When It’s Your Move

Posted on June 6, 2012


In chess, white moves first. This can set the tone for white to be on the offensive, and black the defensive, the entire match, or it can be a minor detail in the outcome. Offense or defense. It is important to remember what position you are in each day.

One of the most comical memories of my soccer playing youth came in high school. Our opponent, a small school where soccer was a sport that carried significance akin to a football or baseball team, traveled with their cheerleaders to our field. As I was warming up during the game, one of the opposing cheerleaders asked me if our team was on offense or defense, which obviously had a big influence on the type of cheer the squad was going to perform. I said soccer wasn’t like other sports; offense and defense is always changing.

I recently spoke with a senior director of a large regional healthcare system. We were discussing real estate strategy for healthcare.  I asked him if land was acquired systematically prior to a planned need, and how an ultimate use is decided upon when the system could build almost anything in certain cases. He said real estate is a single transaction executed on a case-by-case basis.  To treat it any other way complicates things, especially the emotion of really wanting a particular deal to get done. He said his decision comes down to market share:  are you offensive (the leader trying to maintain a position) or defensive (the upstart trying to gain a position)?

Healthcare shares much of the market fluidity as the soccer example above:  offense and defense can change frequently, and are often matters of aspiration—where do you want to be—or at least subject to perspective:  where you think you are. You can occasionally position your hospital as the underdog internally, even if you are a market leader in some cases. This is part of the mental game commonly mentioned by sports psychologists.

Offense or defense matters in all aspects of healthcare strategy, and especially when a capital project comes around. Hospitals must address their system’s aspirations, not simply the functional project goals (most any team can achieve those), and figure out who is the best partner to execute the strategy. It may not be the same team you have been using, especially if you need to switch strategy gears and go from defense-to-offense or offense-to-defense.

For example, several years ago Haskell’s client, a non-profit healthcare system, and its across-town competitor each embarked on a new hospital project.  The Haskell team made up a three-month head start by the competing, for-profit system, and both hospitals opened within 24 hours of each other.

This is an illustration of how quickly defense and offense can change in healthcare, and more importantly, how valuable the right project partner can be to your strategy. When it’s your move, how will you determine your best strategy and the best team to execute it?