Alternatives Now Industry Norms

Posted on October 7, 2011


Sometime in the 1980s “alternative rock” came to prominence as a fresh, different yet appealing sound from traditional pop music that had dominated radio play. Alt-rock bands produced music that catered to distinct subgroups of fans, some of which enjoyed their music with more folk, goth, poetics, anger, or more electric guitar—there was a very visible rock genre that catered to large subsets of the masses.

Maybe the transition was inevitable, but as the alternative rock sound grew in demand, more groups began producing it, and it then appeared in the Billboard Top 40, which ironically meant it had become “popular”. Philosophically, people argued whether something is alternative anymore once it becomes mainstream. In fact, the underground and outliers like Bob Dylan and Pink Floyd were and are always present, but it takes some gravity and presence to officially be labeled “alternative” in your industry. It means you have been recognized, and recognized as creatively different. This similar transition is happening in healthcare.

What everyone has previously identified as alternative simply because it was not traditional is now more common. Why is this? Because, like music, alternatives cater to a larger subset of the healthcare industry in a more successful way than the one-size-fits-all, traditional means.

Now the business “alternatives”—in energy, in financing, in project delivery, in ownership, in medicine—are growing and recognized as more applicable to more hospitals and systems. What we all must question, as the music industry did when alt-rock debuted in the Top 40, is whether the popularity of alternative methods means a paradigm shift?

For instance, alternative financing. In the past, any healthcare project financed by anything other than a bond or bank loan was “alternatively financed”. With traditional funding now nearly suspended, most hospitals must get more creative in getting buildings built. Some would argue traditional bond financing can never be counted on again. And with much more evolved lending standards, the alternatives now become the new norm.

Likewise with project delivery. When money was no object and inflation from the construction schedule did not affect the project cost like it does now, traditional design-bid-build (DBB) was fine. Now hospitals want schedule and cost control through design-build, IPD, design-assist—by any means necessary whatever it is called—which is why alternatives to DBB are now the majority of the market. Again, the alternatives have become the norm.

Given the speed of innovation, anything labeled “alternative” does not remain that way for long. Something new either gets adopted because it has improved benefits, it evolves into something with improved benefits, or it dies a quick death because it does not offer improved benefits. Each hospital is different and the best solution for one hospital will not be the best for another, even if they are right across the street from each other. Hospital administrators must be wary to take no decision for granted, and set history, ego and fait accompli aside, to explore all options, all alternatives.