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Source
The Professional's Guide to Value Pricing 2000
Harcourt Trade Publishers, July 1999
ISBN: 0156069938
Comments
Stephen Milgate, ADF
The following quotes are taken from The Professional's Guide to Value Pricing by Ronald J Baker CPA. Some of the quotes in Baker's book are from other authors which have been acknowledged. The book was written for Certified Practising Accountants as a guide to understanding the general principles of business and economics. It is also interesting how Baker marries general business principles with professional accounting practice. Baker favours accountants using the term 'customer' instead of 'client'. He states that the term 'client' is derived from the Latin work cliens, which is a follower, retainer, one who hears his patron. He points out that Walt Disney insisted that his customers be called 'guests' and he referred to his employees as 'cast members'.
The opposite of the word professional is not unprofessional, but rather technician. Professionalism is predominantly an attitude, not a set of competencies. A real professional is a technician who cares (Maister, 1997).
The Spirit of Service: An attitude based on certain values and beliefs about people, life, and work, that leads a person to willingly serve others and take pride in his or her work. It's an element of giving - a spirit of generosity that makes people give something of themselves in addition to just doing the job. It's going beyond the bear minimum or the standard actions. It's being attentive to the person behind the need, and responding to the person more than just responding to the need. It's being there psychologically and emotionally as well as being there physically (Albrecht, 1992:88).
Comment: The recent Australian Doctors' Fund Conference 'Values Based Medicine' reinforced the above view expressed by Albrecht as far as medicine was concerned. This is why you cannot produce a set of guidelines which will embody the spirit of service in a doctor. The continual interference in medical practice by bureaucrats and third parties is most dangerous because it erodes the spirit of service as Deming, the father of quality assurance so rightly taught almost 70 years ago, remove barriers that rob people of pride of workmanship. Eliminate the annual rating or merit system.
Serving people is what being a professional is, or should be, all about. Focus on your customers, and continually solve an ever-increasing share of their problems and burdens. Give as much as you can for a dollar, rather than as little as you can. The profits and rewards you seek will be yours.
Professionals are excellent at solving problems. Sometimes they are even too good, because they tend to jump right into the solution without first discovering what the customer really wants and expects, almost completely ignoring the creation of good feelings that are so essential to developing long-term relationships. Simply offering solutions to problems isn't enough. The customer automatically expects problems to be solved, which is why they seek us out, but more emphasis should fall on creating good feelings.
But the majority of business transactions happen without dishonest intent, based upon mutual trust and respect.
Comment:: And so are the vast majority of transactions involving payments for medical treatment.
Business is about serving others and adding value to their lives in excess of payment in cash.
Business is not about survival of the fittest (ie only the strongest survive), as if Social Darwinism ruled the world of enterprise.
This notion can be disproved simply by looking at where all of the growth and innovation come from in a free market economy the small business sector. If Social Darwinism ruled business life, only the Fortune 500 would exist, since all the money is there.
Comment: This quote I believe has profound parallels in medicine. We have a competition policy in Australia with a stated aim that consolidation ie, big business taking over, will somehow improve efficiency. It will not, as Baker points out. What it will do, is stifle innovation and growth. Medical practice has been predominantly and traditionally a vast network of small individual professional organisations who have managed to produce explosive innovation in medical treatment and quicker and safer surgery. Once upon a time independent community based hospitals had their own local teaching and training facilities which have been largely discarded. I am reliably informed that even autopsies are being reduced in teaching hospitals. The Federal Government is hell bent on forcing consolidation on medical practice. There is a fundamental belief in the bureaucracy that innovation comes from the boardroom. As Baker points out, when big companies merge it is the dinosaurs mating, and mating dinosaurs don't produce gazelles.
The loss of this focus on the customer as a human being is probably the single most important fact about the state of service and service management in the Western world today (Albrecht, 19992:10)
The higher the customers expectations are from the start, the higher the probability of being dissatisfied.
Customers should not be treated equally, they should be treated individually.
Customers judge CPA's not only against other professional in the same trade, but against any organisation that has the ability to raise customer expectations. The customer cares about results, not how results are achieved. Yet most professionals tell customers not what they do but how they do it.
The customer is the ultimate judge of the value that we, as professionals, provide.
Comment: And so is the patient. The idea of a Relative Value Study comparing the value of one procedure against another is so ludicrous because patients do not value a broken leg against appendicitis or a toothache against a broken rib. Also, what the patient values is the benefit of the procedure ie, being able to take my grandchildren for a walk and do my garden is the real value of heart bypass surgery to the sufferer. Coming out of a serious operation alive, is also of enormous value to patients, even more so if it is our children who come out of the operation alive.
Modern Management theory is no more reliable than tribal medicine. Witch doctors after all often got it right - by luck, by instinct, or by trial and error. (Micklethwait and Wooldridge, 1996:12)
Do not accept anything at face value. Be wary of anyone who considers himself an expert, for as Harry Truman said: 'An expert is someone who does not want to learn anything new, because then he wouldn't be an expert.'
Today's customer is more value conscious (though not necessarily price conscious) than ever before.
Today's buyers are More demanding, more value conscious, more knowledgeable about buying, less loyal, deluged by choices, more uncertain about the future, more at risk if a mistake is made, much more cautious. (Davis 1996: 3)
Comment: Many doctors are reporting that their patients are coming to them with information from the Internet. This is a great opportunity for doctors because the doctor is the only one who can let the patient know if the information they have downloaded from the Internet has any validity. There is so much misinformation on the Internet that the doctor may now become an Internet adviser for the patient and hence add value to the consultation in the patient's eyes. Furthermore, all doctors are now able to have their own website and talk to their patients via email. A service of importance to loyal patients, particularly those with chronic illness and another way of adding value to the relationship.
Fortunately, customers are beginning to regard their CPA as a sort of financial psychiatrist.
Yesterday's profit and loss statement is as useful in foretelling what tomorrow may bring as poking into the entrails of birds or dipping tea leaves. (Buckley, 1996: 38-39)
Comment: So many decisions about health care are now being made on the same reports.
If you aim to profit, learn to please. Winston Churchill.
The successful producer of an article sells it for more than it costs him to make, and that's his profit. But the customer buys it only because it is worth more to her than she pays for it, and that's her profit. No one can long make a profit producing anything unless the customer makes a profit using it.
You're not really in business to make a profit, but you're in business to render a service that is so good people are willing to pay a profit in recognition of what you're doing for them.
Comment: The unwillingness of buyers to purchase health insurance is based on this simple observation. They do not perceive it to have value particularly when compared with their compulsory membership of Medicare. The patients know that the doctors are the only ones that add value. All other resources in health care are made productive by the medical practitioner. This is why the health funds are desperate to build the value added by the doctor into their product by contract and control. Advertisements pushing the value of Medicare always show doctors in hospitals doing things for patients. What patients want is unfettered access to the best GPs and specialists. That is why managed care will ultimately self destruct because it runs contrary to what patients want and that is unrestricted choice.
NB: I have included some of my own comments and would welcome any comments you might care to make.
Stephen Milgate
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