4 Rules Physicians Should Learn From Business

JUNE 02, 2016
Joseph Chiweshe, MD

Why is it that some individuals, organizations, and corporations are able to withstand the winds of change and still position themselves for success both culturally as well as financially?

In a prior post we discussed some key elements for leadership growth. Today, I would like to expand on these with four rules drawn from the Toyota Production System and put forth by Steven Spear and H. Kent Bowen as they worked to decode the DNA of the Toyota Production System (TPS).

The basis of TPS continues to be studied and applied across various disciplines including process improvement, quality, population health, and leadership development, as well as many other facets of our physician and current culture in health. 

Here are the four rules physicians can take from all of this:

1. All work shall be highly specified as to content, sequence, timing, and outcome.

The TPS model is based on the elimination of waste, and much of the waste occurs in deviation from a process that is highly specified. Corporations that adhere to rule number one understand the importance of being committed to excellence and thus put in the framework that calls for defined content, sequence, timing, and outcomes. Although, this rule is often criticized as being more easily achieved in a mechanical realm, the reality of the situation is it is very applicable to the provider space. Wherever there is a process that has a beginning and an end, rule number one can be applied. 

2. Every customer-supplier connection must be direct, and there must be an unambiguous yes-or-no way to send requests and receive responses.

As discussed in a prior post on the cost of medical errors, and how providers may miss opportunities to address patient concernsambiguity in the channels of communication and transference of information more often than not yields less than desirable results.

Every component in the supply chain for the ultimate delivery of physician services should ensure direct and unambiguous connections. This is analogous to putting processes in place like checklists that have been supported by many like Atul Gawande or Peter Provonost in regards to patient safety for highly complex situations. 

However, every interaction between customer and supplier when possible must be direct and occur in all interactions, whether complex or not. With all the new players in a physician’s arena, the role of customer or supplier will change frequently in conveying or receiving information. Learning to give information succinctly and clearly helps to decrease ambiguity and achieve intended outcomes.  

3. The pathway for every product and service must be simple and direct.

The ability to achieve simplicity that is often strived for in business should be more common for providers as well.  As team-based care continues to take hold, establishing simple and direct roadmaps for services and their outcomes will facilitate the onboarding of new players onto a team. In addition, this forms the basis for physician champions leading these teams to continuously improve how they are delivering their intended outcomes. 

4. Any improvement must be made in accordance with the scientific method, under the guidance of a teacher, at the lowest possible level in the organization.

Rule number four calls for repositioning providers to embrace the role of coach or teacher. At the core of most providers is a teacher that helps navigate patients through their health. As providers apply rule number four, evidenced-based medicine becomes both a cornerstone and litmus test for physician product delivery. Applying the lessons incorporated from business should hopefully not contradict or oppose this, but instead be rooted in scientific rigor. As the physician’s role continues to evolve, building skills that call for physicians as coaches will help spread these tenets for achieving success. 


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