It’s All About Transformation

March 13th, 2009 by Webmaster Leave a reply »

This morning I had an experience that could only be described as Transformational. My presentation to the World Health Care Congress 2nd Leadership Summit was finished yesterday afternoon and it went as well as could be expected. We discussed HCAHPS, Employee Engagement, Patient/Family Partnerships, Evidence Based Design, and how to appropriately staff the various seats on the proverbial bus.

My flight was not scheduled until Friday, so attendance at the morning sessions seemed like a viable option. Listed on the speaker’s schedule was B. Joseph Pine ll, and his topic was “Work is Theatre and Every business a Stage and Authenticity: What Customers Really Want.”

As Mr. Pine went through his 55 minute presentation, my initial reaction was “Yep, knew that; heard that before; understand that,” but then, during the last five minutes of his prepared remarks, Joe hit us between the eyes with that thing that had always been there but had never become completely clear to me during the past two decades.

He asked us what people wanted when they joined a health club, went to business school, or a psychiatrist? The answer, of course, was that they were looking to be transformed. Each and every day for a dozen years, I have watched this process and never grasped the nature of this metamorphosis.

One of the participants made a point of asking why it was that a person could come to a hospital, have open heart surgery that changed or even saved their life yet would not donate even $200 back to the hospital during the annual fund drive? Yet that same person would leave their entire estate to a university that they had attended fifty years earlier? What was the difference? In both cases something dramatic had happened, but in the case of the open heart surgery, it was just seen and presented as a service or at best an experience.

The university however, provided a significant transformation of the life of that person. This simple description explains why so many open heart patients go back to doing exactly what they had done in the past, and end up back on the table two or three more times. It was seen by the patient as a service or at best an experience.

With this in mind, my observations of what happened to those patients who participated in the Dean Ornish Coronary Artery Disease Reversal Program was that, for the most part, they had joined that program looking for a transformation, and that indeed is what they found. Most of the participants who had come there seeking a total change and a new way of living a more healthful life were transformed by the program. They no longer perceived of themselves as being victims of their health.

How does this all play out in the field of healthcare? WalMart is going to produce a commodity, electronic health records, competing with WalMart on any level will prove to be a fruitless journey because they have mastered the world of commoditizing services. The Starbucks experience may get customers in the door time and time again, but what is it that we need to do that will produce grateful, loyal, generous customers or patients forever? Provide a transformation.

For those of us who are getting this, begin to look at your hospital, your practice, your business as more than just a service and much more than an experience. Think of what you do as providing the tools necessary to transform those with whom you are working, and present your product, your passion, your involvement with the client, the patient, the customer as a means of transforming them. Dedicate yourself to helping them reach their goal of changing their life in a positive way forever, and see where that leads you. TRANSFORMATIONAL CHANGE is what we all seek at some level. The product: To help us make our lives better.



  1. Carl says:

    Very interesting topic. One thing that strikes me is the difference between healthcare and other services. When we talk of transformation for another service, the goal is an outcome that is wanted. When we talk about a transformation in healthcare, the goal is not always welcome. Even though better health is the final goal, a diet, exercise, taking medication 2-4 times a day, cutting out drinking, smoking, etc., these transformations are not always welcome. It can be difficult to convice patients that their lives will be better after the interventions of healthcare providers.

  2. Ellen says:

    I’d like to make note that the patient who comes to the psychiatrist, in my experience, comes most often for transformation via medication and hoping for miraculous speedy results, not for the experience. I believe Community Mental Health typically strives to engage the patient to enter into a transformational experience beyond the psychiatrist, and often does that. However, there is a Catch 22 with hospitalization. Loyalty is not encouraged, recidivism is not a goal, and although patients’ inpatient hospitalization experience may be transformational and they may develop loyalty, should they return again and again (which they do) because they favor one hospital’s care over another (and many try them all) they ultimately may face a less than welcoming and sometimes even closed door. Behavioral health unit staff bedside manner is complicated, to say the least.

  3. Keith Morgridge says:

    Great topic and thanks for pointing me to it. A hospital I have had interactions with is trying to raise funds for a new facility and it dawned on them that their message in the community was not inspiring donations – what you have pointed out and they have not realized is they are focused on the the services they offer – not the transformation their work brings to their lives of the people in the community they serve.

    Another point – this is also a great motivation tool for front line staff – how their work and effort transforms the lives of the patients/customers they interact with each day.

  4. Mike says:

    Great post Mr. Nick. Your post is already getting my brain chewing on this thought, but as Carl mentions above this may not be so easy to do with health care – not impossible, but difficult. I agree that patients see health care much more as a service than as an opportunity to “transform” themselves. Even in the face of the obvious like the asthmatic or COPDer that continues to smoke when they know how bad it is for them they come to us to make them breath better so they can go home and smoke.

    Probably hard to get this concept to work in my setting – an ER but I need to think about it to see how to use this idea – which I like by the way.

    My question for you and CEO folks in health care like you is how would you go about developing a hospital culture that transforms patients? That would be a presentation I would come and see and sit in the front row for.

  5. Nick Jacobs says:

    Well, Mike, the idea behind my post was to challenge my former peers to begin to position the aspects of the health care business that can be appropriately positioned to teach, explain, and help convince the patient that their participation could lead to absolute, total transformation.

    Lots of people who went to college weren’t transformed either, but it’s the concept of transformation that is so appealing to me.

    Do you want open heart surgery, or do you want your life to change so dramatically that you will not be faced with collapsed arteries, blocked bypasses, and widow makers again?

    Of course some of this is a dream, but, unlike those individuals who take everything literally, I just think that if we could get the clinician behind this idea, not only could patient lives change but also the lives of the health care professionals who serve those patients. It puts complete meaning back into the job. As a former teacher, I’d rather think of those lives that I helped to transform than those who just got through without commitment.

  6. Nick, I enjoyed your talk at the conference. You are a great storyteller.

    Mike, sometimes the best way to teach people to stage a transforming experience is to immerse them in one themselves. So, to extend Nick’s message, how are hospitals helping to transform employees? Health care is powerful vocation that should be inspirational and transformative for clinicians and staff, often times, that is not the case.

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