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Mike's Book Reviews

  • Book Review: The Business of Nonprofit-ing
  • Making a Lasting Difference
    I've been struggling to finish "Making a Lasting Difference" by Graeme Reekie since first I received this book about 6 months ago from Wren and Greyhound.  The press is British but I thought the subject would be universal for nonprofits.  Alas and sadly, this is a slow, tedious read filled with platitudes and almost helpful considerations nonprofit managers might want to consider when thinking about how to financially sustain their organizations. I have generally posited that a nonprofit has 4 "pillars" that comprise its DNA: program, management and operations, governance and sustainability.  M. Graeme offers five: involvement ((having community support); Income generation; Innovation ("how to nourish and encourage incremental innovation); Improvement (systems and structures); and impact measurement.  So he and I don't operate from the same lens but his is certainly one perspective. Making a Lasting Difference is constructed in four parts, 20 chapters and 211 pages.  The possibly most innovative content is in Part 2, Chapter 2 where paradoxes, principles and practices of sustainability are presented.  The paradoxes:     a. Change - only by changing can organizations be sustainability, sustainability does not mean sustained, and, the lesson is that an org. must learn, adapt     and  evolve purposefully.  Here the author poses that an org has to have its act together to achieve sustainability     b. Octopus - organizations need to reach out in new directions to grow but growing in too many directions pulls them out of shape; diversified income does     not mean reduced risk; and, an org must focus on core organisational purpose and structure. Here the author says that mission drift will not make you     sustainable.     c. Yes/No the things that an organisation needs to survive can also kill it. Saying yes to everything is fatal; sustainability is about more than just money.      Capacity and quality matter. Understand when, how and what to say no to.  I would offer this is the "stay in your lane" paradox.     d. Efficiency - Efficiency preserves resources but can impair development.  Organisations cannot evolve, adapt or respond without spare capacity.  And     orgs should balance strategy and scrutiny.  They should invest in capacity building. To all of this I just want to say: uh, ok and thanks for the amazing insight.  No, not really!  I would not invest in this book.  You can better spend your time reading the Federal Register looking for grant opportunities (good luck given the current environment) or going through the Foundation Center directory or building an endowment from rich people who loved you (yes, this really is the key to sustainability).  Making a lasting difference may be a good idea when thinking about long-term impact from what your nonprofit does - reading this book will not.
  • The Board Member Orientation
    Michael E. Batts
  • Nonprofit Finance: A Practical Guide
    Sheila Shanker
  • Functional & Funded
    Harvey Chess - grant proposal writing
  • Roberta's Rules of Order
    Alice Collier Cochran - Meeting Management
  • Boards That Deliver
    Ram Charan - corporate governance
  • Nonprofit Board Crisis: Nonprofit Book Review: The Mission Myth
    Deirdre Maloney
  • Tiny Essentials of an Effective Volunteer Board
    Ken Burnett
  • The Non Nonprofit
    Steven Rothschild
  • Leap of Reason: Managing to Outcomes in an Era of Scarcity
    Mario Marino
  • Everyone Leads
    Paul Schmitz
  • Marketing Lessons from the Grateful Dead
    David Meerman Scott, Brian Halligan and Bill Walton
  • Perspectives on Social Media Marketing
    Stephanie Agresta, B. Bonin Bough and Jay Miletsky
  • Zilch: The Power of Zero in Business
    Nancy Lublin
  • SHIFT: How to Reinvent Your Business...
    Peter Arnell
  • Working in the Shadows
    Gabriel Thompson

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December 28, 2008

Hospitals are in Trouble - especially urban and rural

Hospitals are in big trouble what with the economy and all. 

That's the "news" according to the Chicago Tribune's December 27 article describing a condition of "tight credit, higher borrowing costs, investment losses and a jump in patients -- many recently unemployed or otherwise underinsured -- not paying their bills.  Most endangered are rural hospitals and urban ones in areas with excess hospital beds and a lot of poor, uninsured patients."

The expert's solution appears to be either severe downsizing, mergers or closings.

I don't agree.  Now is the time for federal intervention, just like the car companies and financial services industry.  Really, who needs more bailout support than hospitals?  Here is a truly worthy beneficiary (the under or uninsured) rather than a corporate board or executives. Come-on Washington - get this over with and nationalize health care - we all need it.

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