WORKING BELOW THE BOTTOM LINE

by Martha Blake, MBA,  LP, NCPsyA,
Psychologist Resident
Dunbar Carpenter, PsyD,  Supervisor

After fifty years as a medical care program, Royal Managed Care re-visioned its mission as the preservation of wellness. A decade of increased competition and missed financial targets, propelled senior managers to examine the dissonance between Royal's reputation with customers and the intention of its founders.

Royal Managed Care (corporate identity disguised) is the trademark for a physician group and health insurance company. Royal is a multi-state managed care organization with twenty million members. Physicians own the for-profit professional group that delivers medical care. A not-for-profit foundation owns the corporation that sells health insurance. Royal Managed Care offers its pre-paid service to employers and to individuals.

In 1999, a Middle Management Development team diagnosed inadequate marketing of high quality for Royal's poor consumer reputation. Royal initiated an internal marketing campaign which enlisted each employee as an ambassador to the local community. Meanwhile stiff competition, mergers, and divestitures aroused senior leaders to the need to clarify the vision as they solidified a new form.

Participating in National Demonstration Projects during the healthcare quality movement had acclimated Royal to rapid change of product and service line. In 2001, Royal began to change itself from the inside out. Royal reached below the standard knowledge base of consumer and employee research. Royal leaders tapped into unconscious knowledge about the archetypes of business and medicine to reinvent itself.

Working with consultants conversant with Carl Jung's concept of the group unconscious, Royal explored the personality of its founders to re-engage with the core personality of the organization. Over the years, Royal had lost touch with the health orientation of its founders. Royal had gradually become a medical program focused on illness. Royal leaders reconnected with the larger than life, pioneering energy of its corporate founder and the creative, caring concern for wellness of its physician founder. As Royal leaders reconnected with the core personality of the organization, it again focused on the needs of its customers. Royal leaders courageously shifted their focus from medicine to the needs of people.

Focusing on the needs, behaviors, and values of people aligned the internal organization with the external world. People want health, wellness, and medical care when they fall ill. Royal's orientation to the wellness needs of its membership shifted its emphasis from acute care to prevention, from Royal medical intervention to customer access to care.

When Royal focused on the needs of people, Royal had to address how it related to its customers. Royal consciously examined its marketing messages. More importantly, Royal examined the unconscious messages communicated by its service. Royal discovered the dissonance between its marketing messages and the people's needs for access. Customers hear both the conscious and unconscious messages and tend to believe the unconscious messages more. Poor access to service was communicating that Royal did not care for customers as much as its founders had cared.

By reconnecting with personality of its founders, Royal approached the archetypes that had energized them. Royal leaders reconnected with the founders' unconscious heroic and caring energies. They shared the myths and values that vitalized the organization. They explored the unconscious beliefs and fears that currently held them back. They named a conflict in the underlying drama that was playing out in their behaviors: a medical program cares for people. A wellness program cares about people. Royal managers worked below the bottom line to align vision, mission, values, message and performance.

Changing customer perceptions takes time. By 2003, Royal moved into a sustainable market leadership position. Royal is meeting financial targets that allow it to build new facilities while it engages customers in their health.