There's an old joke about the May Day parade in the former Soviet Union: Two Communist Party officials, one a veteran and one a newcomer, are reviewing the procession of military might. Armed troops, tanks, artillery, surface-to-air missiles and nuclear rockets all pass by the approving political hierarchy.
Suddenly, a fearful hush falls over the crowd as a group of ordinary-looking guys punching hand-held calculators marches by.
"Who's that?" asks the young official. "And why is everyone so intimidated?"
"Economists," answers the veteran. "Those weapons are formidable, but these guys can do real damage."
Healthcare executives may be excused if they cowered in their offices during the past 15 years. A parade of economists, consultants and other experts predicted the near-demise of the healthcare sector, particularly hospitals. DRGs, Medicaid, managed care, healthcare reform plans and runaway inflation were all going to create a dark and dismal future for providers.
The reality is decidedly cheerier, as reporters Patricia B. Limbacher and Deanna Bellandi note in this week's cover story (p. 62) and financing special report (p. 68). Overall healthcare spending has been restrained, provider efficiency has increased, Medicare margins are generous, and the biggest problem facing many hospitals is how to invest their abundant cash.
This is not to say that all is rosy or providers should adopt a complacent attitude. Troubles are plentiful. And history teaches us that organizations that fail to change with the demands of changing times meet with extinction.
But history also shows that the future belongs not to the people who try to predict it or worry about it, but to those who try to shape it. In previous editorials, we have called on providers this year to focus on the primacy of the patient. Putting customer service first has been the world's most reliable business strategy. Executives who follow that strategy need not fear the future.