Outside Your Own Backyard

A couple of weeks ago, I spent an invaluable day at the corporate headquarters of American Express in New York along with key members of my marketing team. The former CEO of American Express, Harvey Golub, sits on our Finance Committee. Harvey was generous enough to facilitate this opportunity so we could learn directly from global leaders more about the practice of consumerism - marketing products and services directly to consumers.

Until recently, health care has been strictly a wholesale business. By this I mean, we dealt only in volume and negotiated our fees directly with insurance companies. As a wholesale business, they were able to leverage access to their clientele for discounted rates. We were also told what we would get paid by CMS, based on the volume of services we provided. As the health care landscape dramatically changes, with consumers taking a more active role in their health care choices and managing their health care spending dollars, we find ourselves entering the retail business which means marketing directly to consumers. Since the retail model is new for the health care industry, we need to reach outside our sector to learn best practices from some of the leading companies in the consumer business.

During my meeting with American Express, not only did I gain some valuable insights on how they market to consumers, but it underscored the knowledge gained by stepping outside my own environment to learn from others. Throughout my career, I have discovered the extraordinary value in learning from leaders of other industries - from manufacturing to hospitality to fast food - and then applying that knowledge to the work I do in health care. These experiences have directly impacted the organizations which I work for and the way in which I lead them.

One of my most profound professional experiences came from three days I spent at the corporate headquarters of Ritz Carlton to learn more about the practice of top-notch customer service. While I learned a great deal about the way we should treat customers (and have applied that to patient relations at the medical centers at which I have worked), the most valuable moment for me came in a session with a hotel operator as he explained that at the Ritz they refuse to focus their energy on difficult employees. Instead, they cut loose team members who do not want to subscribe to their culture and their values so they can focus time and resources on those who either get it right away or the individuals that want to learn and be developed.

I have brought this lesson to every leadership position since then and it has been incredibly illuminating. In fact, it has radically changed the environment and culture of the businesses I lead. I have learned that in order for an organization to be innovative, entrepreneurial, and downright successful, you need to stock your team with the overachievers. Underachievers and overachievers simply do not get along, so you sometimes have to let those underachievers go so the overachievers can thrive. I admit that this practice is not easy. It can be unsettling and it makes some people angry, but it has created a work environment of accountability and a place that demonstrates the care and value it has for its team members.

Finally, I was fortunate to spend time in the last few years with Jack Welch of General Electric. Jack has provided a wealth of insight on a wide-range of subjects but it was his discussion of transparency and candor in the work place that left a lasting impression on me. Jack explained that it is our tendency as managers to tell our team that when a colleague has been let go - for whatever reason - that he/she “has moved on to bigger and better things.” Jack warned against that, saying that offering this sanitized explanation signals to your remaining team members that you do not value them enough to be honest with them. It also denies you the opportunity to reiterate to your team members the core values of your organization and expectations you have of them. I have taken Jack’s advice and put it into practice. Doing this has allowed me to cultivate a more open and honest environment, and signaled to employees that I live and breathe the values of our organization. It also signifies that I expect the same out of each of them.

In closing, I cannot stress enough the value of getting outside your own backyard to discover new practices by those in other fields. While industries outside your own might operate on a different scale than your company and there will certainly be aspects of their business that will not apply to your work, there is still a tremendous amount of knowledge to be gained from them – we can learn from their systems, their culture, their processes and their leadership style. You never know where your next inspiration will come from. 

Give the People What They Want

People in my industry are always striving to do a better job of putting patients first. Urgent care centers are probably the most successful example of customer service in action in medicine. The centers can't replace ERs, which are equipped to handle real medical emergencies.  Nor should they replace primary care doctors, who focus more on continuity of care, especially for chronic conditions. But urgent cares are now well-recognized as being an essential part of the health care system.

And so, it is no wonder that over the past several years the number of urgent care facilities, including for-profit chains, clinics inside drug stores and box store chains as well as hospital and physician group operated facilities, has dramatically increased. In fact, according to the Urgent Care Association of America, between 300 and 600 facilities are anticipated to open this year across the country, bringing the total of these types of centers to more than 7,000. For the sake of transparency, Jupiter Medical Center will soon have a total of four urgent care centers in Palm Beach County, with more being planned. Given the shifts in our industry, we consider urgent care facilities an integral component of our health care delivery model.

The popularity of this type of care is driven by patient preference. They are conveniently located with hours that extend past the normal 9 a.m. to 5 p.m. schedule, the wait times tend to be modest and the prices are affordable. And for straight forward medical treatment - from strep throat to sprained ankles - the quality of care is strong.

The success and proliferation of urgent care facilities represents a dramatic sea change in the delivery of health care across our country. I believe their popularity is directly tied to the fact that they represent the health care industry’s first foray into delivering retail based care –care that is designed specifically for and with the health care consumer in mind. Simply put, these types of facilities are speaking and marketing to the two basic needs and wants of the consumer— convenience and affordability.

As patients continue to take a more active role in selecting their health care choices, pay for a greater percentage of their health care, and manage their health care spending accounts, they will continue to evolve into more savvy health care consumers. With this reality, along with the demand for providers to keep cost down by insurance companies, the retail or consumer model of health care delivery will continue to grow. In fact, urgent care health care delivery (which is now a $16 billion a year industry), is expected to grow about 3.5 percent a year for the next decade. This will make it one of the fastest-growing segments of the health care system according to IBIS World, a market research firm.

And so for us to remain competitive, we need to embrace this change and prepare for the dramatic rise in outpatient service and look to the retail model as a way to provide high-quality, affordable and convenient service. More importantly, we need to tailor and expand these services to the specific needs and desires of the health care consumer in our own communities. For example, at our facilities here in Palm Beach County, we will not only offer care for minor injuries and illnesses, but provide additional services like routine physicals, and dispense vaccines (including travel-related vaccines and information). We will offer access to laboratory and basic x-ray services where images are read in real-time by board-certified radiologists.

Finally, as we live in a highly active community with an increased demand for rehabilitation services, we will offer physical therapy on-site. This will provide consumers with a convenient “one-stop-shop” for evaluation and treatment of injuries.

Simply put, we need to offer our patients what they want and when and how they want it.

Courage Starts at Home

In my most recent post, Where We All Lead, I talked about the practice of Transformational Leadership and how it can be highly effective when working with a team to deliver the highest quality goods and services. As I mentioned, practicing Transformational Leadership requires one to be courageous. I want to expand on that idea of courage and talk in greater depth about what it means to be courageous in the workplace and how to put that into practice.

So what does it mean to be courageous? Is it, standing up in a room full of fellow team members and simply saying what you think regardless of what others might think or feel? Not exactly. There will be times, yes, when you will have to deliver the unpopular news, but being courageous is much more than that. Possessing and, more importantly, implementing courageous practice is the willingness to be personally accountable for all that you do and all that you ask of others.

To practice courage, you must be:

• Open to taking personal inventory on a regular basis by looking at yourself and asking: What am I bringing to the table? How can I give more and do better?
• Actively seeking feedback especially from your toughest critics and more importantly, hearing it.
• Taking frequent stock in all aspects of your business, of what is working, and reflect on how it can be improved.
• Taking responsibility for the missteps and crediting others for the successes.
• Being willing to have the tough conversations—with yourself, with your team members, with your clients and with your stakeholders.
• Leading by example—don’t be afraid to have people look to you.

By doing these things, you will build a foundation of respect and honesty with and within your team, allowing for greater loyalty and productivity. And hopefully, it will make the tough calls a bit easier to make and the successes even sweeter to share.