Steve Jobs had a penchant for dreaming big. His far-reaching vision brought personal computers into the home, revolutionized the music industry and contributed to the advent of today’s world of cloud computing. Yet at the same time, he also kept his hands in the nitty-gritty details of the products Apple was producing. He set not only the destination of Apple, but he paid attention to every turn along the way. This ability to ‘zoom out’ to the big picture and ‘zoom in’ to focus on details is part of what made him so effective.

Small business owners, particularly in service industries like physical therapy, are often pulled in a thousand directions. We have to make decisions on a grand scale - ‘Do I buy this building?’, ‘How big do I want to grow?’, ‘should I participate in this ACO?’. However, we also have an overwhelming flood of details to oversee. ‘who has the best price on theraband?’, do I have time to put another patient in my 2:30 slot?, ‘should I give my technician a $.25 raise?’.

“Details matter, it’s worth waiting to get it right.” - Steve Jobs

Focusing in on just the big picture can create problems. In today’s challenging payment environment, the margin is often found in our management of expense details and avoiding unnecessary costs. It takes almost $1.25 of revenue growth to equal $1.00 of cost savings. This means that controlling costs is often an underutilized mechanism for improving performance. The success of our teams often also happens due to paying attention to details. Getting the right people on the bus and making sure that we only tolerate A players has everything to do with careful selection of every member of our team.

However, focusing only on the details stifles innovation. Strategic thinking, big picture goal setting and innovation are necessary ingredients for a vibrant culture and practice growth. We have to have a vision and a strategic plan for reaching that vision. As Vince Lombardi said “hope is not a strategy.” As leaders in healthcare, we have to be part of the nationwide conversation going on right now. We need to be involved in coming up with the ideas that guide our changing healthcare system, and we will need to be ready to adapt to the new reality that is coming.

“I want to put a ding in the Universe” - Steve Jobs

To grow and to be successful we have to know both the big picture and the details.

This Jobs Applied lesson reminds me of one of my favorite principles from Jim Collins. My next #Browdering series will apply this principle and several others from ‘Good to Great’, ‘Great by Choice’ and ‘How the Mighty Fall’ to our world of physical therapy management and leadership. I hope you will join me next week as we discuss ‘The Stockdale Paradox’.