Corporate Health Promotion Has 3 Years to Get It Right

In comments before the 2009 Annual Art and Science of Health Promotion Conference, Michael O'Donnell, PhD, MPH, MBA (Editor in Chief, American Journal of Health Promotion) described rapid changes in this field and what it meant to practitioners. "Despite 4 decades of corporate health promotion as a profession, there is still no consensus as to the most effective and efficient way to render services. We have only about 3 years to get it right."

 

Michael offers examples: "In smoking cessation, we have good science to guide us. We know that counseling therapy or nicotine replacement medication typically yields a 10% success rate. But when we combine counseling and nicotine replacement, the rate goes up to 30%. We also know when you increase the number of minutes of counseling, you increase success rates; but at 300 minutes we reach a plateau. Involving different types of people in counseling sessions also increases the likelihood of positive outcomes. By applying these scientific principles, we multiply our success 6-fold. Yet in something like weight control, beyond knowing people need to eat less and exercise more, we have very little knowledge of what works."

 

Strongly believing the industry needs to dedicate itself to studying what works in health promotion, he was actively involved in promoting Senate bill (S.1001/HR2354). Called the Health Promotion FIRST (Funding Integrated Research Synthesis and Training) Act, many provisions became law when President Obama signed the Patient Protection and Affordable Care Act and began going into effect in 2010. The bill included additional health promotion provisions and enjoyed bipartisan support. Highlights include:

Development of a national health promotion plan
Increased health promotion research
Technical assistance to enhance evaluation of worksite health promotion programs
Regular surveys on worksite health program prevalence and components
Grants to pay part of the cost for comprehensive worksite health promotion programs in small organizations
Allowing employers to offer employees an insurance premium discount of up to 30% (instead of the current 20%) for positive lifestyle practices or participation in worksite health promotion programs and asking Health and Human Services to study the benefits of increasing to 50%.

Focus on What Works Best

 

Michael challenges practitioners to focus more on what works best in their area of expertise. "What are the most cost-effective ways to reach the greatest number of people with the most hard-hitting programs to improve their lifestyle? I realize this is difficult for individual employee health and wellness practitioners. They may have great intuition and ability to assess a person or organization, and they may develop very effective interventions to encourage change. But when you ask them why they are successful, they can't articulate the core principles critical to their success. This has been a classic problem in our field."

 

"I realize that practitioners dedicate a great deal of time and effort to figure out the most useful strategies for each individual and organization they serve. Unfortunately, this approach is not practical if we want to reach most employees in most workplaces. When you build cars one by one, it's not so hard to get it right. But when you build an assembly line and crank cars out at a high volume, you need to be sure the best procedures are in place to make it work. As we scale up our wellness programs, we need to draw on standardized protocols that can be tailored to the special needs of each situation."

 

"Practitioners need to look for opportunities to team up with the scientific community and help them develop good theories as to what works best. Learn to articulate why what you do works. We need to network and share more with people. We must test programs that have been shown to be successful and find out why they work. We don't do that nearly enough."

 

"Time is running out for us to get it right. The industry is growing very fast. For a while purchasers entering the market will not know the questions to ask. It will be relatively easy to sell wellness programs. But eventually purchasers will become more sophisticated and require higher levels of quality proof. As more products become available, they will push down on the price. And when they do, we must make sure these commodities offer the best possible solutions to change lives."

 

Growing Our Future Leaders

 

To meet this growth in the health promotion industry requires energetic and forward-thinking leadership. Michael is concerned that in a few years, there may be a problem finding those leaders. "For the most part, today's wellness program leaders are in their 50s. When this group entered the field in their 20s, it was a new industry with many leadership opportunities. The youngest and brightest out of grad school moved into leadership positions quickly. Unfortunately, the pool of emerging leaders to replace us is small. In the 1990s the field experienced an economic downturn. Many of the new cohort of professionals were forced to move into other lines of work to survive. These would have been the professionals to eventually fill future leadership positions, and it was a small group to begin with. I often hear managers say it's difficult to find qualified people with 15-20 years experience."

 

Michael expresses concerned about the consequences of this looming leadership vacuum. "If new leaders don't come from within our field, they will come from outside the field. It's wonderful to gain new perspectives, but will they have the same philosophical value we have to help people? I worry that they will be oriented more toward medical healthcare cost containment and making money. What has been unique about our field is the focus on quality of life. That is a value we must preserve. We need to continue this dialogue on growing our future leaders."

 

"Don't get me wrong; talent must prevail. We don't want to coddle people or they won't be able to stand the pressure of a leadership position. It's got to be survival of the fittest, and emerging leaders need to challenge existing leaders for control. Cultivate the qualities in yourself and others that you expect to see in any leader. Create a vision and put a plan in place to achieve that vision."

 

What if We Don't Get It Right?

 

When asked about the consequences of not getting it right, Michael predicts, "We have a golden opportunity right now. The Obama administration and Congress are very interested in wellness and prevention. Prevention is the only thing that is not controversial. Congress believes prevention is the magic bullet to fix healthcare. But if we don't develop programs that produce consistent positive outcomes, we'll be in trouble. We have less than 3 years to get it right or we will lose the credibility we've worked so hard to achieve. If that happens, government and employers will shrug their shoulders and say, 'We tried, but it didn't work.'"

 

And Michael isn't sure who (or what) will fill the vacuum if it doesn't work. "It's kind of like managed care. In the original closed panel approaches developed by two of the larger HMOs, managed care produced better health outcomes at lower prices. This mutated into PPO approaches which are basically bulk purchasing arrangements that lack internal quality or cost controls. Managed care got a bad name. I think something similar could happen to worksite health promotion if we don't take action now."

Dean Witherspoon, CEO and founder of employee wellness firm, Health Enhancement Systems, has 25 years in health promotion. He has served on the board of the Association for Worksite Health Promotion and held several regional as well as state offices. Dean is a nationally known speaker and author, having presented at more than 70 conferences and written hundreds of employee wellness articles for national publications.

For more information on employee wellness topics, check out our free white papers at http://whitepapers.hesonline.com/.

Contact: Dean Witherspoon, Health Enhancement Systems, http://HealthEnhancementSystems.com, 800.326.2317

Corporate Wellness Programs Open Doors to Integrative Therapies

The National Center for Complementary and Alternative Medicine (NCCAM) website lists over 600 specific alternative therapies. According to Ken Pelletier, PhD, MD (Professor of Public Health, University of Arizona School of Medicine), "When I hear someone in a workplace wellness program say alternative therapies don't work, I ask: 'Which therapies, for what conditions, in what populations, and in what situations?' It really depends on what you are talking about. Then there are people who say, 'If it's natural, it must be OK.' But look at that list of over 600 therapies. A significant number carry a very real potential to do harm."

Ken has extensively reviewed complementary and alternative medicine (CAM) studies from around the world. "Because of where I work, my research must conform to a standard of best possible evidence as seen in randomized clinical trials. But there are a number of potentially important therapies and interventions that simply don't lend themselves to that type of analysis."

Often such studies lack the necessary documentation but still see excellent outcomes. Ken cautions corporate wellness practitioners against discounting such studies and recommends analyzing them using a 3-pronged triage-type approach:

Is there clear evidence from clinicians that the therapy works well in the patient's situation?
What's available in the literature and online showing what does not work?
What studies are underway that require us to simply wait and see?

As increasing numbers of CAM therapies gain acceptance in employee health programs, it becomes necessary to develop a common vocabulary. The term Integrative Medicine (IM) describes an evidence-based fusion of conventional and CAM practices. IM is not a physician-centric system -- practitioners function in truly integrated or virtual systems with providers of diverse competencies. Together they form a clinical network where outcomes are enhanced from working together, rather than at odds with each other. These networks typically fall into 4 categories:

Freestanding IM clinics that house multiple disciplines
Family practice group with a virtual network of respected CAM practitioners for patient referrals
IM services affiliated within a hospital setting
Therapeutic disciplines offered through nonmedical settings like worksite health promotion programs, schools, extension programs, and even churches.

According to the 2007 National (US) Health Interview Survey of 23,393 adults and 9417 children ages 17 and under, 38% of adults and 12% of children use some form of CAM. This is reflected by the increasing numbers of health insurance plans that cover such CAM therapies as acupuncture, chiropractic care, naturopathy (in certain states), nutrition counseling, stress management, and behavioral medicine. Even vitamins/minerals, herbals, exercise equipment, books, videos, and fitness club memberships can be found as health plan benefits. Ken points out the reason: it's what their corporate health and wellness customers want. "Although health plans increasingly counsel corporate clients on CAM coverage trends, the insurance industry is not the point of innovation here; it's the purchaser. Larger companies form a purchasing coalition based on demands from employees and unions. If there is solid evidence behind the request, they balance the interest with legal issues, costs, and other practical considerations to determine what becomes part of a benefit package."

High-tech industries took the lead in offering IM to corporate wellness audiences. Computer, telecommunication, banking/financial, airline/aerospace, petrochemical, and automotive employers know IM appeals to their highly educated, competitive employees... who tend to stay with their company for the long term. "These corporations look at their employees' welfare as an investment. They want to preserve these assets and enhance their productivity on the job in every way possible. Because these industries are so competitive, IM therapies often become a recruitment and retention benefit."

Even when a health plan can't (or won't) cover CAM, other workplace wellness programs have opened their doors to practitioners who provide onsite services. Ken is all for this. "Certain CAM providers are almost universally accepted now, but this is too new an area to know definitively what works. If a wellness program wants to offer aromatherapy in conjunction with a relaxation room, why not? I've seen Ayurvedic medicine in larger employee wellness programs along with traditional benefits, especially when there's a significant Asian demographic. Fitness programs go beyond aerobics to include yoga and martial arts. If these services meet employee expectations and are done responsibly with employee cost-sharing, it's a win-win proposition."

Finding the Right Practitioners

The trend is toward outsourcing IM therapies, and corporate wellness purchasers must do their homework when selecting practitioners. Whittling down the field can be challenging; find out if the practitioner:

Carries appropriate licenses/credentialing
Is a member of any well respected professional associations and serves on any boards in their field
Graduated from a recognized school in their field
Has a successful record in providing the services required -- demand measurements and outcomes that show evidence within a given period
Provides excellent references
Has a history of any lawsuits or complaints
Maintains a good reputation... ask around.

Planning the Program

Wellness program planners need to involve employees, unions, labor, and management in defining what is wanted. If they help develop specifications, it won't be viewed as a union or management program... it will be their program. This minimizes problems with acceptance or disillusionment.

Next build a clear picture of the desired services and define specifications to practitioners. What will the chiropractor do for us? What will an acupuncture session look like? If pain is a cost center, what is the evidence that this therapy will reduce those claims and disability leaves?

A Bright Future Ahead

As Director of the Corporate Health Improvement Program (CHIP), a collaborative research program involving 15 Fortune 500 corporations, Ken has a unique perspective for IM's future. "CHIP is 25 years old. Over that time, some of the first true IM models have been tested within member corporate wellness worksites. We meet twice a year with our corporate members to review the research. The data is extremely positive and the impact will permeate throughout the industries involved."

"One of our members is Ford. Back pain was the single largest contributing cost to producing their cars. They had 24/7 clinic staff onsite to deal with back pain alone. We demonstrated that combining traditional medicine with acupuncture and mind/body therapies was more effective than traditional medicine alone."

"When you can demonstrate a more cost-effective way to manage a condition, a company will be interested. They have no inherent bias; they just want evidence -- and a vast amount of literature shows it. The return on investment runs from 3:1 to 5:1, taking about 3.25 years to see that ROI."

Corporate wellness professionals can read Ken's summary, "A Review and Analysis of the Clinical and Cost-Effectiveness Studies of Comprehensive Health Promotion and Disease Management Programs at the Worksite: Update VII. 2004-2008," in the Journal of Occupational and Environmental Medicine, Volume 51, Number 7, July 2009.

Ken concludes, "Read the evidence. The literature is there to allow you to make informed choices. But be a Doubting Thomas. As researchers say, 'In God we trust; all others must present data.' Wellness program managers will find IM to be a sound business strategy... a tremendous investment in your population. They are worthy of that investment and they'll reciprocate when they see you care."

Dean Witherspoon, CEO and founder of employee wellness firm, Health Enhancement Systems, has 25 years in health promotion. He has served on the board of the Association for Worksite Health Promotion and held several regional as well as state offices. Dean is a nationally known speaker and author, having presented at more than 70 conferences and written hundreds of employee wellness articles for national publications.

For more information on employee wellness topics, check out the free white papers at http://whitepapers.hesonline.com/.

Contact: Dean Witherspoon, Health Enhancement Systems, http://HealthEnhancementSystems.com, 800.326.2317

Corporate Greed Driving India Farmers to Suicide by the Thousands

The promise is the same everywhere. Buy our patented seeds at twice the price of others, buy our chemical fertilizers and pesticides and you will prosper like the government subsidized American farmers. These corporate parasites know how to sell in any language. The cost of the promised prosperity which seldom occurs without government subsidy and requires annual borrowing, as with American farming, is more than a poor farmer can afford. But corporate greed convinces him to gamble his future and his life on false corporate hope.

Working hand in glove with the corporate scum are the local money lenders, sometimes taking 5% interest per month and sometimes the entire harvest if drought or floods do not beat Mr. Moneybags to the harvest. India could not have chosen a worse model to modernize its agriculture than American corporate farming, which has already destroyed more value than it has produced, excluding corporate profits of course, because corporate balance sheets are all that matter in this world. Raped lands and environments be damned.

People and the people in government especially, easily lose sight of the fundamental importance of agriculture to the total national economy. A nation which does not feed its people is forever dependent upon the good will of people who cannot be trusted. Even the rich nations have boarded this leaky boat and they will pay dearly for so doing and are already paying dearly, in terms of food quality, environmental damage and disease.

If a nation is to have healthy people, requiring a minimum of medical attention, it must have health producing food, not the plastic the corporations peddle in the name of high yields and damage resistance. To have health building food, grow in rich organic soil 100% chemical free. In the story I read, a 31 year old farmer borrowed $9 for a bottle of pesticide which he drank to kill himelf. So the manufacturer made five dollars to create a widow and two small fatherless children. Congratulations on your keen business acumen, corporate parasite. Win - lose marketing at its finest.

Indian government must discourage all farming and switch to organic gardening to continuously enrich the soil upon which a combination of subsistence and high value cash crops are grown. Competing with government subsidized, environmentally destructive, disease producing corporate agriculture is like running a marathon on your hands and knees. You might finish the race but you will win no prize. We are talking about a sustainable foundaion for a national economy. It deserves more thought and planning than where to build the next chemical disaster.

To have rich and healthy soil as a foundation for prosperity it is essential to compost mineral rich plants and manures, green and vegetariabn animal wastes. The best source of mineral rich plants are seacoasts. The next best source is former cotton fields planted in alfalfla or a similarly deep root crop which mines the deep minerals in sub soil. A government which will subsidize small scale agriculture will make strict conditions. A gardener must produce twice the food his family requires, so a partial failure allows his family to eat. Crops sprayed with a mixture of kelp or seaweed and fish emulshion are drought resistant, insect resistant (few insects eat fish or kelp), disease resistant and yield more plant and fruit than anything corporate agriculture will ever have to offer.

Build raised gardens close to the house or shanty where it is natural to keep a close eye on them. Make them any length and four feet wide, waist high. Fill the bottom half with sand or stone, the top half or one third with topsoil and compost. Build with brick, block or stone which will not wash away with heavy rain. Use either a square foot method or third meter, in the case of a one meter wide bed. The idea is an easy reach from each side to the center of the bed. By growing food and high value cash crops in these raised beds, one has purchased one time flood insurance. Small pipes at the bottom of these beds allow the bed to drain by gravity. The soaked soil will drain. If the rain is severe or prolonged, spread inexpensive covers over a sturdy frame above the plants in the bed. In Winter or cold weather, clear plastic covers will heat the bed and prevent crop freeze overnight. The thermal mass of such elevated beds acts as a thermal flywheel, maintaing desired temperatures.

As each gardner is growing twice the table food required by his family or more, let the surplus be split. Half for fresh seed and half for the local market. The independence and security the regular production of surplus food engenders cannot be valued in currency. This is private, personal, life and health insurance. Cash crops should be both common and coveted medicinal herbs and spices. There will always be a free market for such. Wisely chosen herbs and spices may be dried and shipped around the globe at very high profits. Trends in rich countries will always tell you how to harvest the most cash from a square foot or third meter of crop.

Square Foot Gardening is now so highly developed, one can grow five times the crop volume with the same resources wasted in conventional farming and gardening. Any nation not using this method is wasting resources and labor. Harvest humanithy for record profits and growth, not chemicals and scarce resources. Outlaw the corporate confidence men and the local money lenders. Teach your rural populations sustainable agriculture and become the dominant economic power of the New Age. The wisdom to do so is among your people. When you end farming, you end farmer suicides.

Ed Howes sought and found, knocked and entered. Now he sees things differently. To see more of what he sees, please visit http://www.justanotherview.com or do an author search here at Ezine Articles.

Corporate Wellness Becomes CEO Issue - How to Reduce Workplace Health Costs

The Partnership for Prevention was formed to encourage Fortune 1000 companies to consider making workforce health a CEO issue and adopt strategies to promote prevention and wellness. After several years of double-digit rate increases for health insurance, companies are realizing that one of the best ways to slow the cost increases is to have employees take more responsibility for both costs and health choices. A majority of companies surveyed feel that the best way for reducing costs is financial incentives to encourage employees to adopt healthier lifestyles.

Nearly 100% of employers surveyed say that health costs will be a critical or significant concern over the next five years, according to a survey by United Benefit Advisors. More employers are adopting higher deductible health plans with HRA's or HSA'S, wellness programs, and expanded disease management programs in order to control ever-increasing health care costs.

Failure to deal with these issues could be disastrous for an employer. Wayne Sensor, Chief Executive Officer of Alegent Health recently stated, "I think that we have built a health care machinery we can't afford. I think we are choking the economic engine of America." In his October 2005 newsletter, Dr. Andrew Weil stated, "I think rising health- care costs are becoming the major economic issue in our nation". Obesity costs California businesses billions of dollars each year. Projected costs for 2005 may reach 28 billion dollars for direct and indirect medical costs, worker's compensation, and lost productivity. California has experienced one of the fastest growing rates of obesity of any state.

According to California Health and Human Services Secretary Kim Belshe, "The obesity epidemic is more than a public health crisis, it is an economic crisis." What is frightening is that most people do not even realize that they are obese, which is defined as only 20% above normal weight. There is a great need for additional education on weight and resulting diseases, and the workplace is an ideal venue. Wellness education and programs can result in a significant return on investment and, if structured properly, can produce results in a very short period of time.

Although many employers have attempted some form of wellness program in the past, results from those efforts have been disappointing. In many cases, the healthier employees participated for incentives, such as gym memberships, but those who needed it most did not take advantage of the program in a meaningful way. Companies are looking at ways to encourage more employees to buy into the wellness movement.

A recent webinar hosted by Human Resource Executive Magazine and presented by Carlson Marketing Group titled, "Healthier Employees; Healthier Bottom Line: Engaging Employees is the Missing Link in Managing Health Care Costs," drove this point home. This session provided actionable advice on how companies are achieving higher impact with their wellness investments by focusing on employee engagement. It also highlighted how you can create an Economic Engagement Model to forecast the potential impact for your organization.

Employers can simply no longer ignore the issue of their employee's unhealthy lifestyles and must take action to engage them in a meaningful wellness program to reduce health costs, absenteeism and lost productivity. Employees also benefit as they derive better health and greater satisfaction in both their personal and professional lives. The alternative is being caught in a non-competitive position and severely impacting the bottom-line of the business.

Contact me if you want a link to the broadcast.

Michael Framberger was a health insurance professional in California for 28 years, including regional manager for Blue Cross and is the author and creator of the "Get Happy - Get Healthy - Be Wealthy" system.

Michael lectures internationally on Personal and Corporate Wellness and is President of Michael Framberger Seminars, Inc., and National Corporate Wellness, Inc. which offers workplace wellness programs and employee health services to businesses, and connects the benefits broker/agent, HR/Risk Manager & business decision maker with appropriate Insurance providers to show the rewards of a properly designed wellness initiative. For more information see: National Corporate Wellness

How to Sell Disability Insurance - Plan Design Key to Corporate Executive Market

If you're looking for a disability insurance market that is both lucrative and under-penetrated, consider the corporate executive market. Many of the nation's millions of small to mid-size businesses offer employees no disability income protection whatsoever. And, of those that do, the coverage is often inadequate, particularly for middle- and upper-management.

As a result, numerous opportunities exist in the corporate executive market - opportunities you can take advantage of through creative, expert plan design.

A good disability plan design is one that is custom-tailored to fit the unique needs of your client company. Usually, it will include a blend of group and individual features that provide the most coverage at the best price. Such "combination plans" emphasize the strengths of group long term disability and individual non-can while minimizing the drawbacks of each, and are excellent door openers in the corporate executive market.

Ask the right questions.
To begin, approach your prospective clients with questions: What are their problems? What do they want to accomplish? How much coverage would they like to provide? Do they want upper-level executives to have more favorable treatment than others? How much money are they willing to spend?

Questions help clients clarify their disability insurance needs and enable you to explain many of the options that are available. Often, you will need to take an educational role. Group insurance is the only disability product that's been introduced to many employers. The concepts of combination plans, underwriting concessions, and discounting are new to them.

Combination plans are especially attractive because of their flexibility. They can be structured to meet a variety of needs, thereby giving employers great control over their benefit programs.

Determine the right coverage mix.
Traditionally, the standard approach to combination plans has been to add a small amount of individual disability insurance to long term disability - say 20 percent individual added to 40 percent LTD. But more recently the group/individual mix has become more varied, and there is really no longer a "standard" approach. The right mix is determined by the unique make-up and goals of the client company, as well as any concessions the underwriting department is able to offer.

After you have determined the insurance goals of your clients, the next stop is to work closely with a risk manager or advanced underwriter. Always remembering that the primary strength of combination plans is flexibility - both in product blending and in underwriting - it is important to work with underwriters who are thorough professionals in plan design. The knowledgeable underwriter will look at the dynamics of each case to determine the optimum package for the client company and to establish the guidelines under which the case will be underwritten.

Consider Guaranteed Issue.
In large cases, guaranteed issue (GI) frequently replaces individual underwriting. GI means that a disability policy is issued at the standard rate with no restrictions. The size, occupations, incomes, and ages of the group are carefully evaluated in order to establish specific underwriting concessions. Guarantee to issue is a variation on the guaranteed issue offer, in that it is the standard policy but with certain rights reserved by the insurer.

Ensure continuity and flexibility.
If you're looking to replace or enhance an existing disability insurance plan design, the underwriter will want to be certain that nobody loses under the new plan. This is especially important in smaller cases, where the individual portion of the plan design is individually underwritten. Your goal should be to create seamless coverage for everyone in the plan.

A good plan design should also stand the test of time. It must be flexible enough to cover promotions, salary increases, future employees and other personnel changes. In many cases, a well-designed disability plan provides the best coverage for your employer clients. Learning to develop good plan designs can also be highly rewarding for you: You will profit from multiple cases in one sale, add-on sales, and new enrollments. What's more, your client base will grow, as you are able to offer precisely what your customer wants.

To develop and offer the best paycheck protection plan designs, it's important to work with an experienced carrier or distributor. The best carriers have been developing combination plans for many years and have entire departments dedicated to helping producers devise the best plans for their clients.

Offer the best of all worlds.
By developing first-rate disability insurance plan designs, you will be able to offer your clients flexibility and quality - the best of both worlds. And you will have the necessary skills to open new doors in the corporate business market.

Daniel C. Steenerson, CLU, ChFC, RHU, is the President of Disability Insurance Services, headquartered in San Diego, Calif. For more information about disability insurance and to obtain free sales tools and articles, visit http://www.diservices.com.

What Does it Take to Be Successful in Today's Corporate America? Is it Different Than 20 Years Ago?

Has anything changed during the last decade?

I do not think so. The following paragraphs summarize what I told an audience of recently MBA graduates at their 11th Annual Conference of the National Society of Hispanic MBAs in November 10, 2000. At the time, I was the President of Phelps Dodge Industries with responsibility for an operating group comprised of 50 plants in 27 countries engaged in the manufacture and sale of engineered products for the electrical, communications and automotive industries. The Group had revenues of $2 billion and employed over 5,000 people. After early retirement in 2002 and 35 years of corporate experience I became an entrepreneur. Bottom line, nothing has changed.

This is what I said then and what I would say today:

Good evening ladies and gentlemen. I am delighted to be with you on this special day. A few minutes ago my fellow panel members talked to you about the challenges and opportunities that you will face in this new era of e-commerce, globalization and high technology. These are indeed very exciting times! You will be part of a generation of leaders that will take our businesses to uncharted territories. It was only 30 years ago that I was sitting in a room like this wondering what it would take to be successful in Corporate America. Little did I suspect that one day I would be discussing with you my impressions on what is a very complex subject with no "clear cut" answers. My bottom line advice to you is this: "Business mirrors life. There will be highs, lows, compromises and sacrifices in your quest for success. Approach it as a journey and use your head, your heart and your gut to guide your decisions along the way." I am not going to spend any time stressing the need to be technically proficient in your field of expertise. That is the price of admission. Rather, I will share with you a simple model that has worked for me as I have progressed in the pursuit of my professional dreams. I refer to this model as my "Seven Ps"


Plan
Preparation
People
Passion
Proactive
Partnerships
Performance

P number one - Plan

Planning your future is like putting together a strategic plan. A Company defines its vision and you must do the same. For each of us, that vision is more like a dream. I had a dream and I am sure each of you has one. But you can't achieve that dream without following a disciplined and systematic process. What is your dream? What will it take to achieve it? Are you willing to make the personal sacrifices that may be required? Having the intent is not enough. It is the combination of will and vision that eventually allows you to reach your full potential.

And this takes me to the second P - Preparation

Education and experience are two critical factors for success. You must be obsessed with learning. Learning is a never-ending process. Some learning opportunities will be provided by your company but that alone is not enough. You must take the initiative and be in control of your professional development. And this requires significant commitment and personal sacrifice. I'm an avid reader and the number of books and magazines I read each year has a direct correlation to the number of air miles I travel. I firmly believe that to become a well-rounded businessperson you must expose yourself to a diverse range of subjects and viewpoints. I generally encourage my key managers to read between 3 and 4 newspapers a day, and 20 to 30 publications each month covering a wide range of topics: economics, finance, demographics, social issues and politics, management and technology. No single one of these topics should be considered in isolation and much less taken as the gospel. And if you're waiting for the one good book that will guide your entire career, forget about it...You are the author of this book and it is work in process. Instead, consider everything you read as an opportunity to germinate new ideas that you can apply to your business challenges. I can tell you from my own experience that even at this stage of my career I learn something everyday. Failure to do so translates into what I refer to as "intellectual obsolescence." None of us can afford that. The second component of preparation is experience. You are all probably familiar with the expression that there is no substitute for experience. In my professional life, I have never turned down an assignment that would increase my know-how of a process, a country, a company, a culture or any other subject essential to my future ability to accept more responsibilities.

P number three - People

There is a business adage that says that you will pass the same people in an organization on your way up as on your way down. I know this to be true from personal experience. And always remember that you are only as good as the people you work for, the people you work with and the people who work for you. Never abuse or misuse your power. You can be demanding but you must also be fair. And never forget to act on what is right and not on who is right. You also must mentor and develop the people in your organization. A decade ago, mentors were the "seasoned old guys" in the executive suite, and mentorees were the MBAs fresh out of school. Today thanks in large part to the rapid acceleration of technology development, mentoring is more diverse. It's not unusual, for example, to find a 25-year-old technology guru mentoring a group of seasoned leaders. Look for every opportunity to be both a mentoree and a mentor at every stage of your career. As I said, there is always more to learn, and as you advance, your experience can help others succeed. In addition to my mentoring role within my company, I have been a mentor and a lecturer at the University of Miami MIBS Program for several years. You would be amazed at what I have learned from your contemporaries both one-on-one and in the classroom. Transferring your knowledge to others is a very rewarding experience that can be accomplished at all levels of the organization.

P number four - Passion

Leading an organization requires you to be Passionately Committed. I have never met anyone who excels at anything that does not possess an inner fire. Ordinary efforts will only produce mediocre to average results. Drive and passion produce outstanding results. Sometimes, success leads to a false sense of comfort. Often, some of the best people lose their passion. When that dies, it is difficult if not impossible to sustain excellence. So, I encourage you to work hard to feed and fuel your inner passion.

P number five - Proactive

Today's rate of business change also will require you to be Proactive. You will be required to seize challenges and opportunities. Speed and innovation are the keys to staying ahead. Quick victory is the aim of competitive action. You need to move fast and move first. This does not mean that you will always do things right but you must always do what is right. You must have the intellectual honesty to acknowledge that some solutions or actions did not work. If they didn't, try something else. As President Roosevelt once said: "It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something". Proactivity allows you to stay one step ahead and this is worth more than any other competitive advantage.

Successful executives also rely on the next "P" - Partnerships

In today's world you cannot do it alone. You'll need to forge alliances to offset your weaknesses, and to bring together diverse geographic and business cultures. You'll also need to harness the commitment of your team to get the job done. And let me emphasize the word TEAM. This would be a natural point for me to offer some anecdotes about the power of business partnerships, but instead, I'd like to put the emphasis on the partnership that you now have, or that you may have in the future, with your spouse, your significant other and your family. All of the business demands on your time will make it increasingly difficult for you to create a balance between your personal and professional life. I must confess that this is the area in which most of us fail, at least from time to time. And I am no exception. My wife Maria, who is here with me tonight, gets all the credit for providing the on-the-ground, day-to-day stability that our young sons needed in their formative years. But she, and my sons Manuel and Carlos held me accountable for being present at the important events, and there were no excuses accepted if I failed to pick up the telephone and check in each morning while they had breakfast, and again each evening to hear about their big events of the day. There is no right or wrong answer about how to calibrate the balance needed to make that partnership succeed. You will learn with time how and when to compromise. But you must learn how to do it sooner rather than later. Our families are often thought of as being in the background. But make no mistake about it. It is only through their support that we have a chance to advance in our business endeavors.

P number seven - Performance

Performance is critical. You must focus your efforts in results not politics. It is not how well you play the game or how much effort is applied. The end result is to create value for all your stakeholders. You'll also find that success is a constantly moving target. You will never be able to sit back and relax. It is true that you are only as good as what you deliver today. Get used to it. And remember this is driven more by the demands of the customer and the marketplace, than it is by your manager's expectations. Learn to stretch your expectations of yourself. At some point in your career you will become "good." But don't let good get in the way of becoming "great." If your quest is to be the best there is no room for complacency. You must aim higher and higher. Today's excellent performance will be average tomorrow if you do nothing to get better. Make continuous improvement a part of your life. Remember, becoming the best at what you do does not happen by accident. You must continuously work hard at it with passion and intensity. When you sum the total of your efforts you will achieve outstanding performance. From time to time, I hear managers describe someone else's good performance as "luck." But long-term business success is not "luck" unless you define luck as the point at which opportunities and preparations converge. You must be always ready to take advantage of an opportunity.

In fairness to this audience, I suspect I could not adequately address your interests unless I also speak about the subject of diversity. Be proud of who you are and where you come from. Use it to your advantage, but don't take advantage. Being a minority does not entitle you to anything. Each of us must earn what we have, and must maximize what we have been blessed with. I believe that diversity in a very broad sense is strength. It is in our differences, not our similarities that the most dynamic, exhilarating and life-changing experiences can be found. Allow your heritage to give you clarity of self -- to know who you are and what motivates you. But let your brain, and your guts and your heart - not your gender or the color of your skin -- lead you through life. As the global leaders of the future you must learn how to balance your technical strengths with the many cultural requirements of the people who you encounter.

You also must learn to be diplomats. I say diplomats because to become a global leader you must possess a keen understanding of the history, geography, religion and politics of the local economies in which you will conduct business. You must learn to be flexible, resilient and adaptive. Respect for local, country or regional culture is and will continue to be essential elements for success. Only "global leaders" will be able to strike the proper balance. As a member of this new breed of leaders you must be able to conduct business in at least two languages and let me emphasize the word "conduct."

The ability to read, write and speak a language is not sufficient to fulfill the requirements of the future. You must understand the culture and be sensitive to cultural differences. You must be able to create a seamless bond. A case in point. English has become and will continue to be the universal language of the Internet, but the cultures of the English-speaking world don't represent a universal culture. Economist Milton Friedman says it is now possible for a company located anywhere, using resources from anywhere, to produce a product anywhere that can be sold to customers everywhere. What Mr. Friedman does not tell you is that you cannot build the plant, purchase the resources, or market the product if you do not relate to each culture individually on its own merits and within its cultural paradigms. This is a most important and difficult point for global leaders to accept when learning to work with different cultures: A single paradigm does not work universally. You by virtue of your Hispanic background have the best of both worlds and an excellent foundation to accommodate the best of various cultures and to create new ways to lead business. You can make a difference. I went with confidence in the direction of my dreams and lived the life I always imagined for myself and my family. Now, it is your turn to create and follow your dreams. Thank you for your kind attention.

Mr. Iraola is the founder and CEO of The Aloaris Group, http://www.aloaris.com, a privately owned group that provides financing and manages start up ventures with the potential to revolutionize existing business models.

The Group also provides a full range of advisory services to companies operating or planning to operate in emerging markets. He is also a co founder and CEO of http://www.Homekeys.com a developer, integrator and provider of state of the art web-based information tools and services for the real estate industry.

Mr. Iraola currently serves on the Board of Directors of Central Hudson Energy Group Inc. (NYSE:CHG). He previously served on the Boards of Phelps Dodge Corporation (NYSE:PD), Southern Copper Co. (NYSE:PCU) and Schweitzer Mauduit International Inc. (NYSE:SWM).

Five Easy Steps to Create a Corporate Presence for Your Virtual Business

There is a strong entrepreneurial spirit in the UK at present. Whether that is driven by the intrinsic individualistic nature of the population, a genuine wish to better ourselves, a need to get rich quick or just get out of the traffic jam is open to debate. The fact is it is there, the government is keen to promote it and there are lots of people doing it: some succeeding, some surviving and some, unfortunately, failing.

The perennial problem that all new startups have to face is how to not look like a start up when you are pitching for that large job that will feed you for the next 6 months and will allow the business to get on its feet.

The internet is a good starting point of course and although the phrase is less used these days it is still true that: "on the internet no-one knows you are a dog". Not unless you 'let' them know of course.

But the same can be as true off-line as well as online these days as technology makes it easier and easier to create that corporate presence from your back bedroom.

Before getting started on this in earnest, it is as well to address one specific issue that may already be in the back of your mind. Yes, it is possible to address this issue by tying up with a national business centre that will offer at least some of the things I am going to outline below. Before leaping into this, check the pricing - it will make you think again. The steps below will cost you a great deal less.

Step 1 - Establish an Address This can be a surprisingly tricky one. It is a relatively simple step to set up a post box with the UK Post Office. There is information on the Post Office website about this and at a basic level it will cost you about £60 per year - more for additional services such as mail forwarding etc.

If you are operating as a sole trader or partnership, this may be enough. After all you will see many very large businesses giving their correspondence address(es) as a post box, or range of post boxes these days as it is a good way to manage or re-direct mail towards the correct specific department.

If you are setting up through a Limited Company, then you may have difficulties in deciding upon the right head office address and using your home address sort of gives the game away. In this instance it is worth looking at an alternative business address that may be prepared to handle your company related mail. As long at it is restricted to Companies House type mail and not much more, you may find your accountant would be willing to have their premises used as your registered head office. After all, a large proportion of your Companies House correspondence might end up going their way anyway. Failing that, try a friendly solicitor or a even a friend with an established business that may be willing to help.

Obviously what we are looking for here is something for free. Remember that a post box can still be used for normal business correspondence - we are just looking for a head office address at this stage.

Step 2 - Get One or More Telephone Numbers Do not mess about here. If you are working from home to begin with you will need to put a second line in for four main reasons: 1 - it will be much easier to manage your bills / accounts 2 - you need to know when the phone rings that it is a business call and everyone in the house needs to know how to deal with it (and / or behave) when a business call comes through. 3 - The last thing you need is your phone tied up with your family chit chat while a business customer is trying to get through 4 - You do not really want to have your private telephone number bouncing around in the public domain from both a privacy and security perspective. More of this later.

Yes, the additional line will have an associated cost, but not having it will have a much greater hidden cost.

Least Cost Routing (LCR) can be used to cut your outbound call costs if you have a BT line and there is a link on the bottom of this article to Phone Lines 2u who offer a very competitive service in this area.

In terms of the number you give out, it makes a great deal of sense to mask the location of the number by using a national 'marketing' number. Remember, we are wanting to look like a substantial business here. Initially there are three types of number you might consider using:

0870 - national number with a national cost no matter what the origination location 0845 - Local call rate number no matter what the origination location 0800 - free to the caller, the receiver pays

All of these numbers are re-directable ones. That is, you will still have your normal phone line and phone number, but when someone calls your dedicated 0800, 0870 or 0845 number they will be re-directed to your normal phone line.

From a general marketing perspective, 0845 and 0800 numbers make good sense. However they will cost YOU money to RECEIVE the call and in a start up situation it is difficult to recommend these numbers unless you have substantial funding behind you.

The 0870 number option is commonly used with large businesses these days and has the added benefit of generating an income from inbound calls. This can make good sense if you expect to receive many calls, but it might be a high expectation if you are just starting up.

What the marketing number can do you for you is provide a mask to the real destination number. This makes you look like a bigger player, but can also have the added benefit of maximising your flexibility behind the number. So if things go well and you move out of the back bedroom into dedicated business premises, your literature, business cards, website and advertising do not need to be changed.

Equally, you can have a range of numbers and may choose a different number for each advertising campaign so that you can measure the relative effectiveness of each. Phone Lines 2u offer a reporting service on these numbers for free on 0870 numbers, so you do not even need to do any work to get the analyses.

Step 3 - Get a Fax Number

This does not necessarily mean get a fax machine as it is possible to receive faxes via e-mail for very moderate fees. Again, you can choose a national number in line with the telephone number you may have selected in step 2 to cement the national presence. Faxes arrive by e-mail as an image so you can view them on any standard PC or Mac with a whole range of viewing and printing software - the vast majority of which is either available for free or bundled with other software you may have (e.g. MS Office).

A link to advice on how to set this up is on the bottom of this article.

Step 4 - Get a Virtual PBX By PBX I mean a telephone exchange system. Like the big boys use, but virtual. A telephone call comes into a virtual call handling centre and handles calls just like a large business would, eg: "Welcome to our company, press 1 for sales, press 2 for accounts, 3 for production and 4 or hold for all other enquiries."

You may have 2 or three colleagues all working in different places: one who handles sales, one handling accounts and one responsible for producing the service overall. Depending upon the choice made, the caller will be directed to the right person.

There will be a charge for the redirected call, but if you are using an 0870 contact number, the chances are that the total amount you make on the O870 call will negate any re-direct call charges from internal transfers.

Setting this is up is easier than you think - details are available on the Phone Lines 2u site - see below

Step 5 - Get to grips with Video / Audio Conferencing If there is more than one person in the virtual business, you will need to meet up / talk on a regular basis. The quickest and cheapest way to do this is 'virtually', either through video or audio conferencing.

Basically what means this is everyone involved in the meeting on the line at the same time, controlled by a chairman.

Lets begin with video conferencing first as this can be done for free. All you need for this is a PC each, a basic web camera on each machine and a microphone of some sort. I saw a basic video conferencing pack on sale in the supermarket the other day for £10 - so you do not need to break the bank to set this up. Software to manage the call is available free from Skype or MSN and it is relatively easy to set it all up.

Failing that, or in the (probably common) instance that not everyone can get to their PC at the time of the meeting, then audio conferencing works the same way, but over telephone lines instead of the internet. Yes there is an added cost to this either by subscription or additional call charges, but it will be minimal when measured against fuel costs, travel time and lost productivity if every one has to travel into a central location for a face to face.

Audio conferencing also work well for those who work in low tech environments, out on the road a great deal or for people who are just plain technophobes. It is as simple as making a call at an allotted time, putting in a pin number and getting on with the meeting. There is a little bit of additional skill involved in managing this type of meeting, but that is something for a future article I think.

In conclusion then, having a small startup (or even larger ongoing) virtual business is cheaper and easier than you think. You can look like a big player to your customers on the one hand, but the tools and techniques above will also make the whole operation much cheaper to run and more effective too. Yes there are some associated costs, but the savings and increased sales opportunities far outweigh any downside they may present.

Not only that, but the virtual business is environmentally friendly - it is nice to know that making the business more efficient and saving you money can also save the planet too.

More details on Marketing Numbers, Virtual PBX, Fax to E-Mail and Audio Conferencing can be found on the Phone Lines 2u website at: http://www.phonelines2u.co.uk.