Half my town is crammed into our library this morning, getting their fix after 48 hours off the grid, devices plugged desperately into every open outlet after two days without power. Hurricane Sandy, which hit 200 miles south of us, has plunged one of the wealthiest municipalities in one of the world’s wealthiest countries into darkness.
This situation reminds me of a speech Vijay Govindarajan gave us at the Fortune Growth Summit last week. The Dartmouth professor and first professor in residence and chief innovation consultant at General Electric is one of our most forward-thinking innovation gurus. Coauthor of The Other Side of Innovation and Ten Rules for Strategic Innovators, he was there to share his newest book: Reverse Innovation.
He argues that innovations spring from just this type of environment. In countries that have to live without power (we have only endured two days so far) and that must adapt to ongoing poverty, health threats, and populations that overwhelm their infrastructure, a new crop of innovators is emerging.
They include people like a doctor who founded NH Hospital in India, which has applied mass production first introduced by Henry Ford to conduct heart surgeries for $2,000 (in the U.S. heart surgery costs more than $50,000). NH Hospital has a lower 30-day mortality rate (1.8%) than the U.S. average (2%). They will do the surgery for you for free if you cannot afford it, but they still produce 40% gross margins, higher than the Mayo Clinic.
How is this possible? Because the NH Hospital challenged fundamental beliefs that lead most of us to conclude a $2,000 heart surgery cannot work.
False belief 1: Mass production principles can’t work in health care.
Henry Ford realized that if you buy a machine, you should maximize its usage to spread the fixed cost across as many units as possible. Similarly, NH Hospital uses its machinery 25 times more often than we do in the U.S. By creating a "production line" of specialist doctors, they achieve even greater efficiency. The idea of turning something as complex as heart surgery into a production line just somehow feels "wrong" to us. Because it feels wrong, we never stopped to ask whether it really IS wrong.
False belief 2: A surgery assembly line must reduce quality.
When people hear the concept, they assume quality must go down. But would you rather buy a car that was built by hand by one person, or one that was built on an assembly line? We know that assembly lines IMPROVE quality for cars, so why should it not do the same for hospitals?
In wealthy environments, doctors do not need to challenge such assumptions because people are able to pay $50,000. But in India, the choice is more complicated: Challenge these beliefs or let people die of treatable heart problems because they cannot afford $50,000.
Tougher environments give us more reasons, more pressure, to make the impossible possible. This is why historically, innovations come from the harsh fringes of civilization rather than the comfy core.
Dr. Govindarajan shared stories of a doctor in Thailand who can fit an amputee with a $30 artificial leg that in the U.S. would cost $20,000 or more. He talked of a team at GE that turned a $20,000 ECG machine, too heavy to move from the hospital, into a $500 version that weighs less than a can of soda so that rural doctors can travel with it door to door.
Now, the lights in my hometown of Greenwich, Conn., will probably turn back on within the next couple of days. Too short a blackout to make us seriously think about how to prevent such blackouts again. We are too comfortable and lazy to solve the problem.
But what about in your business or in your career? Is your mission not worth taking the time to test whether you can make the impossible possible?
Here is a 15-minute exercise that you can use. I’ve been doing this with clients for about two years now. Last week a technology firm in California used it to realize they really COULD push through a major redesign of how they incorporated client feedback. A week earlier a large consumer packaged goods company in Latin America used it to really see that they COULD create a local supply of a key ingredient, reducing their costs and creating more jobs.
It may seem too simple—or even impossible—to turn impossible ideas into doable ones in just 15 minutes. But I’ve done it maybe 200 times and it works.
1. Think of an idea that you think is impossible (e.g., deliver a $500,000 project for just $50,000).
2. List out the three big reasons you think this is impossible (e.g., it takes too much manpower, people won’t value it as highly at such a low price).
3. For each reason, come up with three ideas, even seemingly crazy ideas, for how to overcome that barrier (e.g., automate the whole thing so it requires no people, have the clients do the work, outsource to Africa).
4. Step back and ask, "Is this really impossible?"
I promise you that nine times out of 10, you will find that what first seemed impossible now seems … well … not that crazy after all.
[Image: Flickr user Barry Yanowitz]