However, I know that this question is a very honest one and is almost always coming from someone who accepts that bigger is better. While it is true that bigger companies often have more assets and can weather storms better than smaller organizations, in healthcare in our local market some of the companies actually have less flexibility because they have such high debt relative to their assets.
But finances aside, is bigger always better? I have recently finished reading Small Giants: Companies that Choose to be Great Instead of Big by Bo Burlingham. Mr. Burlingham studied 14 companies who decided that rather than getting as big as possible as fast as possible that they would focus on becoming the best at what they do. The group did not include a lot of household names but did include companies like Clif Bar and Company, a leading maker of energy bars and other foods; Anchor Brewing, the original American microbrewery; and Zingerman’s Community of Businesses, the company that includes the world-famous Zingerman’s Delicatessen in Ann Arbor, Michigan. All 14 companies have had many opportunities to be bought out, to merge, to expand quickly or to otherwise grow fast. Instead, they decided to stay focused on their mission. Their collective vision was to continually make their products better and delight those they were serving.
Mr. Burlingham found seven threads that ran across all 14 companies. First, the leaders of these companies recognized the full range of choices they had about the types of companies they could create. They hadn't just accepted the belief that they had to get big to survive. Second, they had overcome the pressure to take paths they had not chosen and did not necessarily want to follow. Third, the companies had an extraordinarily intimate relationship with the local community in which it did business. Fourth, the companies built exceptionally intimate relationships with customers and suppliers. Fifth, the companies had unusually intimate workplaces that were little societies that addressed a broad range of their employees needs as human beings. Sixth, they had developed a variety of corporate structures that gave them the freedom to develop their own management systems and practices. And seventh, their leaders had a passion for what their company did.
I am sure that Mr. Burlingham would be the first to say that very big companies could also do a lot of these things but it would be (and is) much harder.
Reading Small Giants caused me to reflect on how GBMC HealthCare is doing across these seven elements. I think our Board and our senior team clearly recognize what our choices are and have consciously chosen to stay focused on continually improving our healthcare product. We are frequently “courted” and have resisted the temptation to merge. This does not mean that we don’t understand that we can’t do it all alone and that we don’t value the gift of working with outstanding partners - we do.
GBMC has an excellent relationship with the community and we are working to grow it even stronger as we reach out during our 50th Anniversary celebration. We have good relationships with our patients (see the Alexis Watkins video in this blog for an example) and we are working to make them better one at a time. We do well with our suppliers, although I am sure that we have room for improvement in this area. We are consciously working to make GBMC a better place for our employees and our private practicing physicians, although again, we can do better. Lean Daily Management is an example of a management practice that we have committed a large amount of our time to that would not necessarily be possible if we were just one hospital in a large company. And lastly, I think that most GBMC leaders are showing the passion for achieving our vision.
I would love to hear your thoughts. Do you agree that smaller can be better?
P.S. In case you think that I only read management books, I just finished reading Tatiana, the most recent in Martin Smith Cruz’s Arkady Renko series. Renko is a detective in post-Soviet Russia. For those of you who like suspense and intrigue, Tatiana (and the rest of the series for that matter) is a page-turner.