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New perspectives on Branding in the era of Social Media

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This is to share a thought-provoking piece on branding in the era of social media. Along with the reference to the observation that traditional branding models are failing as markets evolve, I appreciated the reference to the opportunities available in industries where customers are searching for alternatives, such as what we are experiencing today in health care.

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Beyond the opportunity in industries undergoing chance, one cannot ignore bread-and-butter marketing strategy as the impetus for all marketing activities. This articles makes the important point that the channel is the last consideration after clearly defining one’s business objectives. In my view, conversations on on either branding or social media must start with a thoughtful discussion of purpose. Why is this critical to this business? With a well-grounded marketing strategy that is tied to business objectives, the social media and the brand ID can be effective. Otherwise, efforts will prove wasteful in the long-term.

If I Understood You – Communications for Health Care Professionals

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We have an important new piece for health care professionals by Alan Alda, If I Understood You, Would I have this Look on My Face?

Alda covers his own experiences on the topic of communications for scientists – bridging improv and science to move toward a future of closing the gap between the patient and the provider and other critical stakeholders in the continuum of care.


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A Loving Day

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Many don’t realize that mixed race marriages were legalized across the US only 50 years ago today. On June 12, 1967 the ban on interracial marriages was struck down in 16 states, thanks to a brave couple in Virginia.


My kids were born only 30 years after this law was passed in the US. Thirty years is not a long time. When I moved to Japan at the age of 13, I met interracial kids for the first time. Of course, I didn’t think twice about it at that age and haven’t done so since.


Here in the US, however, even 50 years after this law was passed, I can see that some still do a double-take when they realize that my kids and I don’t appear to look the same, racially. Versus other countries where I have spent time (Singapore, Brazil, Sweden, etc), one can tell it is still relatively new and perhaps unusual to us in the US.


I was happy to realize, today, that this pioneering interracial couple was named “Loving.” Coincidentally, this summer, we are also celebrating the 50th anniversary of the Summer of Love here in San Francisco.


Here’s to a future where the word “love” comes to define how we look at racial differences and diversity of all kinds.

The Lovings changed US history in 1967

The Lovings changed US history in 1967

30 years later, kids like these were born legally in the US

30 years later, kids like these were born legally in the US






FTC Chairwoman’s Role

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Today, the Chairwoman of the FTC stepped down to allow the new administration to select their own representative. This piece provides insight in the role that the commission plays in ensuring a competitive and comsumer-friendly healthcare and tech industry.





Laura’s Journey: From Breast Cancer Diagnosis to Radiant Survival

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The blond woman in the flowing red dress who graces UCSF’s “Redefining Possible” billboards and ads in and around San Francisco – you’ve probably seen her, but you likely don’t know her story.


Last week, Laura Holmes Haddad visited the UCSF Imaging facility at 1725 Montgomery Street, and shared her journey from terrifying breast cancer diagnosis to three years of radiant survival. She also talked about how she wants to help others. 

“I never had a health issue before my diagnosis,” said Holmes Haddad. “And I was totally unprepared. I want others to be aware of the type of mindset and teamwork that helped save my life.”

Holmes Haddad realizes that her outcome was the result of a remarkable convergence of opportunities, effort, and will. In overcoming her illness, she worked with the world’s leading medical teams, and had the active care of family and friends who supported her and championed her well-being. Holmes Haddad also credits her own self-advocacy, not to overemphasize her perseverance, but to encourage other patients. 

She hopes to provide tools and perspective to patients who may face a cancer diagnosis in their lifetime. To that end, she has written a book, This is Cancer: Everything You Need to Know, From the Waiting Room to the Bedroom, which will be released on October 18. 

What’s critical: Take time for yourself – don’t delay!

Holmes Haddad was the mother of two young children, ages 14 months and 4 years old, when she was diagnosed with breast cancerand given three to five years to live. That was four years ago. 

When she first started noticing her body was changing, she chalked her breast discomfort up to lactation and the feeling of being unwell to the demands so many young mothers’ experiences. She had the lingering sense she should do something about not feeling well, but procrastinated, as she pointed out, “…like so many others!” The message she wants to spread now? “Do not put off your health. Take time to be screened and to see your doctor.”

Assemble a great team – and work hard to get the care you need

Self-advocacy and the support of a willing community were critical to Holmes Haddad’s success. After she was diagnosed, she set her sights on treatment at UCSF. “I wanted to ensure I had the brightest, most talented medical teamworking on my behalf.” When she let her circle of family and friends know that UCSF was her goal, they advocated to help her begin treatment. Later, when her UCSF oncologist informed her about the clinical trial that ultimately stopped her cancer, Holmes Haddad’s persistence was tested when she had to repeatedly apply before acceptance. “I was lucky to have a strong community, and to have lots of personal support so I could really take care of myself. But what about patients who don’t have that extra help? I’m hopeful the book can teach patients how to get the best care and treatment regardless of their circumstances.”

Life lessons 

Today, after having stared death in face, Holmes Haddad says she focuses on what is essential. How does she define that? She says, “Your kids are essential. Your family. Saying ‘no’ more often.” Then with a smile, she adds, “And saying ‘yes.’”

As a result, she says she is more fun as a parent and kinder to everyone she encounters. She is also more aware of the everyday struggles of chronically ill patients as well as their caregivers.


Holmes Haddad is deeply grateful to those who helped her and remembers the tender moments offered by her care team across UCSF. One was a UCSF Imaging tech, to whom she revealed her feelings of self-consciousness about how she looked after she lost her hair during chemotherapy. In his thick Irish accent he said, “Laura, they aren’t staring at you because your bald head makes you look funny, they are staring because they think you’re beautiful.” His profoundly kind words helped sustain her as she marched forward, not knowing her eventual positive outcome. 

And she had the opportunity in a private meeting to express her gratitude to Dr. Alan Ashworth, who leads the UCSF Helen Diller Family Comprehensive Cancer Center. Ashworth has spent most of his career focusing on the BRCA2 gene mutation of which Holmes Haddad is a carrier. “I shook his hand and I told him, ‘Thank you for saving my life,” she said, and there was not a dry eye in the room.

When we met Holmes Haddad in person, we experienced first-hand the power she has to make others feel great. Said one of our techs, “I just want to be around her.” She exudes values we all can aspire to–kindness, humility, generosity, being in the moment. 

In February, Vice President Joe Biden visited UCSF and met Holmes Haddad. “His kindness, intellect, and determination to eradicate cancer was a privilege to witness,” said Holmes Haddad. “And it was an honor to represent the patient voice to him and Dr. Jill Biden at UCSF.”

We are honored that she chose to say “yes” to an interview, and inspired by her example of saying “no” to things that do not make each day a richer one.


Airbnb’s approach to moving an organization toward a new future – a model for us all

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Airbnb is the story of hard work and a company that challenges itself on a day-to-day basis by stepping back to ask tough, new questions.


Last month, Airbnb announced the birth of new division, an innovation lab, called “Samara.” It was tasked with identifying business opportunities for the organization, one of which they have also just announced – a new hospitality concept in Japan. Thank you, Chip Conley, for encouraging me to follow the progress of this interesting new business by reading some of the interesting articles on the topic. 


Their discovery is ground-breaking on the one hand, because it is a concept that is new to both Japan and other countries. On the other hand, as one unpacks the discovery process, one realizes that the “ah ha” moment was the result of addressing an age-old business question, “What is a customer problem? How can we resolve it?”


Samara is hoping to tackle the issue of de-population among traditional Japanese villages by establishing cultural centers to attract international tourists. Can the model survive in Japan? If so, can it be translated to other countries?


Tracking their progress will provide an interesting way to observe how innovative industry leaders, such as Airbnb, among many others, continue to adapt to shifting industry dynamics and stay competitive.


…and even for those whose organizations who are not considered industry leaders, but who might look at themselves  more humbly as community leaders and use the Airbnb – Samara discipline of looking at their business in structurally new ways by asking, “What is the customer problem we can solve?”

Turning turn both Airbnb and architecture on its head in Japan

Turning turn both Airbnb and architecture on its head in Japan


This Tuesday, July 19 UCSF Lecturers Revealing Potential Advance in Alzheimer’s Assessment

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Amyloid PET Scans

Amyloid PET Scans

I am writing to invite you to join us for an informative dinner symposium about Alzheimer’s disease assessment using amyloid PET imaging. It will be held on Tuesday, July 19th, with a reception from 6:00-6:20 pm, followed by formal lectures from 6:20-8:30 p.m. at the Mission Bay Conference Center. (Please see event details, along with a registration link by visiting our Events landing page, or clicking here.)

The evening event entitled “Learn More about Amyloid PET Imaging and Dementia: What You Need to Know for Your Medicare Patients with Memory Complaints,” is generously sponsored by SNMMI (Society of Nuclear Medicine and Molecular Imaging.)

I am pleased that the dinner event features presentations by UCSF scientists and physicians Miguel Hernandez Pampaloni, MD, PhD; Gil Rabinovici, MD, UCSF neurologist and chair of the IDEAS-Study; and Michael Weiner, MD. These leading authorities in the field will provide insights in advances in amyloid PET and its use in scanning for dementia.

Upon completion of this activity, participants will be able to: (1) Explain the mechanism of how amyloid PET works; (2) identify the appropriate indications and limitations of amyloid PET; and (3) understand how to provide Medicare patients access to amyloid PET.

Please feel free to let us know if you are able to attend or would otherwise like to remain in contact with us regarding our work in this arena. We welcome learning more about your interest.

We are looking forward to hearing from you and to hopefully seeing you on Tuesday, July 19.

What can kids teach us about customer service in the health care industry?

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Providing health care services for kids creates the perfect platform to address customer service in the health care industry.


Themed imaging rooms help children navigate the health care experience at UCSF.

Themed imaging rooms help children navigate the health care experience at UCSF.

Last week, UCSF Radiology launched its latest “adventure series,” an experience designed to make imaging more inviting for pediatric patients.  Why? Many children suffer from anxiety when going through exams. The child-friendly scanners at Mission Bay make a big difference in how children react to being scanned.

Children remind us that we are at our most vulnerable state when it comes to health care – we are often afraid, do not want to be there, and lack information to make us feel empowered. In terms of customer service, we may not be looking for the the definition we might first expect.


In this Doug Dietz TED Talk, we hear the story of a MR scanner designer who has the opportunity, by chance, to experience a young patient’s reaction to his design – the patient is crying and holds onto her parents as she gets closer to the device. For the first time, this designer learns about the fear that customers experience with his product and uses the experience to design customer-centered scanners.

Customer fear is only part of the story. The other is the realization that, traditionally, those designing healthcare technologies and services, even for kids, did not need to focus on the experience. After all, it was patient outcomes, and not patient experiences that mattered most.

When we look across industries, we see organizations that systematically incorporate customer insights into processes. Focusing on customer perspectives and developing systems that emphasizes customer service is considered a more effective way to manage in many organizations. In health care, many still lead with the concepts of “outcomes” versus “experience/perceptions.” My questions is: Could these qualities be related?

Where are customer insights collected?

In most industries, this is not an after-the-fact collection. Instead, the starting point in the design of any new service or product is the customer perspective. One asks –  What is the problem we are solving? What can be improved? Insights are collected from multiple sources.  With this data, the product or service is developed and then tested extensively and evaluated from multiple perspectives. Customer needs and ratings are considered essential to the long-term success of the new launch and to the business as a whole.

Creating new definitions of customer service for the health care industry

Organizations known for prioritizing the customer experience range from those in entertainment and retail to transportation and consumer products. We often associate concepts such as “customer delight” and “cost-competitiveness” with great customer service.   

Those in the healthcare industry, however, understand that customers are not expecting to be delighted, necessarily. As Doug Dietz reminds us, they are looking for concepts like reassurance, compassion and information. When it comes to price competitiveness, the sector faces structural impediments to offering clear pricing and cost-competitiveness, as we might expect in other industries. Clearly, many traditional customer service concepts, including “delight” and “cost-competitiveness”  do not apply to the health care industry.

Despite the fact that the some of the standard models of customer service do not apply, there is still room for the concept of shaping products and services around customer perceptions.

Questions to address going forward include:

  1. How can we optimize patient perceptions of service while achieving optimal safety and care standards? Are these mutually exclusive?
  2. How does team communication and operational excellence impact patient outcomes?
  3. Do we evaluate total customer journeys in the healthcare environment? (Are we asking all the right questions?)
  4. Do we monitor patient anxiety/stress as they navigate our system? Can we develop more objective measures of this issue?
  5. How is compassion evaluated and optimized across teams?

Looking forward to learning more about progress being made in the health care industry. According to The Advisory Board, net promoter scores for companies like Apple and Amazon are in the 70’s and ’80’s, but, in the health care industry, scores range between 14 and 17.

Pulsatile Tinnitus: One Patient’s Quest to End Ominous Ringing in Her Ear

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Talking with patient Alla and UCSF Radiologist Dr. Matt Amans about this case was one of the highlights of my year. It demonstrates what can happen when someone finds the right resource at the right time.

 It started with a small but persistent noise in her right ear.

Alla and Sergei pose while hiking at the Sea Ranch in Sonoma County, California.

Alla and Sergei pose while hiking at the Sea Ranch in Sonoma County, California.


The noise seemed in rhythm with Alla’s heartbeat. Within a month, it seemed more related to her heart than ever—the noise transformed into a clamorous “whoosh” with every beat. Far beyond annoying, the noise was disturbing, even debilitating. Activities like reading and watching TV were suddenly difficult, at times impossible. The noise often prevented her from falling asleep, and broke her sleep when it didn’t. 

Born and raised in Moscow, Alla arrived in the Bay Area in 1992 for a career in civil engineering. She quickly made new friendships, enjoyed hobbies like traveling, skiing, and pottery, married the love of her life, Sergei, and eventually became mother to their two boys. Family life was going along quite well for Alla, until June 2015.

That’s when the noise started. She began two-months of nearly nonstop diagnostic imaging and medical appointments, but no one could identify the source of the noise, much less suggest how to stop it. 

By July’s end, Alla was in survival mode. She and Sergei were desperate to find solutions.

Finally, thanks to Alla’s primary care physician, otolaryngologist Dr. Lloyd Ford, and nerve specialist Dr. Ziv Peled, she was referred to the UCSF Pulsatile Tinnitus Clinic. The clinic is co-directed by Drs. Matthew Amans and Karl Meisel from the departments of Radiology and Neurology, respectively. Images taken during her prior medical exams allowed Dr. Amans to quickly inform Alla she had a dural arteriovenous fistula (DAVF) in her right sigmoid sinus.

“No one could read the MRI the way Dr. Amans could,” explained Alla. 

“DAVF is a very rare abnormal connection of vessels surrounding the brain,” said Dr. Amans. “It happens where several arteries connect directly to a vein or venous sinus.”

Arteries are high-pressure vessels that carry blood from heart to tissues, while veins are vessels that take blood back from tissues to heart. They are especially sensitive to pressure changes. With DAVF, the direct connection between one or more arteries and the vein or sinuses pressurizes cerebral veins and can lead to stroke.

Surgery to treat Alla’s DAVF was scheduled within a few days of diagnosis. The nine hour procedure was performed by Dr. Amans and his team, including several experienced neuro interventional radiologists, anesthesiologists, technicians, and nurses. “Dr. Amans was direct, but reassuring. He was very optimistic, which gave me a lot of strength,” added Alla. 

“After waking up, I remember there were people talking to me, checking my vitals and smiling. ‘That’s a good sign,’ I thought. But the best part was yet to come. When everybody left the room, it felt different, like something I’d been missing for a long time: It was quiet,” recalls Alla. “There was no whooshing or pulsing sound in my ear anymore. I was scared to move and discover it again, so I turned my head a little to the right, a little more, then to the left, and a little more, and the sound didn’t come back. I couldn’t help myself, so I kept doing it and couldn’t stop smiling. Nurses were probably wondering what was going on, but it truly was the best feeling ever. I was cured. It was quiet!”

Only later did Alla learn about the complexity of the surgery, which consisted of three hours of detailed angiographic mapping of the complex network involved and six hours of embolization procedure. It went smoothly but took time, and required an enormous amount of concentration and skill operating extremely sophisticated equipment. 

“I am very thankful to the UCSF Pulsatile Tinnitus Clinic and personally to Dr. Amans, and his fellow Dr. Darflinger, for taking such good care of me. They didn’t just perform state-of-the-artendovascular surgery, but also spent hours talking to me and Sergei and helping us deal with the absolutely unexpected and unreasonable condition of DAVF,” explained Alla. “I owe so much thanks to Sergei’s kindness and patience. And kudos to the medical team and each of the individuals including the office staff, Yuen and Hanh, who were accommodating, understanding, and patient with me. Big thanks from the bottom of my heart!”

On February 23, 2016, six months after her procedure, an angiogram performed by Dr. Amans showed that Alla’s DAVF was entirely cured, with no follow-ups necessary. She and Sergei are now able to get back to the things they loved in life, including quiet. 

Alla is a sanitary engineer who works in water regulation for the Division of Drinking Water. Her background in fluid dynamics helped her appreciate the combined engineering and medical excellence of the UCSF Pulsatile Tinnitus Clinic. 

New Years as a right of passage

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Wrapping up, letting go = moving forward with clarity


“Nothing gets left undone,” commented my dad, Robert Skurko, when I reflected with him about the energy that gets expressed in Japanese companies during the time of the New Year.




This New Year, I read Marie Kondo’s “Art of Tidying” and reflecting on the little-known secret of the New Year’s in Japan. More than anything, the season is about wrapping up and clearing the slate. It’s less about “having fun” and “celebrating” than renewal.


How does clearing the slate manifest itself?
From Ito Yokado to Sony, with every company I have worked in Japan, when the New Year came, we turned our office space inside out in order to clean. All old paperwork was tossed. There was dusting and cleaning. And then, last, but not least, was the creation of a slogan to help unify us in the year ahead. Then, as the New Year unfolded, we set about greeting those near and dear to us. In families, this involved extended days of eating New Year’s food. In the corporate setting, we were ready for quick cups of tea, or a personal phone call, to “greet” those whom we considered important to us.


Years later, living in Singapore during the New Year and then marrying into a Chinese family, I got to experience this all over again. As one friend confided, “We have parties as an excuse to clean.” She talked about the art of clearing and cleaning, at least once in the year, which was followed by greeting friends and relatives. Again, in Singapore, after all the clearing, lucky statements (couplets and Chinese New Year decorations) were placed in the appropriate spots.


What does this lead to?


Letting go of the past is not easy. In Asian cultures, they create momentum behind this act and encourage people to clean up, I believe, in order to move on.
This year, as we sorted and tossed in our own home and office, after reading Kondo’s book, I reflected more deeply on the force behind this act.


One image comes to mind today – seeing the beautiful Daruma, upon whose face we had inscribed our wishes with a single eye, burning at temples. Seeing Daruma and other beautiful New Years decorations from the prior year being burned (especially b/c they were so expensive and precious!) was, at first, a shock to me. Today, it reminds me of the bitter-sweet act of letting go.