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By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates, Dallas
Here is a mental challenge for you: Make the switch from the not-for-profit sector to the "interesting" culture of the corporate for-profit milieu. Those of you who have gone through this culture shock will appreciate what I’m talking about. Even if you don’t anticipate having your department or surgery center merging into a joint venture or being bought outright, this could be helpful by showing you the "best" and "worst" of the other side. There is a different (not necessarily better) mindset in the corporate world. I made the switch about 18 years ago, and I’m still assimilating the rules. Some of the changes are invigorating, and others are tedious and stupid. You determine which.
• Meeting. Not-for-profits love to have meetings. What is that all about? I will never understand the importance of all these meetings. I try seeing some good in them, but most of them accomplish absolutely nothing and just waste time. I used to have seven to 10 meetings a day when I was in the not-for-profit environment. Since I left 18 years ago, I have had — I don’t know — maybe five? In my own firm, meetings are not allowed. We just met on that, and all agreed.
• Budgets. Here is a big difference. In the not-for-profit world, while budgets are important, the person inputting the information often does not have accountability or responsibility for the outcomes. Often numbers already were determined by some VP who has never been in an operating room but spent the night at a Holiday Inn Express and therefore knows more than you. Not good.
In the for-profit/corporate sector, the budget number is "backed into," meaning you have to go from the profit they expect to see and work backward to make it happen. Not good. If you miss your numbers in the not-for-profit world, you will be chastised or told to "Get it right next year!" In the corporate environment, a public execution is likely.
• Phone calls. The not-for-profit world does not return phone calls. (They’re in a meeting.) The for-profit sector returns long-distance phone calls when they know the person is out to lunch so they can leave a message for them and not have to pay to toll charge for a long call.
• E-mail. Pretty much standard to both groups with subtle differences. Not-for-profits use it primarily to set up meetings.
• Passing the buck. The not-for-profits have this mastered and should give lessons to the for-profits. It is rare to find someone who admits they screwed up in the not-for-profit section. Conversely, it is rare to find someone who has not screwed up in the for-profit world.
• Instant messaging. For-profits have this mastered for communicating: It’s faster than phone calls. Not-for-profits should check out this service. It might eliminate a meeting. You can get it free at www.aol.com. (Under "People and Chat," click on "AOL Instant Messenger.") Or ask your kids; they’ve been using it for a long time.
• Paper correspondence. Not-for-profits still have secretaries who type letters and do memos. For-profits cannot afford a secretary, and they do their own e-mail.
Again, these are just some of the differences I have observed. You might have others. Send them to me.
(Editor’s note: Earnhart and Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Earnhart can be reached at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: firstname.lastname@example.org. Web: www.earnhart.com.)