Working in strength sports. Previously an economics journalist.
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Articles by Peter Spence
To The Manor Born
To The Manor Born: Classic TV Novelisation By Peter Spence Joan Walker reads Peter Spence's delightful novelisation of his smash-hit BBC TV series about the veering fortunes of unreconstructed snob Audrey fforbes-Hamilton.
Linking strategy, risk, performance — FRC’s strategic report guidance
Management accountants perform a vital role in reporting business performance to shareholders and other stakeholders through the annual report. The UK’s Financial Reporting Council (FRC) guidance on the strategic report can be used by management accountants to help transition from an annual report consisting of separate disconnected boilerplate sections to more integrated storytelling.
Striking the balance between functional excellence and strategic execution
In business, decisions are made daily in all corners of the organisation. In November, I wrote about the importance of having an engaged workforce, which drives business strategies, takes on challenging responsibilities, and makes decisions to propel the organisation forward. However, things are not always that straightforward. We must recognise that modern business ecosystems are orders of magnitude more complex than previous generations of decision-makers ever have had to cope with.
Balancing control and empowerment: the CFO’s role in fostering a performance culture
It might sound counterintuitive but having a group of individual high performers or even high-performing teams does not always translate to a high-performing organisation. To achieve consistent results and foster a high-performing culture, your employees need to have a strong sense of belonging, ownership, and accountability. This is essential for individuals and teams to be more motivated, engaged, and productive, and in turn, enable your organisation to thrive.
Jam today or jam tomorrow: managing the trade-offs between corporate growth and corporate sustainability
Businesses are told that they must invest in a growing number of sustainability initiatives, which may impair short-term financial performance while improving long-term business resilience. For business leaders, whose performance is largely measured on the organisation’s financial health, this is often a hard sell.
New paths to productivity through AI
A recent Deloitte survey put the UK’s poor productivity at the top of CFOs’ worry list, preceded only by geopolitical risks. This could be seen as an opportunity. After all, if you can work smarter in your organisation while others lag behind or need to work harder to grow their businesses, you should be able to gain a competitive advantage.
What will the finance team of the future look like
A significant part of the work we do at AICPA & CIMA is about looking at trends within the profession and using them to discern what the future of accounting looks like, so as to best prepare our members to thrive within it. This is the rationale behind our Future of Finance 2.0 project, of which we have just released the latest iteration.
Finance and IT: The key partnership of the digital age
The key question facing finance leaders is not about whether they should be strengthening their digital capabilities. That is settled. At AICPA & CIMA, our latest research found that digital transformation is no longer about gaining a competitive advantage; it is necessary to drive value and, ultimately, to survive.
The future of the workplace for finance teams
A great deal has been written about whether remote or hybrid working is here to stay. In my view, this is a small part of a much bigger story about how the workplace is changing. New research conducted by AICPA & CIMA, where I work, looks at these trends in-depth and considers what they mean for finance leaders. Let’s take a look at how some of these changes inter-relate. Shared services The shared service centre model was developed for good reasons.
An integrated view of performance and value
Truly great companies can adapt themselves to new circumstances and consistently generate wealth and returns for their shareholders. This sustained high performance is the foundation on which successful economies are built, and it rests on the creation of long-term value. Building this type of organisation requires finance professionals to develop a wider understanding of value creation than just the information contained in financial statements, although that remains a key part of it.
The trends for CFOs to watch in 2024
It is important for all finance leaders to be forward-facing. In that spirit, I would like to use my last column of 2023 to look ahead and think about the issues that we will be grappling with next year.
From functional excellence to strategic execution
In recent years there have been dramatic shifts in the business landscape. In the past, capital mainly focused on the tangible and financial. Today up to 90% of a company’s value rests in intangible assets. Environmental and social capital forms a vital part of the value creation process, and the value creation process is fundamentally driven by people. These changes mean that formulating and implementing organisational strategy is a more complex endeavour than in the past.
How to ask sharper questions: A systematic approach
Serving on a board is a serious responsibility. You need to be able to interrogate data, proposals and strategies, and evaluate them against goals, priorities and the external environment. This is a complex process which requires deep thinking and business acumen. This task has become more complex in recent years. A 21st-century century business succeeds by creating value for all its stakeholders, including the customer, the long-term investor and the wider society in which they operate.
Zarządzanie ryzykiem a rozwój technologii, geopolityka i wzrost złożoności
Zarządzanie ryzykiem bywa postrzegane jako zadanie w obszarze zgodności (ang. compliance), aż do momentu, w którym ryzyko się urzeczywistnia. Jeśli wcześniej zaniedbano przeznaczenia na to odpowiednich zasobów i czasu, będzie już za późno, aby cokolwiek zmienić. W obecnych trudnych warunkach ekonomicznych uwaga specjalistów ds. finansów może być skierowana na bieżące sprawy związane z wynikami finansowymi, co ogranicza czas, który mogą poświęcić na zarządzanie ryzykiem.
A CFO's guide to adapting mindset to power growth
I have often made the point that the nature of the finance team’s work is changing. The environment they operate in is becoming more complex and technological innovations are changing old ways of working. There are, in essence, two ways of reacting to this. One is to hunker down and try to avoid the challenge. The other is to embrace change and complexity and look for opportunities in the new environment.
Are your risk management processes up to date?
Risk management is sometimes seen as an exercise in compliance, right up to the moment that a risk event becomes a reality. By then it will be too late to make up for not devoting the time and resources earlier when they could have made a difference.
Rethinking best practice in finance
To say the past few years have been eventful for finance professionals is an understatement. The pandemic not only caused unprecedented business stresses, but it resulted in a very rapid and dramatic change in working practices, such as in the rise of remote working. We are yet to fully understand the impact this will have on productivity and business models, but we can say for certain that we are operating in an entirely new business environment.
Two RCSD teachers will embark on Lake Ontario journey for science workshop
ROCHESTER, N.Y. — Two Rochester City School District teachers will embark on a week-long science workshop on Lake Ontario on Thursday morning. Every five years, the New York Sea Grant gives teachers the chance to explore Lake Ontario in a research vessel and interact with scientists to build classroom lessons. The Shipboard Science Workshop is also funded by the Great Lakes Restoration Initiative.
Business model or operating model. What’s the difference and does it matter?
At its simplest, a business model explains how a business solves a problem or fulfils a need or want that customers are prepared to pay enough for to enable it to make money. A business model must consider stakeholders beyond the customer, and capital beyond financial capital, to be viable and resilient in today’s volatile and uncertain business ecosystems.
Health care for profit: How corporate pressures threaten independent medical practices
An excerpt from Confessions of a Surgeon: A Deeper Cut. He screwed us over. I slowly sank deeper into my chair, attempting to digest the letter my group had received from the local hospital CEO. “Thank you for your group’s interest in our hospital. I appreciate your long-standing dedication to the care of our patients. However, our organization has decided to go in a different direction.
Breaking the cycle of racism in health care: a call for anti-racist action
May 25th marks the anniversary of the brutal murder of George Floyd. I remember feeling numb when I first heard the news. Then, some days later, the tears filled my eyes, then came my anger. It is frustrating that we still live in a world filled with so much ignorance and the complicit attitudes of individuals who gain from their white privilege.
Restoring professionalism in health care: How 8-hour shifts and direct payments could make a difference
Yes, America’s health insurance mess requires repair. Meanwhile, there’s an even more crushing burden on America’s patients and health professionals—the replacement of professionalism by greed, the replacement of genuine professional leaders with pliable greedy ones. For a long time before the 1980s, nearly all hospital nurses worked 8-hour shifts, getting sign-off before and giving it after, the same for hospital respiratory therapists, custodians, and pharmacists.
How popular culture has historically portrayed tech in health care and what we can learn from it in the ChatGPT era
Well before the advent of chat GPT, popular culture has explored how technology might affect health care, often with a dystopian bent. Take, for example, the 2013 sci-fi movie Elysium, set in 2154 (spoilers ahead). Matt Damon’s character, Max, is exposed to a lethal dose of radiation when his factory supervisor threatens to fire him if he doesn’t perform a dangerous task. Because he can’t afford to lose his job, Max does it, but when he steps into the room, his face tells us what will happen next.
a doctor's appreciation for therapists
As a doctor who has cared for countless critically ill patients, I cannot stress enough how important therapists are for patient recovery. Whether it’s occupational, physical, or speech therapists, these health care professionals play an integral role in helping patients regain their abilities and quality of life after an illness or injury. In my experience, occupational therapists are especially crucial for patients who have experienced loss of motor function from a stroke, for example.
Use ChatGPT to apply the "7 Habits of Highly Effective People" in health care
The 7 Habits of Highly Effective People is a best-selling self-help book written by Stephen R. Covey. The book outlines universal principles that can be applied to personal and professional success. This article explores how health care professionals can use these principles to improve patient care, collaboration, and effectiveness. 1. Be proactive. Health care professionals must be proactive in staying up-to-date with the latest research, technology, and best practices.
Bing Copilot and LLM: Revolutionizing health care and enhancing clinical practice with a focus on future prevalence, privacy, and the hallucination effect
The rapid advancements in artificial intelligence (AI) have brought groundbreaking technologies that have revolutionized various industries, including health care. Two of the most promising AI innovations are Bing Copilot, powered by ChatGPT-4, and large language models (LLMs), which can potentially transform clinical practice and patient care.
Childhood obesity in the U.S.: a growing health crisis affecting millions and demanding action from pediatric health care practitioners
Childhood obesity has become a health crisis in the U.S. across all socioeconomic levels. CDC statistics from 2017 through 2020 indicate the following for children and adolescents ages two through 19: Obesity prevalence was 19.7 percent and affected about 14.7 million children and adolescents. Obesity prevalence was 12.7 percent among 2- to 5-year-olds, 20.7 percent among 6- to 11-year-olds, and 22.2 percent among 12- to 19-year-olds.
The power of the 5 love languages and emotional intelligence in health care: Enhancing connections and compassion
There has been growing recognition of the importance of emotional intelligence (EI) in health care in recent years. EI refers to the ability to recognize, understand, and manage one’s emotions and the emotions of others. One way to enhance emotional intelligence is by incorporating the Five Love Languages into health care practices. Dr. Gary Chapman developed the Five Love Languages as a framework for understanding how individuals express and receive love.
Why retail giants will revolutionize American health care
In health care, as in life, people devote a lot of time and attention to the way things should be. They’d be better off focusing on what actually could be.% As an example, 57% to 70% of American voters believe our nation “should” adopt a single-payer health care system like Medicare for all.
How strong leadership revives faltering health care cultures [PODCAST] Original
Subscribe to The Podcast by KevinMD. Catch up on old episodes! In this episode, we are joined by Robert Allan Bear, a physician and health care consultant, to explore the challenges of maintaining strong organizational cultures in health care systems. Robert delves into the impact of pre-pandemic stress and pandemic-induced erosion on health care organizations, and the critical need for strong leadership to rebuild faltering cultures.
Psychological safety: the unspoken key to health care success [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! In this episode, we are joined by clinical psychologist and health systems leadership consultant, Nicola F. De Paul, to discuss the importance of psychological safety in health care environments. Nicola shares her personal experience of addressing psychological safety concerns at an academic medical center and the impact of implementing changes in the training environment.
Aligning goals, strategies and business planning to achieve high performance
All senior finance leaders have an important role to play in the formulation of their organisation’s goals and the strategies used to achieve them. To do this, they need to have a clear understanding of the interdependences between purpose, strategy, business model, operating model, plans and objectives. Success starts with a clear vision of why an organisation exists.
Why health care careers are essential in the age of AI: Encouraging our children to pursue the irreplaceable human touch
The rapid advancements in artificial intelligence (AI) have left many parents questioning the best career paths for their children in a world increasingly influenced by automation. One field that continues to be indispensable, despite AI’s growing presence, is health care. The unique qualities of human empathy, critical thinking, and adaptability remain essential in this sector, ensuring that health care professionals retain a vital role in society.
The culture of my health care organization is broken. Is there hope?
A strong organizational culture is considered the secret sauce of successful organizations. But the Latin term, “Abyssus Abyssum Invocat” (“One Hell Calls Forth Another”), explains perfectly why it is increasingly difficult to maintain optimized organizational cultures in health care organizations. Hell #1: Pre-pandemic, health systems and their workers in both Canada and the United States were highly stressed. The reasons were different; the end-consequences the same.
Physicians cry too: 6 tips for coping with death and grief as a health care worker
“FYI, your patient died.” This message from another physician sat in my Epic inbox. Feelings of disappointment and sadness surfaced as I prepared to start my overnight shift in the emergency department. The death of a child simplified to an Epic chat message felt eerily impersonal and distant. Months prior to receiving this message, I had another traumatic patient experience in the same emergency department.
AI and health care: the elephant in the board room
In recent years, the health care industry has undergone a significant transformation, and one of the main drivers behind this change is artificial intelligence (AI). As the adoption of AI continues to accelerate, it is becoming a topic that cannot be ignored. However, despite its potential to revolutionize health care, it remains the elephant in the board room – a topic often discussed but not yet fully embraced by decision-makers.
Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States
The United States is grappling with a significant health care crisis as physician and nursing shortages impact the nation’s ability to provide adequate care to an aging population. A combination of factors contributes to these shortages, with consequences that can be far-reaching. This article will explore the factors contributing to these shortages, their potential impacts, the ongoing efforts to address them, and how artificial intelligence (AI) can be pivotal in mitigating these issues.
The pros and cons of using ChatGPT for your health care needs
Whenever you’re feeling sick, most people will tell you not to Google your symptoms or try to self-diagnose: That’s the quickest way to spiral into panic mode. Reading a list of possible diseases you didn’t even know existed but now are sure you have brings the hypochondriac out of even the most stoic person. But what happens when you can search the internet for physician-level diagnoses of your aches and pains?
The realities of immigrant health care served hot from America's melting pot
By the time I was in elementary school, I was Mom’s right-hand man when it came to interpreting official documents, work emails, or confusing American jokes. Like 20.3 percent of the U.S. population, I grew up in a primarily non-English speaking home since Korean is my parents’ native tongue. Among all the odd translations my mom consulted me for, health care ones were always the hardest.
Here's what you need to know
It has been an exciting several weeks for AI enthusiasts worldwide, particularly those in health care. OpenAI recently released GPT-4, a major upgrade over ChatGPT. Microsoft updated Bing search engine and Office365 business applications Word, Powerpoint, and Excel will run on GPT-4. Google announced PaLM API and MakerSuite, which enables developers to experiment with Large Language Models (LLM), whereas MakerSuite allows quick prototypes.
Beyond the disease: the power of empathy in health care
They are not just sick people in need of care. They are people with lives, hopes, plans, and dreams. A day before they showed up, they may have dropped a son at school, taken a daughter to soccer practice, made dinner, had lunch with friends, done their nails, or even bought a new golf club. Of course, there is the drug addict with endocarditis, the perpetual drunk with intracranial hematoma, or even the drug dealer who got shot up.
Fixing the broken system: Improving clinical documentation in health care
Imagine you found your dream home and hired an inspector to check it out. They walked around for an hour, kicking the tires on the furnace, taking pictures of the roof, peering up the chimney. In the end, they informed you they were done. You ask, “When will I get the report?” They reply, “What report? You hired me to inspect it. A report would be an undue burden.” Wouldn’t you respond that it was part of the job? How else would you know what they found?
Why our quest for self-improvement is failing: Uncovering the immunity to change in health care
I signed up for yet another program in my relentless quest for self-improvement (and perhaps recovery from decades of physician hood). This one features Dr. Lisa Lahey, co-author of Immunity to Change.
Preparing for downturns: Cash management matters
In the current unpredictable economy, it is our responsibility as accounting and finance professionals to make our organisations as resilient as possible. That means we need a laser like focus on liquidity and risks to free cash flow targets. Cash flow and liquidity planning can help a business stay afloat and even support growth opportunities in a turbulent economy.
Lifestyle change: the forgotten solution in health care
Lifestyle change is a first-line treatment for many diseases. However, change is inherently challenging. This difficulty is exacerbated by a lack of lifestyle change “breakthroughs,” whereas multiple pharmaceutical breakthroughs have occurred over the years. Thus, pharmaceutical interventions are emphasized. For example, the American Academy of Pediatrics issued new obesity treatment guidelines that included medications and surgery.
ChatGPT: How generative AI is revolutionizing health care
Over the past decade, I’ve kept a close eye on the emergence of artificial intelligence in health care. One truth remained constant: Despite all the hype, AI-focused startups and established tech companies alike have failed to move the needle on the nation’s overall health and medical costs. Finally, after a decade of underperformance in AI-driven medicine, success is approaching faster than physicians and patients currently recognize.
The paradox of health IT: Improving care, impeding communication
Advancements in health IT have created ease and efficiency in delivering health care that has never been seen before. Electronic ordering and prescribing have reduced medication errors from misinterpreting handwritten information. The interoperable transmission of critical patient history, lab work, and digital imaging from one hospital to another has reduced costs and unnecessary extraneous tests.
Navigating ethics in health care
An excerpt from The Algorithm Will See You Now. Jacie shoved her glasses up her nose. “For those not selected, when PRIMA gives its report, or whatever… and if it says the treatment won’t work, how do you tell the patient?” “We don’t.” Hope paused. “That’s the nurse’s job, of course.” Cecilia gave her a reproachful glance. Hope backpedaled. “I mean, PRIMA has proven that training the nurses in the triage and delivery of test results allows the physicians to be more efficient.
Transforming health care with AI: Google Bard and BioGPT lead the way
Generative language models such as Google Bard and BioGPT are two cutting-edge technologies that have the potential to revolutionize Health care by providing accurate and reliable information to patients and health care professionals alike. Google Bard is powered by LaMDA and trained on web data, while BioGPT is developed by Microsoft and trained on biomedical literature.
Wrongful prolongation of life: a growing concern in the health care system [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! In this episode, we sit down with patient advocate Althea Halchuck to discuss the importance of advance directives in end-of-life care. We delve into the story of Dr. Gerald Greenberg, a New York dentist who was diagnosed with early-onset dementia and executed a living will stating his preferences for end-of-life care.
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