Antoine Flahault’s blog

I am not a management teacher but I am the head of a public health school that is well known internationally, in particular, for training hospital directors. When I read the marvellous story of the Mayo Clinic (English site), probably one of the best benchmarks for a university teaching hospital in a developed country, I thought that we could together, on the V2.0 website, learn the management lessons described by Leonard L. Berry and Kent D. Seltman (McGraw Hill, 2008, in English, €17.86 from Amazon.com). At the moment, the health system in the USA is not considered to be among the best in the world. But there are some hospitals which could be taken as a model, if not to take inspiration, at least to look at, perhaps drawing on what seems to be the best and most applicable to the situation in France (which has its own problems) or elsewhere. I should like, therefore, to open a thread to look at the Mayo Clinic, a hundred years old and as dynamic as ever. A post must not be very long, so once again, looking at this case will take several posts. Looking forward to your reactions.

First of all, you can learn about management from a hospital even if you are the manager of a public or private company that has nothing whatsoever to do with the health sector, all the more so as a hospital is very different from any other service company. When they arrive at a hospital, customers are ill, injured or stressed. They do not just enter the hospital, they come to stay. Hospitals provide services that are needed, not that customers choose. You can treat yourself to a dinner, a holiday or a new mobile phone but you don’t really want a mammography, a specialist examination or an operation. Health care is extremely personal. And health care calls for an approach where the level of personalisation is probably taken to extremes, depending on the patient’s age, mental state, personality, preferences, education, family situation and financial resources. A patient needs a comprehensive service, all the more so if he is seriously ill. When he enters hospital, a patient risks contracting another problem in addition to the one for which he was admitted – owing to a faulty or belated diagnosis leading to unsuitable treatment, owing to a medical error or negligence, catching a nosocomial infection or other iatrogenic disorder.

To summarise, the “customers” of the Mayo Clinic and many other hospitals (1) are admitted to hospital suffering from one or more diseases, injuries, pains, apprehension and fear, (2) need a service but dread it, (3) abandon much of their personal freedom while they are in hospital, (4) see much of their privacy and often their self-respect whittled away before doctors whom they are often meeting for the first time in their lives. Surely managers in all countries and in all companies can learn lessons from these hospital managers, in particular those at the Mayo Clinic, as the customers we are talking about, that are commonly called the “patients”, surprisingly keep their self-esteem intact and are grateful and loyal to those who provided these services.

There will of course be many similarities between the health care and many non-medical services. This is what I propose finding out, in due course, with the two authors who carried out this remarkable case study at the Mayo Clinic, an establishment that I will present to you in another post.