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Change Ability and [I.sup.2]: Two Keys to Success in Both New and Old Economies. (Out There: The Physician as Entrepreneur).


The ability to welcome and take advantage of change (change ability) and the ability to take into account right side of the brain qualities that are difficult to measure are key to an entrepreneur's success.

Change ability is much talked about, but little understood. [I.sup.2], shorthand for immeasurable intangibles, is off most people's radar screen.

The physician leader who can master, understand and account for both change ability and [I.sup.2] has a competitive advantage in either an old or new world economy.

Embracing change

Most of us do not naturally deal gracefully and successfully with change.

Although reflection and direct examination of experience teach us that change is inevitable, natural and healthy, there is also an innate, natural tendency for people to resist change and yearn for stability.

The paradox that we both need change and wish it would go away is obvious to even the most casual student of change and life.

Those steeped in the Eastern traditions that include Buddhism are often more comfortable with this paradox than those of us who are more comfortable with a rational, Western approach to life. Perhaps it is another paradox that both the Eastern and Western approaches seem to be mutually exclusive. But both are needed to be most successful in this life.

There is a whole cottage industry of consultants who rack up frequent flyer miles and charge $3,000 a day to give advice to individuals and organizations on how to deal with change.

In the interest of full disclosure, I plead guilty to taking advantage of both US Airways frequent flyer program and the discomfort of many about change. Consultancies and keynotes on change have been good for my family's budget, and change ability is my expression for the capacity of all of us to learn to welcome change instead of resisting it.

Classic literature

But I think it is a mistake to think that today's management gurus have much that is new to teach physician executives about change.

The $3000 spent on a consultant for one day would probably be better spent on a library of the classics , as long as you actually took the time to read and reflect on them.

I have not run across many experts who improved on Machiavelli's observation that he made in Renaissance Florence in 1513.

There is nothing more difficult to take in hand, more perilous to conduct or more uncertain in its success, than to take the lead in the introduction of a new order of things.

Machiavelli is considered the father of modern political science and knew of what he wrote from firsthand experience. When the Medici family regained power in Florence, they had him arrested, tortured and imprisoned for his hand in "the introduction of a new order of things."

The idea that change is actually necessary for human happiness is also not new. The emperor and stoic philosopher Marcus Aurelius ruled Rome during a time of great change that included epidemics, revolts and frequent wars along its borders. He understood the necessity of change:

Is anyone afraid of change? Why, what can take place without change? What then is more pleasing to the universal nature? And canst thou take a bath unless the wood undergoes a change? And canst thou be nourished unless the food undergoes a change?

And can anything else that is useful be accomplished without change? Dost thou not see then that for thyself also to undergo change is just the same, and equally necessary for the universal nature?

Successful physician entrepreneurs will have a competitive advantage if they spend time seeing how to take advantage of the inevitable changes that will occur in health care.

Unfortunately, many physician executives spend a lot of time and energy esisting change that is inevitable, natural and healthy.

[I.sup.2] = tough decisions to make

Perhaps just as important as the ability to gracefully accept change is the ability to take into account and understand what I call immeasurable intangibles or [I.sup.2].

My Oxford English Dictionary defines "immeasurable" as that which cannot be measured but is still vast and immense and "intangible" as that which cannot be grasped mentally.

Immeasurable intangibles is a concept that is increasingly becoming more important. Perhaps three examples from the world of business will make this abstract thought easier to understand.

1. David Boyle and Charles Leadbeater both remark on the fact that at one time an examination of Microsoft's balance sheet revealed assets amounting to only 6 percent of what the New York Stock Exchange said the company was worth on that particular day. Ninety-four percent of Microsoft's value was intangible assets that accountants find hard to measure with a number.

2. When PriceWaterhouseCoopers teaches its clients about the "k" factor, it is trying to define these intangibles that add value to a company. Their literature states that "every sale is an economic, informational and emotional exchange." They advise their clients to pay close attention to and understand the emotional experience of their customers in every aspect of their relationship to the client's organization.

3. Dream Works is a new movie production company founded by Steven Spielberg, David Geffen, and Jeffrey Katzenberg with an initial investment of $250 million. Wall Street has valued this organization at times as high as $2 billion because of intangibles. That drives accountants to drink because these intangibles cannot be boiled down to one number on a spreadsheet.

The savvy physician entrepreneur knows that some decisions have to be made with incomplete data. The successful entrepreneur knows that hunches and intuition can be more important than spreadsheet analysis. What an experienced leader feels in his gut is often very important.

What do we know about these immeasurable intangibles?

As a former chief knowledge officer at Genomics Collaborative, I think the whole knowledge movement in business is trying to get after these immeasurable intangibles.

I think a catalog of important immeasurable intangibles (13, perhaps?) would include:

* Skill

* Knowledge

* Reputation

* Brand name

* Intellectual capital

* Sense of community

* Employee morale

* Employment of super stars in an industry (Steven Spielberg or Bill Gates come to mind)

* Degree of enlightened leadership

* Willingness to take calculated risks

* Learning

* Amount of internal motivation among workers

* Degree to which Dilbert applies to the organization

What all of these important immeasurable intangibles share is a refusal to be summarized by a single number in a spreadsheet in a year-end report on the organization.

Perhaps we have to turn to literature one last time to understand immeasurable intangibles. This time the quotation is from Antoine de Saint-Exupery's, The Little Prince.'

Grown-ups love figures. When you tell them that you've made a new friend, they never ask you any questions about essential matters. They never say to you "What does his voice sound like? What games does he love best? Does he collect butterflies?"

Instead they demand, "How old is he? How much does he weigh? How much money does his father make?" Only from these figures do they think they have learned anything about him.

RELATED ARTICLE: Additional resources on change and immeasurable intangibles.

Boyle, David. The Sum of Our Discontent: Why Numbers Make Us Irrational. New York, Texere, 2001.

This book changed my thinking about what we can understand by rational thought and numbers and what we can understand only by just living. It's a delightful and important book for any physician entrepreneur who is struggling with the intangibles that separate a successful venture from a failure.

Hock, Dee. Birth of the Chaordic Age. San Francisco, Berrett-Koehler Publishers, 1999.

Dee Hock's story of how Visa became a highly successful quasi-for-profit, quasi-not-for-profit, quasi-consulting, quasi-franchising, quasi-educational, quasi-social, quasi-commercial, quasi-political alliance is full of practical insights and wisdom of the highest order. His story of his on again off again career rings true with this knowledge worker who has changed jobs more often than is comfortable for any normal human being.

Lewis, Michael. Next: The Future Just Happened. New York, Norton, 2001.

A hilarious romp through the changes in finance and legal advice made possible by the Internet. I found the idea that Nokia stays on the cutting edge by letting Finnish school children figure out how technology will be used in the future intriguing and probably important.

Halpern, Paul. The Pursuit of Destiny: A History of Prediction. Cambridge, Mass., Perseus, 2000.

This is the best summary of how rational thought patterns fall short of predicting the future. There is much to learn in this slender volume about the immeasurable intangibles that are becoming more important for a biotech start-up's success.
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Author:Bottles, Kent
Publication:Physician Executive
Geographic Code:1USA
Date:Nov 1, 2001
Previous Article:How to Avoid Common Overhead Allocation Mistakes. (Nuts and Bolts of Business).
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