Category: Airlines

The Employee “Shrug” is the Moment When Your Extraordinary Startup is no More: On Reversion to the Mean

I have family in Canada, and so often find myself flying from Boston to Toronto. There are two ways to fly:  you can take Air Canada from Logan to Toronto’s International Airport a couple of times a day.  Or, for the past 10 years, you can fly on a small turboprop operated by Porter Airlines from Logan to a small municipal airport located on an island in Toronto’s harbor.

Since it started flying in 2010, I’ve always preferred Porter because it’s a scrappy little airline that successfully disrupted the big guys by offering great service, friendly staff and easy airports.  To me, the airline was always a textbook example of how small entrepreneurial companies that have a relentless focus on the customer can win.

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Swiss Flight 188, the Normalization of Deviance and a Better Way to Communicate: Lessons for Healthcare Leaders

I recently came across some captivating footage of a Swiss Airlines flight crew dealing with the unexpected loss of an engine.  Watch this- you won’t be able to take your eyes off this smooth, competent crew.  

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Segmenting Healthcare into “Luxury” and “Value” Brands… Thoughts On Not Getting Stuck in the Middle.

A few months ago, I wrote about how healthcare is poised to segment according to cost and service levels– and that we will likely begin to see healthcare brands emerge that appeal to price-conscious consumers looking for reliable, basic care. My suspicion was that US healthcare is now facing its “Southwest Airlines” moment, where nimble and lean competitors will soon undercut inefficient legacy systems for market share.

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Consumers are Linking Budget Airline Itineraries: Will They “Virtual Interline” Medical Services Too?

A few weeks ago, WOW Air, an Icelandic budget airline, announced that they would be flying Boston-Reykjavik at an introductory fare of $99.  Despite the growth of budget airlines in both Europe and the US, 33256099_886c74f59b_zWOW is apparently the first airline to try to make a margin on trans-Atlantic routes. WOW argues that smaller planes (made possible by Iceland’s mid-Atlantic location), limited service and high aircraft utilization will make the route profitable. On WOW, passengers can book a one way flight to mainland Europe for around $200, half of the roughly $400 going rate for a connecting flight on traditional air carriers.

One of the obvious consequences of this route announcement will be a further growth of consumers who cobble together a series of low-cost tickets to undercut published fares on the network airlines, (now with WOW making it to Europe and beyond). The Wall Street Journal wrote about this trend a few months ago, quoting a traveler who called this practice “virtual interlining”—basically “building connections airlines don’t want constructed”. Continue reading

Asking Patients To Advocate for Their Own Safety is Not Patient-Centered Care.

Last year the New York Times reported that the aviation industry had become so safe that one could fly every day for 123,000 years before dying in an aviation crash.2224681775_e5fae0b58c_z-3

I wish we could say the same for the US healthcare system. Nationally, problems with healthcare quality (doing too much, doing the wrong things, and doing too little when indicated) are pretty clear. The bigger problem is that the progress has been painfully slow. Continue reading

Downed Airliners, the GM Debacle and the Real Danger of Groupthink in Large Organizations


Korean Air Lines Flight 902 Shot Down by Soviets in the late 1970’s

The scenario plays out something like this:  an organization pulls together a team of people to work in a stressful environment.  The team coalesces and after some time a shared set of norms emerges. Everyone begins to do things the same way.  When narratives outside this shared experience emerge, the group closes its ears and marginalizes the outside voice. 

After some time, an unusual situation emerges that is different that what the group expects.  Since there is nobody around to challenge the group’s instinctive response, a serious error is made. Rather than apologize, the organization defends its actions rather than admitting it has a serious cultural and leadership problem.

Sound familiar?

Exhibit 1:  I’ve wanted to write about the GM whistleblower for some time.  By now, everyone knows about the stunning failure of GM to address a lethal flaw in their ignition switches which disabled airbags in a crash.  Businessweek had great coverage of this story a few weeks ago.  The article makes clear that there were internal engineers who kept calling for the company to fix flaws, but that these requests were ignored by senior management for over a decade. Continue reading

Healthcare Mergers are the End of the Beginning: Some Lessons From the US Airline Business

img-thingThere has been a lot of recent discussion about the value of large healthcare mergers, such as Partners ongoing acquisitions in the Boston area and the recent large merger between Baylor and Scott & White in Texas.  Supporters argue that these create better integration of care and economies of scale.  Opponents argue that these deals ultimately drive up costs, restrict options and worsen care. Physician bloggers on Forbes’ website write: Continue reading