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Debate an Investment Strategy for Our Field Before Our Fate is Cast by Outside Forces

March 29, 2021

Decisions about how to invest in the future of our field cannot be relegated only to those with resources. We must ensure our field works for all stakeholders. Of course, those with money will freely shape our field as they like. At the very least, we can try to influence those making capital investments. Leaders in our field might even be bold enough to speak directly with investors about some priorities.

Every investor I have met with over the years can be described as a quick study. I have consulted with several on both large and small investment decisions in behavioral healthcare. Yet it might also be said that some miss the forest for the trees. They absorb voluminous technical information and spot a variety of business problems, but some barely seem to understand the industry itself.

It often does not matter if the big picture or the guiding values of a company or industry are missed. For example, investors have assessed our cottage industries and rolled some small programs up into larger corporations. Others have expanded sites for companies based on geographic need. This is opportunistic. They prudently seize available opportunities. A pragmatic view is legitimate but narrow.

Who cares about long-term interests? Anyone planning on a career in the field should care. They might suffer, along with patients, from an accumulation of limited, pragmatic decisions that investors celebrate. Yet some investors have long-term financial interests in our field too. They may not always seek our broad, long-term perspective, but leaders in our field should offer it loud and clear.

What will drive the future direction for our field? It is likely that broad healthcare forces will shape us significantly. Will those forces support the many improvements we still need, like helping more people access necessary care? A new direction from big healthcare could be positive, or our issues could be minimized and ignored. Again, we should be engaging those in power now.

The strategic direction that I favor for our field is two-pronged: 1) consolidation with primary care and 2) expansion of behavioral programs. We have two funding sources for growth, insurance funding (driven by the mounting impact of parity) and investment capital based on that reality. We should debate such strategic ideas with all involved before our fate is cast by external forces.

Strategy is about where you want to end up, not how you intend to get there. This is not a typical line of thinking for people with a job to do every day. However, it is part of the job for executives in our field. They cannot hope to achieve the long-term goals for their company (and do their job) if the entire industry veers off course. Depending on that course, short-term goals may be threatened as well.

Big problems need dialogue, not quick efforts at resolution. There are probably several good strategic goals for our industry. Yet what is the forum for debating them? We focus much more on the present than the future. Discipline is needed to carve out time for thinking about the future. We should remember the maxim of not letting the urgent always take precedence over the important.

Money can facilitate any plan, and we should remember that investors already believe in our future. They are betting on it. We can help them place their bets. Our executives can simultaneously compete and collaborate. They can compete for investment dollars and collaborate with competitors on a future vision for the industry. Let our strategic debates be broadly inclusive, not limited to like-minded people.

An influential book on this topic is "Range", and it shows that we find the best solutions to problems of all kinds by assembling people from different backgrounds and perspectives. Our field is likely to find better solutions to its strategy challenge by bringing together leaders from mental health, SUD, wellness, higher levels of care, and underrepresented communities.

There are several potential benefits for those participating in such discussions. The focus may be our field broadly, but company leaders can use industry insights to benefit their specific interests. The ideas emerging for strategy may lead to unexpected collaborations among participants. Some strategic ideas may help investors better understand how to help themselves and our field at the same time.

The best ideas do not always win, but neither does the greatest wealth. History is shaped by people with a range of ideas and resources, as well as by known and unanticipated forces. Our leaders must prepare for big changes. The U.S. healthcare quandary of excessive cost with mediocre results will reach its breaking point. Will something big, like a pandemic, be the final shock to the system? Who knows?

Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.

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