My 6-year-old daughter has had a couple of rough nights falling asleep. Our historic (read: old) Chicago bungalow has some very creaky floors, so my wife and I can hear the pitter patter of her little feet as she scampers across the floor to the basement stairs. She sheepishly pokes her head around the corner from the laundry room into the family room and says, "I had a nightmare," or, "I'm not tired; I can't fall asleep." (Two nights ago she actually lambasted me: "Daddy, you need to be quieter, I can't sleep." I apparently got a little too amped up watching Derrick Rose's monstrous slam dunk as Da Bulls took a bite out of the New York Knicks. I did my best to heed her advice last night during the Bulls' nail-biter victory against the Miami Heat. Every time I'd jump up, my wife would shoot me a glance: "Hey stupid, sit down and shut up. Your kids are sleeping.")


So, I bring her upstairs, sit in bed, talk about what's keeping her up and try to calm her mind. She's usually out like a light within a few minutes.

Now, I don't claim to be a psychologist of any kind and I'm not likely to come to your house soon for a bedside chat at 11 p.m., but I would like to know what's keeping you up at night.

We spend a lot of time at H&HN's worldwide headquarters trying to keep a pulse on the hot topics facing hospital executives. We like to think that we do a good job of covering the trends and providing some best practices/solutions to make your jobs just a bit easier. Still, I'm sure that there are things we're missing. I'm sure there are things that all health care media outlets are missing.

Health care is going through a major transformation, so it's a big challenge to fully grasp what's happening from Maine to Alaska, at large academic institutions and 25-bed rurals. My colleague Haydn Bush is finishing up an article for the April issue of H&HN that looks at how CEOs are handling the pressure. He quotes one executive saying, "There's a high stress level of the health care industry going into an era where the patients or family members or community members seeking care know more, want more and feel like they deserve more, and everything we get economically is a reduction in pay. Burnout occurs because you're either doing the same thing, and the same thing will lead to burnout, or… engaging in a variety of things becomes a stressor."

Clearly, reimbursement, the transition to a value-based system and other elements of health reform (and I mean reform with a capital "R") are top of mind. The most viewed articles in H&HN Daily so far this month offer some support for that assessment:

But my question to you is: What keeps you up at night? We are in the midst of mapping out story ideas for the spring and summer and would like to make sure we are providing you, the reader, with valuable information. To be sure, we'll be on top of "hot" such hot topics as meaningful use, Affordable Care Act implementation (or lack thereof, depending on what happens at the Supreme Court). But what stories aren't getting reported? What are we missing? How can we shape our coverage to better inform you?

Email me your thoughts at If you are on Twitter, send your thoughts to, #HHNMatthew.