Finding the Marvel in the Marble Part I: Finding the Hidden Opportunities in Healthcare

This article is the first of three parts.

When Michelangelo was commissioned to create a sculpture of a hero who represented the virtues of the young Florentine Republic—strength, fortitude, and vigilance—he decided to use the David of the Bible. Many famous artists had sculpted hundreds of Davids in bronze or stone before, but all had created a small, weak, and effeminate David dressed as a prince.

Michelangelo’s sponsors surely did not want one of those Davids standing at the entrance to the great city of Florence. Michelangelo had read Bible passages and envisioned a different David. He asked himself, “Could those Davids have protected Florence from her enemies?” He thought about David’s reply to King Saul when Saul warned him against fighting the giant, Goliath: “I used to feed my father’s flock; and if a lion or bear came and carried off one of my rams, I would go in pursuit, and snatch the prey from their jaws. Lion or bear, if they threatened me, I’d catch them by the throat and slay them.” Michelangelo knew that none of the Davids created by the artists before him could have strangled a lion or a bear. He envisioned a unique David—one that was strong and powerful.(1)

Michelangelo further asked himself, “Is that the measure of a man—to portray him after his successes?” as the other artists before him had done? “Or is the measure of a man’s greatness his courage to step up and face his giants?” He was not interested in creating a David who was confidently showing off after severing Goliath’s head. He wanted a David who was tense and taut as a spring about to be released, yet also calm and determined just before facing the murderous giant. Michelangelo did not want to portray a prince who reigned in a palace, but a rugged shepherd who vigilantly defended his sheep from lions and bears. Michelangelo envisioned producing something with a unique value to the world.(1)

How to Differentiate Your Practice from Others

To differentiate your medical practice from all other practices in the community, you must first see, just as Michelangelo did in his piece of marble, a unique vision that can be carved into the stone of your practice. Differentiating yourself and your practice takes into account the “look and feel” of your office, your staff, and your materials. Every detail gives your patients clues as to who you are and what you value. The strategies that go into promoting your uniqueness must be envisioned, so your existing patients, as well as prospective patients, are attracted to and stay loyal to you and your practice.

The business side of healthcare is swiftly changing. Both physicians and office managers are looking for new ways to connect with patients. In the past, a physician would place an announcement in the paper and a listing in the Yellow Pages of the local phone book and then consider him- or herself ready to practice the art of medicine. Physicians would promote themselves by meeting colleagues, going to emergency departments, and waiting for patients to arrive. Today, with managed care plans, healthcare reform, the Internet, social media, and the Affordable Care Act, it is much more difficult to build a practice using these antiquated techniques. Now it is necessary to build a brand for your practice.

Is your medical practice unique and special? Everyone believes that he or she is a member of a truly unique practice or organization, but how do we convey that to our existing patients and to potential new patients? The objective is to create a name, a term, a symbol, or design that identifies and defines your practice and will differentiate your practice from other practices. A well-differentiated practice results in patients who will want to use you and your practice to solve their medical problem.

Marie Curie, who discovered two radioactive elements—plutonium and radium—was intent on obtaining a PhD, but in Europe prior to 1903 no woman had ever received that degree. Madame Curie differentiated herself by selecting physics, a discipline in which she was superior to others in the field. She and her collaborator and husband, Pierre, were awarded the Nobel Prize for Physics in 1903, and Madame Curie received a second Nobel Prize, for Chemistry, in 1911. Madame Curie knew how to identify an area of expertise in which she would differentiate herself from all other women, as well as men.(1)

Another example is Abbott Laboratories, which was in competition with Merck, the leading manufacturer in the world at creating new drugs. Abbott knew it couldn’t compete with Merck in developing new drugs, so Abbott decided to compete by developing products that were less expensive, making Abbott’s medications attractive to patients, physicians, and insurers. Abbott focused on postoperative drugs and medications used for diagnosis of various medical conditions. Abbott became successful because of its ability to differentiate itself from a world leader in the pharmaceutical industry.(1)

Nearly every physician is trained to diagnose and treat diseases. These two skills make up a basic level of proficiency for all physicians. But merely being able to identify medical diseases and recommend treatment will not differentiate your practice from others in the community. Only a handful of doctors who can claim to be the best surgeon or the best diagnostician in the community. However, everyone can find a niche where they can excel. One example of differentiation could be offering early morning, evening, or weekend hours to provide services when other offices are closed. Another area of differentiation might be to provide the opportunity for a patient to make an appointment, see the doctor, obtain imaging studies and lab work, and also obtain their medications on the same visit. This would make the practice user-friendly and certainly would differentiate itself from most other practices in the area.

What area can you can find that will make you unique and special in the eyes of your patients? Every practice has this opportunity and potential. We, like Michelangelo, need to see the David in the stone and remove the excesses. Differentiation is about finding and seizing great opportunities. In today’s healthcare environment, we’ve seen doctors and practices rise out of simple ideas executed well. Don’t ever forget that opportunities are all around us; it’s just a matter of us finding and seizing them.

Rekindle Your Passion to Learn

Always be a student. If you want to differentiate yourself from others, it is imperative to be a lifelong student. Medicine is a lifelong commitment to learning. Doctors can’t be on top of their game if they are still using only the knowledge and skills that they received when they completed their education or training. Balance is achieved if you continue to follow a lifelong pursuit of knowledge. A medical career is a journey and not a destination. You should always make time to be a student for your entire career.

The great artist Pablo Picasso while walking on a street in Paris was recognized by a woman who asked him to draw her portrait. In a matter of minutes Picasso gave her a portrait drawing, as she had requested. The woman asked how much she owed the great painter and he said 5000 francs. The woman was aghast and said, “But you did that in thirty seconds.” Picasso responded, “No, it took me forty years!”(1)

All we need to do is find unmet needs in the marketplace, become an expert in those areas, and fill those unmet needs.

The take-home message is that we are valued by our knowledge and skills. The skills that you learned as a medical student and resident probably were on the cutting edge when you transitioned from your training program to practice. However, if that’s the extent of your knowledge and skills 10 or more years after you became a practicing physician, you will probably find yourself behind, or even antiquated. You must continue to learn and update your knowledge and skills to be an effective physician.

Carpe Diem (Seize the Day) or Carpe Potestatem (Seize the Opportunity)

There are multiple opportunities available to all doctors and all practices. All we need to do is find unmet needs in the marketplace, become an expert in those areas, and fill those unmet needs.

Michelangelo applied for a position in a commercial studio and was told that he must carve only what the patron requested. Michelangelo asked, “What if the sculptor thinks of something new or an idea that has not be carved before?” The owner of the studio told Michelangelo, “We carve here what others have carved before us.” The art world is a better place because Michelangelo didn’t take that job. How many times do we practice just the way it has been done by others or in a way that does not deviate from what has been told to us or what is written in the textbooks? We need to think the seemingly impossible and seize the opportunity.(1)

Two Examples of Medical Opportunities

Before the Salk vaccine became available, nearly 50,000 people had been paralyzed with polio. The party line in the 1950s was that a person had to experience a live virus to become immune. Jonas Salk was skeptical of that theory. He deactivated a live virus and injected it into human subjects. It worked, and a vaccine was developed that dramatically decreased the risk of paralytic polio to fewer than 10 cases per year! Salk saw an opportunity where others saw the only the way it has been done before.(1)

In an even more recent example, Dr. Barry Marshall, a primary care doctor in Australia, noted that gastric ulcers contained bacteria in pathology specimens. Marshall proposed that it was not hyperacidity that causes gastric ulcers but that a bacterial infection, Helicobacter pylori, was the culprit. The elite scientists and doctors, who did not believe that any bacteria could live in the acidic environment of the stomach, ridiculed his theory. In 1984, Marshall decided to experiment on himself. He had a baseline gastroscopy performed on himself, and shortly thereafter drank a solution containing H. pylori. Three days after drinking the H. pylori solution, he developed nausea, vomiting, and abdominal pain. A repeat endoscopy eight days later showed massive inflammation, and H. pylori was cultured in the gastric juice. On the 14th day after ingesting the H. pylori, a third endoscopy was done that showed the typical gastric ulcer. Marshall’s illness and recovery, based on a culture of organisms extracted from a patient, fulfilled Koch’s postulates for H. pylori and gastritis. In 2005, the Karolinska Institute in Stockholm awarded the Nobel Prize in Physiology or Medicine to Marshall and Robin Warren, his long-time collaborator, “for their discovery of the bacterium H. pylori and its role in gastritis and peptic ulcer disease.” It took several years from his identification of the bacterial culprit until the medical establishment accepted that ulcers were caused by an infection, not increased acid, spicy food, or alcohol. Today, gastric ulcers are treated with antibiotics, not surgery.

Finding Opportunities

You are surrounded by opportunities every day and everywhere. Look for ideas and trends that match your interests and your expertise. Develop a habit of looking at everything to see how you might improve it—how you’ll make it more fun, faster, more user-friendly, less expensive, and more helpful to patients. Choose the opportunities that benefit not only your patients, but also your staff, and they will support you.

Ask yourself a few questions to identify opportunities:

• What could I do to reduce waiting time for patients to obtain an appointment?

• What could I do to prevent patients from spending excessive time in the reception area or in the exam rooms?

• How could I respond to emails in a timely fashion?

• How could my staff spend less time on the phone obtaining prior authorizations?

• How could I encourage patients with certain conditions and diagnoses to become patients in my practice?

• How could I increase the number of procedures I do each month?

• How could I add more value to my practice?

• How could I interact with patients over secure Internet operating systems (i.e., telemedicine)?

Finding opportunities starts with curiosity, the desire to try something new, something that will make a difference in some meaningful way. Acting on new opportunities takes courage and the steadfastness to know that failure is part and parcel of finding and then implementing opportunities. Begin by finding opportunities; then use your creative juices to solve the problems you have identified that get in the way of the opportunities.

Practices that get to the next level have learned to successfully differentiate themselves and find opportunities that make a difference to their patients. These exceptional practices learn to leverage their expertise and become the very best at providing the special services that maintain existing patients and attract new patients to the practice. Finally, these outstanding practices have identified opportunities that result in a good return on the investment of their time, energies, and resources required to make the opportunities a reality.

The Bottom Line: It is vital for the success of a hospital or medical practice to leave the pack or take the road less traveled and find that unique, special activity or behavior that separates your practice from all the other practices or hospitals in the community. Every doctor who graduates from a reputable medical school is able to diagnose and treat diseases—that’s a given. The vital questions that you must answer are: What makes you different and special? What can you offer your patients that will be in awe of you and your practice? How can you, like Michelangelo, cut away the unnecessary marble leaving you with a world class service and product that you will be so very proud? It all begins with finding great opportunities.

Reference

1. Swartz JB, Swartz JE. Seeing David in the Stone: Find and Seize Great Opportunities. Carmel, IN: Leading Books Press; 2006.