Strategy is about making choices, trade-offs; it's about deliberately choosing to be different.

There's a fundamental distinction between strategy and operational effectiveness.

The thing is, continuity of strategic direction and continuous improvement in how you do things are absolutely consistent with each other. In fact, they're mutually reinforcing.

If a strategy meets a goal: It's working. If a strategy meets a target: It's a success.

Sound strategy starts with having the right goal

If your goal is anything but profitability - if it's to be big, or to grow fast, or to become a technology leader - you'll hit problems.

Health care historically has been a very siloed field that's organized around medical specialties - urology, cardiac surgery, and so forth - and around the supply of these specialty services. The patient is the ping-pong ball that moves from service to service.