Avoid “Just This Once”

I look up to Clayton Christensen, and not just because the fellow is as tall as a tree. You may know him from his book The Innovator’s Dilemma, or you may have seen him on the speaking circuit as a Harvard professor. He threw a curveball this year with one of the best articles I have ever read, “How Will You Measure Your Life?” published in the Harvard Business Review (and yes, the summary is in this month’s Reader’s Digest).

The piece that really caught my eye was a section about “just this once.” He throws in all kinds of ideas about marginal cost, but the bottom line was that it isn’t worth it to give in and do something wrong “just this once.” His lesson is that it is easier to hold to your principles 100% of the time rather than 99% or 95% of the time where you have to decide and re-decide every time if you will keep your principle. He shares the story of the time he had to decide if he would play in a prominent basketball game on a Sunday, after he had committed as a youth to never do that. There certainly were extenuating circumstances that would have allowed him to break his commitment, but as he says, there are always extenuating circumstances.

How does this apply to healthcare IT? Just look at the software vendor that normally sells to customers they know they can satisfy. What happens when “just this once” they sell to someone they know is likely to not be successful, but they do it anyway? What about the healthcare provider that negotiates a vendor down to a cost so low that they know there is no way the vendor can work with them profitably? Or the provider that cuts out most of the training or post-live follow-up services from the contract? It is easy to say “Just this once”.

I do the same thing. “Just this once,” I thought this morning, “I am going to sleep in and not go running.” (Not a good plan for a diabetic.) It was only 12 degrees outside, which seemed like a good reason to skip. I got up. I ran. And I know I will have to deal with the “just this once” curse next week or until I get to Christensen’s 100% theory.

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