American Medical Association National Leadership Development Conference Fontainebleau Hilton

Hen 37,000 feet …

Microsoft = R.O.W. Microsoft > GM + Ford + Boeing + Lockheed Martin + Deere + Caterpillar + USX + Weyerhaeuser + Union Pacific + Kodak + Sears + Marriott + Safeway + Kellogg Source: Business Week data through 5-99

Microsoft = R.O.W. (II) Microsoft > GM + Ford Boeing + Lockheed Martin + Deere + Caterpillar + USX + Weyerhaeuser + Union Pacific + Kodak + Sears + Marriott + Safeway + Kellogg + McDonald’s + Bank One + General Mills + American Airlines + United Airlines + + Delta Air Lines + US Airways + Quaker Oats Source: Yastrow Marketing (through )

No Wiggle Room! “Incrementalism is innovation’s worst enemy.” Nicholas Negroponte

Just Say No … “I don’t intend to be known as the ‘King of the Tinkerers.’ ” CEO, large financial services company (New York, 5-99)

64/24

Goal?

“It means nothing less than the total reinvention of this company.”

Jacques’ New New Ford Ford + MSN CarPoint Ford + Yahoo! Ford + Oracle Ford + HP/MCIWorldcom Etc. Etc.

TP2000: A broken Record GE Power Systems Anheuser Busch FitLinxx Yellow Freight Time Inc. Etc.

Web Total Reinvention Consumer Control Speed Terror/ Opportunity Brand Power/ Communication Imperative

“There’s going to be a fundamental change in the global economy unlike anything we have had since the cavemen began bartering.” Arnold Baker, Chief Economist, Sandia National Laboratories

“Medicine looks likely to change more in the next 20 years than it has in the last 200.” British Medical Journal ( )

“We are in a brawl with no rules.” Paul Allaire

S.A.V.

Tom Friedman on Bob Rubin* No phone on his desk. Why? No one to call! *NGA address/CSPAN/

Forget > Learn “The problem is never how to get new, innovative thoughts into your mind, but how to get old ones out.” Dee Hock

C.E.O. to C.D.O.

“It used to be that the big ate the small. Now the fast eat the slow.” Geoff Yang, IVP (Institutional Venture Partners)

E.g.: Craig Venter/ Celera Genomics

BW: “human brain has only a short time left as the smartest thing on earth”/ “subjugate humanity by 2050” Health Forum Journal: “In one generation or less, every element of health care, every assumption, will be changed or gone.” Dr. George Poste, SKB: 500 molecular targets in ’95 to 70,000 in ’99/ 35 compounds per year to 2M

“Researchers say they have found a way to mate human cells with circuitry in a ‘bionic chip” … The tiny device – smaller and thinner than a strand of hair – combines a healthy human cell with an electronic circuitry chip.” AP/AOL/02-00

And Now the Equivalent … White Collar Revolution!

“The coefficient of friction associated with the grunge of business is amazing!” Michael Schrage

RR on Sara Lee “The most profitable businesses in the future will act as knowledge brokers, linking insights into what’s available with insights into the customer’s individual needs and preferences.”

The “&-!!+#$% in the middle”* Jim Clark on Healtheon/WebMD * ’twixt docs, patients and providers; $300B in waste (?); source: Michael Lewis, The New New Thing

[ Incidentally … CEO Jeff Arnold Age: 30 First Start-up: Age 24]

Hewitt & HMO e-bids!

“We want to be the air traffic controllers of electrons.” Bob Nardelli, GE Power Systems

“E-business is the final nail in the coffin for bureaucracy at GE.” Jack Welch/ GE Annual Report 2000

The Character of the Web, per The Cluetrain Manifesto … Hyperlinked Decentralized Hypertime Open, direct access Rich data Broken [no one owns it or controls it] Borderless

Jargon Bath! Bureaucracy free … Systemically integrated … Internet intense … Knowledge based … Time and location free … “Instantly” responsive … Customer centric … Mass customization enabled.

Translation … Bureaucracy free = Flat org, no B.S. Systemically integrated = Whole supply chain tightly wired/ friction free Internet intense = Do it all via the Web Knowledge based = Open access Time and location free = Whenever, wherever “Instantly” responsive = Speed demons Customer centric = Customer calls the shots Mass customization enabled = Every product and service rapidly tailored to client requirements

“Our business needs a massive transfusion of talent. And talent, I believe, is most likely to be found among non-conformists, dissenters and rebels.” David Ogilvy

“The boundaries for acceptable weirdness have dramatically expanded.” Michael Schrage

“Wealth in this new regime flows directly from innovation, not optimization. That is, wealth is not gained by perfecting the known, but by imperfectly seizing the unknown.” Kevin Kelly, New Rules for the New Economy

$35,000,000. = ???

Dell’s Web sales … daily

2X = 100 days (Internet traffic) 2X = 9 months (network capacity) Source: Red Herring (1-00)

I-24 to 1-28: BizRate.com Online Shopping Index [Consumer Goods] 52 Weeks: +622% Source: The Industry Standard/02-00

Time to 50M Users Radio … 38 years TV … 13 years PC … 16 years Internet … 4 years Source: Business 2.0 [01-00]

Tomorrow Today: Cisco! $7B of $10B Save $500M (service and tech support) C.Sat e >> C.Sat H Customer Engineer Chat Rooms ($1B?)

Community rules!

SoftWatch (MS) “Manage relationships across the healthcare continuum”/ Amir Kishon Establish e-relationships with customers/retain customers/collect data Patients record info + receive feedback/ Online access to nurses Community with others with MS Etc. Source: Start-Up

B2B = No.1 CarStation (auto-body shops), ChemConnect (chemicals), Collabria (commercial printing), DigitalThink (corporate training), E-Steel (steel), Medibuy (medical supplies), Portera (knowledge workers), Etc., Etc., Etc., Etc.

Welcome to D.I.Y. Nation! “Changes in business processes will emphasize self service. Your costs as a business go down and perceived service goes up because customers are conducting it themselves.” Ray Lane, Oracle

Psych 101: Strongest Force on Earth? My need to be in perceived control of my universe!

Shop in your Underwear Source: SM’d logo for ae = American Eagle Outfitters

Anne Busquet/ American Express Not: “Age of the Internet” Is: “Age of Customer Control”

Amen! “The Age of the Never Satisfied Customer” Regis McKenna

“IT enables total transparency. People with access to relevant information are beginning to challenge any type of authority. The stupid, loyal and humble customer, employee, patient or citizen is dead.” Kjell Nordstrom and Jonas Ridderstrale, Funky Business

Patricia Seybold’s “Basics”: The E-Customer Bill of Rights Don’t waste my time! Remember who I am! Make it easy for me to order and procure service! Customize your products and services for me! Source: customers.com

“Where does the Internet rank in priority? It’s No. 1, 2, 3, and 4.” Jack Welch

There are 2 Kinds of … Defense* vs. Offense** *Fend off upstarts. ** Reinvent our marketspace!

Women … 49% of Web users; 6 of 10 new users; 83% of wired women are primary decision makers for family healthcare, finances, education. Source: Business Week (11-99)

Women and Financial Advisors Women want … a plan, to be listened to, to be taken seriously, to read about it, to think about it. Women do not want … an in-your-face sales pitch Source: Kathleen Boyle, Wheat Boyle Butcher Singer

Women and Healthcare Women are … more dissatisfied, frustrated by the way they are treated and spoken down to by physicians, seek more information, are more pressed for time … and make 75% of health care decisions and control 2/3 of health care $$$$ [and constitute 2/3 of health care employees]. Source: Patricia Braus, Marketing Healthcare to Women

Marketing to Women: Help Them Save Time! 80% … work 86% … cook 58% … run errands with kids 38% … take child to school 21% … go to the gym 21% … take outside classes

74/55 “At each stage of their lives, the needs and desires of the baby boomers have become the dominant concerns of American business and popular culture. If you can anticipate the movement of the baby-boom generation’s life-span migration, you can see the future.” Ken Dychtwald, Age Wave

Aging/“Elderly” 2X growth rate $$$$$$$$$$$$ “I’m in charge!” “Experiences” vs. Products Design revolution! Good source: Ken Dychtwald, Age Wave

Leadership: Ann Richards’ Dogma Show up! Know your message! PUT YOURSELF AT RISK!

“If you ask me what I have come to do in this world, I who am an artist, I will reply, I am here to live my life out loud.” Emile Zola

“I’d rather regret the things I have done than the things I have not.” Lucille Ball

Foot-in-Mouth Moment!

Dr. Peabody Dr. Bill[ingsly] Dr. Hahn Dick Bartlett Rich Lanzerotti Mark Novotny

Are You Fighting Yesterday’s War? Docs don’t know it all. There are a lotta bad medical decisions. “Hospitals” kill far too many people. (Bad decisions, bad execution.) Systemic waste is stratospheric. (Still.) Patients are getting (much) smarter. Patients have had it with HMOs. (And Docs with the “white-coat syndrome.”) You are not smarter than I am. (I am your partner.) You are not busier than I am. (!!!!!) Patients want more data. (And can readily get it.) Boomers will control their lives. Period. Medicine is about to be overwhelmed with a tsunami!

“Is it good medicine?” WHO KNOWS??!!

Marketing “gurus” see all business problems as “marketing issues”! Etc.

IF YOU [TOTALLY] TRUST YOUR LAWYER/ MANAGEMENT GURU/ARCHITECT … YOU ARE … A PERFECT IDIOT.

1965: “ ‘Doctor’ will see you now. ‘Doctor’ will take care of you.” YES, NURSE. ME GOOD PUPPY DOG. 1995: “HMO will take care of you.” BULLSHIT. 2005: “I will take care of me. I’d like your expert help.” [P.S.: “HEY, DOC,THE VIAGRA, ETC. I ORDERED ON LINE IS GREAT.”]

YES … patients WILL make mistakes … just like Chevrolet owners!

Patient-centric* Health Care Wellness (Fix to prevent.) Partnership (“Tour guide” model.) RESPECT! (Mutual.) WOMEN RULE! *Not: HMO-centric, Employer-centric, Insurer-centric, Doc-centric

Partnership Architect Lawyer Accountant * * * Doctor (??)

AMA: Push “Patient Partnership” Model????

Present: Nostalgia Absent: Tomorrow/ Cool

How sweet it is!

F.Y.I.: Slides are available in Power Point at …