Category Archives: Strategy

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What does the Hedgehog say?

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One of the most elegant and useful concepts from Jim Collins’ Good to Great study is the Hedgehog Concept.

The Fox knows many things, but the hedgehog knows one big thing - Archilochus

In his famous essay “The Hedgehog and the Fox“, Isaiah Berlin divides people into two groups: foxes that see the world in all its complexity and pursue many ends at the same time vs. hedgehogs that condense concepts and reduce challenges into simpler ideas. The parable would have the crafty fox attack the hedgehog with a variety of clever strategies, to be repeatedly beaten by the hedgehog’s simple, but powerful strategy - roll into a ball so the pointy parts are facing out. While the fox is crafty and nimble, the hedgehog is focused, determined and stays the course.

The companies that went from good to great discovered and then had the discipline to stay within a foundational hedgehog concept that kept them from being distracted from their core business. In contrast, the comparison companies that never made the leap to greatness often lost focus and took opportunities that were outside of their strengths.

A hedgehog concept is found at the intersection of three dimensions:

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  • What you can be the best in the world at.
  • What drives your economic engine.
  • What you are deeply passionate about.

The good to great companies (compared to comparison companies) were disciplined enough to understand and stick to their Hedgehog concept despite the temptation to chase after increased profits or ‘once in a lifetime opportunities’.

In the medical field we see some great examples of finding and sticking to a hedgehog concept. One local example is a practice called Sullivan Physical Therapy. This practice has a niche - women’s health - that they are great at. Another is Balance 360 that focuses on balance and vestibular disorders. In these cases, these practices don’t try to be all things to all people - they have a concept that they can be the best at, that drives their economic engine and that they are passionate about.

I don’t think that the hedgehog concept applies only to practice niches, though. At Texas Physical Therapy Specialists, we can be the best in the world at developing clinical specialists and team leaders. This is where our passion lies and the team it produces drives our economic engine. By understanding and sticking to our hedgehog concept, we have the potential to be the best in the world. We have to have the discipline to avoid ‘once in a lifetime opportunities’ that don’t fit within our concept and we have to have the discipline to stay the course when it seems like jumping to a different strategy might be more effective.

What’s yours?

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Jobs Applied: Know Both the Big Picture and The Details

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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.14866993_m

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’.

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Violently execute!

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I have found that coming up with strategies, setting goals and knowing what to do is often not the problem facing us. Its finding the time and energy to get these things done! General George Patton said:

“A good plan violently executed now is better than a perfect plan executed next week”.

I’ll take that further and say that a mediocre plan that is executed is better than a perfect plan written on a piece of paper in a desk drawer. What plans do you need to execute on? Get violent with them!

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Jobs Applied: Focus

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“Deciding what not to do is as important as deciding what to do” Steve Jobs

goals-dart-bullseye

One of the major strategic shifts that Steve Jobs made upon returning to the failing Apple in 1997 was to sharpen the focus on the company on creating just a few products… but pouring all of their energy into making those products fantastic. That’s why even today Apple, arguably the number 1 computer company in the world, only has 46 products. Only 13 of those are in their core hardware business (the rest are software or accessory products -I found that tidbit here). Spend a few minutes browsing the Dell website and you can see how remarkable this is.

Isaacson, in the article that spurred this Blog series, describes an annual strategy meeting Jobs would hold with his ‘top 100’ people. He would ask them to brainstorm what 10 things they should be doing… slowly narrowing all the ideas down until he got to 10. He’d prioritize them… and then drop the bottom 7. This narrowing of priorities down to 2 or 3 is a strategy theme that seems to be everywhere once you look for it. Perhaps the most well known of these ‘no more than 3 priorities’ advocates is Jim Collins, of ‘Good to Great’ fame.

“Create a ‘stop doing’ list. Work is infinite; time is finite. If you have more than three priorities, you have none …” – Jim Collins

The principle of playing to our strengths and figuring out what one or two things your firm can be excellent at has been an ongoing theme in our Executive Program in Private Practice Management. Part of focusing on your strengths is to accept that it is acceptable - perhaps even preferable to be mediocre or even suck at alot of things if you are going to be world-class at anything. I, for example, am steadily losing my skill at manual therapy. For the first decade of my career, it was all I thought about. I obsessed about it, studied it, practiced it… I practically manipulated anyone who I could get to lie down on my portable manipulation table. I did my best to put in Malcolm Gladwell’s 10,000 hours. Now I’m focusing on other things - such as learning to write better blog posts. If I want to become a master at THIS, then I can’t spend a big chunk of my time practicing THAT.

“My success, part of it certainly, is that I have focused in on a few things.” — Bill Gates

Our practices, similarly, can’t be amazing at everything. We probably can’t be the best place for an endurance athlete to be seen and also the best place to go if you have a stroke. We probably can’t be the women’s health mecca and also the very best at treating cervicogenic headaches. We could certainly collect some people who have these skill sets - but we as a practice can’t be the best at everything and as the number of therapists gets larger, Cindy’s special skill set in treating elbow pain becomes more and more difficult to use as a differentiation.

“A person who aims at nothing is sure to hit it.” – Anonymous

The lesson the rest of the business world is trying to get across (and that was executed on by Steve Jobs) is that it is better to figure out what you are the BEST at and then use that to differentiate your practice from the others. Everything else is a distraction and could prevent you from achieving the amazing practice you envision.

Coming up next week…. Simplify.