Skip to main content

Thriving Or Surviving? The Big Blah-Blah!

It might be the moon's phase or maybe the Gulf oil spill has everyone in a screaming blue funk (I know it does me) but the week past's theme is best described as "We've no time for new ideas.  We're not thriving, in fact we're in total survival mode."

To which, thankfully, I was tactful enough not to ask "Who the hell's fault is that?"  Because I knew what I'd hear:  "We tanked along with the economy.  We're getting killed by managed care.  The capital markets have slammed shut while our capital needs escalate.  Patients are putting off the health care they can't pay for.  Our volumes slowed while bad debt zoomed.  Medicare cuts are coming.  Medicaid's not paying its bills. We're coping as best we can." 

Such a familiar litany, I've started calling it the Big Blah-Blah, the hospital CEO chant.  But do you notice anything?

The excuses, er, reasons are focused externally, on the "out there."  It's the environment.  It's them.  They're doing it TO us.

I even heard "We might consider taking action if it was up to us, but we have a corporate office to answer to and they'll never let us."  More them, more self-pitying blah-blah.

Respectfully, I beg to differ.  It's not them out there, it's you.  It's us.  I tell my kids that when you point your finger at someone you've got several more pointing right back at you.    Kids get it.  C-suite occupiers have some work to do. 

Today, many hospitals are hunkered down in survival mode because of their decisions last year and the year before that and 5 years ago and 10.  Too long, they were content being just like everybody else, running with the herd, doing what the herd did.   Benchmarking against the herd, listening only to the herd, using the herd's consultants, buying what the herd bought, poring over the herd's white papers, attending the herd's seminars.  What's that old line about doing the same thing over and over yet expecting different results?

Speaking of results: best described as no worse than most yet not noticeably better either.   How could they be when the formula says safety is better than risk?  That stability is preferred over growth and caution over action?   And I defy you to name one CEO fired for flogging the old business model too enthusiastically while ignoring the future's value streams (maybe you know the ones I mean, those making the business model old AND obsolete.)

Somehow, it was all supposed to be both protective and differentiating.   And it might have been...except the entire herd went off the same cliff, chanting "It's THEIR FAULT!" all the way down.

I don't mean to minimize health care's difficult challenges.  They're always complicated and frequently intractable.  Solutions are seldom obvious or easy.  Call it what you will - I prefer "strategic separation" - the state of "thriving" emerges ONLY from confronting and solving difficult challenges better, faster, cheaper and, yes, more visibly than anybody else.   Real leaders turn complicated challenges upside-down and call them opportunities.

None of us can go back and undo last year's decisions.  I know there's a few I'd like to have back.  Yet we pondered and decided and now for a while we're stuck with the results.  And divining the long-term impact of tomorrow's decisions is almost as difficult.  But every tomorrow is a new opportunity for learning and growth.  A chance to ask "Where am I and how did I get here?"  To be restless and impatient with mere survival.

So you're surviving.  Having fun yet?  Maybe you should ask what needs to change to achieve that "thriving" future state.  Maybe it's time to raise your head above the foxhole's rim and  commit to a new chant, something a little more spirited like "As a leader I'm BETTER THAN THAT!  And different results come from different decisions.  So bring it on!"
 

"When you have exhausted all possibilities, remember this. You haven't." – Thomas Edison

Comments

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor

Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcare

My Take On Anthem-Cigna, Big Dumb Companies and the Executives Who Run Them

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer. In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers."  Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings. $2.4 billion saved