Author: SupremeCmdr

Would You Like Some Statins With That Double Cheeseburger?

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I’ve been thinking about this for a few days, pondering what to write. It’s simple really.

This is just so wrong…

So would you rate an 8 year old on statins?

AAP ISSUES NEW GUIDELINES ON CHOLESTEROL SCREENING

Below is a policy on a clinical report appearing in the July issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: July 7, 2008, 12:01 am (ET)

The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children. The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10. The best method for testing is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years. For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. The statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.

# # #

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.

© COPYRIGHT AMERICAN ACADEMY OF PEDIATRICS, ALL RIGHTS RESERVED

I Lost 200 Pounds…You Can Too

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I’ve added a new links category on Obesity. Recently I joined the National Weight Loss Registry and became participant L8784. It took some time to fill out the questionnaires but since it was for a good cause, I answered each and every question. The only thing I didn’t do was the narrative. I was given the option to write about my weight loss experience. So after much thought and digging deep I wrote the following which debuts here first.

How To Lose 200 Pounds in Two Easy Steps

  1. Eat less.
  2. Move more.

Hopefully the accumulated data from people who have lost significant amounts of weight will lead to insights about losing weight and keeping it off. Over 65% of the US population age 20 and higher are overweight or obese.

And we wonder why 8% of the population has diabetes…

PSST…Wanna Learn How to Write a Cancer Abstract?

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I’ve always felt that good writing comes from good thinking and that learning how to write well is difficult.   With the advent of the Internet you can find wonderful teaching websites for the craft of writing.   My inner underwriter has always believed that if underwriters were taught how to write about disease we could ultimately better understand some of the cryptic medical language found in the APS’s we read every day.  Well you’ll never guess what I found while doing some purposeful surfing (not mindless).

I’ve added a link to the training modules from the U.S. National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program at Emory University, Atlanta SEER Cancer Registry, Atlanta, Georgia, U.S.A.

This training website provides web-based training modules for cancer registration and surveillance. When the site is complete, it will comprise about 30 training modules, each covering a particular cancer registration training subject. The site started in September, 2000 and is under continual development.

And to think all I wanted was to find out a little more about recurrent high grade focal dysplasia just to make sure the pathologist was on spot about the colonic mass despite everyone else calling the thing cancer.  I’m gonna have some fun playing around in this website.

Remote Underwriting – Better Baked Thoughts

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“Oooh, that’s scary.”

Owner of Siam Smile, a Thai restaurant in downtown Edmond, OK as I was liberally sprinkling red hot chilies over my Pad Thai.

While enjoying a plate of Pad Thai at a local restaurant it dawned on me that the debate about remote underwriting has become nothing more than an academic tussle.  On one side of the debate, there are insurance companies that totally embrace remote underwriting.  On the other side there are companies with endless reasons who do not care for the concept of remote underwriting.  But in the end, the debate is purely academic at this time.  I got a phone call the other week that convinced me of this.

A very large multi-national company placed a recruiting call to me and I had a very nice conversation with the head of their HR.  This particular company has over 100 underwriters and over 40 are remote.  This got me thinking about other companies who have embraced remote underwriters.  These firms are all big names with big budgets, good technology, and a vision for the future.

The future is here and we all better get used to it.  Scary or not.

We Interrupt This Blog for an Earthquake

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When someone mentions “earthquake” I tend to think immediately of San Francisco or Japan, perhaps the horrific quake that just jolted China. But Oklahoma?

On June 6, a minimum of four small earthquakes were recorded and confirmed in the Oklahoma City area by the Oklahoma Geological Survey. The largest quake occurred around 1:15 a.m. and measured 2.5 on the Richter scale. The epicenter was near the Interstate 44-Interstate 40 junction. This location is about 20 miles from my house.

This information is for all of you out there who believe there is nothing in the state of Oklahoma except for tornadoes. We have earthquakes too. Just another reason why we love this place.

Flat Wind Damage

Addendum – I forgot to mention on the day of the earthquakes we had sustained flat winds between 35 and 45 MPH with gusts exceeding 50 MPH.  Note how the winds split this tree nearly in half.  This happened two blocks from the world headquarters of UW Solutions LLC.

Five Minutes of Fame (literally)

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A year ago I was in Phoenix to participate in one of the sessions at the spring SOA meeting. I was given five minutes to make a point. While five minutes is not a lot of time, it was more than enough time to make a point, especially if no one else is debating you. To celebrate my five minutes of fame I have reprinted my brief, yet scintillating talk. The point I was trying to make was underwriting needed to become an insurance company’s strategic intellectual asset. Of course, re-reading what I wrote/spoke a year ago, I never mentioned my point in exactly that fashion. Not that it mattered. After all, I was talking to a bunch of actuaries.

Society of Actuaries Life 2007 Spring Meeting

May 10th Session 43

Speed Underwriting: At Least 10 New Ideas in 90 Minutes

Strategic Outsourcing

Strategic outsourcing represents a significant shift in the way businesses operate to stay competitive in the global economy. Outsourcing strategies have evolved from short-term tactical cost savings to higher-level strategic initiatives that drive revenues and profits. Cost reduction is tactical, not strategic. As insurance companies focus on core competencies and migrate away from fixed cost to flexible variable cost models, outsourcing becomes more and more attractive. Outsourcing must be pursued on a partnership basis. The buyer should get excellent service at a reasonable cost and the provider should make a profit or service quality will suffer.[1]

Strategic outsourcing begins with careful planning. Explore your strategic options for the current reality: a supply and demand imbalance in underwriting talent that will persist for many years to come. Downsizing and demographics have combined to create the current reality. What are your company’s strategic plans to attract, acquire, and retain talent? What does your company’s long-term underwriting training program look like? Does your company have a strategy to capture its underwriting knowledge before that knowledge walks out the door?

This reality is not a short-term threat. Unfortunately, our minds do not perceive longer-term threats because the human mind is not equipped to comprehend the modern world we have created.[2] Decades of downsizing and the aging of the Boomers are simply two drivers of strategic outsourcing.

Skills and knowledge can be taught. Talent must be acquired.[3] And talent needs to be matched with the work to be done. The scarcity of talent demands different approaches.

Combined intelligently, your company’s core competencies plus extensive outsourcing strategies can improve returns on capital, mitigate risk, provide greater flexibility, and make you more responsive to the needs of your customers.

Disclaimer: Strategic Outsourcing Program LLC Edmond, Oklahoma is not me. I was doing a Google search with the term “strategic outsourcing” and I found this company based in the same town I live in.

[1] The American Management Association (AMACOM) published a guide in 1999 titled Strategic Outsourcing: A Structured approach to Outsourcing Decisions and Initiatives by Maurice Greaver.

[2] New World New Mind, Robert Ornstein and Paul Ehrlich. This is a great book published by Simon & Schuster in 1989 and will provide a fundamental understanding of our cognitive shortcomings.

[3] First, Break All the Rules, Marcus Buckingham and Curt Coffman. Another fine book from Simon & Schuster that explains why conventional thinking in business is not always correct.

Medical Information – Enough is Enough or Is It?

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My thoughts have crystalized on the amount of medical information you need to know to compently underwrite life mortality risk. Consider what follows to be totally unscientific and strong personal opinion based on experience. I developed this opinion from reading way too many APS’s in my lifetime and some recent observations from #1, the pre-Med student. After shadowing some doctors and observing a few colonoscopies, an EGD and knee arthroscopy up close and personal, #1 made this comment:

“Wow, specialists need to know a lot more than a family medicine doctor.”

Classic Duh, what do you think? But his comment got me thinking about what we do for fun and money. I have always thought I would make a good GP/Family Medicine type of doctor. Aside from the real world reasons why I didn’t pick that path, I understood intuitively why I have felt that way. I am the ultimate generalist. I like to do something intensely for a few years and then do something else. This drives my wife crazy. It’s not a real good strategy either for building up a nice pension. I also don’t recommend this strategy for career development. But hey, it’s what I am.

I’m drifting here. My thoughts have crystallized. We are underwriters. We don’t need nor will ever use the knowledge a specialist in medicine requires. All we need to be are halfway decent family medicine practitioners with an emphasis on preventative care. We need to understand what diseases and what behaviors will kill you. So how do you become a quasi-family practice person without the medical school training? I have to think about this some more. As always, comments and input are appreciated.

Remote Underwriting – Half-Baked Thoughts

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Several years ago I led a project team that designed and implemented a paperless work flow system for new business and underwriting at a company I once worked for.  I saw the future and remote underwriting definitely was going to be a significant contributor to the ability of companies to attract and retain talent.  Envision a cadre of experienced underwriters working from their homes in a human network that rewards individual members of the group for finding work not only for themselves but for others within the network as well.  Kind of a modern day intellectual collective.

At the upcoming AHOU meeting there will be a networking breakfast session on the topic of remote underwriting.  Due to a number of reasons involving comittments you really don’t want to know about, I will not be in Miami for the meeting.  But since I’m not going, I’ll toss in my two cents for whatever its worth.

“The discussion will cover all of the unique issues associated with remote underwriting, inlcuding technological concerns, training, scheduling, phone coverage, processes, management, and any other concerns brought to the discussion by attendees.”

Here we go:

  • Technology.  The technology to enable remote access to company systems has been around for many years and remote underwriting is a reality for many.  If you don’t have the technology, you better get it.  But more importantly you need to build a solid business case.  With the supply and demand equation favoring the underwriter and not the employer, each year that passes without the commitment to the technology puts a company in a more difficult position to attract talent.
  • Training.  This is a big one.  FLMI, FALU, CLU, yada, yada, yada.  Companies need to first figure out what the gaps are and what needs ought to be addressed through training.  Then create, buy, outsource, something, anything, to address your training needs.  How do you train a dispersed band of underwriters without breaking the budget?  See point number one.  Technology.  Try a webinar.  Check out http://www.gotomeeting.com.
  • Scheduling.  This is not an issue limited to remote staff.  You will have scheduling issues whether your underwriters are all under the same roof or if you have them all over the globe.
  • Phone coverage.  See scheduling above.
  • Processes.  Look for best practices.  Find out what has worked and what hasn’t for companies using remotes.  This isn’t and never will be a one size fits all answer.
  • Management.  Communicate clearly and often.  How do you make remotes feel part of the team?  What are the retention issues?  Can mentoring and coaching (not the same as training) get done?  Can remote mentoring be done at all?

Well, I think I’ve raised more questions than answers.  If someone attends this session let me know how it goes.

Lifelong Learning

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I was thinking the other day about reading a book a week and the value of lifelong learning.  Never make the mistake that learning stops when school stops.  Be a lifelong learner.  Understand that stuff changes all the time and there is always more to learn on your path to success.    Try the following strategy:

Teach yourself what they don’t teach you in school.  Sounds simple doesn’t it?  Well, it’s not really that simple.  Lifelong learning is not simple because school may not teach you a lot of useful information for your chosen line of work.  If you’re a recent entry to the world of work, you probably figured that out already.  The problem is not just what doesn’t get taught.  It’s deciding what to teach yourself to become the best you can be on your chosen path.

There are a lot of people who go through their lives trying to figure out why they’re here and what they’re here to do.  I personally know some boomers who are still trying to figure what they want to be when they grow up.  Imagine yourself at 60 trying to figure out what you want to be when you grow up!  Don’t let this happen to you.  Take one simple action.  Make a decision.

The decision you make may not be the “right” decision but at least you have made a decision.  Indecisiveness will doom even the most well intentioned.  Make up your mind.  What you settle upon may not be the grand purpose for your existence but at least it’s a start.  And if whatever you choose turns out to be not what you expected or wanted, then try something else.  As people age we limit ourselves to what is possible.  Try something you’ve never done before.  Maybe, just maybe, you’ll surprise yourself and begin the journey that is yours alone.

It helps to have an uncommon curiosity about everything to be a good underwriter. Arguably this is true across many different professions.  You have to want to learn before you truly learn.  I spent some time this past week adding more links to my sidebar.  I wanted a kind of underwriting friendly mini-portal.  Click through and continue your lifelong learning.  If you have any suggestions for a good website, email me or comment and I’ll add a link.

Medical Information – How Much is Enough?

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So how much medical information does an underwriter need to know to become a competent underwriter?  I don’t have an answer to this question but it’s been something I’ve thought about since attending a seminar and tour of the OSU medical school facilities in Tulsa, OK.  I was impressed by the facilities and quite frankly could live in the library.  I’ll be returning to this question over time as my thoughts crystallize.  Right now, my answer is:

  • More than the average human, and
  • A lot less than what doctors need to know.

So what exactly as underwriters do we need to know and how much is enough?