SURGEON  are required when growth is starting to decline.

Surgeon leaders must be:

  • “Hold Nothing as Sacred”
  • Fix it before it is broke or replaced.
  • Willing to challenge the folklore   
  • Be Realists and not dreamers   
  • Have the Ability Sell assets at a profit and Find new homes-
  • Be able to take criticism and the heat 
  • Be prepared for success! (Often leaders are surprised themselves when the changes the implement are more successful than they anticipate. This may enable the competitors to prosper even though they were not the cause of changes.)

         I believe that MOST of the U.S. companies have been led by surgeon leaders and have been divesting assets instead of growing them. This compounded by the defensive behaviour of the Caretaker leaders we described earlier. If you look at all of the GIANT companies of the 1950-70 period, like GM, Ford, Xerox, GE, Proctor Gamble and others they are not growing and have liquidated valuable assets, permiting others to take their leadership position. Microsoft, Apple would not exist today if IBM didn't give them ther market and new technologies. Sears should be the Amazon of today, but it is not because they too refused to innovate.

       The result is a consolidation and restructing markets and industries.


        Healthcare is in this mode now. Many of the smaller and regional players have either sold out or merged with "larger brand name" companies. In Connectiut and New York we find many hospitals mergering with larger players. 

        Making inefficient organizations bigger is not a solution but actually makes things worse. I have watched N.Y. Mount Sinai continue to take over one medium and small sized hospital after another and it has become clear that the cost structure, pricing, ability to provide better healthcare has NOT IMPROVED and clearly has added complexity. Several brand named institutions like MAYO, YALE NEW HAVEN, CLEVELAND CLINIC, HOPKINS and many other regional brands have electriced to co-brand and lease space in non-branded institutions. This may work initially but are potential problems if the new branded organizations fall in improving healthcare.