Strategy–The land of small ideas

Hangin’ by a thread

“It will feel better when it quits hurtin’.” Well duh. It will also feel better when we stop self-inflicting the hurt.

To help me understand how things work I need to decompose issues, not into small parts, but into a series of pictures or shapes. The pictures I come up with represent my particular perspective of how things look. That can be a far cry from how others view them. Maybe that stems from when I was a child and enjoying putting puzzles together upside down.

Instead if hitting myself over the head with a hammer, I set aside the easy pieces—those with straight edges and the four corners.

The puzzle was equally complete no matter whether you worked with the picture or just the shapes, but the exercise was quite different. The advantage in doing it my way is that upon staring at 500 pieces of cardboard backing I had to bring different problem solving skills to the table. The disadvantage is that once I could picture the solution in my mind, I lost all interest in completing the last few pieces of the puzzle.

I find myself looking at coming up with a reasoned approach for attacking the large provider healthcare business model. Puzzle pieces are scattered across my desk; some right-side up, others right-side down.

Here’s where the process breaks down or breaks up—I am sure the direction is irrelevant. How does one change someone that either does not want to change or one who thinks change is not needed?

Just because you think you’re being followed does not mean you are paranoid—it could mean you are the only one with enough focus to know what is happening. Charging someone eight dollars for a bag of popcorn to keep your business afloat is not insightful, frankly, it is embarrassing. Charging forty dollars to check a bag on a plane does not earn a CEO the Baldridge Award, it only allows the airline to lose less money, to stave off inevitable bankruptcy a little bit longer. Eastern, Pan-Am, Braniff, TWA, Republic, Northwest, Piedmont, Midway, Independence. They proved the same thing. Continuing to use the same failed strategy delivered the same failed result. Just because the first five people to jump off the garage roof couldn’t fly doesn’t mean you can’t. Or does it? Bigger wasn’t better, was it?

What does it cost to fly from New York to Seattle? It depends. What does it cost to have an angioplasty on Philadelphia? It depends. Did the airlines adopt their pricing model from hospitals, or was it the other way around? Does it matter? Probably not.

The land of small ideas, like Monty Python’s silly walks. Somebody actually comes up with these ideas. I doubt it is someone on the board. People who lead do not one day lose their marbles and decry, “Our model is not working, let’s start charging passengers if they sit during the flight.”

If staying afloat requires a hospital to charge eight dollars a unit for Tylenol, the land of small ideas is winning.

Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy