Why 'and' is more powerful than 'or'

Foreground and background

One of my clients is a Catholic order of nuns that operates a large national network of hospitals and aged care services. As part of their strategy process, I asked them, “Who are you here for?”

Their answer was, “Everyone. All people are God’s children and therefore we don’t exclude anyone”.

Now, on the surface that makes sense, but I dug a little deeper. Of course their hospital emergency departments see every case that walks (or can’t walk) in. But, I asked, “Are there those who?need?your services more than others?”

That led to a much deeper conversation on the nature of vulnerability and ended up with them identifying three priority groups:

1. Women in precarious situations, often related to family violence;
2. Older people who live alone, and have no family or supports;
3. Families from cultural backgrounds that speak little English.

The logic was this: these groups experience disproportionate powerlessness. From a ‘mission’ perspective, these are the people God wants the nuns to serve. From a pragmatic perspective, these are the people whom the government wants to serve: if untreated and unsupported, they will have burdensome and costly future health needs.

But even this deep conversation led to something more fundamental, which was about exclusivity. One executive member asked, “Does this mean we should turn away people who are NOT those groups?”

Her ‘zero-sum game’ approach failed to appreciate that these ‘priority groups’ are?not?literally that. Rather, this identification gives them spotlights to shine upon certain groups, which then modifies the way in which they attract patients & residents, design services, and deliver care.

The final ‘a-ha’ moment came when another executive said this: “Isn’t it true that, if these women, families and older people are served well, then that type of targeted care benefits everyone who comes through our door?”.

Precisely.

Question: How do you prioritise without eliminating?

Explaining complex things in empathetic ways

I read?a fabulous article?this week describing how a doctor uses ChatGPT not to treat patients, but to communicate with them.

Josh Tamayo-Sarver is an ED physician who has to make numerous rapid clinical decisions, and explain these to concerned patients and family members. Sometimes the family members get belligerent if they don’t understand, or if they feel Josh doesn’t understand them.

In a recent case, he had a 96-year-old woman who had difficulty breathing because of fluid on the lungs. Her children (all in their 70s!) kept questioning why Josh didn’t administer IV fluids. They didn’t understand his reasoning and kept asking him to put her on a drip, becoming increasingly distressed that he wouldn’t do so.

In frustration, Josh went to ChatGPT with this instruction: “Explain why you would not give IV fluids to someone with severe pulmonary edema and respiratory distress even though you might be concerned that the patient is dehydrated. Explain it in simple and compassionate terms so that a confused person who cares about their mother can understand.”

Within seconds, ChatGPT gave him this:

I truly understand how much you care for your mother, and it’s natural to feel concerned about her well-being.?

In cases of severe pulmonary edema and respiratory distress, it might seem like giving IV fluids would help with hydration, but it could actually make her condition worse.?

When someone has pulmonary edema, their lungs are filled with excess fluid, which makes breathing difficult. If we were to give your mother IV fluids, it could potentially increase the fluid in her lungs, making it even harder for her to breathe and causing her more discomfort.

Our primary goal is to ensure your mother’s comfort and well-being. The medical team is dedicated to providing the best possible care for her, and they will closely monitor her hydration levels while using other treatments that are more appropriate for her specific condition.

Please know that your mother’s health and comfort are our top priorities, and we are here to support both of you during this difficult time. If you have any questions or concerns, don’t hesitate to reach out to the medical team.?

We are all in this together, and we’ll do everything we can to help your mother recover.

Josh printed this out, gave it to the family members, and read it to them. They immediately relaxed. When they had questions, he reminded them to re-read it. They did and stayed calm.

Is this perfect? No. Did it rapidly give Josh the ability to settle people’s qualms and get on with other life-saving activities? Absolutely.

Question: How could you use AI to generate the empathy you?want, to add to the facts that you?need?to share with your clients?

Analysis or insight?

I do 30 to 50 strategy projects a year and always start with this definition: “Strategy is a set of?insights?from which we build a?framework?to guide your future?decisions”.

The first keyword is?insight, and I ask my clients to generate insights on four things: (i) their environment (“What’s going on around us?”), (ii) their identity (“Who are we, fundamentally?”), (iii) their focus (“Where do we invest time, money & effort?”) and (iv) their results (“What does success look like?”).

But I sometimes encounter clients who want to replace insight with analysis.

“We need a competitor analysis”, they’ll say. Or a PESTEL analysis. Or a revenue analysis. Or a customer segmentation analysis. Or a staff performance analysis.

My response is always the same: “What will that analysis tell you that a group of well-informed and experienced executives don’t already know?”

My experience is that in the vast majority of cases, boards with executive teams already know the answers to the 13 questions I’ll typically ask them. So, why this reliance on analysis?

Now, don’t get me wrong: analysis is invaluable when you’re trying to work out operational issues, like which customers are coming to you most often, or which programs get the best results. But analysis is a security blanket: people like to feel they’ve got data to back up their intuition.

But, we’re asking ‘analysis’ to do more work than it was designed to do. Recall that analysis is the “detailed examination of the elements or structure of something”. That is what’s needed to build bridges, or develop a new drug, or win a complex legal case. It’s NOT what’s needed for strategy. Insight is.

Question: What analyses can you dispense with, without?any?effect on the quality of your insights?

Let me know you’ve read to this point by clicking the ‘Like’: I love to know you’ve enjoyed reading. And, use the questions above with your teams to get their strategic minds in gear. Let me know, too, about your favourite strategic questions to ask.

Over the week ahead, think about all the ways in which ‘and’ is more useful than ‘or’, and I’ll see you next Friday.

Andrew