If you are long time reader of our entries, you'll recognize the recurring theme of “companies integrated into the community. It's not a statement against national or international chains, but a conclto have something big, with experience in other communities? We don't deny that experience is goodm ir that there should not be a degree of standarization and uniformityin the processes. The problem is commitment and responsibility toward the community, not just compliance with it's customers. We'll focus the discussion fron the social and economic standpoints.
Some time ago, a voice memo from a manager in an insurance company was leaked on social media explaining why it was better to send biopsies to a neighboring country for processing and diagnosis because it was faster and cheaper. This made many pathology labs upset in this country and the insurance company had to issue a written apology to contain the damage. We as a company, since that date have severed ties with that insurance company.
The problems of this dynamic, that of sending pathology specimens out of the country ,are evident and we've grouped them into several points:
1) Custody chain. From the moment a sample of tissue or cells is taken from a patient, there is a legal (and moral) chain of responsibilities among those involved: the operating room staff, the messenger that takes the samples from there to the pathology laboratory, and the pathology laboratory itself.
1.a) The mobilization of these samples outside the community poses a risk that can be damaged or lost from point A to point B to point C.
1.b) If the processes are always running, production costs will be increased because each specimen would be an individual commission, or a large segment of the market would have to be monopolized to achieve sufficient volume of sample shipments to minimize expenses, creating in the process a monopoly. On the contrary, if what's desired is to send an economic lot, then the response time is sacrificed in sensitive cases such as certain types of cancer, which harms the patient.
1.c) When outsourcing services to another community, national or foreign, certain portfolios are killed, such as intraoperative consultations (frozen sections), because no laboratory will operate just waiting to receive a case in an eventual consultation, hindering the capacity of surgeons change behavior at the same surgical time.
2) Currency mobilization. The movement of money is important if you want to see the long-term picture.
2.a) A company that is not integrated into its community will always extract currency from the community, impoverishing it.
2.b) A company that is integrated into its community, even if it has to bring consumables from abroad, will be able to attract and maintain the currencies in the community itself through investment, payroll, donations, improvements and managing the facilities and payment of taxes, between many other lines of expenses.
2.c) “Integration” requires more than just profit in the community or create jobs, because the company will have participate in projects that help the development of the community, such as teaching, research, development of new products and services, collaboration with other community entities as in education or social sectors.
3) Custom fit. Each community has its particular combination of features. You can share some characteristics with other communities, but never all in the same way or magnitude.
3.a) A large company that has to satisfy many communities, will logically have to establish a “one size fits all” policy, leaving some aspects of the service unsatisfied in most communities.
3.b) Medium and small businesses, and microenterprises, have fewer processes to standardize or standardize, allowing them to experience ways to provide new and better services adapted to the characteristics of their community.
4) Legal (and moral) responsibility. A company integrated to its community cannot avoid its responsibility because to continue operating, it must respond to failures in its service. A company outside the community can always contain the damage, closing operations and moving to another community.
5) Uniformity and coonformity. The pillars of fast food companies have been to provide a uniform service in all their branches, aspiring to comply with their customers. This has infected the rest of the economic sectors, creating a distant and depersonalized attention, which imposes its standards on the consumer.
So, no standardization?
Nowadays, the mere process standardization is implemented as a quality control, which works well to manufacture parts but which cannot always be adapted to the communities. In health, there are attention sides that are not mere physiological parameters, such as cultural concepts or language, that cannot be universal in a company that aims to cover different geographical regions.
Therefore, it is not that we advocate against an internal quality control program, but in believing that mere standardization is quality control. One can standardize certain aspects of care, not all. Nor can you impose a standard that works in one community, in another community where it could be harmful, much less try to increase profit margins in the same way in different regions.