"Advancing Our Common Interests" by Allen Weiss, MD, MBA, President & CEO

Advancing Our Common Interests

February 1st, 2013 - In her book Governing the Commons, Noble Prize-winning economist Elinor Ostrom defines the concept of successful interdependence. We all depend on each other cooperating, because any one group or person can abuse the system and cause everyone to suffer.

Examples are plentiful at any scale—globally, American, Florida, southwest Florida, our local community and even our hospital system can be more productive while advancing each of our own and every else’s interests.

This concept of cooperating and at the same time competing is being called Co-Opetition, a term coined by Yale Economist Barry Nalebuff and Harvard Professor Adam Brandenberger (and also the title of their book).

Creating value by using increasingly limited resources is in everyone’s best interests. In order to add value, people cannot act in isolation. The old expression that “No one is as smart as all of us” comes to mind and is even more relevant today.

The theory of creating value can be split into two parts. The first is the creation of value, which is inherently cooperative. The second is how to capture this value, which is inherently competitive.

A few examples will bring these thoughts to life. At a simple level, baking a pie requires cooperation and some simple resources—flour, sugar, fruit, and a recipe. Getting the ingredients and a working oven is the cooperative part of the venture. Sharing the pie can be a competitive decision.

Locally, finding good locations for fishing, and then sharing information among sport or commercial fishermen, would be the cooperative part of creating value. Actually being the first to be on location and potentially overfishing the area would be part of the competitive value.

In healthcare, sharing a new best practice would be cooperative. Trying to capture the market would be competitive.

This dynamic balance, recognizing the interdependence of creating value and sharing, is important at all levels. Locally, we need to develop new markets and commercial enterprises to avoid the seasonal and multi-year peaks and valleys in our economy. Regionally and at a statewide level, we can further our interests by collaborating with trading partners from surrounding regions. Along with creating these interests we need to determine who will profit and by how much—which is the competitive portion of the mix.

The best way to create and capture value is with “complementors” which the thesis that Co-Opetition defines as the opposite of competitors. Namely, a “complementor” is someone or some entity which who makes your product or services more valuable, rather than less valuable.

Let’s go back to our examples. Understanding there may be a desire for home-baked goods at a local store or at a bake sale for a charity would create a complementary market for the creation of more home-baked goods—or even wholesome, commercially produced baked products “like mom used to make.”

Commercial and sport fishing guides could complement each other by mutually sharing in the cost of locating, catching, and marketing their products—making fresh fish a desired or coveted dietary product. Sport fishing guides can make the catch-and-release standard for all but the few pounds of fresh fish to be enjoyed by immediate family or friends, while at the same time having knowledge of where to locate game fish.

Medically, the famed Mayo Clinic desires to share their knowledge base and expertise at tertiary and quaternary care with the nation and the world. That fits perfectly with the NCH Healthcare System’s goal to grow as a medical destination for primary and secondary care. The cooperation to create value is so natural between the two institutions. Capitalizing on this cooperation can optimize everyone’s desires—through the complementary values of helping patients with various complexities of illnesses to be correctly matched to the optimal location with the most knowledgeable professionals.

Making our services, products, region, and nation more valuable is critical in our new economy and environment. The seamless transfer of information in the digital age creates even less need for geographic proximity.

Think of the last time you boarded a plane and used a handheld device as your boarding pass (or watched someone else doling so). Compare that image with calling a travel agent and having a hard copy ticket mailed to you, which was our normal just a decade ago.

Cooperation between the airline industry and the computer industry has changed our travel habits. Complementors in this example are the manufacturers of bar code readers and scanning devices. Certainly the cost and bother of booking a flight has decreased, which makes this form of travel more competitive. And that allows and encourages more travel. Unfortunately, the actually overall cost of flying has probably increased due to fuel costs and labor costs. Clearly there are opportunities for complementors and innovators in this sphere.

Along with the digital age, we are now entering the age of genetics. I can envision complementors predicting the likelihood of various illnesses even before the first sign of an illness or disease is detected. Other complementors could suggest preventions and treatments to avoid the illness entirely, thus revolutionizing treatment for diabetes, cancer, high blood pressure and even degenerative brain disease.

The evolution of people, communities, institutions, nations, and our world for collective action as suggested by Noble Laureate Elinor Ostrom is still an ideal. Understanding the power of this concept, growing from selfishness to selflessness, will be necessary to ease the growing pressure on increasingly meager resources. Competition must be seasoned with cooperation.

Looking for complementors and successfully making the connection will help everyone thrive. Our standard of living going forward will be dependent upon everyone working towards a common good.

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.