Positive Leadership

Bonus WEF episode: Transforming healthcare through self-management (with Jos de Blok)

May 25, 2022 Jean-Philippe Courtois
Positive Leadership
Bonus WEF episode: Transforming healthcare through self-management (with Jos de Blok)
Show Notes Transcript

JP's next guest, Jos de Blok, doesn’t believe in management.

So how is he a Positive Leader?

Because he believes in empowering employees by giving them the freedom to develop their own skills and careers, and providing quality coaching when needed. 

It’s why he created the self-managed model that has allowed his community healthcare organization Buurtzorg to transform the Dutch healthcare industry, become one of the country’s top employers, and touch the lives of patients all around the world. 

JP was so inspired by the conversation they had in WEF, and is sure you will be too!

JEAN-PHILIPPE COURTOIS: Hello and welcome to another bite size edition of the Positive Leadership podcast, coming to you from the World Economic Forum’s annual meeting here in Davos, Switzerland. I’m Jean-Philippe Courtois, JP. 


For over 50 years this meeting has provided an informal space for leaders to discuss the most pressing issues of the day and to try to work out how they can improve the situation for the benefit of all. The concept is simple. From a diverse gathering of leaders, innovations for the global good can be born. And that word diverse, is key. There are over 2,000 participants at this year’s meeting. Heads of states and developments, yes, but also business leaders, leaders from civil society, researchers, and academics contributing their expertise and insights all together. 


JOS DE BLOK: If you say, okay, we need KPIs, we need targets, we need this. So people feel it as pressure. If you take it away, people will perform and they’re develop. I’m Jos De Blok and I’m the founder and CEO of Buurtzorg, a community healthcare organization, which delivers care at home in neighborhoods in small, self-organizing teams. 


JEAN-PHILIPPE COURTOIS: Jos De Blok, my guest today, is a nurse by education. And he started a movement, which has transformed healthcare and elderly care in the Netherlands. Jos has got rid of managers and in doing so, he’s enabled the Dutch healthcare system to reduce costs by around 40%, while the time it takes to administer care has been slashed by a staggering 50%. Meanwhile, Buurtzorg has improved job satisfaction so much that he has repeatedly won Dutch employer of the year. 


JOS DE BLOK: Self-development is one of the most important things. So people understand what their strengths are and we develop their strengths. Do what you think is good for your development then it will also contribute to the healthy status of everybody. 


JEAN-PHILIPPE COURTOIS: Warm welcome to Positive Leadership podcast, Jos. 


JOS DE BLOK: Thank you. 


JEAN-PHILIPPE COURTOIS: Jos, I understand you’ve grown up in a family of five and that family was deeply immersed and you were deeply immersed with people and situations where solidarity, social issues were very common. Can you briefly share what and who shaped the values you have and what triggered your interest, I would even call it a vocation, if I can, in becoming a nurse? 


JOS DE BLOK: I think what I saw in my parents’ behavior was that it was normal to support people who had problems. We had a lot of people in our house with mental problems, sometimes with addiction, but also refugees. I was talented with economics so I started to study economics for a few years. But then I got more or less depressed by the world of money. So I thought with my values that I learned in my family, I decided to quit my study and to start being educated as a nurse. I worked for 14 years as a nurse then they asked me to become director of home care organization and I thought, perhaps I can change things because things became more and more bureaucratic. And then in ten years’ time I saw things get worse and worse and in these ten years my idea of starting something myself and the model that came with it, I was inspired by my own practice and I created kind of a model there. I thought this is the best environment for nurses to work in. And it’s also a sustainable model from a financial perspective. 


JEAN-PHILIPPE COURTOIS: When we talk about social innovation, very often we talk about the theory of change. So what is your theory of change and how did you model this new healthcare approach to replace the existing one that you are fighting with in a way? 


JOS DE BLOK: Yes, it’s true. It’s always a fight with the system. What I wanted to show is that if nurses are working based on that professional ethics, that the hours needed, the hours of care needed, are getting less and less. So focusing on empowerment of people, focusing on self-support creates other outcome. So on both sides, I wanted that nurses could decide together with the patient on what is the best thing to do. What are the interventions you should take care of and I wanted that the patients felt that the nurses were there for them. And I wanted to reduce the bureaucracy. And I wanted also to show that it can work without a management structure. 


JEAN-PHILIPPE COURTOIS: Which is quite incredible. I’d like us to build on that because in many ways you talk about empowering both the patient and the nurse. Can you elaborate a little bit more about what it means to give more powers to a nurse, as an example, and a patient. To do what? What would they do differently they were not allowed to do in the bureaucratic system? 


JOS DE BLOK: But nurses are very entrepreneurial. This is very powerful. But a lot of regulations and organizations take away this power. So if you create ownership for the nurses, if you say, okay, you’re going to work in a team in this neighborhood and the networks and the results and your colleagues, it’s all the responsibility of the team. Then it will create a lot of dynamics in this neighborhood and it will use all the resources that are there to create solutions for patients. So if you say we don’t need to control it. These nurses will do the best possible thing, then you see bad things happen.


JEAN-PHILIPPE COURTOIS: I’m really interested in this concept of teams you build. I think you deeply believe in teams and the power of teams as well. Can you explain to us how a team unit would work? 


JOS DE BLOK: They build the networks with the doctors, the hospitals. They get the referrals. They advertise in their own way in the neighborhood. And then it’s just talking about how do we do this as a team. So they make their own plans. 


JEAN-PHILIPPE COURTOIS: So they self-manage, basically. 


JOS DE BLOK: It’s all self-managed. You don’t have to say anything. You don’t need to be supervised on nursing, do this, do that. No, we have coaches and the coaches come in when the teams have a difficulty they can’t solve themselves. 


JEAN-PHILIPPE COURTOIS: So it’s kind of a mediator coming in to facilitate. 


JOS DE BLOK: This coach thinks with them about okay, what happened and what can we do about it. But very focusing on the solution. 


JEAN-PHILIPPE COURTOIS: I love it. You’ve been certainly building them all, which I think is very human centered. How have you stayed true to the principle of minimizing layers of management? Working in a very large company, Microsoft, with a lot of managers across the company. How do you do that because you have now more than 12,000 people I think.


JOS DE BLOK: 15,000. 


JEAN-PHILIPPE COURTOIS: 15,000 so you keep growing even faster. How do you do that? 


JOS DE BLOK: The idea is that if you have these routines in a team and the team is responsible for also the financial results and the teams understand very well, have a very simple business model. I simplified the whole tariff system so I said we only want to have one price. So that makes it super easy. Then on the other hand, I build it on the different costs per team. And said okay, if the income is this and the costs are that, then it’s very easy to understand for teams that I need this kind of productivity to be... That’s what we do. And then every team can monitor in their own team dashboard how they’re doing. And what we see is because we have now almost half a billion turnover, but it’s still on one sheet. So one financial report is on one sheet. 




JOS DE BLOK: And it’s important because in my opinion, if everybody understands how the financial flows are and how they can influence it, everybody will take responsibility. For therefore we say, okay, we don’t need the CFO. So I had a few years of economics. 


JEAN-PHILIPPE COURTOIS: You don’t have a CFO today? 


JOS DE BLOK: We don’t have a CFO. We have two controllers and they have to focus on the soft controls. So we build on trust and we build on soft controls so always a discussion with our accountants that we have enough information that we are sure that things are going well. 


JEAN-PHILIPPE COURTOIS: Integrity of the account. 


JOS DE BLOK: After 15 years it’s always the same. This management paradigm, in my opinion in a lot of industries, is limiting people. 


JEAN-PHILIPPE COURTOIS: What about the patient on the other side of the equation? What would the patient ask, say about their needs? Because we probably all had some experiences of parents, of friends in hospitals and all suffer the experience, which is not a nice one. 


JOS DE BLOK: Yes. I remember this young woman and she was 31, 32 I think. I got an email from her and she said I’m not writing this email myself. My mother is doing this. But I wanted you to know that at the end of my life, because she died of breast cancer, at the end of my life I decided to go back to my parents’ house and I got supported by one of your teams. I never could have imagined that at the end of my life I would get four new friends. And they took me to all the places I wanted to see in the last weeks of my life and I felt that I could do anything and decide anything I wanted to support me in the last moments of my life and that made my last week’s so meaningful. My mother’s writing this email. I wanted you to know that I’m thankful for you and when it’s happening for me, it probably will happen for many other patients too. When she sent me this she already died. So when I read this I was crying behind my screen. And it felt like, okay, this is what I felt when I was a nurse that if you do these things, it’s so important and have so much impact on people’s lives. And this is what the bureaucracy took away, that people were not able to do these things anymore because it was not seen as productive nursing work. 


JEAN-PHILIPPE COURTOIS: That’s pretty amazing. It’s pretty amazing to listen to your, Jos. The more I listen to you and the more I see you clearly as a fantastic example of positive leader, what would be the advice you’d give to other people to become that positive leader? What would be your recommendation to them? 


JOS DE BLOK: Start thinking what’s important for you. What kind of purpose, what kind of thing would you like to develop? And then how does it fit with possible businesses. And there it starts. And then people understand, okay, the purpose first and then the profit. 


JEAN-PHILIPPE COURTOIS: All right. The right order. 


JOS DE BLOK: In the right order. And then I also say, you really have to think about a good business model. Because you can be idealistic but if the business model is not right then you will get big problems. 




JOS DE BLOK: And I also say connect with people who inspire you. If you have a network with the people with different skills, different ideas. 


JEAN-PHILIPPE COURTOIS: Meet with them. Be curious. Understand the way they have been realizing their potential as well. We are in Davos together at the World Economic Forum. Tell me more about what you’re expecting and how do you think that changemakers, what can you achieve in a firm like Davos? 


JOS DE BLOK: What I see is that the attention for social innovation and social impact is growing so also with the existing companies. So I think we can contribute to how it can work. But I’m also advising organizations to make transitions towards a more self-organized way of doing things. So contributing to that discussion, I feel responsibility for that. The other thing is I meet people who inspire me. It’s good to have some reflection myself from others, from different countries, different places. And that gives also the opportunity to bring my ideas, for example, to the prime minister and our queen, who I’m meeting tomorrow. I will see. The formal part is not what I’m looking for, but it’s there, of course. I will try to use my time as useful as possible to meet people and talk about what I think is important. 


JEAN-PHILIPPE COURTOIS: And I’m sure you’re going to have a good impact of who is the queen and many others. 


JOS DE BLOK: We will see. 


JEAN-PHILIPPE COURTOIS: To impact so many lives in the Netherlands but also far beyond. Jos, Jos De Blok, it’s been a real deep pleasure to meet with you. Wonderful to share your story but more importantly, the way you’re impacting so many lives in the world one nurse and one patient at a time. It’s been inspiring so thank you so much for being here with us. 


JOS DE BLOK: Thank you. 


JEAN-PHILIPPE COURTOIS: You’ve been listening to the Positive Leadership podcast with me, Jean-Philippe Courtois. To hear more from inspirational global leaders who are making a difference, subscribe now wherever you get your podcast.