More about scale: Shared appointments and Passion

A few weeks ago I posed the question of how to scale operations in health care. This topic came from reading In the Plex by Steven Levy, a book about Google and their history of managing the scale of operations to support their vision of searching the internet. Since then I have continued to toss around the question to friends and colleagues. How do you take an operation that is sequential, one patient after another and methodical within the visit with the patient, and scale it so it retains quality and personalization? Right now I still don’t have the answer. However I have two concepts that might contribute to an answer. These concepts are shared medical appointments and passion.

Shared medical appointments (SMA) is a model being used by Harvard Vanguard where a group of patients are seen at the same time by the same doctor. They are applying the concept to groups that are homogeneous (have the same medical condition) and heterogeneous. Preliminary research results indicate higher quality and patient satisfaction with lower cost (Noffsinger). From the perspective of face validity this makes a lot of sense. One big challenge for medical practices is having the space for the SMA. Medical offices are cut up into small rooms designed for the sequential individual visits. Where can you hold a SMA for 25 people? If you move too far from the exam room space you can’t reach the equipment needed for some individual care and testing. We need more flexible space in medical offices, like what you find in hotel meeting rooms. Movable panels that can rearrange space quickly to flex with the demand.

Another concept became evident today when I was reading the RSS feed from FastCompany. The article was on a new concept for a nail salon. Why it caught my eye I can’t be sure. However in reading the article the owner of MiniLuxe was asked about scaling franchise operation that retains the quality in the vision of the organization. Sue Thirlwall, the owner,  responded by saying that the key is to find a franchise operator who will embrace and have a passion for the business in the same manner as she does. Maybe this is part of the answer. Scaling the operation requires a passion for the vision. It is passion that carries the work forward despite obstacles. What is work without passion anyway?