SETMA has used the following phrase for years: “If you are going to make a change, it had better make a difference.”  The only way people are going to follow a leader is if that leader helps them define and fulfill their own vision.  I have always associated this phrase with an article which I read in a Continental flight magazine.  It turns out, my wife read it.  The article was about “change agents” and IBM’s transforming itself in the early 1990s.  I looked and looked for the reference to the quote and could not find it.  I even asked IBM executives about the article. 

On August 8, 2011, I found it!  Early in SETMA, I wrote the SETMA Sentinel which was an in-office publication.  It was a way of communicating with all of the practice and of getting everyone to know each other.  It was our first step in team building. I would write it early in the morning and walk around and put a copy on everyone’s desk before they got to work.  Fourteen years and four months ago, the March 30, 1998 Volume IV Number III, the following Sentinel appeared.

SETMA Sentinel
Volume IV Number III
March 30, 1998
Responses to SETMA

“You might be interested in some of the things, which I learned during the Medical Management Institute’s three-day “Business of Medicine” conference in New Orleans.  First, the responses to SETMA were:

• “A general surgeon said, ‘You’re (SETMA) light years ahead of any of the rest of us.’  (speaking of those at the conference)
• “A managing partner of a small, primary healthcare group said, ‘You know that you (SETMA) are extremely unusual.’  The physician and his administrator asked to spend several hours together discussing their situation and getting counsel on how they should proceed.
• “Every innovative and advanced recommendation made to the conference represented things which SETMA has already done or is actively in the process of doing.  Let me reiterate to you, it was not just some, but EVERY recommendation, was things SETMA is already doing.  This should make each one of us proud and grateful.
• “At many critical points in the conference, illustrations of what SETMA is doing provided direction and understanding for other participants in the conference.  At other points, questions, generated by SETMA’s experience, provided insight for others into potential solutions for their problems.

“You can be proud of the organization, which you serve.  You can be confident that your future is secure and bright because of the commitments, which Drs. _____, Holly and Wilson have made to you and to the way in which we will do business.

“Change Agents:  Rules for Radicals

“While traveling, Mrs. Holly read an article in Continental¹ entitled, ‘Rules for Radicals,’ which was from ‘IBM’s Top Change Agents.’  Two ‘change agents’ gave their lists of ‘rules for radicals.’  They are:

• “Think fast - then act fast!
• “Fight for change, but pick your battles wisely!
• “Never compromise the truth--but modify your style!
• “Get it fast or get out!

“The second list is:

• “You can’t make a difference without doing things differently!
• “Pressure from below requires protection from above!
• “People who sponsor change need sponsors!
• “Want to make change?  Get results!

“The complete article is entitled, ‘Grassroots Revival.’ Read it.  Every one of us is a change agent, if we choose to be.  And, in the long run, change agents are what businesses are looking for.  Your future is in your hands.  Where will you be five years from now?  Where will SETMA be?  Five years ago, everyone thought IBM was ‘history.’  Today, it’s leading the parade!!

“Truth - Beauty - Goodness - Unity

“Also, while I was gone, I finished Tom Morris’ If Aristotle Ran General Motors.  In coming weeks, you will receive an extended outline of this book, and we will have several discussion sessions with all of you concerning the issues raised in the book.  For SETMA, it is one of the most important books any of us could read.  Morris begins with Aristotle’s four timeless virtues:  truth, goodness, beauty, unity.  He applies them to modern business practices, and in many ways, he describes the ‘corporate culture’ of SETMA.

“SETMA’s motto is ‘Healthcare Where Your Health Is The Only Care!’  But, we also have a ‘standing order’ which declares that we want to ‘Do Good While We Are Doing Well.’  In his chapter entitled, ‘The Moral Dimension at Work,’ Morris states, ‘’Doing well by doing good’ has come to be one of the slogans of business ethics in the last few years.”²   Surprised!  What SETMA adopted three years ago, Tom Morris wrote about a year ago.

“In a chapter entitled,’“Creativity and the Meaning of Life,’ Morris states:

‘A deep view of the meaning of life will give us a new perspective on that one thing which seems to be the most feared by the most people in the modern business climate - change.  Rapid, even dizzying, and nearly constant change seems to be swirling around us in all sectors of our economy.  Every industry is affected, and it’s not going to go away.’³

“Healthcare is changing.  The business of medicine is changing rapidly, and the only successful response to change is learning.  Remember Peter Senge’s quote in The Fifth Discipline:  ‘The ability to learn faster than your competitors may be the only sustainable competitive advantage.’  (Arie De Geus, head of planning for Royal Dutch/Shell)⁴   If we do not learn, we will not survive, but more importantly than not surviving, we will not succeed!  If we do not change, we will not meet the challenges of the next thirty years.  If we do change, we will lead others to success and fulfillment.

“Take a few moments to look at the motivational pieces hanging on the wall outside of the break room and the one hanging inside of it.  Apply these messages to your personal life.

• “One is entitled, ‘Change.’  The picture depicts a 360-degree curve in one of our National Parks and states:  A curve is not the end of the road unless you fail to make the turn.  The changes in healthcare present us with some very challenging ‘curves.’  If we change, we not only survive, we succeed.  See if you can list four of the curves, which we face in healthcare!  How can you job performance, attitude, enthusiasm, changing help SETMA negotiate those curves?
• “Another is entitled,  ‘The Challenge of Survival.’  This depicts a beautiful lion and addresses diligence, persistence, excellence and ‘starting early.’  It states, ‘Every morning in Africa, a Gazelle wakes up and knows that if does not outrun the fasting lion, it will be eaten. Every day a lion wakes up and knows that if it does not outrun the slowest Gazelle, it will starve. So, whether you are a lion or a gazelle, when the sun comes up you had better be running.’  In the 19th Century, Charles Haddon Spurgeon said, ‘You don’t have to defend a lion, you just turn him loose.’  Allow your passion to turn the lion within you loose!
• The third is entitled, ‘Passion.’  Depicting a beautiful golf course, this picture states:  ‘There Are Many things in Life That Will catch your eye, But only a few will catch your heart...Pursue those!’  Is there anything about your job, which catches your heart?   That is where your opportunity for true greatness lies.  That is where personal fulfillment and success will be found.
• The fourth is entitled, ‘Rule #1.’  It states, ‘If we don’t take care of the customer, someone else will.’  Ultimately, our success is dependent upon our sincere concern for the benefit of those whom we serve.

“Mentoring

“Mentoring is a method of training which has been known by many different names:  apprenticeship, discipleship, etc.  Morris talks about ‘mentoring,’

‘Michael Polanyi thinks it’s no coincidence at all...(that) Given the right context of intimate and sustained association, greatness gives rise to greatness...The old master-apprentice model of education captured a powerful truth.  You have a much better chance of becoming great if you hang around with great people...Polanyi suggests that we convey to those around us insights, knowledge, and wisdom that can never fully be put into words.’⁵

“Most of us never think about ‘being’ great or ‘living’ great lives, but ‘greatness’ is as intentional as it is accidental.  And, we choose to live ‘greatly’ when we choose to live ethically, morally, virtuously, wisely.  When we choose to live for others!

‘Etiquette is where ethics meets everyday life!’

“Incredible thought, isn’t it?  In a section entitled, ‘Morals and Manners,’ Morris quotes:

’At Hampden-Sydney, we have a rule that every student must greet everyone they pass on campus...(because) we believe that etiquette is where ethics meet everyday life...A big part of ethics is fundamentally just other-regarding behavior.  And that’s precisely what etiquette is.  If we don’t help our students get it right in the little things, they’ll never be in a position to get it right in the big things.  We teach them to be courteous, hoping that this will help them to be moral.’ ⁶

“How you treat those with whom you work and live, reflects a great deal about your honesty, your integrity and your commitment to live by truth.  The reality is that you can start to become more like you want to be simply by changing the way you respond to those around you.  As you treat them well, they will treat you well.  While at first it may be a conscious effort, before long it will become a habit - a part of your spontaneous and automatic response.  It will become a part of your character.

“Marketing to Ourselves

“Marketing is such a vital aspect of any corporation’s activities.  We have had long discussions at SETMA about the value and philosophy of advertising.  Morris comments:

‘Whenever we make the people around us feel special in positive ways, we ourselves benefit from the results.  And this is not the fluff of psychobabble, it’s the reality of human nature....Not only do individual human beings need to have a sense of distinctiveness in themselves, groups of people working together in partnership for some form of good also need to carry in their minds and hearts a sense of distinctiveness as a group, a sense of unique community....And employees of a company need an excitement or pride in what they distinctively do as a company.  That’s one reason why an advertisement, done right, is often almost as worthwhile for its effect on the people who work in the company as for its impact on customers and potential customers.  It enhances a sense of company distinctiveness and importance.  As long as we feel unique in what we do, we’re in a position to be deeply motivated to grow and improve, to go beyond what is required, and to move forward to new levels of excellence.’⁷   (Emphasis added)

“We all want you to be proud of SETMA!  And, we spend a great deal of time, effort, money and planning to make it possible for you to be proud of what we are doing.  Morris’ book is such a confirmation of the ‘corporate culture’ of SETMA.  Let us both be affirmed and challenged by the realization that we are doing a great deal ‘right.’  Let us resolve to follow our ‘passion’ as we face the challenges of the future.  And, above all, let’s do it together.  For in reality, nothing is nearly as satisfying, even surviving and succeeding, as when it is done with your family and your friends.  You are my family, and you are my friends.  I have been blessed by God with the greatest job in the world.  As I enjoyed this past week, I missed you.  I needed to be away, but I need to be back, also.  I am grateful for both.  Together - there’s that word again - we can make a difference worth making in medicine.”

Bring this up to date

SETMA has changed dramatically since March, 1998, but what has not changed is our desire to change!!  We continue to innovate and to create.  Everyday, we find new ways of “doing it better” and of finding “better things to do.”  In some ways and even in many ways, we ARE leading the parade.  Our partnership with IBM with COGNOS BI started a long time ago as we adopted their mantra in creating our marching orders:  “I want it done right and I want it done right now!’