The customer is King. That is an immutable truth in business.
In healthcare, like every other business known to mankind, we have customers.
In business there are two groups of leaders, one that understands and respects that truth and then walks the talk. The other, the one I label as misguided group B, believes, consciously or subconsciously, that they know best and that the customer should agree and compliantly respond, or to sit down and be quiet.
In the end though, the customer is always right and hell hath no fury like a customer scorned, ignored or otherwise disrespected. That, too, is an immutable truth.
The reason this concept is so important is because of something called population health management. In the past, healthcare was a wholesale enterprise. We focused on independent physicians who controlled the patient flow into the hospital. They were our primary customers; the patients were, in effect, end users. As long as the physician was satisfied, presumably with the feedback from their patients, all was well and life was good for the hospital CEO. We had marketing programs but our model was still a wholesale-based approach. While that model has slowly changed over the years, population health management will, based on how I see this concept unfolding, dramatically change our business model from wholesale to retail. For some, this doesn’t seem to be a radical change from where we find ourselves today, on March 4, 2015. But nothing could be farther from the truth.
Health systems and hospitals now employ or rent physicians and that variation to the traditional relationship gives hospital executives a false sense of security. If we own, rent or control the physicians, then we have control of their patients, or so goes the reasoning in many hospital/health system circles.
In fact, this new business model will make the hospitals/health systems and their physicians, function like true business partners, rather than a variation of their traditional wholesale arrangement, because population health management will sooner, rather than later, disrupt traditional patient/physician/hospital loyalties and service migration patterns. Like banks, auto dealerships and other retail businesses, we will have to compete for customers – and compete aggressively. To retain their loyalty and their business, it will all boil down to price, quality outcomes, level of service and satisfaction.
In this new healthcare economy, that the customer is King takes on new meaning. Those who do not understand that dynamic will face an uncertain career future.
© 2015 John Gregory Self
A wise and seasoned, if not a little cynical CEO I know, once described the payroll process at a former hospital as “distributing cash to zombies” or “paying people for something we are not getting.” In other words, paying employees just to show up.
He also described that hospital’s payroll and benefit plan as the biggest “entitlement and giveaway program in healthcare. These employees are not engaged in any shape, form or fashion. They do not care and the quality, service, satisfaction and financial performance is proof positive.”
He was not normally that cynical or outraged but when he uttered this biting assessment of his workforce, he was in week six of a massive operational/financial turnaround. This hospital was as bad as it could get without collapsing into default, bankruptcy and liquidation.
While his assessment was spot-on – I was brought in to conduct several executive searches – there was a reason that the morale/engagement/performance was in the trashcan, top to bottom:
I think the one thing the organization did well – well, passable – was skating through the regulatory surveys, always with exceptions that required arduous correction plans and always promises to improve.
Five years later, the hospital is still open and operating, sometimes in spite of itself, but the tide was turned. That turnaround CEO was successful and on his last day he reported that he repeatedly said, “Never again. Never, ever again,” as he walked to his car.
How did he do it? He quickly rebuilt the senior leadership team. The departed leaders had lost their way, their self-confidence and their credibility. Then he began to work on the hard stuff beginning with employee engagement. There was no magic bullet there, no sexy expensive program that would somehow woo the mediocre and poor performers to get back in the game. It took backbreaking work, seven days a week at first, then a relentless, sometimes noisy effort, to communicate and enforce the new core values. The team put in long days reviewing and improving processes, and focusing on performance improvement from housekeeping to patient care.
It was this CEO who coined the phrase for me, “traveling evangelist” to describe what his job became. “It is one of the hardest things in the world to get people to care again.”
While this hospital was a worst-case example, there are many hospitals and other businesses in America where employee engagement is not just bad but shockingly abysmal.
Overall, 70 percent of the workforce is not reaching their full potential or are actively disengaged, according to a Gallup survey. That is a lot of waste, waste that healthcare providers cannot afford in a post-reform economy.
That fact is also why we continue to struggle in healthcare with quality and safety.
© 2015 John Gregory Self
The resume writer assigned to me advised me not to include my mailing address on my resume. How do executive recruiters feel about that recommendation?
I think it is bad advice. When recruiters create a database record, they prefer to have all the information. When candidates do not provide all their contact information, it raises a flag. Not red, but yellow. Why would you want to raise a flag with a search consultant?
Your mailing address is important for the vetting process. Recruiters want to know where you reside.
That said, if you are a manager-level candidate living in a metropolitan area, there is an argument to be made that listing your address may raise inappropriate questions about your commute time, and your long-term commitment to the job. But senior level executives should not follow advice better suited for lower level managers.
Here is the information you should include:
If you agree, or have an alternative view, please share your thoughts.
If you have a question, write to John at email@example.com.
© 2015 John Gregory Self