09 Mar 2018 17:25 IST

What we can learn from the ‘and’ form of thinking

Great leaders have the vision, the imagination and the courage to fashion an 'and', instead of looking for an 'or' BL on Campus | iStock.com/Natali_Mis

Dr V of Aravind Hospitals is an example of what happens when you choose an ‘and’ outlook over ‘or’

As we pursue our leadership journey, one rewarding way is to look at role models and treat them as gurus who can help us in our own journey towards becoming better managers. They can illumine our path, save us from pitfalls and give us the inspiration to raise the bar in the way we lead.

Every few columns, starting from this one, we shall look at a role model leader — some from the world of business, some from outside it. In each case, we will reflect on what they can teach us and which of their qualities we can embrace.

The ‘ and’ and ‘ or’

Let’s begin with a leader who embodies the spirit of and, not or. In an earlier column, we reflected that one of the defining traits of great leaders is that they do not allow themselves to be trapped in the false choices that an or situation often presents. Instead, they have the vision, the imagination and the courage to fashion an and. Dr Govindappa Venkataswamy, fondly known as Dr V, lived and embodied this trait.

Dr V

Dr Govindappa Venkataswamy | aravind.org

A brief background for those who do not know him. By the age of 58, when most people retire, Dr V had served as an ophthalmologist and had personally performed over 100,000 surgeries. After retirement and plagued by rheumatoid arthritis, he founded Aravind, a 11-bed eye clinic, in 1976. The hospital has since treated over 32 million patients, performed over 4 million surgeries and done more to eliminate blindness across the world than any other organisation, public or private. In pursuing this magnificent obsession, Dr V always chose ‘and’ instead of ‘or’.

Let’s look at a few ways he did that.

With purpose: Dr V had a simple purpose — to eliminate curable blindness. In a country with over 12 million blind people, he chose to define his purpose as removing blindness and ensuring that even the poorest of the poor could afford the treatment.

As Dr V’s nephew puts it so inspiringly: ‘If somebody is blind, that’s our problem. It doesn’t matter whether they have money or not. The problem is ours’. It’s that kind of and outlook in their purpose that created an organisation of such scale and quality — so much so that even paying patients travel across states and countries to get treated at Aravind.

High volume, high quality and affordable cost — a mantra that would typically come with a bunch of ‘or’ caveats, has been packed with the power of ‘and’ by a man who wouldn’t take small goals as an answer. ‘To give sight for all’ — as his journal entry reads.

Consider this comparison that Thulsi Ravilla, Dr V’s nephew by marriage and its first real ‘manager’, provided: the National Health Service of the UK conducts around 500,000 surgeries annually in the whole country. In comparison Aravind, a single institution, does about 300,000. And here’s the kicker — at less than 1 per cent of Britain’s costs!

We must ask ourselves: how can we give our leadership that kind of ‘and’ power for us and the teams we lead, both personally and professionally?

With possibilities: Dr V’s vision was to bring the power of McDonald’s to eye-care — to bring the standardisation, processes, brand recognition, training and scale that worked so well in fast food, to eye-care. That’s the kind of thinking that created possibilities where others saw only problems.

Tim Brown, the CEO of IDEO, one of the most influential design firms in the world, puts it well when he says: ‘Dr V brought in his own set of constraints when he insisted on a particular mode of delivering care. He said it had to be high-quality, compassionate care and that it also had to be affordable and sustainable’.

Notice all the ‘and’s that Dr V wanted to achieve. Most business people would routinely think ‘or’ — that something had to be high-quality or at value-price. Something could be done with high standards of care or you could reach the mass market.

But Dr V broke all the expectations and created possibilities with his ‘and’ thinking.

A majority of Aravind’s patients receive free or heavily subsidised treatment, yet it is financially sustainable.

Is it possible to make a difference when people who need your service can’t always afford it, while being financially sustainable?

Turning around

At Aravind, year after year, the answer to that question has been a resounding ‘yes’. In 2009-2010, it made an operating surplus of $13 million. Not only do poor people get free or subsidised treatment, they also receive the same quality as the paying patients receive. The you-get-what-you-pay-for thinking does not find space at Aravind.

It also does not take a traditional view of competition. They help them. Aravind shares its knowledge and expertise with a generosity that is born of a selfless giving. This has just helped accelerate progress towards their vision — as more and more ‘little Aravinds’ have sprung up both in India and overseas, harnessing the power of the Aravind model to cure blindness.

Can we too embrace the power of ‘and’ by creating possibilities in the products or services we design, the processes we put in place, the ways in which we make money, expand and innovate?

With people: Dr V used the ‘and’ form of thinking with people as well. He didn’t think that you had to be highly educated or you couldn’t serve at Aravind. He took in people with basic educational qualifications who brought a service culture and a caring-for-the-patient ethos.

He enlisted his own family members who had high paying jobs (many of them overseas) by persuading them to join him and find the and of making use of their professional experience and expertise, and finding meaning in what they do. Those who showed promise and potential were often assigned more demanding tasks, testing assignments and daunting targets. As Dr V put it — ‘You don’t just find people. You have to build them’.

Instead of pushing poor people away, Aravind tries to draw more of them. Intuitively an uneconomic act; but with Dr V’s thinking, the systems and the processes have been so creatively designed, with such power of conviction that more poor patients has allowed for better use of resources, pushed down per unit costs and given staff the productivity metrics that hospitals across the globe only aspire for.

In all these and many more ways, Dr V’s life is a leadership lesson more powerful than you will find in any leadership book. Perhaps his secret lay in those beautiful words he penned — ‘My interest in my profession is how to make this work a field for inner growth and perfection. Aravind Hospital aims at bringing higher consciousness to transform mind and body and soul of people. It is not a mechanical structure repairing eyes. It has a deeper purpose’.

(Note: The quotations and facts in this article are from the book Infinite Vision- How Aravind Became the World’s Greatest Business Case for Compassion by Pavithra K Mehta and Suchitra Shenoy. I would strongly recommend that every young person and definitely every business student read the book.)

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