- is IM healthcare involved here because it sure reads that way with the global headline as stated. You answered it, I included your response as a courtesy in the revised post and that should be the end of it. Obviously it's not. If you want more you need to do it yourself. I also am not embarrassing or meaning to embarrass you or anyone else or me here; how you can say I am embarrassing myself just defies logic. Maybe from your perspective but not from anyone elses.

The bottom line is we can agree to disagree here but if a press release is made about IMC in print like this I would take immediate actions to modify this. This release actually went out last Friday (4/8) so the problem is not just with Gartner but IM as well for not catching it and addressing it promptly. You caught my post within 15 minutes of it hitting AM- why couldn't IM catch this one equally as fast and address it? Someone obviously is not minding the fort there. I also told you that I was modifying it on AM and here it is 5+ hours later and you are just getting around to calling me about it? That's not what I would call being proactive in my book either.

If you care to add to the post on AM you are more than welcome to do so and were even invited by Outcast to do so as well. His post reads:

They have a brand name and were supposed to use their current relationships to try to build up this business. Other than the occasional press release, I never heard about any customers signing on with them or about an active sales force.

I would be interested in the hearing from IM to clarify the facts.

Many people in this industry feel the same way- we never hear anything about you even though you consistently claim to be so much larger than all the "little piss ant" companies you compete with. That doesn't speak very well for IM now does it?

So here's your chance….get on your pedestal and clarify the facts. Just don't make it personal because that would be a violation of AM's terms and conditions. State your case and let's see where it go where it goes...

Good luck. I'm in tomorrow if you want to chat but I'm not changing anything. Also, if you call please use the business line and not my cell-….

Thanks. Sleep well.


So where are we today? Let’s go back to the Silence of the Lambs- a great scene where Dr Lector and Clarice have a bit of “interaction”…

Hannibal Lecter: I will listen now. After your father's murder, you were orphaned. You were ten years old. You went to live with cousins on a sheep and horse ranch in Montana. And...?
Clarice Starling: [tears begin forming in her eyes] And one morning, I just ran away.
Hannibal Lecter: No "just", Clarice. What set you off? You started at what time?
Clarice Starling: Early, still dark.
Hannibal Lecter: Then something woke you, didn't it? Was it a dream? What was it?
Clarice Starling: I heard a strange noise.
Hannibal Lecter: What was it?
Clarice Starling: It was... screaming. Some kind of screaming, like a child's voice.
Hannibal Lecter: What did you do?
Clarice Starling: I went downstairs, outside. I crept up into the barn. I was so scared to look inside, but I had to.
Hannibal Lecter: And what did you see, Clarice? What did you see?
Clarice Starling: Lambs. The lambs were screaming.
Hannibal Lecter: They were slaughtering the spring lambs?
Clarice Starling: And they were screaming.
Hannibal Lecter: And you ran away?
Clarice Starling: No. First I tried to free them. I... I opened the gate to their pen, but they wouldn't run. They just stood there, confused. They wouldn't run.
Hannibal Lecter: But you could and you did, didn't you?
Clarice Starling: Yes. I took one lamb, and I ran away as fast as I could.
Hannibal Lecter: Where were you going, Clarice?
Clarice Starling: I don't know. I didn't have any food, any water and it was very cold, very cold. I thought, I thought if I could save just one, but... he was so heavy. So heavy. I didn't get more than a few miles when the sheriff's car picked me up. The rancher was so angry he sent me to live at the Lutheran orphanage in Bozeman. I never saw the ranch again.
Hannibal Lecter: What became of your lamb, Clarice?
Clarice Starling: They killed him.

I did my best to try and keep the little lambs from being slaughtered, yet the company sat back and did nothing while poor little Clarice gets sent off to the Lutheran orphanage. "I opened the gate to their pen, but they wouldn't run. They just stood there, confused. They wouldn't run." . Sounds a lot like what is happening in Massachusetts. What’s funny in a not so funny way is while I was being presented to many as the Anti-Christ by individuals within the company I was actually trying to HELP Iron Mountain, not hurt it. I gave them a chance to clear the air publicly and they blew it, not I. That said, I’m sure it will be my fault again/yet/still for resurrecting this nightmare on my blog site but it defies logic that it should take any company a week or longer to put out a clarification on this. My God even GE can- and would- do it faster…

I used the analogy in the PDF that waiting for IM to do something is like an ED doctor watching his patient die instead of triaging them first and wondering about the how and why later. After much reflection I think instead it’s closer to your wife asking you if this dress makes her look fat. There is only one correct answer and “No honey, your fat is what makes you look fat” isn’t it. You think it through and answer honestly- “While you look stunning both in and out of your clothes, sweetheart, that dress doesn’t compliment you nearly as well as others I have seen you in.” Fred Astaire may have died in 1987 but any man worth his salt knows how to dance.

So here it is a week later and there is still nothing clarifying or correcting this release in print. If/when something finally does come out in print it will no doubt be so anticlimactic it will be all but worthless. There is only one way to address this nightmare in print but I’d be willing to bet they completely miss it in whatever they do. I know what will work here but I don’t work for free and besides they have so many marketing, PR and legal types up there that I’m sure someone can figure it out. That said, doing something now will be like bringing flowers home after making a huge faux pas, walking through the door finding a home as empty as Guido the killer pimp did to Joel in the movie Risky Business and a note that the wife moved in with the neighbor- and BTW here is my attorneys number. Ouch.

This post should have been titled “You Can’t Fix Stupid- Part II” but the “stupid” company I wrote about before has parts II and III coming up because they really are that stupid and for that reason alone they get their very own post. God there are so many stupid companies out there….

Dr Lector asked the question that made Agent Starling pause before answering: “Well, Clarice - have the lambs stopped screaming?“ I can only hope that they do for everyone’s sake. But in the interim I would ask that this company not test me or my patience any further because as Dr. Lector also said, smiling, “A census taker once tried to test me. I ate his liver with some fava beans and a nice chianti.”


Monday, March 28, 2011

You Can't Fix Stupid

I was on a conference call the other day with a client who hired me to evaluate their marginally performing PACS and RIS and to look at options for replacement as well as options relating to a VNA. My first step before initiating vendor divorce proceedings is to always to see if this marriage can be saved, so I went to the vendor and asked if we could have someone come and look at the systems. The answer I got was:

“Support will complete an analysis of (the client’s) current stability issues to include looking at the database and a possible re-org if needed or required. We will provide a summary of findings on Tuesday's ...conference call with (the client). We will then prepare to send someone onsite relative to our findings. Resources are aware of the possibility of onsite time, but we first need to know and understand the issues at hand. “

Huh? Understand the issues at hand? What has my client been documenting for the past several years? What kind of ‘splainin’ do you need there, Lucy? Again keep in mind that the problems they have had have been documented out the ying yang and evaluated, masticated, desecrated, flatulated and every other “-ated” including probably masturbated to for months, if not years, so my response to the vendor was:

While I appreciate the efforts taken here I have a hard time understanding why it will take so long to schedule someone to come on site… (My client) have been documenting the problems….since day one and have been paying (a whole lotta money) per month in service for that privilege. Is it too much to ask to send someone on site NOW instead of waiting until your "resources" "know and understand the issues at hand" and delay this further with yet more calls and more discussions? Quite frankly if (you, the vendor) doesn't understand the issues at hand by now- after all the documentation provided by (my client) to (the vendor) over the past several years- talking about it further isn't going to do anything but delay this further. From my discussions with (my client) as well further delays and excuses are not what they want or need further nor is it what they are willing to accept.
I will be suggesting to my client that all further service payments be placed in escrow until the problems they have experienced have at the very least been addressed if not properly fixed by (the vendor). Paying (a whole lotta money) per month for service to experience the type of problems they have had is simple unacceptable. This has gone on for way too long and has been very well documented as well. I have at least two trees work of documentation here- I'm sure, or at least hope- you have the same there. I would respectfully request you have your service department provide copies of all the records and documentation that (my client) has provided (the vendor) over the past several years to the stated resources, have them review this, and then set up a time to make at least a two day on-site visit ASAP. Decisions need to be made by (my client) ASAP whether to stick with (the vendor) or look for a replacement source for their RIS, PACS, (and other clinical information systems). Merely talking about it will NOT get the job done. They need someone on site NOW.
Until such time as you can provide us with a time and date for someone to come on site and discuss this I feel that the calls (with executive management on the future of our relationship)….. to provide us with a summary of findings and ...to discuss product and business related issues will not be necessary. That said, I will defer this to my client to have the final say in this.”

Lo and behold late that same day we get notification that someone from the vendor’s service department would be out to my client's site within a week. When he did come out he found a number of issues that had could only be dealt at the vendor service level, not by the client’s IT department or PACS Systems Administrator. That was good. The changes to the system were made and the system performed better and was much more stable.

“Can you look at our RIS and other systems too?” we asked him. "I’m sorry, I only can address PACS.” Now I learned long ago to never shoot the messenger, having been the messenger way too many times myself, plus he was much too nice a guy and did fix the problems he came to fix so….we thanked him and went back to the well.

“We greatly appreciate.(your rep’s) visit last week and his ability to work closely with (my clients) staff to understand and improve the PACS performance. From what I understand (your rep) made some changes….that resulted in much improved system performance and stability. That is a great start. There still remain several issues that need to be addressed so we all look forward to reviewing a copy of (your rep's report) and the plan(s) of action that will be outlined as well as the associated timeline(s) to address these issues from (the vendors) support organization.
As (your rep) was only able to address the PACS, (you, the vendor) needs to set up a time to send someone else out to address the ongoing RIS and (other) issues as well. Optimally this can be one person but nominally two can come out as well, so let us know when this can be set up so we can have the right people from (my client) available.”

Their answer:

“On Friday, we can also discuss the need for additional support to address any RIS and (other) related issues and concerns. “

I love it. Let’s talk some more. So back I come again with this statement:

“One of the first priorities that needs to be addressed is getting someone on-site to (my client) to handle the RIS and (other) issues next as has already been done with (your rep) and the PACS. We will need a date and person(s) for that addressed ASAP.”

Their answer:

“We will discuss additional onsite needs tomorrow on our call.”

I love it again. Let’s talk some more…and more and more So back I come again with this more direct statement that left little room for interpretive error:

“It's fine to discuss this all tomorrow- just know there is an expectation on the part of (my client) that an on-site visit to address the RIS and (other) issues will be made. Just as with PACS, attempts to fix issues with these systems remotely to date have been unsuccessful so (my client) feels an on-site visit is dictated for these systems as well.”

I followed this up with yet another e-mail reiterating the same thing so there were absolutely no Cool Hand Luke moments. The vendor knew our expectations so….let's fast forward to the conference call. There were at least seven people from the vendor side on the call (that we knew of) including four stuffed suits pulling in six figure salaries, five from my client, and me. Lotsa lotsa bodies.

So we start out recapping what the rep did to fix the problems with the PACS. So far so good. Then we move on to the RIS. I ask “When can we have someone on site to review the RIS (and other) problems? “ No answer. I ask the same question again. No answer. A third time. Again, silence. By now I am waiting for the cock to crow like it did with Peter’s denial of Christ, yet the more I asked the more we were met with silence. Can someone- ANYONE- please tell me that you will have a warm body out here within the next 3 weeks? Silence. Madness. Now in Mark 14:67-72 it says the cock crowed each time after Peter’s denial but in Matthew, Luke, and John it said it crowed only after the third time. I would have been happy if it crowed after any time but the while there were a lot of vendor cocks on the call, not a single one dared crow at all. Finally the regional rep spoke up and said “We’ll get back to you by the end of the day with a decision.“ OK, that’s some progress, I thought. And low and behold, 25 minutes before the end of the work day, we get this very detailed e-mail:

We will send someone onsite to (the client site) before 4/15 and are targeting 4/11 and 4/12 specifically. We will be back in touch with further details.
Have a nice weekend!

THAT is what took seven people including four "management types" an entire day to get back to us on- that “someone” will be on-site? No wonder why this company is so "challenged" in the marketplace. They suffer from analysis paralysis with no one there making ANY decision let alone an executive decision. Without going into details this is a seven figure install and the customer has nearly paid as much again in service as they have for the system in the 5 years or so they have had it. That said is asking the vendor to spend $1,000, or even $2,000, to send “someone” out to assess a problem with one of the systems really too much to ask? Not in my book or in most companies books either but obviously it is in this companies book. Hell if this were a larGE-er company there would be 6 people on site- 4 watching the one person doing all the work and the other taking notes to insure that Sick Sigma is being followed properly.

Knowing that “someone” would be finally coming here’s what I wrote back:

We would prefer (the rep we know) to be (the vendors) on site person if/as possible given he has both a positive existing relationship with (my client) and knows many of the problems they have faced intimately, but in his absence "someone" else will do...I'm also sure (my clients administrator) will also make sure all the parties at (my client) are made aware of these tentative dates and will have them free up their schedules accordingly.
Have a great weekend!!

Do we really need to go through all this? No. Does the vendor really care about losing this account? No. Can the vendor afford to lose this high visibility account? No. Can you fix stupid? No.

To be continued…..

Tuesday, March 15, 2011

Gypsies, Tramps and Thieves

I was listening to the radio this morning and up pops an oldie but goodie that Cher did way back in 1971.....

I was born in the wagon of a travelin' show
My mama used to dance for the money they'd throw
Papa would do whatever he could
Preach a little gospel
Sell a couple bottles of Doctor Good

As the song went on I got to thinking- gee, that sounds a lot like my industry.

Gypsies, tramps and thieves
We'd hear it from the people of the town
They'd call us gypsies, tramps and thieves
But every night all the men would come around
And lay their money down

Even the vendors were represented well..

I never had schoolin' but he taught me well
With his smooth southern style
Three months later, I'm a gal in trouble
And I haven't seen him for a while
I haven't seen him for a while

So why do I think we are an industry of Gypsies Tramps and Thieves? Look at the definitions:

Gypsy: a laborer who moves from place to place as demanded by employment.

Tramp: a person who engages freely in promiscuous sex; or as the Urban Dictionary defines it “ Any woman who will open her legs for anyone, except for me.”

Thief: a person who steals, especially secretly or without open force.

Every year when I go to RSNA, HIMSS, and other trade shows I am amazed at the number of individuals who have moved from one company to the next…IMHO half of them should be collecting unemployment checks but instead their incompetence is often rewarded by them securing a better job with a different company at twice the pay. Does this make sense? Of course it does….That is one of the reasons I don’t have a “real” job in this industry.

The Peter Principle is stated in chapter 1 of the book with the same title: "In a hierarchy every employee tends to rise to his level of incompetence." In the 30 years I’ve been in this industry I’ve seen the Peter Principle applied time and again. This often affects people who lost their jobs due to attrition in a half hearted attempt to show profitability for the company’s quarterly or year end statement. “Look, we made money!! Of course we have no R&D or sales force left but we made money by reducing our overhead!!” The fact that sales wasn’t selling and leadership wasn’t leading that largely contributed to getting you into this fine mess to begin was somehow overlooked…. but these are minor details. Give them a nice farewell package and let them move on to screw up yet another company. This does not apply to all individuals- there are some very good people in our industry who have done exceptionally well and deserve an upward move- but there are some "moves" that I've seen that just completely defy logic.

At times it seems like no one is minding the castle or even cares. I recall several years back when I was asked to come join the sales force of a major PACS company who were holding their annual sales meeting down here at Disney- at the Grand Floridian no less. This week long foray had to have easily set the company back $1M with airfares, hotel charges, luxury meals, etc.- for a sales force that hit all of 74% of its quota. I laugh when comparing this to my times working for Motorola in the late 70’s where we ended up having our sales meeting at a divey Best Western in Cordele, Georgia. We all wondered what we did wrong to deserve this locale- the land of Stuckey’s pecans and shelled peanuts- and the answer came quickly- “You were at 96.7% of quota- close, but we don’t pay you for getting close. When you hit quota you get rewarded, when you don’t you count your blessings you still have a job. You have 90 days to get the numbers up- let us know what we need to do to help you..“ That was it- short, sweet and direct. And you know what? We never missed our quota again.

The contrast between the two companies was stark and is one of the reasons why “big spender company” still hasn’t turned a profit in many many years…and probably won’t for a while either. While “leadership” is finally taking steps to bring spending into control they are doing it the wrong way- by cutting areas that don’t need to be cut, not hiring as many people as they need while burning those they do have out and….but that’s a big company for ya…That’s why I love the little companies…..they think small…and even a few medium size companies who still think like a small company. They see it paying dividends in big ways.

While I'm at it because you hold the title of Senior VP, President, or CEO of the company doesn’t mean you need a limo to take you to McCormick Place or that your require a suite at the Fairmont with fresh fruit platters delivered daily and plenty of space for your handlers to roam about. Get a regular room, meet in the restaurant and take the bus- you might actually learn something about your company as well.

So how does mediocrity continue to thrive in our industry? I guess no one read Ephesians 4:25 “Therefore each of you must put off falsehood and speak truthfully to his neighbor, for we are all members of one body.” If anyone did speak truthfully about the people who were up for various jobs most wouldn’t be in positions they are in now, but the threat of lawsuits is so prevalent that no one dare say anything negative about anyone. There are also always seemingly valid excuses for not making quota, for the company not growing etc. It’s like dealing with my kids when they were younger- it was NEVER their fault and always related to circumstances beyond their control. Thankfully my sons have matured and they now accept responsibility for their actions- most times .

Only once in my decades in this industry have I found a situation that was outside a person’s control where I said you have to leave. This one company was beyond unreasonable when a friend of mine was given a quota for a relatively small territory in South Florida. His quota was larger than what all companies in the entire state of Florida combined would be able to even come close to hitting if all the planets were properly aligned. He was a top performer too and left soon after. Now is making four times what he would have there with one quarter the pressure and at a much better company. He was the exception though, not the rule. Most just move on and do the same thing for few year until the company gets smart and sends them to more verdant pastures- or other companies.

OK, that’s gypsies. Now on to tramps and thieves. In my business- PACS consulting- tramps and thieves are often one and the same. Our business has taken a financial hit like many have plus we are now being inundated with wannabe consultants who head to Fed Ex/Kinkos, print business cards, and viola- they are an instant PACS consultant until they find the next real job and close up shop leaving their customers hanging. Some- but not all- of my counterparts have also started to compromise their own personal integrity by taking on just about any job that is out there to pay the bills. I understand their rationale but…I’m just not willing to sell out that cheaply- or at all.

I have had many jobs offered to me in recent years but more than half of them I pass on because I couldn’t see the value in them and hate taking money from a company for basically doing nothing- even if they see the value in their own request. With damn few exceptions I’ve been in this industry longer than most and can tell in a New York Minute what a company needs and what it doesn’t.

It’s the same with end users who come to me saying “We want to get rid of our incumbent vendor.” My first question is always “What is wrong with them and what steps have been taken to correct the problem?” In 80% of the cases we can save the marriage and move on. Now this doesn’t benefit me at all- I make a whole lot more money do replacement PACS that includes doing data migration and establishing a VNA- but doing what is right for the customer is what is paramount. As the late Michael Jackson sang:

I'm Starting With
The Man In The Mirror
I'm Asking Him
To Change His Ways
And No Message
Could Have Been Any Clearer
If You Wanna Make The World
A Better Place...
Take A Look At Yourself
And Then Make A Change...
(Na Na Na, Na Na Na, Na Na,Na Nah)

I‘ve only done one project in the past several years I didn’t want to do- a customer survey- but the company was insistent that I do it so I swallowed hard and I did. They hated what I found out (it was less than positive) and they had a hard time believing the results even though I had the e-mails from their clients that documented the findings. I’m sure they will now spend 10x what they paid me to take a more “scientific” approach like they did when they were employed by big boys who had more money than common sense and finally get the results they were looking for. Sounds like the methodology many rankings companies seem to take actually .

Thieves steal but isn’t being paid for something that will not benefit the customer the same as stealing? It is in my book. Is taking money for doing nothing stealing as well? Yes. Now I love retainers and yet hate them for the very same reason. Yes, I can make a company a much better deal work-wise if I know that money is coming in regularly, but please make sure I earn my keep by giving me jobs to do. It’s an integrity issue, pure and simple. You get paid, you do the work. Conversely it annoys me when you do the work and then have to beg to get paid months later too. Thankfully there are only a few companies like that…and most are the bigger companies where you are just a number…and where your invoice that will address next month’s payroll can just sit there because it is so low dollar value-wise relative to the other invoices in the queue.

So- gypsies, tramps and thieves? You bet!! It’s what makes our industry so special.

Friday, March 4, 2011


It’s been over a month since I last posted but then it’s been a VERY busy month. I’m going to try and do much better but as I said I don’t make New Years’ resolution’s because I rarely keep them so…here ya go!!

HIMSS®- what an interesting show!! 1000+ vendors, 31,000+ people and I asked myself time and again why was I there? It wasn’t to increase press registration although just like RSNA® there were more vendors than attendees (16,586 vendors, 14,639 professional registrants, all willing to pay $3.00 for a 12 ounce Diet Coke® at the Orange Convention Center’s soda machines). Radiology, at least in the form of RIS and PACS, was all but invisible, hidden behind big company facades of products that more clearly addressed the buzzwords of “meaningful use”, EHR/PHR/EMR , and the like and not something as plain Jane or boring as radiology (although there was good representation by VNA and cloud providers.) Why then was I humped like a dog in heat from every advertising and PR agency this side of East Jesus asking me if I could spare “just 30 minutes” to meet with the companies they represented? I kid you not I got 178 e-mails on companies products and services- 178!!!. Of these exactly three (3) represented radiology and radiology-related products and the rest just wasted server space, although it was fascinating to see the way these companies market products for their clients. I loved the “Hi, are you going to HIMSS?” e-mails. Look, dip shit, you got my name from HIMSS as a registered member of the press covering the show but know I’ll be covering it remotely like the Casey Anthony trial….. watching TV and eating bon-bons on the couch but send me your stuff anyway…. just like one major company did by sending me their press kit on CD via Fed Ex overnight one week after I had already submitted my story to the editor. Good move. It would have been much better if you had done what others did having flash drives with your press kit on it in the press room. That would have guaranteed I had at least two copies of your kit were readily available when I needed it- and perhaps even more if you had then on 2GB or 4GB flash drives . Of course it must be pointed out that I was just obtaining these extras for my counterparts who could not make it and wanted their own copies and no other. I do have scruples and integrity you know…and do use the stock photos as well, so thanks.

I covered my thoughts on the show and a few highlights on AuntMinnie.com® (http://www.auntminnie.com/index.aspx?sec=sup&sub=ris&pag=dis&ItemID=94411 if you are interested) but the fun parts were really looking at the vendors and chatting with them. The giveaways here were awesome- check these out- scooters, jet skis, and of course at least 1500 Apple ®iPads.

Of course with the new iPad® coming out this week the ones that were won were already obsolete but still…I have a 6 year old computer that works semi-fine but my kids are still trying to get me over to a Mac.

I did the PACSMan® awards for RSNA on AuntMinnie ®
(http://www.auntminnie.com/index.aspx?sec=sup&sub=pac&pag=dis&itemId=93457 if you are interested) so here’s my version for HIMSS:

“Ich bin ein Berliner!" Some vendors really got screwed with their booth placement but few worse than poor Canadian-based Client Outlook, Inc who got stuck behind ECM Software’s Berlin Wall . Nothing like a 10’ wall in front of you when you are trying to have people see your enterprise viewer product. E-Unity® is a good product too- too bad many never got to see it. At first I thought “Hey, WTF is ECM doing here putting up a wall like this!!” but then I realized it wasn’t ECM’s fault but HIMSS for allowing this. Truth be known most of the radiology companies- at least first or second time exhibitors- were in the very back of the exhibit hall while several non-radiology first time exhibitors happened to be located near the front of the hall. Mere coincidence? You tell me…but considering that radiology was all but ignored by HIMSS…it sure looks highly suspicious to me.

Best Marketing
- without a doubt XLR8r. They had it together.

Worst Marketing- No names will be used to protect the guilty, but it deals with infection control and I’ll leave it at that. I wish I could have taken a picture but guys tend to frown on you when you bring a camera in the men’s room so you’ll have to take my word on this one. I’m standing there getting rid of the morning's coffee and look down and there, written on the urinal screen, is the message “Your keyboard is 4 times dirtier that this” (or something like that). I’m like- “Is NOTHING sacred any more?” Now I’ve been in sports bars and such where they had the newspaper sports section posted above the urinal so you can look at the headlines while you take a leak but the urinal screen? And I really didn’t want to argue with the guys but in the absence of a disease condition urine is basically sterile and is greater than 95% water, with the remaining constituents, in order of decreasing concentration urea 9.3 g/L, chloride 1.87 g/L, sodium 1.17 g/L, potassium 0.750 g/L, creatinine 0.670 g/L and other dissolved ions, inorganic and organic compounds so what’s so dirty about a little pee. If it was good enough for Gandhi it’s good enough for me…. But alas I digress lest someone say I’m full of piss and vinegar.

Most Fun- Cattail Software’s Karate Choppin’ Buzz Lightyear™ giveaway. When I asked Heather Duffy, the attractive gal in the photo below, what the connection was to their product she said “The future is here.” OK, I get it…”To infinity and beyond!!!” and all that jazz. Next year though they need to get some Woodys so I could say “I got a Woody at Cattail Software!”. That might turn a head or two…

Best Giveaway (outside of the jet skis and scooters and such)- Formfast’s Indiana Jones hats….Must have set them back $15 each but it brought the people in for sure…

Silliest- Gotta love the “Operation” game in Sepaton’s booth

Best Product Name- ebc wayfinding's “Electronic Breadcrumbs”

Best Button- Extormity (aka MIE Medical Informatics Engineering) I love truth in advertising.

Best Double Entendre (and don’t tell me that’s not intentional either). Zebra Technologies.

Most Realistic Representation of How Much Going to HIMSS Costs- KGS/Kforce Government…Their TraumaFX® product was pretty cool although I’m not sure how it ties in to HIMSS outside…Now while I understand why they call the trainer MATT and acronym for Multiple Amputee Trauma Trainer that’s also my son’s name so…

Weirdest- WTF was going on in the Carefx booth with the “Glee” meets “Dancing with the Stars” routine. Three times a &(&^$ day…I though the guys in the Fuji booth were going to smuggle in shotguns by Wednesday morning….and it would have been justifiable homicide at that. Now I am all for corporate enthusiasm but his was carried wayyyyy to far…The decibel level was also ridiculous…..and the tie in? Now I read the company’s tenets- “Benefit of the Doubt”- trusting each other while knowing that all team members have your back while you’re giving your best; “Make It Great,”- the amazing collective energy by striving to improve each and every day and; “Juice.”- solutions, positive attitude, teamwork, and results while under pressure- but come on, this is a trade show, not an audition for America’s Got Talent. I guess I missed it. Maybe if they had a guy dressed as Jesus it would have been better received, playing off their “I Am…” tee shirt giveaway instead.

They’re Tanned They’re Rested, They’re Back!!- …and I loved chatted with them. I smiled hearing the comment “AT&T® is entering the world of healthcare!!” Really now? Ever heard of CommView®? No? Oh wait, that was before you were born my little 22 year old puppy…...my bad…

And last, but not least, from the “I sure hope they paid you a lot for dressing up like this” file, the guys at TeraMedica® who had to endure four days of dressing up like a male version of Betsy Ross to drive home the company’s “Declare Your Vendor Independence ™” message. It’s a great message but…..

Now for those dozen or so people who actually read this blog and wanted a follow on to my prior post here is an update:

I got over the cold from Hades that destroyed my one and only vacation week between Christmas and New Years and now just have to deal with everything blooming down here. Yes it is Florida and yes everything is in bloom. Thank God for Claratin® D and Zyrtec ® D- I’ll live on the stuff for the next 3 weeks or so. Unfortunately wearing contacts is out of the question so I get to embarrass my son by wearing my 1980’s vintage glasses instead. …

Business has picked up to the point where I am about as busy as I need to be (but in typical consultant fashion there is always room for one more engagement. Call NOW!!). With over 25 years experience being on my own I have gotten used to this month to month hand to mouth existence and never once missed a mortgage payment or had to suffer some of the hardships that others have had to endure.

My friend is back from addressing the challenges he faced and has a completely new positive outlook on life. While it cost his insurance $16,800.00 for 30 days treatment (what a racquet!) it was worth ten times that to those of us who have witness this near complete transformation of this train wreck that was waiting to happen.

Things seemed to have worked out on the home front as well. The bump in the road I experienced took all four tires off the road for long enough to have me concerned, but thankfully I’ve been driving long enough to be able to recover and stay on the road instead of hitting a tree. I realized that cruise control can only go so far and that I need to look at the road a little closer to make sure that bumps like this don’t happen again but so far so good.

Overall life is good. Now if I can just get another post up in less than 6 weeks it will be even better. Till next time, enjoy!!

Wednesday, January 19, 2011

Bring back 2010

It’s a New Year. Whoopee! Nearly twenty days into the new year and already I long for 2010 again. I vowed years ago to never make resolutions I can’t keep (and even more directly, to never keep those that I make) and so far I’m right on target considering that my one big resolution was to blog more. Considering how 2011 started out though I probably would be better off saying nothing at all.

I spend New Years Eve in bed – alone- under my down comforter with a pair of jeans on, tee shirt, sweatshirt, my heavy winter down jacket with a hood and gloves on and was still shivering like crazy with the flu or whatever you want to call it…I can think of much better ways to ring out the old and ring in the new, but let it suffice to say the week between Christmas and New Years was sheer hell. Thankfully I’m healthy and my body won out in the end. I’d shudder to think what might have happened had I had any form of compromised immune system.

December led me to more contracts than ever before and I finally celebrated being able to relax a bit financially going into 2011. And then, just like that- poof- almost every contract that my clients had verbally committed to disappeared like Al Sharpton at a Klan rally. All of a sudden I went from what was a rancorous feast at a churrascaria to eating in the church hall with the elderly people from the trailer park our church feeds every month, people looking for a free meal and some companionship. Thankfully I had some embers in the fire that will get me through the next month or so (I learned a long time ago to never ever to put your eggs in one basket) and have few longer term contracts pending as well. Still, it taught me that once again the only thing you really can trust in is yourself.

I saw yet another long time PACS veteran pass on and while little was said about him- two short paragraphs was all- I do miss having Tom Goliash around. Tom and I agreed to disagree on just about everything since we met in the early 80’s. He was brash, he was direct, he was opinionated, he was everything you aren’t supposed to be running a company- but above all Tom was true to himself. You never had to guess where you stood with Tom- if he liked you he liked you for life, if he thought you were an a$$hole or an SOB you would hear it from his lips directly, not through third parties. As crazy as it sounds I liked that about him. He was an entrepreneur back in the days when the PACS market could sustain entrepreneurs even though almost no two products he ever delivered to his clients were exactly the same. Thankfully I don’t believe they conducted many GMP reviews back in the days of AVP and Megascan and by the time he founded UltraRad a few years back he finally seemed to have his act it all together. Tom was a dedicated husband married for 44 years to the same woman, a father, grandfather and friend and a guy who had one thing so few have in this marketplace- passion. He could have easily retired with the money he made from the sale of his company but instead decided to jump back in with both feet again after taking just a little time for himself to enjoy his passion for sailing. Tom deserved more than just two short paragraphs and while he is gone his presence will be long missed by those of us who knew him.

The day after Tom’s passing my world turned upside down yet again when my very best male friend in the entire world completely decomposed and ended up having to formally address the demons that have haunted him since his childhood days by entering a rehab facility. While his timing was abysmal-he had a week long all-expense paid vacation in Hawaii waiting for him two days later as a thank you for exceeding his quota yet again- it was bound to happen. In so many respects my friend is a huge success- he makes a boatload of money, is a super dad to his kids, is a wonderful friend- and yet he has two weaknesses. He just can’t say no and takes care of everyone but himself often at the expense of himself. A large part of his problems stem from a toxic ex wife who just won’t let go three years hence and keeps hounding him on everything from financial support (he gives her more than twice what the courts would have mandated plus pays for everything related to the kids and still it’s never ever enough) to his personal life about who he dates and what he does. It finally got to the point a little over a week ago where the only rest he got was in the place where he had taken comfort for the past 30 years. Unfortunately once he started his escape this time he just couldn’t stop escaping and needed help. I and a few of his closest friends have been meeting to put together a plan to keep him on the straight and narrow, but we all believe he needs to stop living his life as others think he should live it and instead live his life for him.

The final coup de grace was a change in my own life circumstances. For only the second time in nine years since my divorce I took the chance to get to know someone quite well this summer. All was going fairly well yet we hit a bump in the road that was more like a Florida sinkhole than anything else. As I thought about what I told my friend in rehab I couldn’t help but hear myself talking as well. I enjoy my new friend a lot yet I am trying to absorb myself into a lifestyle that really isn't me and have my friend absorb a lifestyle with me that really isn’t her either. In the end this lead to a few uncomfortable situations and misread communications which just isn't good. I am about as close to being a cowboy as Martha Stewart is to giving my house an award for cleanliness, but that's OK- I Yam What I Yam and frankly Roy Rogers I ain’t. The same can be said about her not being my divine garage sale goddess although she has gone to a few with me and done quite well. Yes, I will mourn the loss of a very dear friend if it comes to that yet I also celebrate my ability to finally open up and share MY feelings directly instead of hiding them behind a wall as has so often happened in the past. I have grown and that is good, even if this relationship did add a very nice vintage Luis Vitton bag to add to the collection of baggage my friend says I seem to carry with me. I always said though if you have to have baggage, then by all means make it the best…

I have so much to share….and yes, lots of PACS news too. Standby- it looks like it’s going to be a very interesting year…