Scott Carson: How Business Strategy Can Drive Healthcare Reform
Since 1998, Queen's School of Business’s The Monieson Centre has positioned itself at the intersection of business research and policy. It’s built a solid reputation as a facilitator of practice-based research that brings together academics, business leaders, and policymakers. Its new focus is “Business Research in Healthcare”: how traditional business research disciplines such as strategy, finance, accounting, marketing, and organizational behaviour can help to address challenges facing the healthcare sector.
To learn more about the centre’s new focus, QSB Insight sat down with Director Scott Carson, professor of strategy. Before Queen’s, Carson was Dean of the School of Business and Economics at Wilfrid Laurier University as well as Dean of the Sobey School of Business. He also served as Chief Executive Officer of the Ontario Government's Privatization Secretariat and was Vice-President and Head of Corporate Finance for CIBC.
His edited remarks:
On what healthcare can learn from the best managed businesses and industries:
Look at the overall approach to strategy that’s commonplace in the corporate world. The starting assumption is that strategy should drive structure. The organizational structure, the governance systems, the way in which you develop administrative frameworks, all are largely seen as ways of supporting the overall strategy that you wish to pursue. In healthcare, the reverse exists. You have province by province governance systems, administrative structures, legislation and regulations, that basically determine what’s available by way of strategy. Could a business approach to strategy say something to Canadians about how to examine national healthcare strategy? Should we consider what we would do if we didn’t have all of that administration management and governance structure? Could we then see ways to modify and develop the administrative structures that we have?
There are also different perspectives that businesspeople have on healthcare. I’m not referring to turning healthcare into a for-profit model. I’m thinking of how operations management or decision sciences people look at, say, deciding among an array of options. Looking at which drugs or genetic tests physicians recommend for their patients, or how to decide whether or not to conduct a test on a patient when multiple factors around the patient’s condition are present. Business decision modelling does those kinds of evaluations.
"This is not an example of businesspeople saying, medical world, here’s how you ought to do things. It’s more open-ended and research oriented. And businesses have as much to learn from the perspectives of the traditional healthcare disciplines as the reverse"
On why healthcare research is a good fit for The Monieson Centre and Queen’s:
The idea of the healthcare focus came from two presumptions: one, believing that there was great capacity across the university that we could leverage; and two, the general alignment of healthcare issues with areas of research done by QSB faculty. If you take matters of governance and control, accountability, organizational behaviour, operations management, and decision sciences, all of those are very important in healthcare and the meat and potatoes of business research. The breadth of potential research interests is what’s especially attractive about healthcare and offers the greatest potential for aligning broadly across the interests within the school.
On how to leverage cross-sector collaboration:
What’s struck me about academia, government, and business is how similar the challenges are in developing strategy, how much in common are the issues around motivating people. It’s true that they have their own perspectives and contextual issues, but the similarities are greater than the differences. My background in multiple sectors has shown me that lots of opportunity exists for cross-sector collaboration, and has given me a practical set of illustrations around how collaboration can happen.
[During a meeting of faculty and staff from Health Sciences and Business], it was most instructive as we went around the table and people asked questions of each other. Someone from the School of Medicine said, ‘We do such-and-such,’ and someone from the School of Business replied, ‘We do that too. Except we call it this.’ When you get enough of these examples of similar problems and issues but different perspectives and a different language, it becomes apparent that only translation or a slightly different methodology stand in the way of people getting together. Those aren’t impassable divides. When you think about the way in which the university is organized, it’s around its disciplines and fields of study; there just simply aren’t many administrative entities that can devote themselves to building those bridges. Well, we’re one who can.
On what The Monieson Centre will generate over the coming years:
You’ll see the development of research partnerships. We’re working with a federal health ministry on a potential partnership involving support in several areas that are focused on business and change management. We’ve met with the CEOs and Chiefs of Staff of each of the three local hospitals. All three are interested in pursuing projects with us. We’ve found opportunities for QSB graduate students who want access to medical data or medical institutions or who wish to connect with people in other faculties.
We’re also embarking on a series of three conferences in collaboration with the Faculty of Health Sciences and School of Policy Studies. The conferences will look at the establishment of Canadian healthcare strategy, the politics of implementation, and measuring and enhancing healthcare delivery. Around those conferences will be white papers that we’ll commission for presentation. Beyond that, there will be research opportunities that we can help QSB faculty with, opportunities that they otherwise wouldn’t have known about.
— Interview by Alan Morantz