There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.

The outsourcing gurus have been driving the theory, and they are saying everybody ought always to do this. But it is really contingent on where you are on the spectrum from "not good enough" to "more than good enough," relative to each tier of the market.

Doing deals doesn't yield the deep rewards that come from building up people.

If you ask the average guy on the street to name five companies that have truly transformed themselves over the few decades, Hewlett-Packard would be on everybody's list. You'd also put on this list GE and Johnson & Johnson.

A lot has been written about the Internet bust. From my point of view, it's quite clear the Internet isn't a category; the Internet is a technological infrastructure that can be deployed to facilitate a disruptive business model or a sustaining business model.

Many think of management as cutting deals and laying people off and hiring people and buying and selling companies. That's not management, that's deal making. Management is the opportunity to help people become better people. Practiced that way, it's a magnificent profession.

If the technology is disruptive, on the other hand, the odds are that at the end of the transition, the leaders will have been toppled and new companies will be on top.