“When you come to a fork in the road, take it.”

Over the years I have collected some aphorisms, quotations and “classics” perhaps worth sharing.

“I made a lot of mistakes in my time but didn’t waste any time making them.” (attributed to Gustave Levy, Goldman Sachs)

“There are no secrets to success. It is the result of preparation, hard work and learning from failure.” (Colin Powell)

“A person who never made a mistake never tried anything new.” (Albert Einstein)

The three umpires (attributed to many):

At a post-season symposium three umpires were discussing “what’s a ball and what’s a strike?”

The rookie umpire said “There are balls and there are strikes and I call them as they are.”

The mid-career umpire said “There are balls and there are strikes and I call them as I seem them.”

The veteran umpire said “There are balls and there are strikes but they ain’t nothing til I call them.”

“Trust, but verify!” (Ronald Reagan)

“If Columbus had an advisory committee he would probably still be at the dock.” (Arthur Goldberg)

“Meetings without an agenda are like a restaurant without a menu.” (Susan B. Wilson)

Dr. Jerome Groopman in “How Doctors Think” developed a classification system for medical mistakes, observing a tendency to treat a case based on past experience rather than looking at it based solely on the evidence.

Vertical Line Failure – thinking inside the box

Confirmation Bias – confirming what you expect to find by selectively accepting or ignoring information

Anchoring –the failure to consider multiple possibilities but quickly and firmly latching on a single one

Availability –an unusual event that recently occurred which has similarities to the current case causing MD to ignore important differences

Commission Bias – tendency toward action rather than inaction due to “bravado”, desperation, or patient pressure

Relying on “Strict Logic” – answering a clinical question in the absence of empirical data

Over-reliance on Clinical Algorithms – simply filling in the blanks on the template

Haste – complicated problems cannot be solved quickly

Outcome Bias – thinking that the diagnosis that is wished for has occurred• Limited Searching –stop searching for a diagnosis once “

This is not to criticize physicians who get most things right and in a very challenging, fast-moving environment occasionally make mistakes. The point is we all fall into comfortable patterns of thinking – our own default classification systems.

“If you’re stuck in a routine that’s limiting your creativity or you’re faced with a challenging business problem and need a fresh approach, you can think outside the box. Or even better, think like there is no box.”

When you’re not sure flip a coin because while the coin is in the air, you realize which one you’re hoping for.” (source unknown)

“There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. These are things we don’t know we don’t know.” (Donald Rumsfeld)

“No battle plan survives contact with the enemy.” (Helmuth von Moltke the Elder. He was the Chief of Staff of the Prussian army before World War 1)

“Insanity: doing the same thing over and over again and expecting different results.” (Einstein)

“Life is What Happens to You While You’re Busy Making Other Plans.” (John Lennon)

“Never, never, never give up.” (Winston Churchill)

“Don’t depend on anyone else to bring the coffee.” (me)

“The best things in life aren’t things?” (Art Buchwald)

…and the most important

“Character is how you act when no one is watching” (attributed to many)


“When you come to a fork in the road, take it.”  Yogi Berra


“…what would it look like if Amazon CEO Jeff Bezos took the helm of a major integrated (health care) delivery system?”

“If you don’t have a seat at the table, you’re probably on the menu.”

Tomorrow morning’s Emergency Preparedness meeting (just scheduled for 8AM)

DON’T DEPEND ON ANYONE ELSE TO BRING THE COFFEE! & other Lessons Learned as a junior hospital CEO back in the day….

“Trust but Verify” (Ronald Reagan) – Four Lessons Learned as a junior CEO back in the day..

Confidential September 11, 2001 LESSONS LEARNED memorandum by hospital CEO Jonathan Metsch goes “viral” and becomes a New Jersey gubernatorial campaign issue

If Columbus had an advisory committee he would probably still be at the dock. (A)

We don’t know what we don’t know” (1) The challenge to emergency preparedness…..

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