March 2009 Archives

The "Openers" column in the business pages of the March 29 New York Times carried an interview with CEO of Amgen, Kevin Sharer by Adam Bryant. In Feedback in Heaping Helpings Mr. Sharer reflected on his earliest experiences as a leader in the military and in the corporate world as well as a number of practical and humbling tips regarding his leadership style which can benefit health care leaders and which are well worth the five or ten minutes it takes to read them.

When was asked what he did on his first day as CEO at Amgen, Sharer's response was that he posed several questions to the senior staff - potentially risky questions I have infrequently seen asked by newly placed physician or executive health care leaders:

• What 3 things would you like to change?
• What 3 things would you want to make sure we keep?
• What is it that you would like me to do?
• What is it you are afraid I am going to do?
• Finally, is there anything else you want to talk about?

Sharer then spoke with the top 150 people in the company one at a time for one hour each, asking each of them the questions. He listened, took notes, and synthesized all the responses. He then sent the synthesis to the 150 along with his responses and his list of priorities for the company. He said people were candid and it gave him a chance to quickly get to know the key people in the organization.

This is the action of a confident, open-minded person who believes he has plenty to learn from those below him in rank, a key quality in any effective leader. In his own words:"... leadership is not about charisma and it's not about style. It's something about authenticity. It's something about integrity. It's something about willingness to take risks. It's something about the ability to make others feel part of a larger thing."

That larger thing for health care leaders is the dream of getting people on board with the mission of health care system improvement? Can we learn something from Sharer's approach?

The April 2009 issue of Harvard Business Review arrived this weekend and I devoured it on the plane yesterday. There were so many provocative pieces for health care leaders that I decided to bundle several of the short ones into this commentary. They all happen to take contrarian views to "common management wisdom" - on such "no brainers" as the value of employee satisfaction, the wisdom of following the path set by "best of breed" organizations, and the degree to which organizations gain replicable competency from the alliances they create. If the conventional wisdom found in the management literature is actually wrong, how are we to learn leadership skills and techniques from those who came before us...

In Southwest Airlines CEO Flies Uncharted Skies March 25, The Wall Street Journal's Mike Esterl takes a look at how Southwest Airlines - the perennially successful low cost airline - plans to fly above the industry clouds. As you might expect, it's not by using strategies the other airlines use. What's interesting for health care leaders about SWA's approach is not so much what it is, but what it is not...

Everyone's abuzz about the Tata Nano. The world's cheapest car is taking India, and the world, by storm. Leveraging the wundercar's impending launch, Business Week (on March 18, 2009) asked the critical question in its eponymous article: What Can Tata's Nano Teach Detroit? I immediately tried to leverage their question to your advantage - so I began to wonder about what the Nano can teach health care leaders...

The March 15 issue of The Wall Street Journal carried another one of those "business" articles that health care leaders could easily overlook as too corporate. But Seven Lessons for Leading in Crisis, written by Bill George, former CEO of Medtronic and a member of several mega corporation Boards, is important reading for both physician leaders and executive health care leaders - especially these days which are anything but crisis-free. George dismisses the technical causes of the current economic crisis (poor regulation, bad investment decisions, risky investment vehicles) and lays the blame squarely on people just like us: "The root cause is failed leadership....[It] can only be solved by new leaders with the wisdom and skill to put their organizations on the right long-term course."

On March 20 The Economist (web edition only) published a short bio of the late Herbert Simon, 1978 Nobel Laureate in economics, who is considered to be one of the leading management thinkers of his time. As I read about this, it seemed to pretty well sum up the conundrum health care leaders find themselves in - and why former clinicians can feel really conflicted as managerial leaders...

Five Leadership Lessons From Obama's Second Month appeared on the Forbes web site on March 19,2009. I have a feeling we are going to be learning a lot about leadership from this President as time passes. Authored by Shaun Rein, this article puts Barack Obama's behavior under multiple recent stresses into a strategic leadership framework that is exportable to sometimes embattled health care leaders...

When Economic Incentives Backfire which appeared in the March 2009 issue of Harvard Business Review examines another dimension of the same issue -namely the economic incentives that organizations design to motivate employees to achieve goals and targets. This is more than a hot topic today with the AIG incentive bonus issue in the forefront of news and commentary around the country. The author, Samuel Bowles, is a behavioral scientist at the Santa Fe Institute who reports briefly on evidence about how financial incentives influence moral sensibilities and behaviors. Or, conversely, how human nature influences the behavior of incentive programs. And the picture, similar to that for goals, is not always what you might predict in ways that are particularly relevant to health care leaders...

THIS SPECIAL GUEST POST WAS AUTHORED BY Jeff Levin-Scherz, MD MBA who writes the Managing Health Care Costs blog. A more complete bio can be found at the end of this post. Please click on the link below to read this provocative piece...

I've previously commented on Thomas D. Kuczmarski's innovative ideas about innovation (see Is Don Berwick the Secretary of Innovation?). I am going back to the well because An Innovation Action Plan for Obama which appeared in his March 9 Business Week web site column seemed worthy of translation from the business world to the world of health care leadership...

While every health care leader should read every article in the January 2009 Harvard Business Review, I can't resist going for To Lead, Create A Shared Vision, contributed by James M. Kouzes (Dean's Executive Professor of Leadership) and Barry Z. Posner (Dean) of the Leavey School of Business at Santa Clara University. They also happen to be the co-authors of The Leadership Challenge, an easy reading business book of biblical stature among leadership gurus. It would be a mistake to think that yet another spin on vision is bound to be trite...

Executives Have No Idea What Customers Want, by Andrea J. Ayers, President of Customer Management for Convergys - a company that specializes in customer relationship management - appeared on Forbes.com on March 10. It's a bold assertion based on a sobering survey conducted by Convergys across 10 industries revealing that: "Nearly half of consumers (47%) say they don't believe company executives understand their experiences...More than one-third (41%) of the customers who take the time to complain don't think companies listen to or act on their feedback.... [of these] more than half will defect--leaving a company flatly--based on bad customer experiences, without ever telling the company why." Overall, she claims that: "17% of [all customer] interactions result in a customer leaving the company..." Is health care an exception. I doubt it. This is something health care leaders could do something about...

All the best ideas come from the big centers, right? Not always, if you believe what you read in Innovation Trickles in a New Direction published on Businessweek.com on March 11. In this article, Reena Jana turns conventional thinking about innovation on its head by describing products developed in third world or remote countries by the likes of General Electric, Microsoft, Nokia, Proctor and Gamble, and the like, that have found their way into wide application in the industrialized world. This must mean something about where and how to look for innovation in health care...

McDonalds Seeks Way to Keep Sizzling which appeared in the March 10, 2009 Wall Street Journal is a pretty standard business press article which is nominally about how the "golden arches" has remained profitable during the recession - but it reads like an instructional manual in effective management style for any industry (yes, health care is an industry) in any economy. If Janet Adamy's characterization of McDonald's President and COO Ralph Alvarez is anywhere near on the mark, health care leaders have plenty to emulate in his leadership methods and style. This is another of those often published corporate snapshots that I suspect are not on the daily "must read" list for most busy health care leaders. Hence the mission of this blog - to "push" it out to you. And your reciprocal response - to take a few minutes to read it. Here's why....

The March 16 issue of Business Week features a profile of Ford's CEO. Alan Mulally: The Outsider at Ford,. At a time when there is plenty to say about the auto industry and its executives, the author, David Kiley, instead focuses this piece on the risks and benefits of bringing an outsider into a position of substantial responsibility. In December of 2006, when Mulally was brought from Boeing to lead Ford, the company was already on the ropes. A risky time for a controversial choice. It's also a familiar dilemma for health care leaders when considering a critical recruitment...

Job Losses Hint at Vast Remaking of Economy was published by The New York Times on March 6. This article by Peter S. Goodman and Jack Healy sparked my thinking about the unique position health care leaders "enjoy" in a grim economy which has not (yet) landed a direct hit on our industry. Can health care actually be part of the solution for the US economy? Please read on....

The entire January 2009 issue of the Harvard Business Review is devoted to perspectives on leadership, cover to cover. So it's hard to recommend one article over another. That being said, Picking the Right Transition Strategy is particularly relevant to health care leaders. In this article, Michael D. Watkins examines the critical importance of differentiating situations (rather than positions) as a success factor when moving into new job situations. Health care leaders, especially when they have responsibility over clinical areas, do this every day, within the same job...

On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act of 2009--the largest one time domestic spending bill in U.S. History. This package, which includes a massive dose of tax relief, is intended to do two fundamental things: (1) stimulate the economy; and (2) more specifically to create or save 3.5 million jobs during the President's first two years in office. Both sound like good prescriptions for health care leaders, right? Well....

Ken Anderson, author of Ethnography Research: A Key to Strategy which appeared in the March issue of the Harvard Business Review is an anthropologist working for Intel Corporation. You may already be wondering how will I twist and blog his experience into something useful to health care leaders! Well, in Anderson's own words: "I believe that ethnography [has been] so beneficial [to high tech companies] that it will spread widely, helping firms in every industry truly understand customers and adapt to fast-changing markets." Read on....

In his March 2 Business Week article, Pushing the Limits of Crowdsourcing, Damien Joseph recounts several successful design projects resulting in the creation of animated features and video games, that utilized a free global design crew consisting of many thousands of contributors via social networking applications. Does this represent an opportunity that should be harvested by health care leaders in order to innovate operational improvements?

The blog was "on vacation" last Friday - more precisely I was "on the road." So today's post is extra spirited. I hope it provides incremental value. The Dangers of Turning Inward, published in the print edition of the Weekend Wall Street Journal on Saturday, February 28, presents a chilling scenario for the potential demise of globalism as a result of the current economic crisis. As I read, it occurred to me that health care leaders may face some similar choices as we select strategies to combat the inevitable "other shoe" - when the full impact of this recession is felt in our industry. Please read the source article and, of course, continue further in this commentary for my perspective on the connections it suggests for health care leaders...