Posted by: Knightbird | August 13, 2011

Moneyball, by Michael Lewis

A new movie will be coming out shortly about the Oakland Athletics baseball team and how their executive staff, General Manager Billy Beane and Paul DePodesta, a baseball statistic addict, made winners out of one of the smallest big league payrolls in the Major Leagues. I bought to book to read as a part of my interest in baseball as a pitching coach, but never imagined what incredible relevance it has to healthcare management and the slow adoption of lean management philosophies. If you haven’t read it, I highly recommend it.

Our management culture attempts to develop superstars, people who can do it all. If you look like an Executive, talk like an Executive, and find, hire and pay for the best people, you are viewed as a successful Executive. Of course, there are some organizations that are incredibly dysfunctional, and their dysfunction is attributed to traits such as lack of funding, cannot attract the top talent or poor location with small markets. What Moneyball tells me is that this view is bunk. You don’t have to be rich, blessed with abundant “talent’” or in the right big market to be successful. You can think and manage your way to success year in and year out. You just have to understand the advanced knowledge that is already out here.

Billy Beane was not the innovator who kept the A’s winning Division Title after Division Title against better funded teams in bigger markets. Instead, he analyzed his workplace, the baseball field, and learned that certain skills were more important that the skills idolized by those currently in charge-he establishment. Instead, Beane and DePodesta mapped a game through statistics and found that getting on base was the most valuable skill in baseball, and that you could accept an otherwise flawed ballplayer as long as he had an ability to get on base-through walks, hit by pitch, hits-and extend at bats or protect the plate. By analyzing the game, they understood that certain players generate runs, and that runs win games.

What is even more fascinating is the extremely slow, almost glacial, adoption of the new tools by MLB teams. Toronto and Boston are the other teams using these tools today. But these teams are shedding payroll and winning games. One interesting quote is a statement made by one of the first proponents of this system, Paul Palmer, who said “Managers pick a strategy that is least likely to fail rather than pick a strategy that is most efficient.” In other words, we do what is least likely to make us look bad. We do those things that are expected of others in our situation. If it doesn’t work, then we didn’t have the right people, enough money or other resources necessary to success. We can blame our lack of success on other circumstances. But when one team (or business) is having success doing it a different way, success is based on luck, or some other intangible. This is what I see happening in healthcare. We adopt best practices because they have worked at some time in the past for someone. We never examine how the practice made it to best, or became “evidence based.”

Healthcare Executives need to do a deep dive into the statistics and practices. The information is already out there, but it doesn’t develop because we have massive blinders on. We would rather use a much ballyhooed consultant, or the flavor of the day, to seek success. We need to accept our failures, not fear them, and learn, learn, learn.

Oakland wins more games than teams with double or triple their payroll. I believe that our healthcare costs way more than it should because we are afraid to fail, and as a result hide that failure through a well practiced set of excuses.



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