Skip to main content

Small Is Beautiful

How do you grow?  A critical question for health systems, communities, policy makers and incubators alike.   Writing in Bloomberg Business Week, Vivek Wadhwa argues that nurturing a few tiny companies is a better bet than what he calls misguided "behemoth-centric policies."

"Established companies are job destroyers..." says Wadhwa, citing research from the Kauffman Foundation finding big companies erasing 1 million jobs per year from 1977 to 2005.  Maybe there's a better way...
"...the Kauffman Foundation's Robert Litan just published Inventive Billion Dollar Firms: A Faster Way to Grow. It's a succinct argument that suggests helping a few really innovative startups become big businesses. How many? Maybe less than 60."
Read the article, review the fairly compelling math.  And notice that Kauffman puts its money where its mouth is, with an initiative called Kauffman Labs For Enterprise Creation targeting promising industry sectors and entrepreneurs ready to change the world.

Could your health system benefit from a "Lab For Enterprise Creation" and like-minded entrepreneurs?  Are you exhausted by cardio/ortho/neuro/oncology/EMR/private beds' near-infinite capital appetite and diminishing growth prospects?

Stop trying to feed the monster - at least to the exclusion of everything else.   Try letting 60 flowers bloom.  Find a few people in your organization itching to change the world.  Don't believe you have any?  You haven't looked very hard.

Another riff on Getting Big By Going Small, from Strategy+Business and biotech CEO Francois Nader.

Maybe you can get 'small' by assessing all your possessions' true value.  Try moving.  You really can't take it with you.

Sometimes what you subtract is more important than what you add.  Everyone should get "small" by having a stop-doing list.


Popular posts from this blog

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 healthcar…

Becoming Consumer Friendly In Five Easy Steps...Or Not

An article at offers hospitals 5 steps to becoming more consumer friendly.

If you still think there's a secret sauce to your hospital becoming more "consumer friendly," these 5 steps are as good a place to start as any.  Unfortunately, it's a little like that old Steve Martin comedy bit where he says he'll teach you how to be rich. The first step is to go find a million dollars.

Step 1 from the article is realizing that "...a Medicare beneficiary with chronic conditions is different from a young mom who brings her kids in for an annual check-up." This is market segmentation for beginners, and, yes, one size decidedly does not fit all. I'm sure your marketing team's been saying this for a while.

Steps 2-5: have a strategy, metrics, a champion and resources. OK. Hard to argue with any of those.

But those things, alone or together, won't overcome culture. They're important components to be sure, but insufficient without a …

Behind Every Resume Is A Potential Customer...and Karma.

I recently heard from an executive colleague who, thanks to a merger, found herself looking for her next opportunity. Her story, probably depressingly familiar to many of you, was all about the big black hole of rudeness and non-responsiveness that so often sums up employers' attitudes toward candidates.

This colleague, thinking she'd see the healthcare world from a new vantage point, pursued opportunities with consultants, IT vendors, architects and other suppliers who, far from appreciating her solid resume, were like the 3 Stooges of clueless.

So back to a senior health system role she went, WHERE SHE NOW INITIATES AND MANAGES RFPs FOR SOME OF THE VERY SAME COMPANIES who wouldn't talk to her as a candidate, but profess their LOVE for her now that she's got money to spend on their services.

Not gonna happen. Any guesses who's off the RFP list?

I smiled when I heard her story, imagining the BusDev people working hard to grow the revenue pipeline, all the while b…