Get Smart

• Widen your lens. By viewing the healthcare industry in a retail context, the founders of MinuteClinic were able to identify an anomaly: Many simple complaints that didn’t need a doctor’s attention were nonetheless being treated, elaborately and expensively, in physicians’ offices and hospital emergency rooms. Retailing offered an obvious alternative: Just as Jiffy Lube and Midas Muffler perform small repairs and services without fully trained mechanics, mini-clinics could give shots, treat sore throats, and prescribe flu medicine without a doctor on the premises. The service could be quick, convenient, and inexpensive.

  Why did no one else see this opportunity? Bubble thinking is common in large medical centers, and it is absolutely rampant in research and teaching facilities. The irony is that one would imagine very smart people to be more capable, not less, when it comes to understanding and responding to the needs of their customer-patients. But my experience with the healthcare industry has shown just the opposite: With the exception of perhaps the Mayo Clinic, usually the better the clinical care is, the worse the customer service is.

  Patients typically endure long waits, fill out multiple and redundant forms and are forced to navigate a complex and confounding set of systems and processes without guidance. And if they ask for help, they often receive a frosty response. The problem is that clinicians are focused on providing good medicine, not great service.

  Most patients, myself included, have been willing to trade amenities such as shorter wait times and simplified paperwork for the best clinical care. But we don’t have to, and that points to another opportunity for healthcare providers. Even at the high end of the industry, outside the MinuteClinic model, great care and satisfactory customer service are not mutually exclusive. Medical personnel and hospital administrators merely need to take their cue from the retailing and hospitality industries, where streamlined check-in procedures and quick response to customer requests are standard operating procedure.

• Make friends. Your number one goal, of course, is to outsmart your competitors. But after you’ve done that, it’s time to think about cooling things down. No one wins in an industry war. MinuteClinic has gone to great pains to reach out to physicians and hospitals to explain its operations and earn their trust. As Howe told me, “Our message is that we want to be part of the solution, a partner, not a head-to-head competitor.”

  Conflict resolution frees up a lot of energy and resources that can be devoted to the business. It also provides an opportunity to sell your services to your one-time rivals. That’s what MinuteClinic has done, reaping thousands of referrals from overworked full-service clinics and hospital emergency rooms.

  You will make friends more easily if you offer services that not only benefit your customers and your company, but also address the ills of your entire industry. People in an industry such as healthcare, with its many moving parts and multiple players, can be brought more easily to a shared table if there is something in it for everyone. I don’t know of a single patient, employer, bill payer, hospital administrator, insurance company, nurse, or physician who doesn’t want a more efficient healthcare system. A business such as MinuteClinic is offering a new model from which an entire industry can learn and benefit. Ask yourself if your business model can lead your industry to needed change.

  YOU WILL MAKE FRIENDS MORE EASILY IF YOU OFFER SERVICES THAT NOT ONLY BENEFIT YOUR CUSTOMERS AND YOUR COMPANY, BUT ALSO ADDRESS THE ILLS OF YOUR ENTIRE INDUSTRY.

• Execute on the change. Identifying a problem and finding an out-of-context business practice to emulate is only the first step. Next comes the careful implementation of your idea. For MinuteClinic, execution meant building a company that could deliver both high-quality healthcare and a high standard of service, and changes had to be made in people, processes, and technology to get the job done.

  Sometimes people are able to adjust to the life a new business model dictates, and sometimes staffing changes are necessary. In filling its nurse practitioner slots, MinuteClinic paid a good deal of attention to personalities and skills. It sought people who were both clinically competent and well attuned to customer sensibilities. The company strictly enforced its rules on what could and couldn’t be treated, and it backed up its standard diagnostic and treatment procedures with the latest technology.

  As you progress through this book, you will find that nearly all the companies cited have fine-tuned their people, processes, and technology to meld them into a smoothly operating machine that delivers more value to the customer. And similar to a piece of precision-made machinery, any breakdown in the business sets off alarms.

• Redefine the culture. You can’t take anything for granted when you create a bubble-bursting business model. You need to establish a culture that will support what you’re trying to achieve. Howe recognized that nurse practitioners are, by nature, caring, empathetic individuals, but they are not in the retail business (unless they already work for MinuteClinic). His understanding of the distinction led him to create a customer-centric culture that was exemplified by his program to teach MinuteClinic nurses to welcome complaints as a way of improving their service.

  AND IF YOU DON’T TRUST YOUR PEOPLE TO ADAPT, YOU HAVE THE WRONG PEOPLE IN PLACE. I STRONGLY BELIEVE THAT YOU CHANGE HOW PEOPLE THINK BY CHANGING WHAT THEY DO.

  People need to learn quickly how to behave as the new business model demands. You might lecture them about the required behavior change or take them on an adventure in the woods and make them scale walls and climb ropes (a popular practice these days). But in my experience, lectures and rope-climbing exercises are too far removed from the real work people do to effect sustainable change. To change the culture in your business, get people off the ropes and on the firm ground of doing real work inside your new business model as quickly as possible. And if you don’t trust your people to adapt, you have the wrong people in place. I strongly believe that you change how people think by changing what they do.