Monday, August 17, 2015

Do Amazon’s Leadership Principles Apply to Health Reform?

Yesterday’s New York Times front-page exposure on Amazon’s leadership principles has made quite a splash ("Inside Amazon" Wrestling Big Ideas in a Bruising Marketplace," Aug. 16, 2015).

The article brings into question whether these principles are too harsh, rely too much on data rather than human relationships, and drive talented people out of the company.

On the contrary, Amazon says. Its CEO and founder, Jeff Bozos, and his followers and investors, claim Amazon has effectively deployed a dazzling array of metric measurements to create discipline among its staff and employees, to select effective leaders, to cut through red tape, bureaucracy, and politics; to focus on outcomes and performance, and to build a premier online high tech company. Amazon employs 183, 000 people and ranks at the number one retail company in the world, now surpassing Walmart in stock market value.

Here are the 14 leadership principles, as explained by Amazon.

1. Customer Obsession
Leaders start with the customer and work backwards. They work vigorously to earn and keep customer trust. Although leaders pay attention to competitors, they obsess over customers.

2. Ownership
Leaders are owners. They think long term and don’t sacrifice long-term value for short-term results. They act on behalf of the entire company, beyond just their own team. They never say “that’s not my job".

3. Invent and Simplify
Leaders expect and require innovation and invention from their teams and always find ways to simplify. They are externally aware, look for new ideas from everywhere, and are not limited by “not invented here". As we do new things, we accept that we may be misunderstood for long periods of time.

4. Leaders Are Right, A Lot
Leaders are right a lot. They have strong business judgment and good instincts. They seek diverse perspectives and work to disconfirm their beliefs.

5. Hire and Develop The Best
Leaders raise the performance bar with every hire and promotion. They recognize exceptional talent, and willingly move them throughout the organization. Leaders develop leaders and take seriously their role in coaching others. We work on behalf of our people to invent mechanisms for development like Career Choice.

6. Insist on the Highest Standards
Leaders have relentlessly high standards - many people may think these standards are unreasonably high. Leaders are continually raising the bar and driving their teams to deliver high quality products, services and processes. Leaders ensure that defects do not get sent down the line and that problems are fixed so they stay fixed.

7. Think Big
Thinking small is a self-fulfilling prophecy. Leaders create and communicate a bold direction that inspires results. They think differently and look around corners for ways to serve customers.

8. Bias for Action
Speed matters in business. Many decisions and actions are reversible and do not need extensive study. We value calculated risk taking.

9. Frugality
Accomplish more with less. Constraints breed resourcefulness, self-sufficiency and invention. There are no extra points for growing headcount, budget size or fixed expense.

10. Learn and Be Curious
Leaders are never done learning and always seek to improve themselves. They are curious about new possibilities and act to explore them.

11. Earn Trust
Leaders listen attentively, speak candidly, and treat others respectfully. They are vocally self-critical, even when doing so is awkward or embarrassing. Leaders do not believe their or their team’s body odor smells of perfume. They benchmark themselves and their teams against the best.

12. Dive Deep
Leaders operate at all levels, stay connected to the details, audit frequently, and are skeptical when metrics and anecdote differ. No task is beneath them.

13. Have Backbone; Disagree and Commit
Leaders are obligated to respectfully challenge decisions when they disagree, even when doing so is uncomfortable or exhausting. Leaders have conviction and are tenacious. They do not compromise for the sake of social cohesion. Once a decision is determined, they commit wholly.

14. Deliver Results
Leaders focus on the key inputs for their business and deliver them with the right quality and in a timely fashion. Despite setbacks, they rise to the occasion and never settle.

Do these leadership principles apply to health care?



Yes, health care needs leadership principles.

Yes, health care needs to be obsessed with patients.

Yes, health care needs to earn the trust of the populace.

Yes, health needs to measure its results, and metrics are one way to measure these results.

No, health care is not a private business and cannot impose its will on its employees.

No, metrics are not the only way to measure value and satisfaction.

No, physicians and other health care professionals are not employees, devoted to carrying out the mission of their employer.

No, health care is not a high tech profit-based enterprise, it is a human relationship between professionals and the American public, who believe a non-profit safety net is an essential part of the human equation.

That said, it Amazon’s leadership principles have much to teach us about the importance of disciple, focus, and data as tools to improve health care performance.

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