Retailing is huge and
growing relatively slowly. Healthcare, by contrast, is huge and growing
fast. There may be no industry with more exciting prospects, both in the
aging “first world” and in the increasingly wealthy “rest of the
world.”
Healthcare, like other
industries, is best understood by considering its fullest scope: medical
care, drug stores, hospitals, pharmaceutical companies, over-the-counter
drug makers, nutritional supplement makers, natural foods stores, health
insurance companies – everything from massage to Medicare, from webMD to
World Gym.
This key industry will
continue to be fraught with challenges in a period of change. Not just
change, but accelerating change. Gene therapies will be incredibly
effective but may be incredibly costly. As of 1997, our $379 billion
hospital industry was 90% non-profit and 10% for-profit, a ratio that is
bound to keep changing. HMO’s which seemed like such a brilliant idea
when first devised are now under great pressure.
Healthcare is
another industry that needs to take a fresh end-to-end approach. Everyone
knows that health is linked to exercise and nutrition, and today more and
more evidence indicates that spiritual and mental well-being also play an
important role in physical health. But on the business side – the
transactions – all of these disciplines remain compartmentalized. Only
Walgreen’s knows all the pills we are taking. It’s time this changed.
In the future, “wellness” and “prevention” will not be sideshows
or buzzwords, they will be at the heart of healthcare.
Successful participants in
the healthcare industry will have to increase their awareness of the whole
customer. It’s ironic: no profession is more committed to human
well-being than medicine, yet medicine may also be the profession with the
lowest levels of service. We’ve all heard stories about people waiting
months to see a specialist, about X-ray mix-ups, about surgeons operating
on the wrong leg. I heard a well-known actor say that his doctor
had told him that he had terminal cancer – on the phone! Medicine
is an industry that desperately needs to learn the art of service – to
learn to focus on what it feels like to be a customer.
Partly in reaction to the
low levels of service in healthcare, people are taking matters into their
own hands. As more people attain higher levels of education, fewer people
feel the need to rely on doctors as health information gatekeepers. More
and more people are seeking out second opinions – sometimes from another
physician, often from a book, a patients’ support group, or a website.
Consumer-oriented ads for prescription drugs and new treatments fill the
airwaves. Little by little, the professionals’ healthcare monopoly is
crumbling.
These trends have their
dangers. Snake oil salesmen will take advantage of the uninformed and the
desperate. Millions of people, each with their own unique body chemistry,
will take hundreds of pills, resulting in billions of untested
combinations. Aspirin, the first wonder drug, was introduced in 1899, but
it has taken 100 years to discover all its effects – good and bad.
Lawyers will do well. There will be dramatic growth in “vanity
medicine’ – surgical procedures and other treatments people undergo
not out of medical necessity but in order to feel good or to look good, or
even simply because everyone else is doing it.
This changing environment
will present huge opportunities for healthcare enterprises to
differentiate themselves. Some will strive to become known above all for
their integrity. In a world where healthcare consumers are inundated with
advice good and bad, those who provide unbiased, independent, reliable
information will become key linchpins in the system. Computer buyers have
Ziff-Davis and PC Magazine; auto buyers have Consumer Reports
and J.D. Powers. Who can patients turn to for advice? Powerful brands in
this field could be built by groups like the American Medical Association,
respected institutions like the Mayo Clinic, publications like the
Physicians’ Desk Reference, and personalities like alternative medicine
authority Andrew Weil or radio host Dean Edell.
Like the financial services
industry, the healthcare industry is very early in its evolution. One
hundred years from now, it’s likely to have changed beyond recognition.
But some of today’s enterprises may still be at the top of the pack.
Will yours be one of them?
Another industry whose
prospects are enhanced by the aging of the baby boom is travel.
While the events of September 11, 2001, have caused havoc in the industry,
the long-term outlook remains extremely promising.
As usual,
I define this industry as broadly as possible, including travel books and
videos, travel gear and luggage, airlines, state parks, cruise ships,
hotels, tour operators, and theme parks. Other industries from restaurants
and museums to Broadway theatres and convention centers are also potential
beneficiaries of the coming boom in tourism. On a global scale, aircraft
makers and high-speed rail operators have great upside potential. Even the
auto industry, often seen as a mature business, will ship huge numbers of
units to customers in emerging nations, due in part to the upsurge in
travel.
As the baby boom
ages, they will have more time and more money. In many cases, their
desires for material goods will become sated and they will increasingly
turn to experiences. From sailing to the symphony, from trekking to
doubling down, more money will go into “capturing the moment.” This
will occur at many income levels and all over the globe. While we have
historically thought of travel as a single part of the economy, every
little niche will grow, especially if smart enterprises pave the way.
For example, I believe one
could start a successful enterprise of significant size specializing in
hunting, fishing, camping, and golf trips. Such a business might operate
through bricks-and-mortar storefronts or online – probably both.
Likewise, there is potential in religious and spiritual travel (reviving
the ancient tradition of the pilgrimage), classical music travel, rock
music travel, baseball travel, auto racing travel, gardening travel,
health travel, history travel, and about every other type of travel you
can imagine.
Another opportunity is the
potential of business travel, which has barely been tapped today. You read
that right. I’m not talking about traditional business travel, which
involves traveling somewhere to negotiate a deal, attend a convention, or
sit in a business seminar. I’m talking about business travel designed to
broaden, deepen, and enrich your understanding of human behavior and its
economic consequences. Think about hanging out at Venice Beach (as Nokia
engineers did) to observe people skateboarding, sunbathing, and flirting,
in search of ideas about how wireless technology could enhance the
experience. Or visiting the souks (traditional marketplaces) of Syria in
search of ideas for more exciting retailing. Or taking a behind-the-scenes
tour of O’Hare Airport or Disney World to learn how to effectively
manage a complex business.
Travel is best
understood if it is seen as a combination of many things – a way to
escape, a way to learn, a way to enjoy. A form of education and
entertainment. I guess you can tell from the chapters on geography (14
through 21) in Hoover’s Vision that I believe that travel is a
fundamental part of any education. A bachelor’s degree handed to someone
who has never been out of state doesn’t mean much.
Now the bad news: most of
the travel industry is not prepared to take advantage of the opportunities
that lie ahead. Let’s start with one key component, the airlines, a key
ingredient.
The airlines today take a
lot of flack, especially for their delayed, overcrowded flights and their
surly service. They don’t get the credit they deserve for doing the
fundamentals amazingly well. Inflation-adjusted air fares are lower today
than forty years ago. Despite crowded skies and runways, flying is safer
than ever. The US airline system is carrying dramatically increased
numbers of people, with little support from the infrastructure provided by
government agencies (few new runways, few new airports, inadequate traffic
control systems). I’d rather be on a flight that is late and safe than
one that is on time and landing too close to the previous flight.
Airline service quality is a
mixed bag. I fly about one hundred times a year, all over the world, on
many airlines. In my experience, the European and Asian carriers,
Southwest, Continental, and a few other airlines give service that ranges
from above average to outstanding. Unfortunately, some of the big US
carriers, notably United, Delta, Northwest, and USAir, are notoriously
poor in this area. These companies also tend to overcharge their customers
in non-competitive markets or on last-minute reservations. Some in the
industry call it dynamic pricing, others call it yield management. I call
it gouging.
However, I believe that
competitive forces, if allowed to play out, will force these companies to
improve. My major criticism of the airline business relates not to service
but to the lack of personality and the weak branding that characterize
most carriers. Wake up from a nap on a typical flight and tell me which
airline you are on. Chances are good that you won’t be able to tell. The
seatbacks, the aisle widths, the color schemes are all alike. So are the
snacks, the in-flight catalogs and magazines, the entertainment.
The two most successful
airlines in the world, Southwest and Singapore, have achieved their
success by differentiating themselves – Southwest at the mass end of the
market, with few frills and short hops, Singapore at the high-service,
long-distance end. Both earn consistently high ratings from travelers and
are very profitable. But most of the other carriers are undifferentiated.
In this field of look-alikes, it wouldn’t take much to really stand out
from the crowd. Possibilities might include:
You may be saying, “I
stayed in a Four Seasons (or a Ritz-Carlton) last year, and they had these
things.” Maybe so, but what about the less expensive hotels? The average
American home has more of these things than most $100 hotel rooms. Office
Depot sells inexpensive office chairs by the tens of thousands that are
better than those found at most hotel desks.
The lodging industry offers
relatively little segmentation except on the basis of price. That is, we
have cheap places and expensive places, but we don’t have inns for older
people, inns for travelers with toddlers, inns for sports junkies, inns
for people with pets, or inns for gadget freaks. I was recently searching
for a hotel for a very tall person, and not one hotel website
listed “king-size beds” as a searchable field.
If airlines allow you to
select a window seat or an aisle seat, first class or coach, couldn’t a
200-room hotel or motel give you multiple options on the style or
amenities of your room? Why not a Michael Graves room or a Laura Ashley
room? Why not a rooms for seniors or rooms for parents with toddlers?
Hotels are, in a sense, in
the architecture business. They have physical facilities that many people
spend a lot of time in: not only bedrooms but many public areas, from
lobbies and restaurants to meeting rooms, ballrooms, and shops. But how
many of today’s new hotels and motels are going to win architecture
awards? Industry leaders thought in those terms generations ago, when they
built the Palace in San Francisco and the Waldorf-Astoria in New York –
hotels that are still turning nice profits. If the average new American
home can be reasonably attractive to the eye, why can’t the average new
Best Western?
I make a lot of speeches in
hotel ballrooms, and I find that the average junior college classroom is
better prepared for meetings than many of our fanciest hotels. The college
is likely to have theatre-style seating and a built-in, up-to-date screen
and projector. At the fancy hotel, outdated A/V equipment is rented by the
day and placed in rooms that were not built for conferences or seminars.
Perhaps the biggest
indictment of the lodging industry is its inability to break the tradition
of the noon checkout. The largest inns run housekeeping operations from
early in the day through the evening, but even so a 2 p.m. checkout
usually requires a battle with the front desk. The poor road warrior who
gets off a redeye flight and checks in to his hotel room at 2 a.m. only to
depart at 7 a.m. for his next meeting pays the same as someone staying a
full 24 hours. There should be other options.
I raise these many issues
only to underscore the industry’s huge potential for innovation. There
are some signs of change. Bed-and-breakfast inns offer great variety and
originality. The W Hotels are trying new things. Ian Schrager operates a
group of hotels, including New York’s Hudson and Paramount, that are
each unique and interesting. Club Quarters gives guests many checkout
options, puts an excellent desk in each room, and even provides a
dictionary and other reference books. Austin’s San Jose Hotel, a
remodeled 50s motel, combines great architecture with CD players and VCRs
in each room, supported by a music and movie library at the front desk.
The hotels operated by Disney, like the Grand Floridian at Disney World,
offer an experience that would be hard to equal in most major cities. Most
impressive of all, San Francisco’s Kimpton Group, which now has
facilities as far east as Chicago, operates extremely original hotels,
each unique, some in restored buildings like Chicago’s wonderful
Burnham.
These examples, representing
only a tiny percentage of America’s lodging industry today, point the
way toward the future.
As the travel industry grows
dramatically in this century, we’ll see whole new companies begun, and
old ones remodeled, to offer customers new and more interesting choices.
Business battles will not be won via mergers and cost controls alone. They
will increasingly be won through differentiation, showmanship,
entertainment, visual design, a sense of history, and skillful catering to
market segments.
Is your enterprise truly innovative, or, like today’s hotel chains, just
functionally competent? Which of the ideas we’ve explored above has a
parallel in your business?