This is a start to my detailed book review of Good to Great by Jim Collins.

Good to Great – In Review

About the author: Zachary has been a technology fanatic since he first laid his hands on an Apple IIe when in high school. Upon graduation from the University of Michigan Zachary went to work for Intel where he found his passion of being a liaison between business and technology people, helping both better understand one another. As the waves of the Internet swelled Zach decided to take part, leaving Intel and joining Akamai Technologies. After helping businesses better leverage the Internet at Akamai, Zachary decided to join Diamond Consultants where he helps clients better use technology to improve operations and support growth strategies. It should be noted that Zachary’s first focus is on people, as he believes that to do great things it first requires great people, as they are the creators of business and technology. To put together a great meal, one must first ensure the ingredients are of the highest quality.

Introduction: Below you will find my raw (caveat: not completely polished) notes about the book. The notes consists of thoughts about the book contents itself, the thoughts book spurred from within me, and questions for which most of I do not have answers to, only associated philosophies. I organized my notes by chapter with a closing note related to my overall thoughts about the book.

Overall Thoughts

Discipline is a key theme throughout the book. I agree that to be great, one must be disciplined. It is a differentiator between those who lead and those who follow. The interesting thing to me is that discipline tends to imply a high amount of work. When I think discipline two things jump into my thoughts: the military and professional athletes. Both have discipline, but I’d argue the two are quite different. One requires a driver to instill discipline in the others, while (some) the professional athletes discipline themselves – almost involuntarily. Some athletes simply have their passion become their discipline, and therefore, to be disciplined doesn’t take “work”, it becomes play, it becomes fun. These points speak to the fact by following one’s passion, their true passion, they will be successful. It’s almost a universal law by definition: If passionate, you are disciplined, and you will succeed. If you fail, you have falsely identified your passion.

Chapter 2 – Level 5 Leadership

Page 17: I loved the quote by Harry S. Truman at the beginning of the chapter – “You can accomplish anything in life, provided that you do not mind who gets the credit.” It made me think of the type of leadership by which I like to try to live by. I stress “try” in that sometimes ego gets the best of me. It is truly a great leader who can be self-confident and humble enough to not “need the (ego) feed”. Perhaps that type of leader has an ego fed from within. Besides, the people around you, those who you work with, know you, your capabilities, and passions – there isn’t a need to advertise who has done what, it is known, or in some cases, comes to be known.

Chapter 3 – First Who… Then What

Page 42: The quote at the end of the first paragraph states: “Great vision without great people is irrelevant.” This very much aligns with my philosophy that success starts with having the right people. This became part of my philosophy after a friend, who upon graduating from business school asked for my advice on whether she should be more focused on making sure the company she joined had the right idea (i.e. one she believed would work) or that it had the right people. We debated the question for a bit, but no matter the perspective taken, it still comes down to the having the right people. Fact is, the “right” people will not only generate the right ideas, but they’ll be able to ensure they don’t stay just ideas, but are instead realized.

Page 44: What caught my attention on this page was the concept of getting “… the wrong people off the bus.” Collins states that getting the right people on the bus is “… nothing new.”- neither is getting the wrong people off the bus. The thing is that good leaders know who their best people are and who their worst people are. For example, having worked at my fair share of large healthcare insurers and their senior leadership, I have seen leadership blatantly call out their worst people, yet leave them in critical roles on which the success of the company depends. A couple points related to the “off the bus” topic: 1) at a minimum one Level 5 leader must be present for this action to possibly take place 2) even if 1) is satisfied, if a company has a very large amount of people which need to get off the bus, this process can take many months, likely even years. I’d like to hear Collins general thoughts on how, for example, a large healthcare insurer with say 50% of it’s workforce clearly not producing, would get these people off the bus without minimal shareholder and customer impact. For example, one could argue that the company’s Level 5 leaders would only need to remove the weak leaders and new strong (Level 5) leaders could then turn the other employees around. Additionally, page 53 strengthens the point that those who aren’t achieving need to be removed from the bus, in that they not only aren’t achieving success, but they impede those who are achieving. Removing the wrong people from the bus also ties into the discipline and rigor pieces Collins writes about. Something that takes a long time, will take a significant amount of discipline. To quote page 52: “ To be rigorous, not ruthless, means that the best people need not worry about their positions and can concentrate fully on their work.”

Chapter X – not done yet…

Page X: xxxx

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Pages Referenced:
17, 42, 44, 52-56, 58, 61, 73, 121, 128, 129, 134, 138, 141, 142, 144, 147, 148, 152, 168, 172, 176, 184, 182-184, 192, 205

I should be watching a movie.  No, I should be doing business development and writing reviews.  No, I should procrastinate and write a blog entry on the boomers and their impact on the US healthcare system in the next 20-30 years.  Will the Boomers be the main reason the US healthcare systems goes kaboom around 2020?

Recently George Churchill and I were discussing the “big three” so many in the payer space seem to be focused on - healthcare affordability, access, and quality.  He asked me what was the “next thing” after the big three.  Volume came to mind.  While the boomer generation won’t necessarily be the driver of spending increases (see Uwe Reinhardt’s WHCCE data/presentation), one can’t ignore the fact that they will still drastically increase the need in care from 2010 onward.  The US needs to figure out the expense side of the equation, but also needs to figure out the volume side of the equation - how will it care for so many in need?  My hypothesis is - similar to that how manufacturing has moved out of the US - the boomers will get their care outside the US.  This is already happening (see recent FastCompany article), and if there is a lack throughput in the US (and/or a sacrifice in quality) the savvy boomers won’t put up with it.  Many are well financed and will likely take their money and perhaps premiums elsewhere.  Sure, it’ll scare them at first.  All unknown and new things scare most people, who wants to be the guinea pig?  But like the cell phone, it’ll become the status quo eventually.

If it can be put into row column form, needs to sorted, filtered, sliced and diced… it’s probably better in a database.  :-)  e.g. I just moved my movie list (part of it anyway) to mySQL and dynamically populate it on this web site (vs. a static wiki).  Check it out - you can now sort it (filters to come). <can’t believe I spend time doing stuff like this… I guess it’s one way to stay grounded in the technology space>

When I read this article today I had to do a double take: Feds set to stop reimbursing hospitals for medical mistakes - Triangle Business Journal

The article states that under current business practicies Dr.’s get paid even if they screw up.  BUT, in the future the Feds plan to stop paying for these type of operations.  Wow.  That’s an innovative and new idea!

How would you feel if they amputated the wrong arm of yours and then you received a bill for the operation!?!?  Doesn’t it seem like this should be a straight forward issue?  In many other industries people don’t get paid if they don’t do their job, but when it comes healthcare people are allowed to make mistakes and get paid for them.  I didn’t realize physicians can fall in the same camp as meteorologists…

Monica mentioned I should watch this video/flash movie.  It’s about all the crap we consume and buy.  We all contribute and participate in this system (ok, there may be a few that don’t - e.g. Scott and Emma for 8 weeks) for the most part.  It tied into many thoughts and principles of mine - e.g. it’s important to consider the big picture and without my health I don’t have much at all.  Anyhow, it’s a good perspective on what’s going on in the world and aligns with my recent scary thought while in Costco this weekend - what happens when China’s majority needs to consume the same way we do today in the US?  Planet meltdown, that’s what.