Wandering in the desert. Lessons from a life in health care

A physician executive who's worked in many different areas of health care explains the nearly universal problems he's encountered with the "broken" system. He also suggests ways to fix it.     

Crafting business models for conflicting goals: Lessons from creative service firms

The business model construct has become attractive to both managers and academics. It reflects how the most important organization's strategic and tactical choices regarding the allocation of resources interact in order to create and capture value. Yet with the growing entrepreneurial complexity, managers often end up pursuing conflicting and even paradoxical strategic goals, thus rendering the business modelling processes more complex, too. Well-known examples are profit versus social value, stakeholder versus company interests, exploration versus exploitation and environmental sustainability versus economic returns. The academic business model literature so far has provided limited insights on how to implement business models beyond a single goal and focused mainly on the initial strategic choice of a business model, ignoring that such salient tensions are often persistent and resurface within the business practice. In this study we leverage paradox theory to investigate how managers of creative firms make tactical choices to accommodate (not solve) salient tensions within their business models, focusing on the domains like services provided, choice of clients, networking and resourcing practices, revenue models and new venture creation. Based on qualitative case study research, we found four integrating and three differentiating decision-making tactics that managers deploy to create both economic and creative value through their business models. Adding to the business model theory, we show how business models are crafted in managerial practices by making tactical decisions to solve conflicts and paradoxes. The results equally enrich the paradox literature by providing for tactical-level approaches toward working through the paradox.     

Lessons from industry.

Rapidly emerging in public debate as the key to the future of the health care industry is quality. One can hardly pick up a health care magazine or journal or listen to a discussion among health care professionals without quality becoming a concern. Despite virtually universal agreement on the importance of the generic term and secondary agreement on the importance of being able to measure it, discussion bogs down in either of two ways. It may become overwhelmed by the sheer magnitude of the task of describing all the elements of health care quality, or the different viewpoints of individuals will yield quite variable understandings of what the term "quality of health care" means. To make substantial progress in improving health care quality, we will need to come to an agreement on terms.     

Revisiting the relationship between ownership and control in international business operations: Lessons from transition economies

This article develops a conceptual model linking two interrelated dimensions of foreign business operations in transition economies: resources committed to the entry in terms of ownership, and resources committed to control the operations. The model outlines four types of foreign operations in transition economies: 1) arm's length contractor (low degree of foreign ownership and low level of foreign control over the operations); 2) hands-on contractor (low ownership and high control); 3) brand protector (high ownership and control); and 4) market share maximizer (high ownership and low control). These types are illustrated with examples of companies in four sectors of the Russian economy: metals, textiles, oil products, and beverages.We contribute to the literature on ownership and control in foreign operations, and their linkage to resource commitment at different stages of operations. In particular, we explicate situations characteristic of transition economies where ownership and control are not positively correlated. Moreover, we illustrate that the (financial) resources committed at the entry stage do not necessarily correlate with the managerial resources committed to the operations. For example, contractual collaborations in transition economies typically require few financial resources but more managerial resource commitment than in more developed market economies. On the other hand, operations with major commitment in the form of foreign equity investment may be managed autonomously by a local manager or a minority shareholder.     

The challenges of sustainable development: Lessons from Ontario Hydro

Ontario Hydro, the provincial electric power corporation of Ontario, Canada, positioned itself to become a leader in sustainable energy development and use (SED) in 1993. Despite its original strategic vision on sustainable development and commitment to developing renewable energy technologies, the corporation ultimately failed to achieve its goal and failed even more prominently in its attempt to become an industry leader.This article tracks the formulation and implementation of SED at Ontario Hydro from 1993 to 1997, outlining how this experience has improved the corporationís understanding of sustainable development and the management of the process of organizational and social change. It delineates the chain of events that led to Ontario Hydro's failure to implement SED, emphasizing the importance of developing and maintaining a corporate-wide definition of sustainable development that is fully integrated with all other business processes and activities.     

Lessons from the Australian system

International experiences are becoming more relevant as the Clinton Administration searches for answers to America's health care problems. While interest is focused on the Canadian and European experiences, a brief look at far away Australia offers some potentially useful insights.     

Productivity: Lessons from Japan

The purpose of this article is to compare Japanese productivity on an industry basis with the U.S. and European companies, and then to examine the factors and methods that underline the Japanese success to determine what, if any, lessons Western companies can draw from the Japanese approach.     

Cinderella purchasing transformation: linking purchasing status to purchasing practices and business performance

This paper contributes to the on-going debate about the relevance of the purchasing function for the firm value creation. We empirically examine the role of the purchasing function in improving business performance through an international survey based on 653 responses. Results suggest that purchasing practices related to spend rationalisation have a positive impact on the overall business performance, whereas supplier development & integration and sustainable purchasing have not. Moreover, the purchasing recognition by top managers and other organisational units emerge as a powerful antecedent of all purchasing practices. Instead, pure formal authority provided by the position in the organisation chart (i.e. the report level) does not have any influence on purchasing practices adoption.     

The state of global environmental reporting: Lessons from the global 100

Global economic corporations have global environmental responsibilities that include reporting that extends to their entire global operation. The 1999 Benchmark Survey of The State of Global Environmental Reporting surveys and compares the global reporting practices of the largest one hundred corporations in the world. Global environmental reporting is increasing and is now standard among firms in the electronics, automobile manufacturing, and chemicals sectors. From the 1998 survey to the present, the number of global environmental reporters rose from thiry-nine to forty-four firms. If one discounts the minimal reporting among financial services firms, sixty percent of the Global 100 produced a global environmental report (GER). The quality of reporting also increased dramatically in key areas as Global environmental management system (EMS) standards and specifications and global use of Design for Environment (DfE) and Life Cycle Analysis (LCA) tools increased.     

Reflections from philips electronics,N.A.: Lessons from winning the WEC gold medal

Several years ago I went to a lecture in which documentary film maker Rick Burns described his new film on the history of New York City. He mentioned that his biggest challenge was to identify a theme—an element that was a common thread in the history of the city which he could use as the focus for the documentary. (He finally decided that the theme would be “money.”)To develop the theme for Philips Electronic's application for the World Environment Center's (WEC's) Gold Medal Award for Corporate Environmental Excellence, I encountered the same challenge as the film maker. What theme would I use for a company which is diverse, decentralized, and has a worldwide presence? While Philips was doing many worthwhile things and had significant accomplishments, how could I put that in a package which would be coherent, cohesive, and understandable to the independent judges from around the world?     

Can business learn from wargames?

The value of planning, particularly strategic planning, has long been recognized by both the military and business. Recently, the military has made significant contributions in the area of strategic decision making through the use of war games. Business managers may be able to expand their strategic decision-making judgment by employing the wargaming technology developed by the military. If the wargaming concept is embraced by business, it must serve, as it does in the military, as an aid to decision-making rather than as the decision itself.     

European management and European business schools: Insights from the history of business schools

This article looks at the history of business schools and identifies specific characteristics that are common to European management schools. On the basis of these characteristics, European management is subsequently defined as a cross-cultural, societal management approach based on interdisciplinary principles. In a final step, a closer look is taken at how European business schools should prepare their students for the unique European management context. It is suggested that such schools should provide courses on cross-cultural management and courses explaining the interdependencies between the private and public sector, offer students opportunities to experience other cultures over the course of their studies, and teach management from an interdisciplinary and practically-oriented perspective.     

斯柯达转型之谜

在很长的一段时间里，总部位于捷克的斯柯达都是一家名不见经传的公司，可就在不到15年的时间里，这家公司便实现了转型，从一个行业笑料发展成了一家颇受尊重的汽车巨头。秘诀何在？答案是：质量，知识转移，资本价值，时机把握，上市速度。     

Lessons from the trenches in physician integration

Beyond the theoretical basis for integration, three core considerations stand out as the primary reasons for pursuing integration from a physician's perspective. In the authors' experience, the ability to make a case for physician integration stands or falls based on the ability of the integrated delivery system to address these considerations: Gain greater access to capital; develop human resources with talents in managed care and the full spectrum of care services; and sustain an information infrastructure. This article explores the lessons learned in pursuing physician integration.     

Lessons from planning in Yugoslavia's tourist industry

The post-war history of tourism in Yugoslavia is briefly described. Three main conclusions are: (1) that uncoordinated development of a tourist sector can lead to gross imbalances between, for instance, parts of the country or the kind of tourist being attracted; (2) that providing the right incentives can lead to rapid growth in tourism; and (3) that the direction in which such incentives can move the industry is not always the ideal one. These and other lessons may be relevant to other countries building up their tourist sectors.     

Lessons from the Soviet health care system

The United States and the former Soviet Union have historically organized health care delivery systems according to totally different paradigms. These two divergent approaches have constituted a kind of natural experiment. At the present time, our systems may be becoming more alike, with the former Soviet system decentralizing and even experimenting with forms of medical insurance. Our system, on the other hand, has become much more regulated and, if some have their way, would become increasingly monopsonistic. At this critical point, it may be useful to learn from each other's experiences as we plan for the future.