Where is the Future Taking Us?Strategies for PositioningPublic Health Nutritionists

Presented atPresented at

ASTPHNDASTPHND

Salt Lake City, UtahSalt Lake City, Utah

June 13, 2004June 13, 2004

Sara C. Parks, Ph.D., R.D.Sara C. Parks, Ph.D., R.D.

At the End of my Presentation and the Reaction Panel, Participants Will:

Understand trends shaping the profession for Understand trends shaping the profession for 2014-20302014-2030

Know the drivers to change in health care for Know the drivers to change in health care for 2014-20302014-2030

Evaluate leadership strategies needed to Evaluate leadership strategies needed to position (re-position) public health nutritionists position (re-position) public health nutritionists in the futurein the future

Know personal changes needed to reshape Know personal changes needed to reshape professional practiceprofessional practice

OR- -You may never want to hear

about future trends again!

A Futures Vocabulary Lesson: Can you Define these Terms?

Free Range ChildrenFree Range Children GeriatmosphereGeriatmosphere ReturnmentReturnment Yogurt CitiesYogurt Cities Gene CuisineGene Cuisine MUTTSMUTTS LIPOIDSLIPOIDS Eating AmnesiaEating Amnesia BANKAURANTSBANKAURANTS Content RoomsContent Rooms CarcoonCarcoon COHOCOHO

--Faith Popcorn, 2003--Faith Popcorn, 2003

Futures Vocabulary Definitions

FREE RANGE CHILDREN – FREE RANGE CHILDREN – new generation of kids new generation of kids not over programmednot over programmed

GERIATMOSPHEREGERIATMOSPHERE – environment dominated by – environment dominated by older Americansolder Americans

RETURNMENT –RETURNMENT – retired Baby Boomers go back to work; retired Baby Boomers go back to work; miss the actionmiss the action

-- Faith Popcorn, 2003-- Faith Popcorn, 2003

YOGURT CITIES – YOGURT CITIES – places to live that have active places to live that have active cultures; vital museums, arts, downtown neighborhoodscultures; vital museums, arts, downtown neighborhoods

GENE CUISINE – GENE CUISINE – foods containing genetically modified foods containing genetically modified organismsorganisms

MUTTS – MUTTS – Multiple Upbringing Talking Together Multiple Upbringing Talking Together (multiculturalism)(multiculturalism)

LIPOIDS – LIPOIDS – individuals loosing weight via liposuctionindividuals loosing weight via liposuction

-- Faith Popcorn, 2003-- Faith Popcorn, 2003

EATING AMNESIA – forget what we eat; moving EATING AMNESIA – forget what we eat; moving too fast; multi-taskingtoo fast; multi-tasking

BANKAURANTS – turning banks into subscription BANKAURANTS – turning banks into subscription restaurantsrestaurants

CONTENT ROOMS – new “family room;” place to CONTENT ROOMS – new “family room;” place to convene multiple information appliancesconvene multiple information appliances

CARCOON – cars becoming cocoons; have CARCOON – cars becoming cocoons; have microwaves, computers, refrigerators, etc.microwaves, computers, refrigerators, etc.

-- Faith Popcorn, 2003-- Faith Popcorn, 2003

SEARCHING THE ENVIRONMENT: POWER OF

UNDERSTANDING THE FUTURE IN BUILDING

STRATEGIES

ENTIRE INDUSTRIES, PROFESSIONS, COMPANIES

BUILT AROUND TRENDS

What is a Trend?

Has political, cultural, social or economic Has political, cultural, social or economic impacts;impacts;

Organizations “profit” from trends by Organizations “profit” from trends by translating into strategies;translating into strategies;

Bring about long-term viability of an Bring about long-term viability of an organization;organization;

Support boundary-spanning innovationSupport boundary-spanning innovation

The Next 25 Years: What Will This Country Look Like Demographically?

Oldest Baby Boomer will be 79 years of ageOldest Baby Boomer will be 79 years of age Youngest of Generation Y will be 31 yearsYoungest of Generation Y will be 31 years Oldest of Generation X will be eligible for Oldest of Generation X will be eligible for

Social SecuritySocial Security

NEED TO LOOK AT THE FUTURE THE “EYES OF TODAY’S CONSUMER”

Consumers of Today (1)

Growing Power of Women: Driver of Demographic ChangeGrowing Power of Women: Driver of Demographic Change

Non-working wivesNon-working wives

Working wivesWorking wives Men will be educationally disadvantagedMen will be educationally disadvantaged Increasing diverse marketplaceIncreasing diverse marketplace Understanding at-home business dominatesUnderstanding at-home business dominates

Consumers of Today (2)

Increasing numbers of aging, well-informed, health-Increasing numbers of aging, well-informed, health-conscious consumers; seeking self-care alternative conscious consumers; seeking self-care alternative

medicinemedicine Rising demand for adult education that’s fun Rising demand for adult education that’s fun

(Edutainment)(Edutainment)

Surging demand for luxury goodsSurging demand for luxury goods

- - - - American Demographics April, 2003American Demographics April, 2003

The past gives us knowledge and experience; the present gives us the power to change and together the past and present allows us to envision, and shape, the future.

- - Edward Cornish, 2003

SELECTED TRENDS SHAPING THE FUTURE: TECHNOLOGY

Artificial intelligence, data mining and virtual Artificial intelligence, data mining and virtual reality solve problems beyond today’s reality solve problems beyond today’s computerscomputers

New home robots remotely controlled by New home robots remotely controlled by mobile phones change life stylesmobile phones change life styles

SELECTED TRENDS SHAPING THE FUTURE: TECHNOLOGY

Automobile technology will sense road Automobile technology will sense road conditions, provide smart seats, and manage conditions, provide smart seats, and manage traffictraffic

Teleliving will provide in-home consultation Teleliving will provide in-home consultation and personal communicationsand personal communications

SELECTED TRENDS SHAPING THE FUTURE: MEDICAL (1)

Knowledge doubling every Knowledge doubling every five yearsfive years Human Genome project identifies promising Human Genome project identifies promising

new treatmentsnew treatments Drugs designed to fit specific cellsDrugs designed to fit specific cells Artificial blood will be commonplaceArtificial blood will be commonplace Memory enhancing drugs (2010)Memory enhancing drugs (2010) Bloodless surgery with advanced lazerBloodless surgery with advanced lazer

SELECTED TRENDS SHAPING THE FUTURE: MEDICAL (2)

Surgeons operate in remote areas using robotsSurgeons operate in remote areas using robots Nanotechnology-based therapies (2025)Nanotechnology-based therapies (2025) Physicians leaving en massePhysicians leaving en masse New epidemics and diseases will require more New epidemics and diseases will require more

hospital bedshospital beds Consumers will revolt against managed careConsumers will revolt against managed care Life simplification and stress reduction will Life simplification and stress reduction will surface as major health issuessurface as major health issues

SELECTED TRENDS SHAPING THE FUTURE: LABOR FORCE AND WORK (1)

Funding needed to aid disadvantagedFunding needed to aid disadvantaged Training to avoid obsolescenceTraining to avoid obsolescence Education in schools for kids and adults; 24-Education in schools for kids and adults; 24-

hours per dayhours per day Specialization spreading; generalists become Specialization spreading; generalists become

obsoleteobsolete Information-based teams lead changeInformation-based teams lead change Graying Of America creates shortage of Graying Of America creates shortage of

manpowermanpower

SELECTED TRENDS SHAPING THE FUTURE: LABOR FORCE AND WORK (2)

More entrepreneurs start businessesMore entrepreneurs start businesses Information-based organizations replace old Information-based organizations replace old

management modelsmanagement models Consumers demand social responsibilityConsumers demand social responsibility Consumers distrust large organizationsConsumers distrust large organizations Work ethic is disappearingWork ethic is disappearing

TIME IS WORLD’S MOST PRECIOUS COMMODITY

SELECTED TRENDS SHAPING THE FUTURE: AGING POPULATION

Baby Boomers turn 65 in 2011; 89% report Baby Boomers turn 65 in 2011; 89% report life changes to fight aginglife changes to fight aging

Robots and sensors keep seniors mobileRobots and sensors keep seniors mobile Robots restore limb functions (smart walkers)Robots restore limb functions (smart walkers) Infrared provides remote control for over 200 Infrared provides remote control for over 200

functionsfunctions

SELECTED TRENDS SHAPING THE FUTURE: HEALTH CARE (1)

Market and political dynamics drive reformation of Market and political dynamics drive reformation of health carehealth care

Health care will be transformed to next generation of Health care will be transformed to next generation of service every service every fivefive year or year or soonersooner

Two emerging systems of managed careTwo emerging systems of managed care

1) Networked or virtual1) Networked or virtual

2) Vertical integration2) Vertical integration

- - - - O’Neil and Coffman (Eds) Center for O’Neil and Coffman (Eds) Center for Health Professions; University of Health Professions; University of

California, San California, San FranciscoFrancisco

SELECTED TRENDS SHAPING THE FUTURE: HEALTH CARE (2)

Successful systems will respond to quality, Successful systems will respond to quality, satisfaction and cost criteriasatisfaction and cost criteria

As systems consolidate, healthy As systems consolidate, healthy organizations will aggressively pressure organizations will aggressively pressure alternative delivery systemalternative delivery system

Federal and state government and Federal and state government and professional organizations will NOT stop professional organizations will NOT stop health care reformhealth care reform

- - O’Neil and Coffman, 2003- - O’Neil and Coffman, 2003

SELECTED TRENDS SHAPING THE FUTURE: GLOBALIZATION

Globalization lends itself to resurgence of Globalization lends itself to resurgence of infectious diseasesinfectious diseases

Environmental factors will add to susceptibility Environmental factors will add to susceptibility problemproblem

Drug resistance makes many diseases more Drug resistance makes many diseases more difficult and expensive to treatdifficult and expensive to treat

Lifestyle-induced illnesses will increase Lifestyle-induced illnesses will increase (China leading consumer of tobacco)(China leading consumer of tobacco)

OPPORTUNITY MISSES THOSE WHO VIEW THE WORLD ONLY THROUGH THE EYES OF THEIR PROFESSION. THE KEY TO OUR SYSTEM (OF FORECASTING THE FUTURE) IS MAKING CONNECTIONS BETWEEN SEEMINGLY UNRELATED FIELDS.

-- Gerald Celente, 2000-- Gerald Celente, 2000

OBJECTIVE #2

DRIVERS TO CHANGE IN HEALTH CARE, 2014-2030

THEMES ACROSS TRENDS

Demassification: CustomizationDemassification: Customization Time: New strategic commodityTime: New strategic commodity Quality of lifeQuality of life MobilityMobility EdutainmentEdutainment Centrality: Merging of ideas, businesses, Centrality: Merging of ideas, businesses,

professions, governmentsprofessions, governments Self-DirectednessSelf-Directedness

DRIVERS TO CHANGE IN HEALTH CARE (1)

DEMAND - - capacity shortage, emergency DEMAND - - capacity shortage, emergency crisis, ambulatory expansioncrisis, ambulatory expansion

CONSUMERISM - - consumer-driven market, CONSUMERISM - - consumer-driven market, increased cost sharing, “price” shopping, self-increased cost sharing, “price” shopping, self-health, alternative medicine, customized health, alternative medicine, customized servicesservices

- - Russell Coile, 2003- - Russell Coile, 2003

DRIVERS TO CHANGE IN HEALTH CARE (2)

COMPETITION - - competing on excellence, specialty niches, COMPETITION - - competing on excellence, specialty niches, concierge medicine, large integrated delivery networks (IDN)concierge medicine, large integrated delivery networks (IDN)

TECHNOLOGY - - genomics, digital hospitals, non-invasive TECHNOLOGY - - genomics, digital hospitals, non-invasive imaging, drug-eluding stents, implantable devices, cancer researchimaging, drug-eluding stents, implantable devices, cancer research

REFORM - - senior drug benefits, drug price control, malpractice REFORM - - senior drug benefits, drug price control, malpractice reform, state deficits and uncompensated carereform, state deficits and uncompensated care

TRUST - - consumer, corporate, hospital-MD competition, public TRUST - - consumer, corporate, hospital-MD competition, public imageimage

- - Russell Coile, 2003- - Russell Coile, 2003

POSSIBLE FUTURE SCENARIO“Stormy Weather”

Costs continue to increaseCosts continue to increase Dissatisfaction increasesDissatisfaction increases Inequality of care continuesInequality of care continues Health care scandals are commonplaceHealth care scandals are commonplace Managed care does not changeManaged care does not change Cost of medical technology increasesCost of medical technology increases

Public Health System Offering Minimal ServicesPublic Health System Offering Minimal Services

--Institute for the Future --Institute for the Future Robert Wood Johnson Foundation, 2003Robert Wood Johnson Foundation, 2003

FUTURE SCENARIOS“Long And Winding Road”

Incremental changes in health care system onlyIncremental changes in health care system only Employers decrease health benefitsEmployers decrease health benefits Focus on cost containmentFocus on cost containment Health plans place increased pressure on providersHealth plans place increased pressure on providers Costs grow slightlyCosts grow slightly

Public Health System Engages in Dynamic Competition with Private Public Health System Engages in Dynamic Competition with Private SectorSector

-- Institute for the Future, -- Institute for the Future, Robert Wood Johnson Foundation, 2003Robert Wood Johnson Foundation, 2003

FUTURE SCENARIOS “Sunny Side Of The Street”

Sustainable, efficient health careSustainable, efficient health care Competition drives out excess capacityCompetition drives out excess capacity Young physicians enter system with lower income expectationsYoung physicians enter system with lower income expectations Consolidation of servicesConsolidation of services New innovative payment systemNew innovative payment system

Public Health Systems Embrace Public-Private PartnershipsPublic Health Systems Embrace Public-Private Partnerships

- - Institute for the Future, - - Institute for the Future,

Robert Wood Johnson, 2003Robert Wood Johnson, 2003

FUTURE OF PUBLIC HEALTH IN 21ST CENTURY

Healthy People in Healthy CommunitiesHealthy People in Healthy Communities

- - - - Healthy People, 2010Healthy People, 2010

IF YOU DO NOT CHANGE, YOU CAN BECOME EXTINCT.

- - S. Johnson, Who Moved My Cheese, 1998

BASIC PRINCIPLES OF CHANGE

In a knowledge economy, In a knowledge economy, innovationinnovation becomes a becomes a profession’s competitive advantageprofession’s competitive advantage

Innovation rarely happens within a profession, but at Innovation rarely happens within a profession, but at the boundaries of different professionsthe boundaries of different professions

Clients have many different expectations, are Clients have many different expectations, are sophisticated consumers, and expect excellencesophisticated consumers, and expect excellence

Professions cannot afford to function as “silos;” must Professions cannot afford to function as “silos;” must have strategic partnershave strategic partners

What the future brings to the most sophisticated What the future brings to the most sophisticated aspects of society, trickle down to the least aspects of society, trickle down to the least sophisticatedsophisticated

PRESERVE*Core values*Core purpose

CHANGE*Cultural and operating practices* Specific goals and strategies

Source: Collins, J. 2001. Good to Great, p. 196.

PLANNING (FOR THE FUTURE) MUST BE CRAFTED SO THAT

INDIVIDUALS WITHIN AN ORGANIZATION, OTHER THAN

THOSE LEADING CHANGE, CAN USE IT.

- - James Thomas, Ph.D. Dean, - - James Thomas, Ph.D. Dean, School of School of Information Science & Information Science & Technology, The Technology, The Pennsylvania State Pennsylvania State University, 2002University, 2002

OBJECTIVE #3: LEADERSHIP STRATEGIES NEEDED TO POSITION NUTRITIONISTS

FOR THE FUTURE

RARELY, HAS AN INSTITUTION (A PROFESSION), A LEADERSHIP GROUP FACED AS DEMANDING, AS CHALLENGING, AS EXCITING A TEST AS THE ONE THAT LEADING IN TURBULENT TIME NOW POSES.

-- Peter Drucker-- Peter Drucker

OBJECTIVE #3: LEADERSHIP STRATEGIES NEEDED TO POSITION NUTRITIONISTS FOR THE FUTURE

Complete a frank and realistic assessment of how trends impact Complete a frank and realistic assessment of how trends impact professional roleprofessional role

Understand it’s the “era of the consumer”Understand it’s the “era of the consumer” Work toward a shared vision of new core competenciesWork toward a shared vision of new core competencies Provide expanded models of education and CPE programsProvide expanded models of education and CPE programs Create strategic partnerships to assure excellence in servicesCreate strategic partnerships to assure excellence in services Develop a continuum of careDevelop a continuum of care Invest in new enhanced models of leadership developmentInvest in new enhanced models of leadership development Understand importance of mass customization to mirror the Understand importance of mass customization to mirror the

customization of work and daily lifecustomization of work and daily life

REVIEW THE PHARMACISTS’ MODEL

Focused on patient educationFocused on patient education Partnered with other clinicians to promote use Partnered with other clinicians to promote use

of pharmaceuticalsof pharmaceuticals Positioned members as the most accessible Positioned members as the most accessible

practitionerpractitioner

IN THE LONG RUN, THE ONLY SUSTAINABLE SOURCE OF

COMPETITIVE ADVANTEGE IS YOUR ORGANIZATION’S (PROFESSIONS) ABILITY TO LEARN FASTER THAN

COMPETITION.

- - Peter M. Serge, - - Peter M. Serge, The Fifth DisciplineThe Fifth Discipline

THE ABILITY TO SEE AND CREATE THE FUTURE IS THE ESSENCE OF LEADERSHIP

- - Edward Cornish, President, - - Edward Cornish, President, World Futures Society, 2004World Futures Society, 2004