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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.

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