Somewhere between residency and now, most physicians stop asking why they do what they do. The outcomes are strong, the schedule is full, and the question quietly drops off the list. But the growth you’re chasing, and the fulfillment you might be missing, both live in that question.
The Reality
Most practices are clinically excellent and still stuck, because they compete on the procedure itself: the equipment, the technique, the credentials. All real, all necessary, and all things a patient can find at the practice down the street. Clinical training rewards mastering what you do. Nobody gets graded on why. So practices grow fluent in their specialty and quiet on their purpose, and then wonder why growth stalls even as quality holds steady.
The Shift
Three well-known business authors keep landing in the same place. Joe Pine, who co-wrote The Experience Economy and recently released The Transformation Economy, mapped how value has shifted over the past 150 years, from agriculture to manufacturing to services and experiences, and at the top, transformations, the change in a person that lasts after the interaction ends. His shorthand: what you do is commodities, goods, and services; how you do it is the experience; why you do it is the transformation. Most practices are still competing on the bottom rungs.
Simon Sinek’s famous TED talk, Start with why, describes almost the same idea in reverse: why, how, what. Everyone knows what they do. Few know why. Tesla is a prime example, whether you love the company or not: it has spent close to nothing on traditional advertising, while Ford, GM, and Chrysler (Stellantis) spend over six billion dollars a year combined and are worth roughly 149 billion combined. Tesla is worth about 1.45 trillion, nearly ten times more. Love it or hate it, that’s proof of what clarity about why can do. It’s the exact question my book and our training program both begin with: what business are you really in?
Donald Miller’s StoryBrand framework adds the missing piece. Every business relationship is a story with a hero and a guide. The patient is the hero. The physician is the guide. Practices go sideways when the doctor starts acting like the hero, which quietly demotes the patient in their own journey.
Line these up and something clicks. The real value is in the transformation, not the procedure. Start with why. And the why isn’t about you, it’s about them. Patient experience isn’t a soft skill, it’s a system: structure, clarity, and a shared language about why the practice exists.
What this looks like on a Tuesday: First, spend real time with your own why, the one you had before overhead and schedules took over. Second, take one interaction, like the front desk, and shift it from what you do to how you do it, starting with greeting patients by name before they say a word, using the photo already sitting in your EHR. This extends beyond the greeting to the entire visit. A reader recently asked what one thing would make the biggest difference. My answer: use their name, say it repeatedly, at the front desk, with the tech, with the doctor. Third, and small but telling: when someone asks where the restroom is, walk them there instead of pointing, the way any good grocery store employee would.
The what stays the same. The how and the why are where the transformation happens, and it’s never too late to ask. The practices that ask it, and act on the answer, are the ones patients remember, and refer friends and family to, over and over again.