March 22, 2023 • 23 mins
Jobs to Be Done is a framework to better understand consumer behavior, and it can be used to explain patient behavior when it comes to engaging with the medical system.
Join Jay Gerhart, Vice President, Innovation Engine at Atrium Health, and host Ann Somers Hogg as they discuss the power of Jobs to Be Done to help us see what the patient really wants.
References:
- Competing Against Luck
- Christensen Institute resources:
- https://www.christenseninstitute.org/jobs-to-be-done/
- https://www.christenseninstitute.org/blog/new-entrants-in-womens-health-are-changing-the-rules-of-the-game/
- https://www.christenseninstitute.org/blog/abortion-imperative/
- Scott Burleson: https://www.statueinthestone.com/
- Jim Kalbach: https://www.jtbdtoolkit.com/
- Jay's writing on Jobs: https://medium.com/things-jay-writes/jobs-to-be-done/home
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ann (00:01):
A lot of leaders and innovators talk about disrupting health care,
but what does that really mean? And how does one
actually do it on life centered health care? We dive
into these questions and more talking to innovators who are
leveraging Clay Christensen's theories to transform our health care ecosystem.
I'm Ann Summers Hogg, senior research fellow of health care
at the Clayton Christensen Institute. And I hope these stories
(00:23):
help inspire you along your journey to transform health and care.
Welcome back, listeners, to the second episode of Life Centered
Health Care. Today, I'm thrilled to welcome innovation expert and
my past colleague, Jay Gerhart to the show. Jay is
vice president innovation engine at Atrium Health. And among his
(00:44):
many talents, he is a health care strategist, podcast producer
for a Sherpa's Guide to Innovation, an innovation educator and
an improv master. And also, as you'll hear from Jay today,
he is also a leading job's to be done practitioner.
And I'm thrilled He's joining us to share his experience
with each of you during our conversation today. Jay and
(01:06):
I will geek out about jobs to be done, what
it is, how it explains consumer behavior and why it's
useful in health care. If you follow our writing at
the institute, you'll be familiar with the concept of jobs
to be done. But for those who may be new
to the concept, I'll provide just a brief overview before
jumping in to questions for Jay. But before I do that,
(01:26):
I'll pause and say, Welcome Jay, and thank you so
much for joining us today.
Jay (01:30):
Thanks, Ann Summers. Really appreciate being here with you. Some
of that introduction was a little too generous, but I
appreciate it nonetheless.
Ann (01:39):
Perception is reality, and that is my perception of you.
Jay So therefore, think I think it was spot on.
Jay (01:45):
Let's go with it then.
Ann (01:47):
Okay. At a high level, jobs to be done is
a framework for better understanding customer or consumer behavior. And
while conventional customer segmentation often focuses on demographics like how
old someone is or what their income is, what their
gender is, something like that. Jobs goes beyond these superficial categories,
(02:09):
and it actually exposes what we refer to as the
functional social and emotional dimensions that explain why people behave
the way they do and in purchasing behavior. That's why
they make the choices that they do. So, in brief,
a job is the progress someone seeks in a struggling situation.
And we call this situation or circumstance an individual's context.
(02:32):
So a job to be done has two parts the
progress someone is seeking and the context that they are
within an individual's hire products and services. That is, they
pull them into their lives in order to get a
specific job done. And then when a new product or
service comes along that serves their job better than the
old solution did, that individual will hire the new product
(02:55):
or service and they'll fire the old one. So why
at the institute do we believe that this framework is
so important? In his book, Competing Against Luck, late Harvard
Business School professor Clay Christiansen highlights that understanding and organizing
around customers jobs is what enables organizations to succeed in
the long run. And that's because organizing around the job
(03:19):
makes it significantly harder for new entrants to the market
to disrupt the organization that has organized around the job. However,
the flip side of that, organizations that focus inwardly on
their own products or services are effectively competing against, hence
the title of the book. So for listeners who want
(03:39):
a deeper dive on jobs to be done, then we'll
be able to cover today. I highly suggest reading Competing
against Luck. You won't be disappointed. Excellent stories throughout in
many apply to health care and are specific examples of
how jobs to be done provides value in health care. Okay,
so with that background, I want to turn the mic
over to you. And I love to start with why.
(03:59):
So could you tell listeners why you use the jobs
to be Done framework in your work?
Jay (04:05):
Well, I think, as you know, because you were right
there at the beginning with me, I guess it was
maybe seven ish years ago I was making a career
change within Atrium Health and I was going from our
strategy and planning group into innovation. So I guess I
originally hired it as a framework because I didn't have
(04:25):
a way of seeing customers, consumers. Sometimes they're not the same.
I may interchange those two words a little bit. In
my prior work with strategy and planning, I had all
sorts of frameworks and tools, as you're familiar with, Swat
analyzes play to win all these things. So I had
a way of thinking about strategy, but I wasn't heavily
(04:47):
thinking about consumers and and customers. I think the work
actually was a little bit more supply side focused around
products and services. I was helping figure out where to build. Hospitals,
how to make them bigger, how to develop service lines.
So I didn't have that need to have a way
of seeing consumers and customers because it wasn't so much
(05:08):
my my role in the organization. So what Jobs gave me,
I think it's interesting to use the word framework and
think about what do you call jobs? Is it a theory?
Is it a framework? Is it a tool? I think
the answer is yes. It's all of those things. And
I think why it's valuable is it's not just a
tool or a framework. It's a mindset. There is a theory,
(05:33):
as you said, for customer customer behavior. Scott Burleson is
a leading thinker on jobs to be done that I've
gotten to know a bit over the past year or so.
And he calls it a philosophy. He calls himself a
job's to be done philosopher. And with philosophy you have
a set of principles. So, you know, things like people
(05:55):
hire a product or fire a product and they're they're
not actually seeking that product. They're thinking what will do
in their lives. So if you have these principles and
a philosophy, you can think about it that way. So
I go back to it's a way of seeing, but
then it also gave me tools because I didn't know.
(06:16):
I didn't know how to talk to people, to humans,
to ask them about products and services. I don't think
I had ever interviewed a consumer in what I did.
I worked with lots of spreadsheets, but I didn't know
how to talk to them. So jobs in our work
with Bob, Mr. gave me the ability to do that.
(06:36):
But I would say it gave me it gave me
a lot of different things. Again, framework tools, a lot
of rigor and just a new way of both seeing
and doing that I had never had to do in
my career before.
Ann (06:48):
I love how you opened that with you didn't have
a way of seeing consumers and that it helped you
to see the people that you're really serving. And it's
funny that you brought up what we what do we
call it? Do we call it a theory? Is it
a framework? And I struggle with that as well, because
as you know, especially when working inside an organization focused
(07:09):
on operations, the word theory doesn't always resonate and isn't
really always welcomed. So I really liked how you use
the word philosophy because it's a mindset, it's tools, it's framework,
it's a theory. But that is a broader way to
think about the toolkit of components that the jobs to
(07:30):
be done lens provides.
Jay (07:33):
Yeah. And that way of seeing Jim Kobach is another
leading jobs to be done thinker. And in his book
The Jobs to Be Done toolkit he talks about Copernicus
back in and I think 1540 or 43 you know
previously the traditional way of seeing was that the earth
was at the center of the universe or the galaxy,
(07:55):
and the sun would go around it. And Copernicus proves
mathematically we'll know that's not the case. The sun is
actually at the center and planets revolve around it. So
in that we had this mindset before where our our
organizations and our brands are at the center of everything.
That's where jobs is. A mindset is flip this mindset
(08:17):
where the customer is at the center and companies have
been saying that for a long time. They've been saying
consumer centric. This is a more rigorous way to structure
and think about method, language, tools, all of that.
Ann (08:31):
But that leads me to my next question, which was
what is it about jobs to be done? Or this
new way of seeing and thinking that provides value to
your work?
Jay (08:41):
I mean, I go back to the the structure of it.
It provides mindset, language and and tools. And I think
for a health care organization, you know, in health care,
we've been talking about patient centered care for a long
time and we've been trying to become more patient centered.
But but jobs actually gives us a way to do
(09:03):
that in a more rigorous fashion. And again, if we
have that mindset where we're less at the center of things,
health care is a very expertise driven industry, as we
all know. It's complicated, it's very complex. So we think
about ourselves a lot. And when I'm teaching jobs, actually
(09:24):
one of the very first things I do is I
put a quote out there from Louis, hopefully get this right.
Humility is not thinking less of yourself. It's thinking of
yourself less. So it's this shift from supply side thinking,
thinking about products and services and how we deliver them
(09:46):
to demand side thinking about what our customers need. And
it gives us that that mindset. I was in a meeting,
I think it was last week, and it was with
our medical group. We had a lot of physician leaders,
administrative leaders, and we were talking about how to become
more consumer centric in our digital journey. And one of
(10:10):
the physicians in the room I won't say on the
podcast who it is. I'll tell you later who it
is because you'll appreciate it. We are having a little
bit of a supply side conversation. It was a little
bit about our internal processes and this physician said, Let's
look at this from a jobs to be done perspective.
And my heart just overflowed, you know, because when when
(10:35):
we have people that we've taught this mindset and the
tools and they bring it up unprovoked, you go back
to your question, why is this valuable? It flipped the conversation.
The conversation immediately became less about some of the constraints
we had internally, our physician schedules, limitations of our digital tools,
(10:57):
and got to be much more about what the individual
is trying to do. Because when talking internally, we have
goals as health care systems. We want people to use
our portals, my chart, that sort of thing, utilize those things.
That's not what the person's job is. The person's job
is not engage with Portal. The job is book an appointment.
(11:22):
So if that person wants to book an appointment, is
it required that they go through the portal? So we're
having a conversation about when, you know, is that always
the path or do we make the path of just
more direct booking, more accessible to somebody? And it flips
the conversation, Right.
Ann (11:43):
And I want to build on what you were saying
about how in health care we've been talking about patient
centered care for a really long time, but jobs to
be done as a tool that helps you flip the
conversation in order to actually provide that patient centered care.
So tell us a little bit more about how patients, consumers,
customers benefit from your use of jobs to be done.
Jay (12:03):
One of the ways they benefit us, particularly in how
we apply it, when we apply it, when we go
to uncover the jobs, we're not going to get into
the techniques and tools that we use for that. But
suffice it to say that when we when we have
the jobs mindset and we talk to consumers, we're trying
to understand them very deeply. We're trying to understand, we talk,
(12:26):
we talk about in the Innovation Engine is filming a documentary.
So when we talk to them, we are talking to
them to find out how we are doing as a
health care organization. There's a time and a place to
do that, you know, through surveys and other things. But
when we talk to them in innovation and developing products
and designing experiences, we want to talk to them about
(12:48):
their lives and we want to understand their context, as
you've described, and the progress they're trying to achieve. And
those things are not uniform. Everybody's very different. And we
have to design more customized experiences for people. We have
to design ways to talk to them more, to understand
(13:09):
about what they need. So if if we as an
organization have the jobs to be done mindset or following
that through, then I think if a patient were to
know that, I think they would feel more assured that
we are listening to them and thinking about them. And
and actually, when we do these interviews with people, they're
(13:32):
usually quite delighted to have the conversation because we've listened
to them. It's actually truly practicing empathy. And when we
talk to people, I think people see that that's great.
Ann (13:44):
And it's almost a lens that provides a two way
view and build off what you just said in terms
of people see the difference, they see the empathy. They
see that you care not just about what you offer
as an organization, but what is it they're actually trying
to achieve. And one phrase that has stuck with me for, gosh,
almost a decade now, I was in a class with
(14:07):
Elizabeth Tyson, who for listeners back about 15 years ago.
She wrote Redefining Health Care with Michael Porter and has
since moved on to the University of Texas at Austin
Dell Medical School, where she teaches a course in transforming
health care. And she asked this question about basically shifting
(14:31):
the health systems mindset from a supply side perspective to
a demand side perspective. And to your point, Jay, she
pointed out how surveys focus on asking the question, how
were we? But the most important question we can ask
our patients, consumers and customers is how are you? And
Jobs really provides a lens for healthcare practitioners to not
(14:56):
just ask that question but understand the answers that they receive.
And it also provides the benefit to the patient because
they can see how much the entity actually cares about them.
Jay (15:05):
Yeah, and all organizations are still guilty of it. I mean,
the most popular question, you know, is for Net Promoter Score.
How likely are you to recommend us? That's not a
job centered question. It would it would be more like,
you know, if I left the urgent care center, maybe,
maybe I get a survey 3 to 5 days later
and it asked me, were you able to accomplish what
(15:28):
you were trying to accomplish? Through that visit. Are you
back to work? You back to take care of your kids?
Because that's what people are seeking from. Nobody wants urgent care, right?
They want to get back to work or whatever activity
they have for the weekend.
Ann (15:43):
Right. Nobody wants more health care. They just want more
of their life and health care as a means to
an end. Speaking of patients interacting with or not interacting
with health care, I saw a stat the other day
that said 25% of millennials haven't seen a doctor in
five years. You can make statistics, say whatever you want
them to say, and it depends on who your audience
was for this survey. But I'd love to hear from you.
(16:06):
As a practitioner of jobs to be done, who's speaking
to patients? What have been some of your greatest aha
moments about why people hire or fire health care providers?
Jay (16:17):
One story I'll recount, it's more of an Aha from
the process we followed. We didn't end up with an
incredibly surprising finding, but the way we came about it
was really surprising. It came through a process. We did
what we call switch interviews. We did 15 interviews where
we found people who had changed primary care physicians and
(16:41):
for some really substantive reason, not obvious reasons. So so
we excluded people who had moved or their physician had retired.
We tried to get people who were trying to accomplish
something different. They weren't being forced, you know, to get
a new doctor. They were actually choosing it. And we
interviewed these people. And after doing the interviews, we tried
(17:02):
to find patterns and we had a group of patients
based on their context and their desired progress. We had
four of these patients in one cluster and we were
talking about them as an innovation team, trying to really
understand what their job was. And the I won't get
into all the detail. Their job was basically help for
(17:23):
the future. They were people who had either not consumed
primary care before or they were obtaining it from pediatricians
or ObGyn, maybe not the traditional primary care. And you know,
you talked about demographics not driving everything well in these
four people. We had a we had a guy who
was in his 30s who had just gotten married. We
(17:46):
had a woman who had turned 65 recently. We had
a woman who I think was in her late 40s.
And we had a very young woman who was in
her early 20s. She had wanted to stick with her pediatrician.
So you went to the pediatrician religiously and just wanted
to stay there. All of these people started hiring primary care,
(18:07):
and we wanted to understand why. One of the things
about the context we were looking at this and we
kind of understood they they weren't consuming and we understood
all the details. And one of our interns, Isaac, raised
his hand in a meeting and he said, they're all
going to the next phase in their life. And we
(18:28):
were like, Holy cow, you're right. We were previously looking
at and saying they were all prompted in some way.
You know, someone like the guy in his 30s, the
wife had said something, a friend had said something. So
they had what we call some pushes, some prompts for
them to do things. But then when we step back
and looked at the patterns, they were all going through
(18:48):
another phase in life. A young man was entering, you know,
becoming a husband and probably at some point a father,
a woman who hadn't been using primary care was was
in her 60s and realized, you know, can't keep just
going to urgent care anymore. We had a woman approaching
midlife thinking a little bit down the road to menopause.
(19:09):
I need a different way. And we have a young
woman who realizes she's got to go to an adult doctor.
They were all going to another phase in life and
think the aha, that's not that surprising to us now
as we look back on it. But, you know, as
we looked at it as a research team because of
the deep work and the conversations we had with people,
(19:32):
how Isaac described that was the Aha and we learned
something very new as a result of that. That's just
one example I'd give.
Ann (19:40):
That's a great story and I'll highlight for listeners the
power of uncovering that and the fact that you really
got to the root cause was that people were going
to the next phase of their lives and understanding that
push of the situation that they were in is critical
because it's going to help you speak to those individuals
more clearly through marketing in order to say why what
(20:04):
you're offering is going to help them in the next
phase of their lives, which is going to be much
more useful than using demographic language in terms of is
it time to move away from your pediatrician because then
you only hit 25% of that target market. So another
benefit of the jobs lens or mindset or way of
(20:25):
seeing the world is that it actually grows the pie.
Of who you're serving and doesn't artificially constrain your target
market based solely on on demographics. Now, I know we
could talk about jobs to be done ad infinitum. One
last question I want to ask you is in this
will hearken back to my days in the innovation engine
(20:47):
when we used to ask folks, you know, imagine if
you had a magic wand. So, Jay, if you had
a magic wand, what would you enable innovators in health
care leaders to know about the power of jobs to
be done?
Jay (20:58):
I think I would go back to the fact that
this should be your mindset, language and tools around customers.
Think about finance and accounting. When health care leaders have
conversations about financial issues, they all hopefully most of them
know what net present value is or operating cash flow
(21:20):
or market share. All these things, These terms are defined.
There's ways to understand financial frameworks and how you do things.
But when it comes to cost isomers and how to
talk about customers and think about them and think about
the way they behave. Lot of organizations don't have that.
They may have a mishmash of things. They may have
(21:40):
some tools from marketing and maybe some other things. But
jobs actually gives you a structure around that gives you mindset,
language and tools. And I think my magic wand would
be even more powerful than that. I'd go beyond health
care and just wave it and everyone would understand it
(22:01):
and organizations would design better products. We would also be
much better consumers. So if we as individuals understood our
context and desired progress, we might we might consume health
care differently as well.
Ann (22:14):
Great and love expanding it. You have the magic wand.
That's what you get to do with the magic wand. So, Jay,
thank you so much for joining us today. Thank you
for sharing with listeners about the amazing work you and
the entire team at Atrium Health are doing, how you're
applying jobs to be done, and how it gives you
a structure, a mindset, a framework, a set of tools,
(22:37):
and even a philosophy that helps you see customers, consumers
and patients better than you could before. And listeners can
learn more about jobs to be done. As I mentioned
from Clay Christensen's book, Competing Against Luck. I'll also provide
a few other links to some of the thought leaders
that Jay referenced earlier in the podcast, as well as
(22:58):
some of his writing on jobs to be done. And
we'll leave our listeners with the thought that employing a
jobs lens protects your company from new entrants and it
prevents you from competing against luck. So in the days ahead,
think about how you might apply it to the work
that you are doing. Thank you so much, Jay. It
(23:19):
was so great to talk to you and thrilled to
hear that things are going well at Atrium Health.
Jay (23:23):
Thanks a lot for having me. I enjoyed it.
Ann (23:27):
Thank you for listening to Life centered Healthcare. If you
like what you heard, please leave a review on Apple,
Spotify or wherever you're listening. And for more of the
latest in healthcare, check out our website, Christensen Institute. Org.
You can sign up for our newsletter and read our
latest industry insights. Until next time, have a wonderful day, everyone.
A lot of leaders and innovators talk about disrupting health care,
but what does that really mean? And how does one
actually do it on life centered health care? We dive
into these questions and more talking to innovators who are
leveraging Clay Christensen's theories to transform our health care ecosystem.
I'm Ann Summers Hogg, senior research fellow of health care
at the Clayton Christensen Institute. And I hope these stories
(00:23):
help inspire you along your journey to transform health and care.
Welcome back, listeners, to the second episode of Life Centered
Health Care. Today, I'm thrilled to welcome innovation expert and
my past colleague, Jay Gerhart to the show. Jay is
vice president innovation engine at Atrium Health. And among his
(00:44):
many talents, he is a health care strategist, podcast producer
for a Sherpa's Guide to Innovation, an innovation educator and
an improv master. And also, as you'll hear from Jay today,
he is also a leading job's to be done practitioner.
And I'm thrilled He's joining us to share his experience
with each of you during our conversation today. Jay and
(01:06):
I will geek out about jobs to be done, what
it is, how it explains consumer behavior and why it's
useful in health care. If you follow our writing at
the institute, you'll be familiar with the concept of jobs
to be done. But for those who may be new
to the concept, I'll provide just a brief overview before
jumping in to questions for Jay. But before I do that,
(01:26):
I'll pause and say, Welcome Jay, and thank you so
much for joining us today.
Jay (01:30):
Thanks, Ann Summers. Really appreciate being here with you. Some
of that introduction was a little too generous, but I
appreciate it nonetheless.
Ann (01:39):
Perception is reality, and that is my perception of you.
Jay So therefore, think I think it was spot on.
Jay (01:45):
Let's go with it then.
Ann (01:47):
Okay. At a high level, jobs to be done is
a framework for better understanding customer or consumer behavior. And
while conventional customer segmentation often focuses on demographics like how
old someone is or what their income is, what their
gender is, something like that. Jobs goes beyond these superficial categories,
(02:09):
and it actually exposes what we refer to as the
functional social and emotional dimensions that explain why people behave
the way they do and in purchasing behavior. That's why
they make the choices that they do. So, in brief,
a job is the progress someone seeks in a struggling situation.
And we call this situation or circumstance an individual's context.
(02:32):
So a job to be done has two parts the
progress someone is seeking and the context that they are
within an individual's hire products and services. That is, they
pull them into their lives in order to get a
specific job done. And then when a new product or
service comes along that serves their job better than the
old solution did, that individual will hire the new product
(02:55):
or service and they'll fire the old one. So why
at the institute do we believe that this framework is
so important? In his book, Competing Against Luck, late Harvard
Business School professor Clay Christiansen highlights that understanding and organizing
around customers jobs is what enables organizations to succeed in
the long run. And that's because organizing around the job
(03:19):
makes it significantly harder for new entrants to the market
to disrupt the organization that has organized around the job. However,
the flip side of that, organizations that focus inwardly on
their own products or services are effectively competing against, hence
the title of the book. So for listeners who want
(03:39):
a deeper dive on jobs to be done, then we'll
be able to cover today. I highly suggest reading Competing
against Luck. You won't be disappointed. Excellent stories throughout in
many apply to health care and are specific examples of
how jobs to be done provides value in health care. Okay,
so with that background, I want to turn the mic
over to you. And I love to start with why.
(03:59):
So could you tell listeners why you use the jobs
to be Done framework in your work?
Jay (04:05):
Well, I think, as you know, because you were right
there at the beginning with me, I guess it was
maybe seven ish years ago I was making a career
change within Atrium Health and I was going from our
strategy and planning group into innovation. So I guess I
originally hired it as a framework because I didn't have
(04:25):
a way of seeing customers, consumers. Sometimes they're not the same.
I may interchange those two words a little bit. In
my prior work with strategy and planning, I had all
sorts of frameworks and tools, as you're familiar with, Swat
analyzes play to win all these things. So I had
a way of thinking about strategy, but I wasn't heavily
(04:47):
thinking about consumers and and customers. I think the work
actually was a little bit more supply side focused around
products and services. I was helping figure out where to build. Hospitals,
how to make them bigger, how to develop service lines.
So I didn't have that need to have a way
of seeing consumers and customers because it wasn't so much
(05:08):
my my role in the organization. So what Jobs gave me,
I think it's interesting to use the word framework and
think about what do you call jobs? Is it a theory?
Is it a framework? Is it a tool? I think
the answer is yes. It's all of those things. And
I think why it's valuable is it's not just a
tool or a framework. It's a mindset. There is a theory,
(05:33):
as you said, for customer customer behavior. Scott Burleson is
a leading thinker on jobs to be done that I've
gotten to know a bit over the past year or so.
And he calls it a philosophy. He calls himself a
job's to be done philosopher. And with philosophy you have
a set of principles. So, you know, things like people
(05:55):
hire a product or fire a product and they're they're
not actually seeking that product. They're thinking what will do
in their lives. So if you have these principles and
a philosophy, you can think about it that way. So
I go back to it's a way of seeing, but
then it also gave me tools because I didn't know.
(06:16):
I didn't know how to talk to people, to humans,
to ask them about products and services. I don't think
I had ever interviewed a consumer in what I did.
I worked with lots of spreadsheets, but I didn't know
how to talk to them. So jobs in our work
with Bob, Mr. gave me the ability to do that.
(06:36):
But I would say it gave me it gave me
a lot of different things. Again, framework tools, a lot
of rigor and just a new way of both seeing
and doing that I had never had to do in
my career before.
Ann (06:48):
I love how you opened that with you didn't have
a way of seeing consumers and that it helped you
to see the people that you're really serving. And it's
funny that you brought up what we what do we
call it? Do we call it a theory? Is it
a framework? And I struggle with that as well, because
as you know, especially when working inside an organization focused
(07:09):
on operations, the word theory doesn't always resonate and isn't
really always welcomed. So I really liked how you use
the word philosophy because it's a mindset, it's tools, it's framework,
it's a theory. But that is a broader way to
think about the toolkit of components that the jobs to
(07:30):
be done lens provides.
Jay (07:33):
Yeah. And that way of seeing Jim Kobach is another
leading jobs to be done thinker. And in his book
The Jobs to Be Done toolkit he talks about Copernicus
back in and I think 1540 or 43 you know
previously the traditional way of seeing was that the earth
was at the center of the universe or the galaxy,
(07:55):
and the sun would go around it. And Copernicus proves
mathematically we'll know that's not the case. The sun is
actually at the center and planets revolve around it. So
in that we had this mindset before where our our
organizations and our brands are at the center of everything.
That's where jobs is. A mindset is flip this mindset
(08:17):
where the customer is at the center and companies have
been saying that for a long time. They've been saying
consumer centric. This is a more rigorous way to structure
and think about method, language, tools, all of that.
Ann (08:31):
But that leads me to my next question, which was
what is it about jobs to be done? Or this
new way of seeing and thinking that provides value to
your work?
Jay (08:41):
I mean, I go back to the the structure of it.
It provides mindset, language and and tools. And I think
for a health care organization, you know, in health care,
we've been talking about patient centered care for a long
time and we've been trying to become more patient centered.
But but jobs actually gives us a way to do
(09:03):
that in a more rigorous fashion. And again, if we
have that mindset where we're less at the center of things,
health care is a very expertise driven industry, as we
all know. It's complicated, it's very complex. So we think
about ourselves a lot. And when I'm teaching jobs, actually
(09:24):
one of the very first things I do is I
put a quote out there from Louis, hopefully get this right.
Humility is not thinking less of yourself. It's thinking of
yourself less. So it's this shift from supply side thinking,
thinking about products and services and how we deliver them
(09:46):
to demand side thinking about what our customers need. And
it gives us that that mindset. I was in a meeting,
I think it was last week, and it was with
our medical group. We had a lot of physician leaders,
administrative leaders, and we were talking about how to become
more consumer centric in our digital journey. And one of
(10:10):
the physicians in the room I won't say on the
podcast who it is. I'll tell you later who it
is because you'll appreciate it. We are having a little
bit of a supply side conversation. It was a little
bit about our internal processes and this physician said, Let's
look at this from a jobs to be done perspective.
And my heart just overflowed, you know, because when when
(10:35):
we have people that we've taught this mindset and the
tools and they bring it up unprovoked, you go back
to your question, why is this valuable? It flipped the conversation.
The conversation immediately became less about some of the constraints
we had internally, our physician schedules, limitations of our digital tools,
(10:57):
and got to be much more about what the individual
is trying to do. Because when talking internally, we have
goals as health care systems. We want people to use
our portals, my chart, that sort of thing, utilize those things.
That's not what the person's job is. The person's job
is not engage with Portal. The job is book an appointment.
(11:22):
So if that person wants to book an appointment, is
it required that they go through the portal? So we're
having a conversation about when, you know, is that always
the path or do we make the path of just
more direct booking, more accessible to somebody? And it flips
the conversation, Right.
Ann (11:43):
And I want to build on what you were saying
about how in health care we've been talking about patient
centered care for a really long time, but jobs to
be done as a tool that helps you flip the
conversation in order to actually provide that patient centered care.
So tell us a little bit more about how patients, consumers,
customers benefit from your use of jobs to be done.
Jay (12:03):
One of the ways they benefit us, particularly in how
we apply it, when we apply it, when we go
to uncover the jobs, we're not going to get into
the techniques and tools that we use for that. But
suffice it to say that when we when we have
the jobs mindset and we talk to consumers, we're trying
to understand them very deeply. We're trying to understand, we talk,
(12:26):
we talk about in the Innovation Engine is filming a documentary.
So when we talk to them, we are talking to
them to find out how we are doing as a
health care organization. There's a time and a place to
do that, you know, through surveys and other things. But
when we talk to them in innovation and developing products
and designing experiences, we want to talk to them about
(12:48):
their lives and we want to understand their context, as
you've described, and the progress they're trying to achieve. And
those things are not uniform. Everybody's very different. And we
have to design more customized experiences for people. We have
to design ways to talk to them more, to understand
(13:09):
about what they need. So if if we as an
organization have the jobs to be done mindset or following
that through, then I think if a patient were to
know that, I think they would feel more assured that
we are listening to them and thinking about them. And
and actually, when we do these interviews with people, they're
(13:32):
usually quite delighted to have the conversation because we've listened
to them. It's actually truly practicing empathy. And when we
talk to people, I think people see that that's great.
Ann (13:44):
And it's almost a lens that provides a two way
view and build off what you just said in terms
of people see the difference, they see the empathy. They
see that you care not just about what you offer
as an organization, but what is it they're actually trying
to achieve. And one phrase that has stuck with me for, gosh,
almost a decade now, I was in a class with
(14:07):
Elizabeth Tyson, who for listeners back about 15 years ago.
She wrote Redefining Health Care with Michael Porter and has
since moved on to the University of Texas at Austin
Dell Medical School, where she teaches a course in transforming
health care. And she asked this question about basically shifting
(14:31):
the health systems mindset from a supply side perspective to
a demand side perspective. And to your point, Jay, she
pointed out how surveys focus on asking the question, how
were we? But the most important question we can ask
our patients, consumers and customers is how are you? And
Jobs really provides a lens for healthcare practitioners to not
(14:56):
just ask that question but understand the answers that they receive.
And it also provides the benefit to the patient because
they can see how much the entity actually cares about them.
Jay (15:05):
Yeah, and all organizations are still guilty of it. I mean,
the most popular question, you know, is for Net Promoter Score.
How likely are you to recommend us? That's not a
job centered question. It would it would be more like,
you know, if I left the urgent care center, maybe,
maybe I get a survey 3 to 5 days later
and it asked me, were you able to accomplish what
(15:28):
you were trying to accomplish? Through that visit. Are you
back to work? You back to take care of your kids?
Because that's what people are seeking from. Nobody wants urgent care, right?
They want to get back to work or whatever activity
they have for the weekend.
Ann (15:43):
Right. Nobody wants more health care. They just want more
of their life and health care as a means to
an end. Speaking of patients interacting with or not interacting
with health care, I saw a stat the other day
that said 25% of millennials haven't seen a doctor in
five years. You can make statistics, say whatever you want
them to say, and it depends on who your audience
was for this survey. But I'd love to hear from you.
(16:06):
As a practitioner of jobs to be done, who's speaking
to patients? What have been some of your greatest aha
moments about why people hire or fire health care providers?
Jay (16:17):
One story I'll recount, it's more of an Aha from
the process we followed. We didn't end up with an
incredibly surprising finding, but the way we came about it
was really surprising. It came through a process. We did
what we call switch interviews. We did 15 interviews where
we found people who had changed primary care physicians and
(16:41):
for some really substantive reason, not obvious reasons. So so
we excluded people who had moved or their physician had retired.
We tried to get people who were trying to accomplish
something different. They weren't being forced, you know, to get
a new doctor. They were actually choosing it. And we
interviewed these people. And after doing the interviews, we tried
(17:02):
to find patterns and we had a group of patients
based on their context and their desired progress. We had
four of these patients in one cluster and we were
talking about them as an innovation team, trying to really
understand what their job was. And the I won't get
into all the detail. Their job was basically help for
(17:23):
the future. They were people who had either not consumed
primary care before or they were obtaining it from pediatricians
or ObGyn, maybe not the traditional primary care. And you know,
you talked about demographics not driving everything well in these
four people. We had a we had a guy who
was in his 30s who had just gotten married. We
(17:46):
had a woman who had turned 65 recently. We had
a woman who I think was in her late 40s.
And we had a very young woman who was in
her early 20s. She had wanted to stick with her pediatrician.
So you went to the pediatrician religiously and just wanted
to stay there. All of these people started hiring primary care,
(18:07):
and we wanted to understand why. One of the things
about the context we were looking at this and we
kind of understood they they weren't consuming and we understood
all the details. And one of our interns, Isaac, raised
his hand in a meeting and he said, they're all
going to the next phase in their life. And we
(18:28):
were like, Holy cow, you're right. We were previously looking
at and saying they were all prompted in some way.
You know, someone like the guy in his 30s, the
wife had said something, a friend had said something. So
they had what we call some pushes, some prompts for
them to do things. But then when we step back
and looked at the patterns, they were all going through
(18:48):
another phase in life. A young man was entering, you know,
becoming a husband and probably at some point a father,
a woman who hadn't been using primary care was was
in her 60s and realized, you know, can't keep just
going to urgent care anymore. We had a woman approaching
midlife thinking a little bit down the road to menopause.
(19:09):
I need a different way. And we have a young
woman who realizes she's got to go to an adult doctor.
They were all going to another phase in life and
think the aha, that's not that surprising to us now
as we look back on it. But, you know, as
we looked at it as a research team because of
the deep work and the conversations we had with people,
(19:32):
how Isaac described that was the Aha and we learned
something very new as a result of that. That's just
one example I'd give.
Ann (19:40):
That's a great story and I'll highlight for listeners the
power of uncovering that and the fact that you really
got to the root cause was that people were going
to the next phase of their lives and understanding that
push of the situation that they were in is critical
because it's going to help you speak to those individuals
more clearly through marketing in order to say why what
(20:04):
you're offering is going to help them in the next
phase of their lives, which is going to be much
more useful than using demographic language in terms of is
it time to move away from your pediatrician because then
you only hit 25% of that target market. So another
benefit of the jobs lens or mindset or way of
(20:25):
seeing the world is that it actually grows the pie.
Of who you're serving and doesn't artificially constrain your target
market based solely on on demographics. Now, I know we
could talk about jobs to be done ad infinitum. One
last question I want to ask you is in this
will hearken back to my days in the innovation engine
(20:47):
when we used to ask folks, you know, imagine if
you had a magic wand. So, Jay, if you had
a magic wand, what would you enable innovators in health
care leaders to know about the power of jobs to
be done?
Jay (20:58):
I think I would go back to the fact that
this should be your mindset, language and tools around customers.
Think about finance and accounting. When health care leaders have
conversations about financial issues, they all hopefully most of them
know what net present value is or operating cash flow
(21:20):
or market share. All these things, These terms are defined.
There's ways to understand financial frameworks and how you do things.
But when it comes to cost isomers and how to
talk about customers and think about them and think about
the way they behave. Lot of organizations don't have that.
They may have a mishmash of things. They may have
(21:40):
some tools from marketing and maybe some other things. But
jobs actually gives you a structure around that gives you mindset,
language and tools. And I think my magic wand would
be even more powerful than that. I'd go beyond health
care and just wave it and everyone would understand it
(22:01):
and organizations would design better products. We would also be
much better consumers. So if we as individuals understood our
context and desired progress, we might we might consume health
care differently as well.
Ann (22:14):
Great and love expanding it. You have the magic wand.
That's what you get to do with the magic wand. So, Jay,
thank you so much for joining us today. Thank you
for sharing with listeners about the amazing work you and
the entire team at Atrium Health are doing, how you're
applying jobs to be done, and how it gives you
a structure, a mindset, a framework, a set of tools,
(22:37):
and even a philosophy that helps you see customers, consumers
and patients better than you could before. And listeners can
learn more about jobs to be done. As I mentioned
from Clay Christensen's book, Competing Against Luck. I'll also provide
a few other links to some of the thought leaders
that Jay referenced earlier in the podcast, as well as
(22:58):
some of his writing on jobs to be done. And
we'll leave our listeners with the thought that employing a
jobs lens protects your company from new entrants and it
prevents you from competing against luck. So in the days ahead,
think about how you might apply it to the work
that you are doing. Thank you so much, Jay. It
(23:19):
was so great to talk to you and thrilled to
hear that things are going well at Atrium Health.
Jay (23:23):
Thanks a lot for having me. I enjoyed it.
Ann (23:27):
Thank you for listening to Life centered Healthcare. If you
like what you heard, please leave a review on Apple,
Spotify or wherever you're listening. And for more of the
latest in healthcare, check out our website, Christensen Institute. Org.
You can sign up for our newsletter and read our
latest industry insights. Until next time, have a wonderful day, everyone.
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