Lessons Learned from Lego Building Blocks

Healthcare continues to evolve, and we as a profession need to do so as well. One example of a well-known company that has gone through this process is the Danish company Lego. The first Lego brick was created in 1949, after which the company experienced rapid growth for decades. However, from 1992 through 2004, its dominance began to slip. Lego was on the verge of bankruptcy and almost went out of business. Along the way, the company lost touch with who cared about its product and what those customers—parents and children—wanted.

Through some hard lessons learned and some great strategic decision-making, Lego has refocused its offerings on the art and science of building, along with strategic licensing of leading brands. By asking, “Who cares?” or conducting customer surveys, Lego has been able to reverse its decline; and, in 2014, it became the biggest toy company in the world.

The popularity of Lego bricks results from the endless possibilities of what you can build. Their versatility is magnified when you realize how many ways you can connect them. You can arrange six eight-stud Lego bricks in an astounding 915,103,765 different ways. If you can dream it, the Lego Group believes you can build it.

I don’t know of too many doctors who have not bought Lego for their children, played with Legos themselves, or at least stepped on a Lego brick in their child’s bedroom. Since its inception, Lego has produced over 650 billion bricks and pieces. That’s nearly 93 blocks for every man, woman, and child currently living on the planet. They’ve also manufactured 4 billion Lego mini figures—one small Lego “person” for every 1.75 people on earth.(1)

Arguably more impressive is the company’s unprecedented record of recent success. Ten years ago, Lego was struggling on every financial front and headed toward economic ruin; however, it turned the business around. In the past five years alone, the company has quadrupled revenue while growing net income by 9% and gobbling up market share. Maybe there’s a lesson we can learn from Lego!

The following sections present five building blocks that Lego has learned on the road from near financial ruin to world-renowned success. I hope you can add a brick or two based on Lego’s success in your medical practice.

Build Connectivity and Interdependence

Fact: every Lego piece connects to every other Lego piece in one way or another. There is no silo of blue pieces that refuse to connect with the reds. Yellow pieces aren’t busy trying to establish their own kingdom. Larger Lego pieces don’t dominate or demand more attention. All Lego pieces work together toward a common purpose. This is a metaphor worth noting. Your practice, like Lego, has to interconnect with all the other pieces, i.e., patients, hospitals, providers, insurance companies, and your community.

Consider these questions about the connectivity and interdependence of your practice:

• How much time and energy is spent defending your silos (i.e., your turf, budgets, personnel, and other resources) as opposed to working together for a common purpose?

• Do your teams encourage connectivity and interdependence? For example, is your staff cross-trained?

• What do you do when divisive behaviors or conflicts arise? How does your practice handle difficult patients or staff squabbles?

The time for turf protection is over. What we need to do is focus on the patient. Quality is going to be defined as outcome divided by costs. But the outcomes are going to be from the patients’ point of view, not necessarily from that of the doctor or the insurance company.

Build the Right Team

In his seminal work, Good to Great,(2) Jim Collins discusses the need to get the right people on the team. He argues that before an organization (practice) can be truly great, it must get the right people on (or off) the bus and ensure they are sitting in the right seats.

A decade ago, Lego was hemorrhaging money and floundering and soon to be relegated to the bin where Lincoln Logs and the Erector Set are now to be found. Much of Lego’s remarkable turnaround is credited to getting the right people on the bus, starting with CEO Jørgen Vig Knudstorp. Knudstorp provided the clarity, decision-making, and accountability needed to take Lego through a very difficult period. He bit the bullet and made difficult decisions that were in the best interests of the customers and their parents.

Following Knudstorp’s model, consider these questions about your staff:

• Would you re-hire, right now, each person in your practice if given the chance?

• Do you have the right people in the right places? Are the staff and the doctors’ practicing at the top of their licenses?

• Is someone hindering performance? What should you do to get it right? Do you have one or more person who has a bad attitude that is infecting the rest of the staff?

Build a Simple and Clear Path

At one point Lego lost sight of its direction. The company said “yes” to a lot of ideas—good, bad, or otherwise. As a result, Lego branched into areas ranging from toys to video games to theme parks. To correct the situation, Lego significantly reduced the number of stock keeping units offered, sold off the theme parks, and reconnected to its signature Lego brick with a few raised circles and a few recessed openings. . . . you Lego aficionados know what I mean!

Consider these questions about your team or practice’s path:

• Does every employee know what matters most? What matters most is making sure that each patient has a positive experience with the practice at every interaction with the practice.

• Has saying “yes” to low-value efforts cost your practice money, energy, or commitment? Are you and your practice not following the 80/20 rule, or the law of the vital few, which states that for many events and activities, roughly 80% of the effects come from 20% of the causes? Are you focused on the 20% that is dragging the practice down and sapping your energy and productivity?

• What should you do today to ensure the practice is on the right path? For example, do you have regular staff meetings to correct any problems or deficiencies?

Build Value Based on the Concerns of the Customer

Nothing is more frustrating to a Lego user than having a brick or bricks missing from the box or package of bricks. I have probably built several hundred Lego “sculptures” over the years, and I can count on one hand the number of times a brick or a piece has been missing from the plastic wrappers that contain all the pieces for the model. If the Lego store is contacted, it will find the missing piece and send it along with another toy and an apology note. Wouldn’t it be nice if healthcare did the same thing and sent an apology note if someone in the practice made a mistake or an error? I know it is difficult for physicians to accept blame and say “I’m sorry,” but there is no better way to cement a relationship between a doctor or practice and a patient than by showing empathy and apologizing for an error or oversight.(1)

Lego customers, a group that includes both adults and children, spend an incredible 5 billion hours every year playing with Lego products. I am certain that Lego users know more about Lego bricks and mini-figurines than some of the people who manufacture the product. Lego has found the use of focus groups to be a necessity. Watching children play with those brightly colored bricks led to Lego creating and launching the Lego Friends line in 2012. The Friends line doubled first-year sales projections and tripled overall corporate sales to girls in 2013. I recently met a five-year-old child who built a Lego Star Wars sculpture that included more than 1000 pieces by himself, using only the accompanying manual included with the product. (I hope he decides to become a doctor someday, because he will make a great addition to our profession!)

Consider these questions about your patients:

• When was the last time you observed your patients interacting with your practice? How often do patients try to communicate with you via e-mail?

• Are you making assumptions about your patients based on outdated or inaccurate information? For example, are you continuing to obtain PSA results for prostate cancer screening in men over age 70?

• How might you better capture the needs and wants of your patients? Are you surveying your patients on a regular basis? Are you taking action on the patient surveys?

Build Strong Partnerships

Lego has found tremendous success through building and nurturing strong partnerships. The Lego Batman and Lego Star Wars products are just two examples. By partnering and producing these products, Lego has raised the company’s visibility, increased sales, and encouraged fans of their partners to purchase and collect Lego products. You can do the same:

• Is your practice nurturing important partnerships with your hospital, your payers, and the community?

• Should some relationships be revisited or dissolved? Are you checking on your payers and making sure that they are paying in a timely fashion? Have you considered dropping poor payers?

• Do your partners elevate your practice’s performance and stature? Are your partners pulling their fair share of call and overhead? If not, how are you addressing that problem?

What are the Lessons from Lego?

Lego’s goodwill is based mainly on the outstanding product, not costly advertising campaigns. I don’t know about you, but I have not seen a Lego ad in an in-flight magazine or on TV. The Lego brand allows it to charge a premium price and encourage repeat business. I pay top dollar for a Lego toy or model and never flinch at a $50 price for a box of its Harry Potter- or Star Wars-themed toys.

The lesson for entrepreneurs is just like the “field of dreams” . . . if you build a great product, they will come. As the product constantly improves, the value of the brand increases, creating a barrier to entry that keeps other competitors from wanting to enter the marketplace.

Indeed, the idea of overcoming obstacles and constraints can help your practice build on its established strengths. The Lego Group motto is, “Only the best is good enough,” and the company name derives from the Danish words Leg godt, meaning “play well.” The drive to innovate was deeply embedded in the corporate culture. In the early years, this idea helped the company develop its brand and instill pride in its employees. But after a time, it had come to be seen as a mandate to create new toys at any cost. Lego has emphasized that the company cannot be complacent and rest on its previous products. Lego’s message to the healthcare industry is that medicine cannot remain stagnant but must continue to improve and offer better treatment and services to patients.

Bottom Line: Those colorful little bricks with the little elevations are an example of creativity, fun, enjoyment, and connection with our inner child. In that respect, one could argue that Lego bricks are an ideal analogy for the beauty of creativity. As anyone who has ever played with the ubiquitous bricks can attest, the best ideas sometimes come from thinking “inside the Lego box.”

References

1. Smith C. Business statistics\fun gadgets. LEGO facts, history, records and stats. DMR. January 28, 2019. https://expandedramblings.com/index.php/lego-stats-facts-and-records/ .

2. Collins J. Good to Great. New York: HarperBusiness; 2011.

3. Baum NH. Apology: The power of “I’m sorry” in patient satisfaction (and avoiding litigation). PatientExperience.com . September 10, 2012. http://patientexperience.com/apology-power-im-sorry-patient-satisfaction/ .