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By Don Howard
M.D., Ph.D., Chairman, CellNetix Pathology and Laboratories
02/19/08
Nietzsche said, "That which does not kill us makes us stronger." Merging pathology groups and building an organization and a laboratory from the ground up was a daunting task. However, we did this, we are alive, and we are getting stronger.
In this article, I would like to speak to our laboratory community. I do not want to speak about corporate achievements, fiscal targets, or goals, but rather about something deeper, about who we are as a company, who we are trying to be, and suggest some concepts that you might consider in your own business models. I would like to have a heart-to-heart conversation with my laboratory peers. Call this a "fireside chat" rather than a referenced scholarly article.
As an undergraduate student, I was a philosophy major. In graduate school, I learned the importance of questions. I’d like to share some of my personal philosophy and vision using my own company as a model, as well as ask you some questions.
Question: Why did we form CellNetix? Many reasons come to mind:
- Response to competitive threats (national labs, national specialty labs, boutiques, captive or pod labs, etc.).
- The ability to form centers of excellence via pathologist sub-specialization.
- Improved economies of scale.
- Creation of a corporate structure with real value.
- The ability to joint venture.
- Malpractice insurance savings.
- Billing and compliance improvements.
- Creating a company with the size and resources that would allow us to invest in state of the art technologies.
- The rise of the master/slave model of business in the laboratory world, as exemplified by the big national labs—with the resulting devaluation of employees and people.
- Poor quality from companies whose concern is not patients, but only return on investment to shareholders on Wall Street. (One of the big laboratory corporate wags said recently that his patients were his stockholders.)
Question: How was CellNetix formed?
That is a long story involving many meetings by pathologists over two years, a lot of hard work, investment, the use of specialized lawyers, accountants, and other experts, and the acknowledgment that we were willing to take risks to form a company whose goal is to be better than all others in its field.
The inspiration for CellNetix came from the founders of America. Despite our problems and our politicians, I believe that America is a great country—rich with freedom, democracy, equality, stability, and opportunity. I did some research into who or what inspired the founders to selflessly form a country with no kings, no emperors, and with rule by the people and for the people. This led me to the writings of David Hume, an eccentric British philosopher. Hume’s teachings possessed a selflessness and a desire for the common good that struck a chord with America’s founders. These founders had an opportunity to create a country from the very beginning and to do it right. This resulted in the checks and balances we have today in government—the legislative, executive, and judicial branches—free elections, and more. When we formed CellNetix, we also had a chance to "do it right." To do this we followed a number of principles. Of many, I will share just a few.
Question: What was the most important thing we learned in kindergarten?
What were we really supposed to learn at this grade level was not reading, writing, and arithmetic. But, rather, the principle of how to "share and play fair." In other words, to gain the social skills necessary to function in the world amongst other people.
CellNetix was designed from the beginning to allow everyone, at all levels of the company, to share in its success professionally and financially. More than that, we allow all employees the possibility to own shares in the Company Performance Shares Plan—quite the opposite from the “master slave” corporate model. In a broad sense of the phrase, ours is, or will be, a company of and by its employees!
CellNetix places highest value on our people and on their intellectual capital. Our desire is to attract and retain the best and brightest pathologists and technical and administrative minds in our region and in the country. Governance of CellNetix is democratic. Our board of directors is elected for terms of service, and I serve as chairman as elected by the board. Five committees oversee various aspects of the company and report to the board: Quality, Standards, Finance, Benefits and Strategic Planning.
Charles Darwin, the great evolutionary theorist, said, "It is not the biggest, nor the fastest of a species which survives, it is the most adaptable." We created CellNetix to be the most adaptable company possible. We are able to respond quickly and with multiple options to almost any situation and to form alliances, partnerships, and relationships with almost anyone or any institution—hospitals, clinics, other labs, biotech companies, universities, etc.
Let’s think about probability and possibility. Before we formed CellNetix, we and many others perceived the practice of pathology to be in decline and, in a sense, very likely to suffer from Darwinian extinction. This is what was probable. However, who we are now, as a company who we become, what we make of the company, depends on each and every employee. This is what is possible.
It is said that "no snowflake ever feels responsible in an avalanche." However, an avalanche changes all in its path. Working together at all levels, a company’s employees can effect change. We can create a corporate culture that is powerful from a competitive perspective, beneficial to all employees, and socially good in the process. To quote Thomas Huxley: "The great end of life is not knowledge, but action." Together, by taking action, we are striving to create a great company for all—for our patients, our doctors, our hospitals, and ourselves.
Question: What is any clinical laboratory in the business of doing?
Of course, we process tissues, read slides and Pap smears, render diagnoses, etc. However, these things are not our real business. What we are really in the business of doing is making a difference—making a difference in the lives of the hundreds of thousands of people whose lives we touch every year. At CellNetix, we diagnose over 110,000 surgical specimens each year and supervise or evaluate hundreds of thousands of Pap tests. Each of these "cases" is, in a sense, a person; a person whose life we touch, a person in whose life we make a difference.
Pablo Neruda said, "Every casual encounter is an appointment." Today, through this article, my appointment is with you. However, each and every day, your appointment is with the patients whom you ultimately serve.
Time travel is not impossible, not in a metaphysical sense. We travel into the past through observations of the world, our study of history, and our memories. We travel into the future by way of influence—the lives we touch, the friends and family we help, and the deeds we do for our human community. If you want to travel far into the future, then, I submit, place the emphasis of your life here.
In a recent TV news special on CellNetix (Q13 News), two very brave women shared their stories relating to pathology and the diagnosis of breast cancer. One woman lost both breasts to surgery needlessly because of false diagnoses of breast cancer from another lab. The other woman’s life was saved by an accurate pathologic diagnosis and appropriate treatment. Think about how the lives of these women are changed and how these changes will ripple on into the future, not only affecting their own lives but those of their families, friends, and even strangers. It is with patients like these that you and I have Pablo Neruda’s appointments each and every day.
It has been published that while the lab industry is only 10% of the healthcare budget, it drives 60% to 70% of healthcare decisions. What we do is very important and has a tremendous impact on our patients as well as on the global practice of medicine—far greater than we imagine.
Last question: What is really important in life?
Most would not say work. However, work is a very big part of our lives. Consider two things that are really important in life—family and community. A sense of belonging is an essential part of the human experience. We have the opportunity to create a sense of community and even family in our companies, where all people are valued, appreciated, and respected. This is something that each of us can contribute to every day. This is our goal at CellNetix.
Life, each moment, is an unrepeatable miracle. And for those of you who, like me, have been around a few years, isn’t it over in a blink? Let us, as people, as companies, as an industry, make the miracle of saving lives through the quality and accuracy of our diagnostic pathology and laboratory testing our challenge and gift for our patients and for the future. Let us create a sense of family and community within our companies—our challenge and our gift for ourselves.
Note: CellNetix offers all employees the possibility to participate in the success of the company via a Performance Share plan and a Company Performance Bonus plan. This appears to be unique in the laboratory industry. Sharing the company, we believe, is not only the right thing to do, but it is based on the notion that our most precious resource is the intellectual capital of our people. CellNetix seeks to attract and retain the best and the brightest, a model we call "enlightened capitalism." Bill Gates recently gave a speech at the World Economic Forum in Davos, Switzerland, calling for a kinder model of capitalism, "creative capitalism" (reported in the Wall Street Journal, January 24, 2008).
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