HealthCare Voice

New Way to Look at Healthcare

Hospital Chief Executives and their boards, helped (aided and abetted) by their architects, have constructed some impressive hospitals and support facilities.  From humble community hospitals in small towns across America, to the big box medical centers in the regional centers of commerce, more often than not, the image of the hospital is defined by the quality (size) of the building, the technology inside and its medical staff.

Changes in the way healthcare is delivered, both from the Patient Protection and Affordable Care Act (PPACA) and also some rather draconian deficit reduction measures will most assuredly affect Medicare spending.  This could force us to stop looking at buildings as the center of our healthcare delivery universe and to begin to think about population groups and geographical territories.

Buildings will always be central to healthcare delivery.  But instead of focusing on brick and mortar for how and where we should deliver care, CEOs and their employees should shift their focus to their customers, their markets and geographic territory.  This shift, a nuanced course correction in the eyes of some, will become, over time, a central article of faith in terms of how we design our system and allocate resources.  And over time, this rather radical transformation will play a significant role in reducing healthcare costs.

In the end, however, no one initiative will solve our massive and growing healthcare spending challenge.  There are literally hundreds, if not thousands, of transformative changes and tweaks that will have to occur, from the role of EMS in pre-hospital care, to treatment protocols and locale. 

These will be challenging, but exciting times.  Fortunately, we are an industry that has attracted some of the top graduate school talent over the past 10 years.

I am looking forward to this transformation a great deal.

© 2011 John Gregory Self

Editor's Note: HealthCare Voice, John Self's  healthcare blog, will be moving to JohnGSelf.Com, hopefully later this week.  The blog will run on both sites for a couple of weeks and then the content will be exclusively on WWW.JohnGSelf.Com

 

Steve Jobs' Legacy For Healthcare

If you are a hospital CEO who touts customer service -- the customer experience -- and you have not heard about Apple's remarkable product innovation, their laser commitment to service, and their remarkable out-of-the box retail experience, you are probably so far inside the box that you are immerdiately vulnerable to competitive market forces.

Apple redefined the customer service experience. Not just for the computer industry or the technology sector. Steve Jobs and his colleagues raised the bar for everyone in business. From their technical support access, which is far and away the best in any industry, to the amazing Apple retail experience, this company is about delighting the customer. They thrive on that sense of accomplishment.                                   

When I think about the  average hospital admission process and the endless waits in the ER that can be made worse by, in many cases, the absolutely terrible customer service and non-existent communication from the staff, I wonder why the healthcare industry seems so afraid to explore game-changing innovations.   

When we talk about Apple it is easy to say, "Oh, computers, that is different. That industry is not anything like healthcare," as if to say that Apple wanted to emulate the mediocrity that has come to define Microsoft. The beauty of Apple is that Steve Jobs empowered his people to redefine the customer satisfaction experience from a standard that said satisfactory was OK to one in which anything less than delightful was unacceptable. Outsourcing his customer support through terrible telephone connections to some  remote outpost in India, which is how so many companies attempt to maxmize profitability, was not in the Jobs' playbook.  He drove profits by doing the opposite -- spending money on taking care of his customers.

Apple became a bigger company than the once invincible Microsoft in terms of market cap as the result of its passionate commitment to focus on game-changing design and a level of service that delighted their customers.  

As we mourn the loss of such an incredible innovator, it behooves those of us in healthcare to pause and to think how our industry can bring a little of Steve Jobs' keen insight for innovation and a customer-centered delight into our complex organizations, and to think how we can offer our customers -- doctors and patients -- service that delights and surprises. 

He showed that it can be done.  And he offered some compelling words during a Stanford commencement speech in 2005 to help guide the way.

"Follow your heart...Your time is limited so don't waste time living someone else's life. Don't be trapped by dogma which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice..." 

What are we waiting for?

© 2011 John Gregory Self

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The Gospel of Service and Excellence

With all the pressures on a CEO, it is tempting to think that a consulting package can solve problems that essentially begin and end with people. Employees and physicians look to the boss.  If he or she is not walking the talk, it hits the informal employee news wire, spreads through the organization -- that the latest service initiative is nothing more than the latest customer initiative -- and the program fails.  The best approach I have seen is what I call the Gospel of Service and Excellence.  

Every day, the CEO talks about it and lives it. 

That is why verbal communications skills and leadership presence are shooting to the top of our chart of CEO critical competencies.  If you cannot personally communicate the value and importance of change, you cannot lead change.

On Sunday I am speaking to the national meeting of radiology/imaging professionals at the massive Gaylord convention center near DFW International Airport.  My focus will be on Employee Empowerment: A Strategic Imperative. I have spent a lot of time talking to hospital CEOs and other leaders who are on the cutting edge -- not necessarily in the spotlight -- for improving quality care and and building an environment of safety for the patients.  

Here is what I have learned:

1. Excellence in service and top patient satisfaction scores must go hand in hand but currently that is not necessarily the case even with some of the perennial industry leaders.

2. Landing on the Top 100 or the Top 50 lists is great PR but how are your HCAHPS scores? It is importnt to focus on processes and techniques in improving patient care and safety, but in your zeal to improve, do not forget the patient and their family.   

3. The unsung heroes, those CEOs who understand that improving quality and safety is much more important than securing a top ranking by some national magazine or consulting service, are more often than not those who use the Gospel of Service and Excellence technique.  Not a day goes by that they are not walking the halls, visiting with employees, physicians and patients, preaching the importance of adhering to best practices.  Yes, they invest in technology to measure and track performance.  Yes, they draw on outside expertise from time to time to get a fresh set of eyes for performance improvement opportunities.  But the CEO does the heavy lifting of driving the change, not a coach or team of consultants. He is walking the talk and asking for input at all levels.

© 2011 John Gregory Self

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A New Type of CMO

Healthcare reform is extending beyond the Washington beltway.

You can see it in how health systems, hospitals and other providers are shifting their marketing strategies from the traditional wholesale approach -- physicians are the primary customer -- to retail marketing in which hospitals appeal directly to patients on the basis of quality, safety, technology, scope of services and access.  

As physicians shift their employment and business orientation from physician-owned practices to employment by hospitals and insurance companies -- yes, payors are beginning to acquire practices as well -- hospitals are turning their attention directly to the patients.

In the process, CEOs are creating yet another CMO position for their senior leadership team: Chief Marketing Officer. In the earliest days, marketing Vice Presidents or Directors were seen, more often than not, primarily as strategy, advertising and/or "sales" people.  

Providers now are quickly adjusting their perspective, acquiring sophisticated marketing information systems to aggregate and analyze a mountain of data hospitals have been collecting for years but never used in a meaningful way.

HealthLeaders.Com has published an excellent article, Image Makeover that is worthy of review. 

Read More.

© 2011 John Gregory Self

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Customer 2.0

The nation's hospitals, which have consistently lagged behind other industries in terms of management technology and service, will soon face a new demand for MIS innovation just as they are implementing new platforms, systems, and programs to deal with electronic health records and the concept of meaningful use.

It is called Customer 2.0.

It seems like only yesterday that some hospitals ventured timidly into the 20th century with call centers to assist clients navigate their way through a myriad of questions concerning unpaid balances, paying bills, scheduling and registration.  Now we learn that other industries are looking at innovative ways to meet consumer demands that want them to incorporate new media into the customer service mix.

This will not be a change that occurs overnight.  Thank goodness, since healthcare management information systems, which are today better than ever, are still far behind retail and manufacturing.  But this is a change that will come, and once the critical mass trigger is hit in other industries, it will sweep into healthcare.

Here is a post from Christopher Elliott writing in BNET, the excellent interactive business site from CBS:

"Brett Shockley, a senior vice president at Avaya, told a recent technology conference that businesses are just coming to terms with a new kind of consumer – he called it Customer 2.0 – and defined it like this:

They’re born with a keyboard. They’re born with an attitude.

Now that they’re graduating from college, they’ve got a disposable income and there’s about 80 million of them.

We’ve got to pay attention to all the different ways that they want to communicate. We’ve got totake all of this into consideration in our companies."

READ MORE.

If you are not a regular reader of BNET, I want to encourage to check in on this site from time to time.  They have some excellent articles. 

Now add to the mix that we will have less money for the whistles and bells – aka new technology – and the fact that we are change resistant, voila, you have yet another interesting confluence of competing interests that will make the CEO’s job – already one of the most difficult on earth – even more challenging.

 Have a great weekend.  I am staying indoors, if at all possible.  It is forecast to be 100+ again in Dallas.

 © 2011 John Gregory Self

 

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Can You Spell Bad Service? MICROSOFT

A year ago, as I worked to launch my new executive search firm, I experienced problems loading a customer/candidate database. I needed help in a hurry so I turned to the software company.  What a disaster in customer service.  It was if their motto was We make a lot of money selling software.  Don't bug us.  Visit our web site.

Welcome to Microsoft customer support.

If you are not a technical wizard, the Microsoft web page is as opaque as the complex Collateralized Debt Obligation instruments from the real estate debacle that were so complicated that the bankers who sold them didn't understand. Forget trying to find the right article, among hundreds, that will explain the issue and tell you how to fix it, assuming they were written in easy-to-understand English.   

They make it difficult to find their contact information and more difficult still to find a telephone number to technical support for the specific product.  When you finally get through the telephone decision decision tree, assuming you are not cut off, you are then connected -- using a system that is only marginally better than two orange juice cans and string -- to a technical support guru who is obviously not in the USA.  You struggle to hear. Understanding the representative is another struggle.  A pronounced accent and a bad connection is one definition of technical support hell.

Now compare that with Apple.  Today I had a question; I used their super fast Safari browser, easily found the technical support contact information, entered my product model number and filled in a quick form to explain the problem.  They gave me choices:

1. Immediate call.  They would call me.  The waiting time listed on the web was less than one minute.

2. I could schedule a call

3. I could use their knowledge base -- for the technically sophisticated among us

I chose the immediate call. Within seconds of entering my number, my telephone was ringing.  Apple was calling.  I also received a case number and explanation on my email. The technical support representative was friendly, eager to help and communication was not a problem... I will not ramble on.  Apple owners get it.  They know that this company is committed to making high quality products that surprise and wow their customers, and they back that up with what many think is best-in-industry customer service. No competition.  

Microsoft service is a long standing bad joke.  And given the mediocrity of some of their software, you would think they would take customer service a little more seriously. But what the heck, they are making a lot of money.  Too bad Apple just passed them in terms of market capitalization.

So now we come to hospitals.  We are not even in the same universe when it comes to customer service.  

A friend visited her physician who works in an integrated health system. They took x-rays, performed lab work and gave her two major injections to counter an infection.  She is a Medicare beneficiary.  Several weeks later, she received a bill, which she paid.  Then she received another much larger invoice, which was for her lab work.  Immediate payment was requested.  It seemed high, so my friend called Medicare to determine how much they had paid.

Guess what? Medicare had not been billed. Medicare's representative advised her to wait to pay that amount until the clinic filed a claim and Medicare determined how much they would pay.  The suggestion was clear -- that if my friend paid the clinic the full amount now, she might have to wait for months before receiving a refund. So she called the clinic billing office and dealt with someone whose name should have been: Ms. I Am Clueless. They discussed the situation but it was unclear to my friend if she made any progress, if anything was resolved, based on her conversation with the customer service representative. Hence the clueless moniker.

This week my friend received yet another bill for a different amount for the same test, but the amount -- $43 with another $4 tacked on as a late fee because the amount had not been paid in 30 days. She called the clinic back and talked to another customer service representative, Ms. Dismissive Indifference, who said she could not see why they had added a late fee since the payment due was not late.   In the end, however, my friend paid the principal amount and the late fee. She was told that it was just easier to do so.  I an era of tightening reimbursement, I guess that is just one small way to boost revenue. 

The big bill apparently is still rattling around in payment hell waiting for a settlement. 

This story, unfortunately, is fairly common. Not all hospitals and large clinics operate this way.  There are some great operators who get it right every day.  But many do not.

I work in healthcare and I am beginning to hate even thinking about going to my doctor. He is part of a big clinic whose centralized business office is run, I have come to believe, by some obscure, inept arm of the government.  Who needs the aggravation?  It is like dealing with Microsoft.  

The problem for most hospital CEOs is that they only hear about these incredible stories only if someone complains, which my friend will not do.  So absent an aggressive pro-actve customer service program that can identify problems before they alienate clients, nothing much changes.  Far too many are like Microsoft's leadership.  If they are profitable, the seem to say, don't sweat the small stuff.  I guess that means service, too.

Healthcare providers need to stop and take a page from Apple's playbook. They understand customer service and they love to exceed their customers' expectations.

 © 2010 John Gregory Self                        

Apple Redefines Retail, Delights Customers

Apple has redefined the rules for retailing and continues to set records for performance.  Known as a company that consistently delights its customers with innovative new, cool products, its retail operations are critical to the company’s phenomenal record for innovation.

“They basically took the old book of retail, threw it out and started over,” Piper Jaffray Analyst, Gene Munster, said in USA Today on Thursday. 

Apple defied conventional wisdom that computer makers make poor retailers.  Gateway tried it with their country store concept in the early 2000s. Poor locations, uneven in-store service (I could never get waited on. With checkbook in hand and store associates chatting it up in the back I left and bought somewhere else) and poor merchandising produced a financial disaster, forcing them to close more than 180 stores in 2004.  Gateway is now owned by Acer.

At the core of their stores and customer interaction design is an overarching pillar of the Apple corporate culture: delight your customer with a great experience.

It is definitely working.  Apple now operates 323 stores employing more than 30,000 people worldwide, including 16 high profile stores.  One, their glass cube store in New York, is open 24/7, 365 days a year.  That one store brings in between $400 and $500 million per year, according to USA Today.

Sales last quarter shot up 90 percent to $1.5 billion to $3.2 billion thanks in part to the introduction of the iPad, the company reported.

Their retail success is not due to just their clever, well designed gadgets – computers, iPods, iPads and iPhones – but also to the way the stores are designed both in terms of layout and for customer interaction.

When you enter an Apple store you are met by a greeter. For those of you who have had the experience, you know these are NOT your Wal-Mart greeters.  They are hip, they are cool and they armed with an iPad to capture your name and why you are visiting the store.  When the first sales associate becomes available – the stores are almost always busy – they meet you at the product station.  If you own an Apple product and have a question, you are directed to the Genius Bar where Apple experts can help you solve a problem.  Most technical issues are resolved in the store, including hard drive replacement.  Compare that with a certain technical squad at one of the other big box retailers who also sell Apple: replacing the hard drive means surrendering your computer for up to two weeks.

When you buy a computer, a phone or one of their other products, an associate from the supply room brings it to you – having been electronically alerted by your sales associate with a special iPhone.

There are no “check out” counters.  Using the same iPhone that transmitted your product selection, the sales associate “rings up the sale” using credit and debit cards right on the spot.  Within seconds, you receive a receipt via email.  I do not know what happens when people pay with cash or check, but I suspect that process is innovative as well.

While our economy continues to sputter in a slow recovery mode, and with an ongoing onslaught of dire predictions that the U.S. has lost its innovation and competitive advantage in a global economy, I have a suggestion that will probably help improve your spirits for the future of American business.

Visit an Apple store.

 

© 2011 John Gregory Self

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Delighting Your Customers

Improving the customer service experience is one of the new buzz phrases that many healthcare executives are using in connection with improving their HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. 

For my non-healthcare readers, HCAPHPS scores are important because they will drive higher rates of reimbursement in the near term.  Beyond that, the reality of the federal deficit and long-term debt crisis requiring significant cuts in Medicare spending, HCAPHPS will become a tool to penalize non-performing hospitals with materially lower rates of reimbursement.  For many organizations on the bubble of survival, those reductions could lead to closure.

In other industries, such as the consumer technology segment, tablets, MP3 players and software, an exceptional customer experience is the defining factor between market leadership, acceptable mediocrity, and/or embarrassing failure.

Apple is one company that understands the importance of the customer experience.  Delighting the user and excellent customer experience are hard-wired into the culture.  Some would argue those two phrases are two of the most critical elements in defining what makes Apple a leader in innovation and their ability to deliver products that work – that delight the customer.

By contrast, Microsoft’s reputation is “we get it right – the third time.”  They move product to market and then try to improve on it through endless updates and patches.  The Zune MP3 player and the VISTA operating system are two products that quickly come to mind.

At Apple, the designers are key to the development process.  They are among the most important people in the product development process, and other members of the team know and respect that.  At Microsoft, product development rarely includes designers, according to those who do business with the company.  They are an almost “after-the-fact” part of the process.  Recent “improvements” in Outlook are another example.

Apple’s products work and they typically delight their customers. Yes, Apple makes mistakes in design and production, the early roll out of MobileMe and the antenna for the iPhone 4 are two examples of mistakes that made it to public consumption, but for the most part, their mistakes are made and corrected in the design process. For Apple CEO Steve Jobs, the rule “is do not lie to yourself and call something great when it isn’t.”  Jobs will dump product design or development ideas that are not meeting the Apple standard of great and delay product introduction.

Apple’s design of their retail stores and technical support programs are, again, based on delighting the customer.  Microsoft does not control its distribution and its technical support is legendary – bad. Amazingly, many of the computer manufacturers that run Microsoft products have worked hard to match the dismal Microsoft customer service experience. 

While the specifics of Apple’s business model are not applicable to healthcare, their emphasis on delighting the customer and improving the customer experience certainly can and should be adopted by healthcare leaders.

Personal Disclosure:  My  less-than-a year-old Toshiba laptop with its Microsoft Outlook and Business Contact Manager program is now a very effective paper weight next to my MacBook Pro. 

 

© 2011 John Gregory Self

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New Era in CEO-Employee Communications

The higher you move up in an organization, the less control and absolute power you have, or so goes an old business adage. You are forced to depend on others to do the work, to make responsible decisions.  When it comes down to affecting relationships with employees, you cannot command loyalty and respect. Those are earned.

A health system CEO I know and respect once remarked that he never made patient room visits and certainly not employee rounds by himself because he was uncomfortable in that role. He preferred the familiar surrounds of the executive suite and the structure of department manager meetings and carefully organized town hall meetings. That surprised me given that he was seen as a very successful CEO, reducing costs, enhancing service, improving accountability and building the balance sheet. Yet, he was uncomfortable "mixing it up" -- casual interactions -- with the people who made his success possible.  Not enjoying making rounds and getting to know his workforce while reinforcing the organization's values and strategic vision, felt incongruous to me.  

Fast forward to today's complex tough operational and hyper-competitive market.  It is more important than ever for CEOs to cultivate and store the vital "capital" of employee support, if not loyalty, and goodwill.  There will always be bad times ahead and CEOs will need to draw from this reservoir of support.  

The complexity of change, and the pace at which it occurs, is accelerating thanks to technology, connectivity and high-speed customer and workforce expectations.  Together, they can create some formidable speed bumps, and CEOs will need all the available employee communication tools at their disposal to achieve success.  

Gone are the days when so-called phantom hospital administrators could operate successfully from the confines of the executive office, making use of a private entrance that made their comings and goings almost invisible to employees and physicians and rarely seen walking the halls or taking lunch in the cafeteria. That leadership style began to disappear in the late 1970s.  By the late 1980s it had almost vanished even though today, there are still some executives who have not made the transition. 

A personalized approach to employee communication, supported by state-of-the-art integrated web-based platforms that draw in employees, who increasingly include physicians, is an essential investment -- and a critical tool -- for hiring and retaining top talent.  As usual, other industries are way out in front of healthcare organizations in developing this medium.

This is one investment healthcare cannot afford to put off. 

© John Gregory Self

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Give Up

What seems to be a negative beginning with the headline Give Up is really sound advice, especially for up and coming executives who are trying to leave their mark on the world by engaging in turf battles to expand their profile.  Two things:  the more time you spend on turf battles the less time you are spending on those things that are really important, and, secondly, your overall performance is probably suffering.

With the launch of my new executive search practice, JohnGSelf Associates, that concept  has been front and center for me.  While I am pleased to report that business is good, although as every entrepreneur says it could always be better, I have had to make important choices.  When you are forced to start over, there are hundreds of priorities, but there is time, energy and focus to tackle only a few at a time.   If you follow this blog, you will know that posting less is one of the hard choices I had to make! 

Here is the key takeaway: executives should pick their priorities wisely.  Putting the customer first is the best approach.

George Bradt, one of the leaders in the onboarding field, argues that the trying to do too much is not the smart play.  The math does not add up, he argues.

Give Up.

Give Up

Co-Creation: Market Research, Market Adaptation and Customer Service At Its Best

Co-Creation is a not a new term.  The idea has been around for a long time under different terms.  The most frequently used phrase seems to be a partnering relationship.  Personally, I like “Co-Creation” because it is more specific in its definition and intent.

University of Michigan Ross School of Business Professors and strategy thought leaders C K Prahalad and Venkat Ramaswamy first publicly introduced the concept to the world of business in their 2000 Harvard Business Review article, “Co-Opting Customer Competence.”  “Value will be increasingly co-created by the firm and the customer”, they argued in their Harvard Business School Press book The Future of Competition, “rather than being created entirely inside the firm.”  “Co-creation in their view not only describes a trend of jointly creating products, it also describes a movement away from customers buying products and services as transactions, to those purchases being made as part of an experience,” according to one review.

I would add to their definition by positing that Co-Creation is more than a strategy or marketing slogan to replace the term “partnering relationship.”  It is a business philosophy and a leadership way-of- life that requires time and hard work. 

Co-Creation is market research, market adaptation, and customer service at its best.  

Co-Creation is not a phrase you can tack up on the wall for your employees or on your website and win greater market share.  It is a new framework for doing business.  To start down what will be a new way of managing has its risks.  Asking for client participation – their time and effort necessary for effective collaboration – and then repeatedly failing to act is akin to a high-speed expressway to client conflict and dissatisfaction. 

 If you doubt that, let me provide an analogous example of what will happen if you fail to follow through:  just repeatedly ask your spouse for his or her advice, and then appear – repeatedly – to ignore it.  There will be what I like to call “noisy consequences.”

 In our quest at JohnGSelf Associates to practice transformational executive search, we are adopting Co-Creation as a way of life.  For a small firm that is working to break out of the crowd, we know this approach has its risks.  The time it takes to ensure that there is a beneficial relationship between our company and our clients is not insignificant.  But, we believe that in this new healthcare economy, it is the right approach.  

John G. Self is President of JohnGSelf Associates, Inc.in Dallas.  The Firm provides  comprehensive high-touch executive search and talent advisory services to clients from Hawaii across the U.S. mainland and Canada. You can contact John at 214.573.5095, or [email protected]

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True North: Life's Rules From My First Job

My first job was working in my parents’ upscale and very successful retail bakery in Tyler, Texas.  I washed pots and pans -- lots of pots and pans -- helped the bakers, and made deliveries, primarily the wedding cakes.  In the marrying season, it was common for my father to produce 12-15 major cakes every weekend.  

The holidays were a grind – especially Thanksgiving and Christmas – but they are marked by a family and devoted employees working together to serve customers.  There were grueling hours.  But there was laughter and a sense of purpose.  Today, my memories are filled with some of the greatest memories and smells of a lifetime! 

My dad once picked me up at school a couple of days before Thanksgiving.  He had been making pumpkin pies.  He was driving a new car that the local Chrysler dealer was trying to sell.  It was so new; it still had the plastic shipping covers over the seats.  Remember how new cars use to smell?  It was such a distinctive blend of new fabric, plastic, rubber, and steel that people called it “that new car smell.”  Not this time.  All I could smell was pumpkin pie.  “Dad, I said, you are going to have to buy this car.  No one else in this county is going to want a new car that smells like Pumpkin Pie.” 

I recently saw a LINKEDIN discussion where people were asked to share important lessons from their first job that they use today.  This intriguing question led me to reflect on my childhood and youth. 

Working with my father, I learned some important life's rules and important lessons of business.  He died in 1989 but today, he remains my True North. 

Lloyd Self’s Five Rules:

1.  Do what is right, even when no one is looking .

2.  The customer comes first.  Honor that.  It is not just a rule; it is who you are. 

3.  The customer is not always right.  See rule #2. 

4.  Quality counts. 

5.  We all make mistakes.  We all get tired.  We all want to cut corners because of time or fatigue. When that happens, remember rules #1 and #2.

 In more than 16 years of interviewing and watching CEOs and other senior executives as a partner in an executive search firm, I have added another very important rule.

6.  Respect your employees as if they were your customers.  You will get more for your money.  Do not yell at, bully, or criticize your employees, especially in public.  There is no room in any company for an abusive leader.

2010 has finally arrived.  2009 and a very traumatic decade have exited the stage for the historians economists, and pundits to dissect.

 As we begin this new decade, we should all pause and reflect on our  performance, our behavior and our values over the past 10 years.  As I made my own review, I thought of my of my father and his admonition that I had almost forgotten amid the economic carnage that was 2009:   We all have far more control over our lives -- our success or failure -- than other person, any competitor or any politician. 

I hope that this next 10 years will be known as the decade of personal and professional accountability. 

 Our country will be better for it.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners.  He is a Co-Founder of the Firm and serves as a Senior Client Advisor. 

 A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders. 

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Customer Service Versus Caring Service

As I began my day – at 5 AM with nearly silent downtown streets and a cup of hot coffee in hand – I spent some time thinking about the difference between serving your customer and caring about your customer. What is the difference? Is one better than the other? Combined, do they create something special?

As I have written in the past, my favorite time of the day is before daybreak; when there is time to think about family and friends, my projects and the day ahead. With journal in hand, I make notes about ideas for future blogs. Lately I have been thinking a great deal about how we can serve our clients more effectively, more efficiently.

One morning last week, as I was reading George Bradt and Mary Vonnegut’s excellent “Onboarding: How to Get New Employees Up to Speed in Half the Time,” I ran across this quote from a major search firm executive who was discussing the findings of a study his organization had conducted of thousands of prior searches:

“We found that 40 percent of the executives hired at the senior level are pushed out, fail or quit within 18 months. It is expensive in terms of revenue. It is expensive in terms of the individual’s hiring. It’s damaging to morale.”

Now, this is something I have been saying for years – a bad hire is a costly and disruptive event. It would be very easy to jump with glee, to learn that a major competitor had discovered such a record. However, that would not be fair. The truth is that the search business, which has operated with the same business model for more than 50 years – a rarity in the constantly evolving U.S. economy – has not changed much, save the addition of some technology. Hopefully, what our colleague has done in announcing these results is to sound the alarm that we cannot conduct business as usual in the new norm that is the current economic climate.

There are numerous things search firms can change and at JohnMarch Partners, we are reshaping our portfolio of services to afford clients more flexibility. The nice thing about being a smaller firm is that we can adjust fairly quickly. We have done that with our decision to offer interim management solutions, to unbundle the components of our highly regarded search process that will provide clients with advisory services to help them strengthen their internal recruitment and retention with programs like Onboarding and PredictiveSelection. But there is more to change than restructuring your offerings and that brings me back to my earlier questions.

What is the distinction between serving your customer and caring about your customer? Merriam-Webster defines service in a multiple of ways but these words stood out for me: “to furnish a professional service, to furnish or supply something that is needed or wanted.” In looking up the word caring, I was struck by this explanation: “painstaking or watchful attention…implies great concern and connotes either thoughtful or hovering attentiveness toward another.”

We can furnish a service, but if we also care about our clients, does that carry the implication that we worry about whether the work we perform will bring more value to our customer? Does caring service mean that we will be more invested in whether the work we do helps our client become more successful?

Is caring service the type of change that will enable companies to thrive in a new economy?

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm.

A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders.

John is a highly rated speaker on inspirational leadership, career brand management and the future of healthcare in America. To contact Mr. Self regarding a speaking date, contact him at JohnMarch Partners.

You can contact Mr. Self at 214.220.1234 or [email protected]. He is an active member of LinkedIn and a frequent editorial contributor. You can also connect with John through his Facebook profile.

Or, you can follow him on Twitter at Self_JohnMarch.

Seed Newsvine

The Role Leaders SHOULD Play

SAN FRANCISCO (April 16, 2009) – Long airline flights are conducive to swollen feet and great periods of reflection. I have been thinking a great deal about the important role that leaders play in moving their organization to best-in-class status. Or, the blame they deserve when their organization’s fail to deliver.

For health system or hospital Chief Executive Officers, best-in-class performance means meeting a robust set of standards for patient care quality, safety and the satisfaction of their customers – from the physicians, their patients as well as family members. The best of the best organizations also focus an enormous amount of energy and resources in achieving through-the-roof scores for employee satisfaction.

Let’s be clear. When we talk about best-in-class performance, we are not talking about best effort. No, we are talking about a record of consistently delivering perfection in patient care, safety and customer satisfaction, or as close to perfection as humanly possible.

This type of extraordinary performance does not happen by accident. The CEOs who hope to get anywhere near this level of accomplishment must build exceptional teams who are passionate about this vision. Then, the CEO must champion significant investment in education and development – in the current bad times as well as the good. Without this type of investment in human capital development, best-in-class results cannot and will not occur.

A great many CEOs, when pressed on the issue will most certainly boast that they spend an enormous amount of time on developing their people. OK, let’s face it, far too many CEOs – a startlingly high number – are blowing smoke. The clinical quality and poor financial results just do not support any other conclusion.

There are two ways to ferret out truth from fiction.

1. Does the CEO (and the CFO) view spending money on developing their leaders and managers as an investment or an expense? Again, one only must look at how little is budgeted for human capital development at so many hospitals. This certainly helps explain why we have so many continuing problems with quality care and safety, including preventable deaths. I do not mean to unfairly demean, but is there any other conclusion?

2. In his wonderful book “Talent Is Overrated,” Geoff Colvin writes that companies like to brag about their commitment to human capital issues. Colvin quotes Noel Tichy, a University of Michigan professor and top authority on this subject: “Testing their commitment is easy. Just show me the CEO’s calendar."

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

Somewhere in Tupelo, Mississippi...

ANN ARBOR, Michigan (March 18, 2009) I am at the University of Michigan to speak to graduate students in the nation's top ranked healthcare graduate management program. My host is outstanding teacher and friend, Dr. Christy Harris Lemak. Over dinner, we exchanged stories about our beloved industry, the leaders who have contributed so much, and some of the funny stories that we have encountered through our disparate careers.

As we enjoyed a wonderful meal, I mentally recalled one those classic moments that, if it had been told on the Tonight Show with Johnny Carson by someone with far more talent than me, would have made that infamous anniversary show reel of spectacular highlights.

It was a wonderful, hilarious moment for me. For the "victim," the newly appointed Director of Materials Management at Methodist Hospital in Memphis, it was a bleak, career limiting moment.

The year was 1978. I was the national marketing manager for Rocky Mountain Helicopters' hospital based air ambulance program. I just had lunch with Texan Chester Ayres, a vice president of the Methodist system who had once worked for LBJ at his Austin television station. We had just returned from a lunch where martinis had been consumed. We were both catching flights -- me to LA for a closing dinner at Memorial Medical Center in Long Beach. Chester was flying to New York.

We returned to the Methodist Hospital central unit to fetch my luggage. We had plenty of time, but Chester, a Texan with the bark on, who still had plenty of political stories to tell, wanted to get to the airport so we could continue our conversation over additional adult beverages. Standing between my luggage and Chester's determination to get to the airport was the aforementioned Director of Materials Management, holding court in the main hallway wearing a flashy plaid sports coat on his first day on the job. When he found out who I was, he immediately launched into a lecture on how he was going to control the bid and specification process. Once he got started, he would not shut up. Chester became more impatient by the moment. Finally, he started rubbing the lapel of this awful plaid jacket.

After a few minutes, this fashion king stopped talking – thankfully – looked down at Chester’s hand and asked: “Do you like my coat?”

Chester quipped, “Son, somewhere in Tupelo, Mississippi there is a '57 Chevy that ain’t got seat covers.”

Sudden Silence. I grabbed my bags and we fled the scene. We made it to the airport in time for one more great story about former President Johnson. On the down side, I don’t think the new Director lasted too long at Methodist.

Life is full of amazing stories. And some very clever punch lines. In these tough times, we need to remember that important fact.

Listen for the stories and laugh when you can.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

"Rain" - Lessons From A First Business

As I was flipping through the Dallas Morning News this morning, a small book review caught my eye. "Rain," is a new business parable that uses paperboys and the business of newspaper delivery as a case study. The author's 10 Customer Service Commandments are worthy of review in this rotten economic environment, where companies must compete more aggressively for the available business.

On a personal note, this review resonated with me. In my junior high and high school years, I, too, delivered newspapers for the Tyler Morning Telegraph in Tyler, Texas, a small city 1.5 hours east of Dallas. This was a time when kids on bicycles were a key part of the news distribution system. Not anymore. This is just another part of Americana that has faded from view.

Today, as Chairman of JohnMarch Partners, an international executive search consultancy based in Dallas, we have developed our own customer commandments. Our commandments govern our service, the quality of our work product and being accountable for the tenure and performance of our recommended candidates. Most search firms brag about service and quality. Few mention the word accountability.

With credit to the Dallas Morning News and the reviewer, Jim Pawlak, I want to share the book review with you:
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This business parable takes many of us back to our first job – paperboy. We didn't just deliver newspapers; we ran a business. We had to increase our customer base if we wanted to make more money. We learned and practiced customer service skills.

We dealt with our supplier (the newspaper) and knew the importance of on-time delivery (especially in bad weather). We managed delivery schedules around customer needs. We learned accounting and collected money.

Rain, the paperboy in this tale, reminds us of what should be done to build any business. Rain's 10 Customer Commandments provide the key to customer satisfaction: 1. Thou shalt not fail to deliver. 2. Thou shalt not be late. 3. Thou shalt not be sick. 4. Thou shalt not be on vacation. 5. Thou shalt not be at camp. 6. Thou shalt not deliver wet, damaged or incomplete papers. 7. Thou shalt not have bike trouble. 8. Thou shalt not get lost. 9. Thou shalt not be tired. 10. Thou shalt not make excuses.

Think about how these apply to your business.
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In a final personal note, I must confess that at 4 AM, I struggled with Commandment number 9.

Jim Pawlak reviews business books for The Dallas Morning News.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.