Wednesday, February 9, 2011

Doing Common Things Uncommonly more time

Why do we do common things uncommonly well? I've been asked several times recently about the origins of the statement I so often use "doing common things uncommonly well." I have done a brief post about this in the past and decided to post it again for those who are interested.

Without actually asking George Degnan we can’t be sure what may have inspired his association of Contra Costa County Hospital with his prophetic and simple statement:

“We do common things uncommonly well”

George Degnan, M.D., Chief Surgery, Founding Residency Director, County Health Director, Contra Costa County: 1950 – 1980.

Here is an excerpt from a interview conducted by Caroline Crawford, University of California Berkeley (1997) with Henrik L. Blum M.D., M.P.H., champion of public health, social justice and considered to be one of the true fathers of health planning. He served as health officer of the Contra Costa County Health Department from 1950 to 1966.

Not only do I find these interviews fascinating, I find it reveals a great deal about today to read these historical recounts.

Crawford: Did the two of you (Degnan and Blum)reinforce each other in the community?

Blum: "In a sense, yes. Yes. I mean, we were constantly friendly enemies or friendly competitors, or something. I remember when the Easter Seal Society came around and wanted us to do something. They were going to put on a big campaign, and the campaign was to state that our county health department had the best crippled children's service in the state. Well, it probably did, but that's nothing to put into a campaign which is going to tell my board that their health department is the
best in the world therefore it won't deserve any significant new funding. I mean, one just can't say stupid things like that.

George was at the meeting. It was in my office, I remember, he was this big handsome guy, and he was listening to these ladies who were driving me nuts. They just could not be talked out of it. I said, "Look here, it's our county, and you're coming from San Francisco and are telling me how to play ball here. We'll get you whatever you want, because we want the same things, but don't come out with this kind of propaganda, like it's the best program in the world. It's insane." They just couldn't hear me. So I got up and walked out, slammed my own door, and left. George, they tell me afterwards, turned to look at these people and he hadn't said a thing all this time and he said, "Well, I think that settles that, doesn't it, ladies?" He was a good ball player, a good card player, a good poker player, and it worked. They came around and did what we wanted. It all worked out very well our way without our telling the world we had the best health department. If you do something like that, you're crazy."

I am drawn to this story when I look at the address plaque of Merrithew Memorial Hospital that hangs on my wall. It underscores the perverse incentive/disincentive-based-system we call American Health Care. American Health Care, like all systems, is designed to get the results it gets; needless pain and suffering, needless death, unwanted waits, helplessness, waste and health care inequity. This design rewards settling for less than the best and reinforces perceptions that county/government owned and operated medical centers are a place of "last resort." This design supports a prevailing cautionary note that whispers (or screams, depending on the day), "Don't tell the world you are great. If you do you something like that you are crazy."

I recognize and am truly grateful that we stand on the shoulders of these great and visionary leaders. I also believe that it no longer serves us to downplay what our system can and does do for our community. A "last resort" is not what I see when I look at our publicly owned and operated health system. I see an integrated health system based on primary care and prevention. I see a dedicated team comprised of employees and members of our community working together, drawing on science and the energy and creativity of each other to continuously improve our great health system. I see a place of hope. I see a place where no one is left out.

I see a place where we do common things uncommonly well.

Anna M. Roth RN, MS, MPH, Chief Executive Officer, Contra Costa Regional Medical Center

Below are some potential sources our Residency Director, Dr Jeremy Fish sent (not clear who said it first as they lived amongst each other) that Dr Degnan may have drawn on.

“Learn to do common things uncommonly well; we must always keep in mind that anything that helps fill the dinner pail is valuable.”
George Washington Carver quotes (American. Started his life as a slave and ended it as horticulturist, Chemist and Educator, 1864-1943)

The secret of success is to do the common things uncommonly well.
- John D. Rockefeller 1839- 1937 , Founder Shell Oil

Doing common things uncommonly well.
Orison Swett Marden 1850-1924, American author and founder of Success magazine.

As Jeremy points out, it is interesting and noteworthy that these three men’s lives overlapped.

Thanks for sharing Jeremy.


  1. Well said. Learning from past leaders is a great way of gaining perspective on current issues.
    I regularly share my insight in real estate on my blog for healthcare professionals and would enjoy hearing your thoughts. I would also be interested in hearing from you. My staff would be more than willing to research a topic of interest you have or possibly a recent development that needs further evaluation.

    Jim Ellis
    CEO Healthcare Realty Development

  2. Dear Mr. Ellis,

    I have not had the opportunity to read your blog. I welcome a link.

    Thank you for your interest and feedback.

    My best,