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126. Joe Matarese Defines a Whole New Level of Customer Value to Build a High Growth Service Firm

Firms that can unlock the deep secrets of subjective value can unleash powerful, long-lasting value streams. When these flow in a confluence with well-identified market drivers, revenue and profit growth can be greatly accelerated.

Joe Matarese tells Economics For Business how he conjoined these two forces for his medical staffing service firm, creating a dynamic market leader from a three-person startup.

Key Takeaways and Actionable Insights

Market Drivers are strong, lasting forces capable of projection.

Austrians are skeptical about prediction, but it is reasonable to project some forces into the future. Demographics is one — the progression of age cohorts through the demography of a country can be mapped quite accurately. Increasing longevity is another, based on ongoing increased investment in health care and advances in the associated technologies. When Joe Matarese identified a shortage of doctors, he was able to confidently assume the shortage would continue.

When customer problems result from these forces, a market segment opens for solutions.

One customer problem fed by these forces is staffing for critical roles in hospitals — doctors, anesthesiologists, nurses, etc. Staffing complements need to be assembled, absences caused by holidays, maternity leave, etc. need to be covered, and the natural churn of individuals taking new jobs, retiring, or moving requires flexible response. Not only staffing but scheduling is required — the right medical team for the specific operation at the appointed time.

The problem-to-solve is functional. The deep value is subjective and intense.

Joe’s core insight was about the intense emotional need, not just the functional need. He observed his client — an operations executive in a busy hospital system — stressing out about the problem. Operating room staffing is life-and-death. Unfilled team roles would often arise at the last minute, threatening the healthcare mission of the hospital.

Temporary staffing service providers would sometimes fail to deliver the scheduled stand-in. Stress for the executive intensified.

The solution for a deep-seated and intensely felt emotional need is to transfer the burden to the service provider.

Think of the intense burden the administrative executive bears when she’s not confident that her staffing plans are secure, and her routines and methods are not foolproof. What if there is a failure at the time of a scheduled operation and it can’t go forward? Or patients can’t get nursing care because of under-staffing? How much value is there in a service that can relieve the stress?

Joe Matarese conceived of the emotional solution: take the responsibility off the shoulders of the executive and take it on as a service of his firm. How is that achieved? Bulletproof processes and routines. Comprehensive databases of people and their skills and attributes, and of client facilities and their needs. The latest technology for profile matching and precision scheduling. Impeccable implementation. And, most importantly, intense listening to continuously monitor customer feelings, combined with the responsiveness to act on those feelings.

Growth follows when these market drivers, functional drivers and emotional drivers are aligned.

Medicus Healthcare Solutions quickly gained market share in its initial geography. Growth comes from adding new customers, expanding territory and the underlying forces of an aging population consuming more healthcare.

But growth is a management challenge. One area of great challenge is managing people. Those who signed on for the early stages of growth and development may not have the skills — or the interest — for the later stage tasks of management like strengthening processes and systems. Making sure the team is perfectly tuned to the demands of the current stage is difficult but critical.

Further acceleration of growth is driven by innovation.

Medicus Healthcare Solutions has always grown faster than the market. How? Through an intense search for new knowledge and its application in the form of unrelenting innovation — never resting in the search for better ways to provide client service. For example, in addition to continuous improvement in precision tailored scheduling, Medicus added a consulting service. Scheduling solves the client’s immediate short term problem, and does so again and again. Consulting can examine the client’s systems and solve the problem in the long term by designing and installing internal systems as good as Medicus’.

Joe has a long experience with innovation and how to manage it, and promised to come back to the Economics For Business podcast in the future to share his knowledge.

Additional Resources

“Driving Growth With Core Customer Value Insights” (PDF): Download PDF

“Medical Staffing and the Revolutionary Innovations We Need,” presented by Joe Matarese at the Mises Institute’s Medical Freedom SummitWatch the Video

Medicus Healthcare Solutions: Visit the Website

Entrepreneurs Bring Economic Progress – Which Is Far More Important To People Than GDP Growth.

Economists tend to represent economic growth as growth in the level of income and of GDP. But economic progress is far broader than that, and to focus on GDP growth is to ignore the most important elements of economic progress – the elements that improve people’s lives.

Why do economists miss this point? Because they don’t understand entrepreneurship, and the role of entrepreneurs in economic progress. In economists’ models, firms are run by managers who choose low cost resources and manage processes in order to achieve greater efficiency. In a competitive economy, this would drive companies out of business. Continuous improvement and innovation are the drivers of economic progress, and they come from entrepreneurs not managers.

We invented economic progress only recently. It began in the late eighteenth century with the industrial revolution. Before that, the standard of living and the quality of life was much the same in 1750 as it was in 1650, and it was much the same in 1650 as it was in 1550 and, indeed, as it was in 550.

Since then, economic progress has been greater in the nineteenth century than the eighteenth, greater in the twentieth century than the nineteenth, and every indication is that the progress will continue to accelerate in the twenty-first century.

In the United States, per capita GDP was nearly seven times greater at the end of the twentieth century than it was at the beginning. But looking at only growth numbers seriously misrepresents the nature of the economic progress that took place in that century.

At the beginning of the twentieth century only about 1 percent of American households had cars; by the end of the century 91 percent of households had them. Largely because of advances in medical technology, life expectancy rose from 47 years at the beginning of the century to 77 years by the century’s end. Telephones were rare at the beginning of the century, but commonplace by the end of the century. Information acquisition and entertainment were completely transformed in the twentieth century. At the beginning of the century there were no movie theaters, no radio broadcasts, and no television. By 1900 electricity was available to some, and was used mainly for lighting, but by 1950, electricity powered radios, electric washing machines, and refrigerators.

By 2000, most people classified as poor in the United States had indoor plumbing, air conditioning, telephones, and automobiles. The Internet revolutionized communication and allowed business ventures to span the globe. While only a few computers existed in the world in 1950, many people had more than one computer in their homes by 2000. Computers did not become common until the 1980s, and the World Wide Web did not exist until the 1990s. The first airplane had not yet flown at the beginning of the twentieth century, but by the end of the century travel throughout the world in jet aircraft was commonplace. Despite the tremendous GDP growth over the twentieth century, when one reflects on economic progress over the century, it is apparent that the primary component of economic progress is not the amount of income growth, as impressive as it was, but rather the substantial change in the qualitative nature of the economy’s output, and the extent to which people enjoyed consuming it.

They were also able to enjoy producing progress. At the beginning of the twentieth century the average work week in the United States was about 50 hours, and by the end of the century it had fallen to about 35 hours. Again, this quantitative change in hours worked, while impressive, does not reflect the changing nature of work, which became less dangerous and less physically demanding. People worked more with their minds and less with their bodies by the end of the century, and this is reflected in the fact that at the beginning of the century only 22 percent of adults had completed high school, while by the end of the century 88 percent had at least a high school degree. Accidental deaths, including those on the job, fell from 88 per 100,000 to 34 per 100,000 over the course of the century.

While people work fewer hours for more income, the more significant element of progress in the work people do is not the quantitative reduction in work hours or increase in output, but rather the qualitative changes in the nature of work. At the beginning of the century the reward for work was money, and most jobs were mainly manual labor. While money was still a primary motivation at the end of the century, people considered the pleasantness of a job, including intellectual stimulation, challenges, and workplace amenities as significant rewards for employment. Many people enjoy the work they do: something that would have been much rarer in 1900, when work was often physically demanding, dangerous, and tedious. One can look at growth in terms of increased output per hour of work, but the progress in terms of qualitative changes at the workplace is at least as significant as the quantitative growth.

Henry Ford was the entrepreneurial innovator who brought assembly line production to the automobile industry, which enabled a substantial increase in the output of automobiles per worker. But focusing on growth in output per worker misses the much more important truths about the transformation of lifestyles that resulted. People’s transportation options were greatly enhanced, making automobile travel available to a large segment of the population. This changed many other things – such as shopping for example. Supermarkets, shopping malls and large discount stores would not be feasible if people could not drive their own cars to transport substantial quantities of goods. Because shoppers can buy more each time they shop – because they can transport more in their automobile – stores can offer a greater variety of goods at a lower cost. Entrepreneurs who supply the retailers are encouraged to think up a larger variety of new goods for sale.

Because of the introduction of low-cost long distance telephone calling – and now the internet – these entrepreneurs can contact sellers thousands of miles away to order new products immediately. Sharp declines in transportation costs make it feasible to ship individual purchases thousands of miles to buyers. The variety of goods and services offered for sale continues to expand. Progress in one area leads to progress in others. Life gets better. Progress brings economic growth with it, but growth is a minor component of economic progress.

Progress is not brought to us by managers striving for efficiency, but by entrepreneurs developing specialist knowledge about their area of expertise and thereby discovering new opportunities to serve customers better and to make a profit doing so. The profit-and-loss system amplifies progress. Profits reinforce the pursuit of ideas that are wealth-enhancing for entrepreneurs, and losses terminate the ideas that are not. As a result, the positive impact of successful entrepreneurship is much larger in magnitude than the negative impact of unsuccessful attempts. That’s how progress occurs. Specialization is an important element – something Adam Smith knew at the beginning of the Industrial Revolution.

Men are much more likely to discover easier and readier methods of attaining any object, when the whole attention of their minds is directed towards that single object, than when it is dissipated among a great variety of things. . . . It is naturally to be expected, therefore, that some one or another of those who are employed in each particular branch of labour should soon find out easier and readier methods of performing their own particular work, whenever the nature of it admits of such improvement. (Adam Smith, Wealth Of Nations, 1776)

Entrepreneurs invest in producing the specialized knowledge that will enable them to make future entrepreneurial discoveries. Their pursuit of knowledge makes innovation and progress more likely.

To read more, see Progress And Entrepreneurship; Randall G. Holcombe; QJAE Fall 2003.