Sideways Corduroys and Disruptive Innovation

 I read those back-of-the-airplane-seat magazines. I never used to, but then the Kindle happened, followed by the IPad. You can’t use electronics during takeoff, so I pull the magazines out. I’m now a back-seat magazine connoisseur. If the Kindle and IPad hadn’t happened, I would be less educated. Trust me, you can learn some stuff. Like, who’s the world’s best Sushi chef .

Another example. What do you know about sideways corduroys? They reportedly reduce drag by an amazing 16.24%. And the company, Betabrand, created a market out of people who were never interested in shopping for clothes. Like many other disruptors, it started in a basement, on a laptop, by someone who had no experience in and knew nothing about the clothing industry. He had no idea that you were supposed to create clothes seasonally, to own warehouses stocked with inventory, to replicate fashion designers.

The company doesn’t use models to show their clothes, they use real customers. They communicate via FaceBook, Twitter and other internet-based solutions, and not mass media. They rapidly respond to ideas their customers offer. They individualize. They are decoupled from the established industry.

They don’t think outside of the box, they are outside of the box. So far out that they seem careless about what was supposed to be. The established industry is irrelevant. They saw a need and met it.

There’s a lesson for us in healthcare. It’s not a matter of if, but when. Because we are expensive, are frequently inaccessible to patients when they want and need us (Report Card), aren’t really patient-centered, have not moved into the 21st century, someone will begin building a new way of doing healthcare. It will be cheaper, more accessible, and will support and improve health. Patients will prefer it.

When this happens, it will not look like anything we’ve known for 100 years. It will be consumer-driven and not provider-centric, far less institutional and more home-based. There will be substantial non-professional self-care (read: less professionals), digital, mobile and increasingly virtual.

General Eric Shinzeki is reported to have once said, “If you don’t like change, you will like irrelevance even less.”

I can see some of the smirks and hear the guffaws. Like us, that’s just what the aristocracy was doing at a dinner party the night before July 14, 1789.  It’s just about as funny as sideways corduroys.

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Serendipity, Sushi, and Sitki

I happened to bump into Sitki Copur in the Grand Island airport. He was flying to Dallas, I was on my way to Boston. The meeting was pleasurable serendipity. Sitki is the consummate physician-scholar. We shake hands, he flashes his distinctive unassuming smile, and I feel welcome and appreciated. If it hadn’t been for an article about Sushi the greeting would have remained nothing more than notably nice. Sitki and the story highlighted for me a critical element of effective physician leadership

Jiro Ono owns and serves Sushi at Sukiyabashi Jiro in Tokyo. He is world renown. His ‘restaurant’ seats 10. To get a seat you have to make reservations more than a month in advance. You pay a minimum $390 for 20 pieces of sushi. That’s at least $19.50 per small piece of cold fish. This begs the obvious question: Why? The answer: Perseverant Passion.

Jiro Ono is 85 and he dreams about how to make sushi better. He’s done that for 60 years. He says, “While I’m making sushi, I feel victorious.” He has found his True North.   Hopefully the Saint Francis Cancer Treatment Center team, like Jiro Ono, feels victorious. They have a perseverant passion, Sitki has found hisTrue North, and our patients have reaped the reward.

Passion makes all the difference. The oncology team received yet another highly prestigious recognition: certification by the Quality Oncology Practice Initiative (QOPI®), an affiliate of the American Society of Clinical Oncology (ASCO). Cooperative, effective, team-based leadership and a relentless focus on continuously improving patient and family-centered care is what led to this accolade. A physician leader in partnership with other healthcare leaders is a powerful amalgam. It almost always results in just the sort of high quality healthcare patients deserve. And this, in of all places, happened in Grand Island, Nebraska, where sushi is rare, less expensive than Sukiyabashi Jiro, and really good at Wasabi.

There are many days I wonder, “What kind of care would patients receive from us if we all embraced our True North our own perseverant passion?”

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