What should Sally do?

This is a case study on the www.hbr.org. To read the case, click on the link. http://blogs.hbr.org/cs/2010/03/what_more_evidence_do_you_need.html

After reading the upcoming case study and comments, I see this case differently. AMC (American Medical Center) is not a successful hospital, at least financially. It makes perfect sense to keep the status quote if AMC is successful, but this is not case here. To play defense and go down the path of not losing money in the foreseeable future, AMC's CEO lacks the vision and courage to lead the organization and set a higher standard for AMC. As indicated in the case, senior management is contend to have low standard of not losing money, instead of set the bar high of being profitable. In the long term, low goal standard will formulate a conservative culture and prevent new ideas or changes. AMC's problem lies it does not provide any better cares for the patients than the competing care providers. Even worse, its' facility can not compete against the nearby providers. No wonder AMC can not attract high paying patients to off set poor patients who do not pay.

To improve AMC's competitiveness, it must either invest in the facility to match competitors, or to reform its health care system to bring better health care delivery system and better quality. Major investments in improving facilities are a huge challenge for AMC. However, switching to EBMgmt (Evidence-Based-Management) will increase the quality care and AMC can t make this approach to build its reputation on providing better care than the competitors. Given the choice of better health care or comfortable facility, patients will chose quality over comfort. However, quality improvement takes time and so does the reputation. How to convince the board and senior management is perhaps the biggest obstacle.

A superior vision is only half of the battle for AMC, just like many other companies, it is far more difficult to win the political battle. The key is to have upper management and the board of directors to buy in this vision. I am sure just like Sally's worry about the future of her own career at AMC, the CEO Mark is also worry about his own future. The fact that Mark allows EBMgmt to go forward at the first place is an indication that he believes in it. Then the question is how to persuade the board of directors to believe in EBMgmt. One advantage is that middle managements are already on board. The key is for Sally to express her opinion to Mark and two of them build a strategy to give middle managers a chance to communicate with other senior managers and the board of directors directly. I believe the decision for Sally to make totally depends on how strongly she believes in EBMgmt practice.