Author: mikemallaro

CEO of VGM Group, Inc., a 100% employee-owned company. Interested in healthcare, golf, restaurants, insurance, public policy and life.

Values – The Power of One

Power of OneOur companies are the sum of the people who work for them and the customers that they serve. Further, people have wants and needs that go beyond getting and spending. They aren’t just looking for a paycheck every week or a non-descript service to buy. Today, more than ever, they’re looking for a community that they can belong to full of people that share their values. Values are a powerful part of our identity, both individually and corporately. If they’re taken out of the equation, then everything can veer toward the transactional. A transactional mindset leads employees to apply at the company down the street if they offer a few more cents per hour, and our customers to get what they need based only on who can offer the lowest price.

In an effort to affirm the humanity in our employee-owners and our customers alike, VGM has recently made an effort to articulate our core values to the people who work here and those who might like to in the future. We call them our Power of One Principles, a set of eight pillars that show what we stand for as the owners of this great company. These are values that each of us can embrace to get better at what we do individually so that all of us can go forward together. Our Power of One Principles are not an effort to change culture. We already had a great culture! Rather, they are an effort to capture and communicate our shared sense of purpose and energy.

Every company has a set of values that characterize its culture and its mission. Clearly articulating them is a great exercise, and it allows people to take our measure and decide if we can meet their needs. Not just the financial ones, but the human ones: A place to belong. The chance to find friends at work. A sense of shared meaning and purpose in what we do each day. If we can offer people that, then they’ll offer our customers meaningful and memorable service that will make them want to choose us forever.

Over the next several weeks, I’ll describe each of the Power of One Principles, provide some examples of how they relate to what our company does, and explain why each is an important part of what makes us us.

The Iowa Caucuses


My home state really messed up last Monday night. The Iowa Caucuses are a treasure in the state of Iowa, making us a temporary center of the political world every four years. Interestingly, my caucus site was highly organized and went off without a hitch. In fact, it was the best run Iowa caucus I have ever attended, and I’ve been to many. But at the level above, where results were collected, aggregated, and reported – well, that was a train wreck. There were a whole lot of voices calling for the end of the Iowa Caucuses well before Monday’s counting debacle, but those voices were amplified one thousand percent after our folks failed to produce the results in any reasonable timeframe.

It seems like this conversation comes up every four years, and I find that to be a real shame. I might be a bit biased, having been born and raised here and having been a frequent caucus-goer for several years, but the Iowa Caucuses are a political event unlike any other. I think it would be a regrettable loss for our state and our democracy if we allowed this unfortunate technological foul-up to be the end of them. I’m prepared to admit that Monday’s counting and the delay in reporting that followed were bad things in need of correction. I also think that it would be terribly reckless to throw the baby out with the bathwater and eliminate the caucuses for good because of these mistakes.

A lot of the people who challenge Iowa’s vaunted “First in the Nation” caucusing status cite the idea that a state with a relatively low population that is mostly white shouldn’t have such a huge impact on deciding who either party’s nominee should be. I suppose that’s an argument that a reasonable person could make, but the way that we do things here in Iowa makes our caucuses a unique and very special part of U.S. democracy. Consider, for example, that both parties have about a third of the registered voters in our state, with a third being undecided or independent. That makes for a fairly level playing field as candidates compete for support, and it also gives them the opportunity to demonstrate their electability by showing that they can win over those undecided voters.

Candidates are also able to campaign in Iowa without spending tens of millions of dollars. VGM’s government relations team likes to joke that people can campaign in Iowa on “cheese and crackers,” and that’s true to a large extent. Iowans tend to turn out in droves to volunteer for the candidates that they support, and many open up their homes to serve as campaign headquarters, to feed and house campaign workers, or to host informal town halls where people can meet with and even speak to the candidates close up. As for the money that does get spent here around caucus time, it’s a huge shot in the arm for our economy. Iowa mostly thrives on agriculture, and the revenue that we receive from hotel stays, restaurant reservations, and other spending by campaigns and the media is welcome and needed during the winter months.

Perhaps most importantly, the Iowa Caucuses represent one of the few displays of true community building left in American democracy, particularly on the Democratic side of the equation (it is also on the Republican side but the rules and the process they use in Iowa is a little different than the D’s – if you’re not an Iowan you probably didn’t know that!). People gather together in the gyms where their kids go to school. They don’t argue or fight with one another. They don’t scream at each other over their views. They often see people they know standing on the other side of the room in support of other candidates, and that’s OK. As the night goes on, they have civil conversations as they attempt to bring those same friends and neighbors over to their side. This kind of civilized dialogue between citizens is a rare and precious thing in today’s America.  Not division, not anger, not hate, but instead community.

The Iowa Caucuses attract passionate people who want to play a role in the political system that’s greater than the drive-by votes cast on Election Day by the militant and the unengaged alike. Selecting the candidates who will run for the highest office in our nation is not the same as voting in an election. November the 3rd will mark the culmination of the electoral process; the end of a long and divisive journey that will probably leave a few more scars on our political process. The Iowa Caucuses are the beginning of that journey, where people gather and engage with one another as citizens and human beings to choose a leader and a message that they believe will steer America toward a better tomorrow. There is a civility, optimism, and humanity in this process that is becoming impossible to find in our political discourse these days.

We made some mistakes this year, sure, but aren’t those things worth giving this process another chance?

Five Healthcare Predictions for the 2020s

Crystal Ball

I’ve been talking a lot about the future lately. I think I’ll keep the crystal ball rolling just a bit longer. In an election year where healthcare has pulled ahead of the economy as the primary concern of voters, I think it’s safe to say that we can expect some changes in the next decade to the way we do business in this arena. A lot will depend on who’s in charge after November is over, but a lot won’t. As another week draws to a close, I’d like to share a few politically agnostic predictions for the future of healthcare in the U.S.

1.) Women will achieve parity with men as a percentage of doctors and surgeons. They will be a young and diverse group with more tech exposure than any generation before them, and they’ll bring with them talents and perspectives that will lead to better outcomes for their patients and more innovation in their field. Women already make up about forty percent of our physicians. By 2030, I think they’ll be a lot closer to half.

2.) Security and compliance will put us on the path to lowering costs. Maybe it will be the government under a single-payer system. Maybe it will be a group of America’s largest insurers. Whoever it is, someone is going to force the industry to get a whole lot more serious about security and compliance so that we can stop setting records for the size and severity of our data breaches. This may be expensive at first as systems are created and built out, but once they’re in place we will see costs decline with the number of false insurance claims.

3.) Consumerism will cause healthcare to look a whole lot more like a retail experience. It’s already happening. In fact, major retailers like Wal Mart, Costco, and Amazon are already investing heavily to prepare for the new wave of healthcare delivery models like telemedicine, direct-to-consumer testing, e-pharmaceuticals, and retail care. With more care options than ever before and fewer barriers to accessibility, patients will be shopping around a lot more for their healthcare solutions and products.

4.) Telehealth will explode. China is already investing heavily in this as a solution, with plans to cover over 70% of their public hospitals through telemedicine solutions by 2022. Once we figure out a few things like security, compliance, and connectivity, I predict that we’ll see large scale adoption here as well. This could go a long way toward providing care access to the elderly, the immobile, and people living in rural areas when we figure out how to make it work reliably.

5.) Face-to-face interactions between patients and providers will become more important than ever. I’ve already written about the loneliness epidemic. If you’re a provider, then a meaningful number of the people who come to you seeking treatment or services are lonely. What’s worse, they’re typically going through a very vulnerable time. When we’re sick or injured, we’re scared and depressed. We need to talk to someone about what’s happening to us, and who better than the person providing our treatment. Technology will play a big role in healthcare, and telemedicine will expand, but a provider who knows how to provide their patients with an empathetic ear and is willing to treat them where they are will be well positioned to be enormously successful in the next decade.



“Progress is a historical fact. The numbers show that over the past seven decades humans have become longer-lived, healthier, safer, richer, freer, fairer, happier, and smarter, not just in the West, but worldwide.” – Steven Pinker

In my last post, I tried to make the case for optimism as an antidote for fearing change. Even as I typed the words, I wondered how many of my readers would believe that things are getting progressively better with each passing year. As human beings, we often fall prey to catastrophic thinking. Rather than seeing situations for what they are, we make ourselves crazy by imagining all of the terrible ways that they could go wrong. Or, when we look to the future, we anticipate all sorts of terrible things that haven’t happened yet…and probably never will.

It doesn’t help that there is a huge over-focus on bad news these days. Most of the things that happen suddenly are bad, and in a world gripped by a 24-hour news cycle, journalists often feed our catastrophizing by reporting every sudden event in a sensationalized way as they compete with one another for viewers, readers, and followers. 2020 is an election year, and I don’t expect that to help. Our nation is more polarized that its ever been, and both of our political parties have a vested interest in keeping us that way as they compete with each other for votes.

As we begin the 2020s, I’d like to invite you to join me in realizing that the 2010s were probably the best decade in human history by just about any metric. Rather than ask you to take my word for it, I’d like to share a couple of great pieces with you that have come across my desk recently. Both do a great job of outlining the wonderful things that are happening around the world, and both make the case that we can expect even more in 2020.

The 2010s Have Been Amazing by Johan Norberg

What Can We Expect from the 2020s? by Steven Pinker

It’s not always easy to hope for the best. As you begin your weekend, hopefully this bit of light reading will help.

Letting Go & Moving Forward

Sailing Ship

Happy New Year, everyone. It’s hard to believe that it’s 2020 already. I can still remember when the year 2000 sounded impossibly far off and futuristic. There was a lot of fear that surrounded the coming of the new millennium. Most of it was driven by the increasingly large role that technology was beginning to play in our lives, the rapid pace of change that came with it, and the worry that our over-reliance on it could bring civilization to its knees.

Twenty years after the Y2K hysteria, technology continues to drive massive changes to the way that we live and work. Moore’s Law tells us that the pace of these changes has never been faster, and will never be this slow again. That means that there is a lot of pressure on our businesses and institutions to keep up. There is also tremendous pressure on individuals, who find themselves adapting to new ways of doing things, the loss of loved ones, career changes, and more with each passing year.

Some people thrive in our rapidly changing world, while many others struggle. As we ring in the New Year and prepare to see what changes it will bring, I thought I’d offer a few words of advice and encouragement to those in the latter group.

  • Those struggling with change often place very high value on things like historical precedent, their current state of being, or a particular person that they associated with “better times.” If this is you, allow yourself to grieve for the loss of what’s come before. Grieving isn’t just our emotional reaction to the death of a loved one, though that’s how most of us tend to use the word. Grief is a process of transition following the loss of anything that we hold dear. It’s all right to be sad or upset about a transition of leadership, the deterioration of your health, the loss of someone you love, or a change in the direction of your career. Remember the way things were. Celebrate it. Mourn the loss. Then, turn the page.
  • Adopt a growth mindset. A growth mindset is the belief that you can grow, adapt, and evolve over time, and that change is one of the primary contributors to our personal and professional development. Contrast this with a fixed mindset, which says that everything is static and we can’t grow ourselves beyond a certain point. A person with a fixed mindset typically fears change because they are concerned about being left behind or consigned to obsolescence. We are all capable of growing and adapting to change if we endeavor to do so. Get out there and learn something new. View the world from a different perspective. Believe that you can get better. Because you can.
  • Take note of what’s happening in front of you. Look at what’s happening in your life, at your office, and in your community. You aren’t betraying the past by paying attention to now or looking ahead to tomorrow.
  • Stay optimistic. Just because things are changing doesn’t mean they are changing for the worse. Despite what the media may tell us, there is plenty of reason to be grateful for the changes that are occurring around us every day. People are living longer with a better quality of life than ever before. Fewer people die by violence than at any point in human history. The crime rate continues to decline. It’s easier than ever for people to stay in touch or exchange ideas. New technologies have made just about every task imaginable cheaper and more convenient than ever before. All of these are good things, and we have every reason to expect that they’ll continue to get better.
  • Stay ambitious. Establish goals. Don’t anchor yourself to the past. It’s always a bit sad to hear someone talk about their best days like they’re behind them. They don’t have to be. Always continue to dream, to seek, and to strive for something. The one who says they can and the one who says they can’t are usually both right. Which one will you be in 2020?

The person with one eye fixed on where they’ve been has only one left to see the way forward. Our world is changing. It isn’t going to stop, and the pace of change is only going to accelerate as time goes on. Embracing change can be difficult, but it can also be extremely rewarding. When the winds of change begin to blow, try to remember that they can propel you forward if you’ll just unfurl your sail and turn into them instead of desperately fighting to hold course.

Come what may, I wish you all smooth sailing in 2020.

Epidemic of Loneliness

Image result for loneliness"

Despite technology creating so much connectedness around the world, we live in a time of vast disconnectedness.  People are busier than ever, under more pressure, stressed out and isolated.  We are living amidst an epidemic of loneliness in our country.  Personal relationships are a treasure.  When customers, or employees, treasure those relationships with you and other people in your company, they won’t go elsewhere.  In fact, they find ways to stay and do more of everything with and for you.

Recently a Navy vet named Ronald White was found dead in his Dallas apartment.  The coroner found that he had been dead for three years.  Think about it.  A man died, and for three years, nobody noticed he was gone.

Last year Cigna released the results of a study of 20,000 Americans.  It produced some alarming findings about the state of connectivity and loneliness in America today:

  • Half of Americans regularly feel lonely,
  • 20% of people rarely or never feel close to others,
  • Less than half of us report having one or more meaningful conversations daily,
  • Adults 18-22 are the loneliest segment of our population.

Social media platforms connect people, but it’s a different sort of connection than friendship or companionship.  It lacks authenticity and meaningfulness.  Having a thousand friends on social media actually has very little, if any, impact on feeling lonely.  Personal relationships, real ones in the real world, give life richness.  Feeling connected, feeling like you are part of something, is healthy and desirable – and it is deeply valued by people.

Customers demand compelling solutions to solve their challenges, provided at a fair price.  Employees demand a job that helps them support their families. But customers and employees also want to work with and around people who they like and trust, and who they prefer to spend time with.  People who treat them well.  People who make them feel like they belong, like they are connected and part of a community.  All people have an innate need to belong and to be treated well.  So engage, and be engaged.  Build relationships continuously and intentionally.  Do it because it’s more fun, and because it’s the right thing to do.

Do it because, more likely than not, that other person is feeling lonely.



One might be overwhelmed, but two standing together can resist. A three-fold cord is not easily broken. – Ecclesiastes 4:12

I began my career as a CPA in an accounting firm. One of my clients was a fishing tackle manufacturer whose lead product was fishing line.  Fishing line is made by extruding a melted plastic substance to create a thin line that is both flexible and strong.  Fishing for bigger, stronger fish requires a different line. I learned from my client that the way to make stronger line is to braid many individual lines together, similar to the way that rope is made. Braided line is incredibly strong and very difficult to break, yet it retains its flexibility.

When people work together to solve problems and serve customers, each person usually brings a unique approach and perspective to the task. I’d like to submit that a team is strongest when emulating the braided fishing line. One person with a good customer relationship is a strong beginning, but a web of people building relationships and connectivity and bringing solutions to the customer’s challenges – that’s braiding. Braiding makes the bonds between people much stronger and much more difficult to break.

Bringing the right people, services, and opportunities to our customers to solve their problems and make their lives easier is extremely powerful. Braided fishing line works to catch and keep the largest, most sought-after fish. So does the braiding of the relationships and services that our people offer to our customer.