Souls Served
There are 155 souls on board.
Caring for others is a calling that so many have answered. Over time, countless doctors, nurses, and all of the others that support care have been organized into various company structures with highly variable economic models. Most modern health systems operate under a nonprofit structure. These health systems for years have been referred to as $25B ABC Health or $3B XYZ Health System.
There are annual rankings that are published as an indirect measure of scale and mission impact. This convention has insidiously become a badge of honor with CEOs often touting both the current size as measured in billions of dollars and a mystical future size that the organization must strive for as if scale is the only way the mission of the company can grow.
This has happened for a lot of reasons. The regulatory environment has made it harder to survive on the minimal margins. The bond ratings drive behaviors and the cost of money literally. The asymmetry in information between the various parts of the health industry have driven byzantine pricing and administrative burden. All of this has combined to draw healthcare leaders into increasingly treating healthcare like a business but the reality of that business is not an ordinary one.
The people we serve in healthcare visit us on their worst day. Often they are declaring an emergency. It made me think of the moment when an airplane declares an emergency. One of the questions the tower will ask the pilot is, “How many souls are on board?” The pilot will calmly respond, “There are 155 souls on board.” You will note they don’t ask for the plane’s annual revenue or its maintenance record.
How about we take that same approach with health systems and instead of saying ABC Health is a $25B system, we say ABC Health is a 1.5M soul health system. This doesn’t replace the need to measure, track, and carefully manage revenue, margin, and liquidity to ensure financial viability. Souls served can effectively measure growth in a more nuanced way consistent with the actual mission than revenue. Also, souls served more closely reflects the gravity of what we do and the calling.
When we describe a health system, what if we all committed to stop leading with the dollar figure and start leading with souls served? This simple change in a word from billion to soul just might gently remind us what matters most. The words we say and hear matter. Let’s focus on souls served and the rest will follow.
Written by Hank Capps, MD