In 2003, I published my first medical journal article, and it couldn’t have come at a better time for me. To explain, I need to revisit the 1980s when I teamed with my Texas A&M University colleagues A. Parasuraman and Valarie Zeithaml to conduct and publish the earliest research conceptualizing and measuring service quality. I was working with the right people on the right problem at the right time, and the three of us built our careers as services scholars.
In a 2001-2002 sabbatical leave, I studied service quality in healthcare at the famed Mayo Clinic. Healthcare was a gap in my background as a services researcher that I needed to fill. Studying at Mayo Clinic turned out to be the most powerful learning experience of my career. I was fascinated seeing healthcare in its stark reality, in the examination and hospital rooms, in the operating room, and in the emergency department. A thousand interviews and daily observations of patient-clinician interactions gave me a new perspective on what frightened, vulnerable patients really need from this service and what can get in the way—even at the Mayo Clinic.
My sabbatical got me out of my comfort zone and recharged my batteries. Most of all, however, it ignited a fierce determination to use my business and services background to tackle problems plaguing healthcare. I left Texas A&M for Mayo Clinic as a services researcher; I returned aspiring to be a health services researcher.
Back at Texas A&M full of energy to tackle healthcare, I encountered an unanticipated problem: I didn’t know what to do. I didn’t know the medical literature relevant to my interests nor the culture of medical publishing. Frankly, I didn’t know enough about healthcare. Mayo Clinic was a good start, but there was a lot more to learn. I was used to being productive, but upon returning to Texas A&M, I struggled. For months, I questioned if I was on a fool’s errand. To contribute to better healthcare, I needed to publish in medical journals which meant competing with physicians and academics from healthcare fields. My only realistic path was to fully leverage what I knew more about than they did, which was service quality, service organization management, and marketing. This was my competitive advantage, but only if I kept learning about healthcare.
I published my first medical journal article (linked above) 1½ years after returning from the Mayo Clinic. I am grateful for every publication, but I really needed that one. I needed a confidence boost, a tangible indication that I was not on a fool’s errand after all, that I indeed had something to offer.
It is now 2019, and I remain fully engaged in health services research. I have sought to publish my healthcare work in business, service, and marketing journals as well as in medical journals. One of my favorite papers is in the Journal of Service Research and focuses on encouraging academic service scholars to consider studying healthcare. I’ve studied best practices in employer workplace wellness programs, the application of “lean” quality improvement to healthcare, care coordination for the sickest patients who often see multiple doctors, and how physicians can best help overweight patients lose weight.
In 2014–2015, on another sabbatical, I began an ambitious study on improving the service experience of cancer patients and their families from diagnosis onward. I moved to Boston for the sabbatical to study at the Institute for Healthcare Improvement (IHI), the most influential healthcare quality improvement organization in the world. My original study included field visits to 10 cancer centers in the U.S. plus a hospice and a community health center that serves low-income, often uninsured patients. I interviewed 350 people—patients, family members, oncologists, surgeons, nurses, administrators, and others. My research in oncology is ongoing. I am inspired by this work, by the patients and families I meet and the clinicians who care for them. I collaborate with superb co-authors (including physicians) and by pooling our knowledge we have been able to publish a body of work that addresses issues such as: managing the emotional intensity of having cancer, rebranding palliative care, improving timeliness of care, serving family caregivers of cancer patients, integrating shared decision making, questioning the widely-used term “cancer survivor”, learning from innovative practices in pediatric oncology, patients behaving like hostages, improving hospice care, and finding hope when cure is not possible. Two recent articles are “Putting Healing Back at the Center of Healthcare” with Dr. Rana Awdish, author of the brilliant book In Shock, and “Service Innovation is Urgent in Healthcare” which includes a comprehensive framework for improving the cancer patient experience.
My journey reinforces several “lessons” that I would like to share in closing. First, we should work on problems about which we are passionate. Good academic research is hard and daunting; it becomes more so without genuine passion for the subject matter. I am passionate about services marketing and service quality, healthcare service improvement, and now improving service in cancer care. My passion for the subject matter fuels my drive and helps me through the inevitable days of frustration and disappointment.
Second, we need to work on important problems, ones that truly matter and can make a difference. We have the education and skills to do research that helps corporate or nonprofit enterprises do better for society. Considerable effort is required to publish in a top journal whether the problem studied is highly relevant or not so much. Why not make our publications count beyond adding notches to the CV belt?
Third, we can work on important but highly complex problems by breaking them down into digestible parts and build expertise one study at a time. Untenured assistant professors need not wait for tenure before studying something important; they (like the rest of us) can carve out a piece of a big problem to study, and then another piece, and so on.
Fourth, we should strive to work with the right people and at the right school. Throughout my career, I have been fortunate to collaborate with others who knew what I didn’t, who pull their weight and meet deadlines, who are open to new ideas, who have high standards, and who are good writers. I have also been fortunate to be a faculty member since 1982 at Texas A&M’s Mays Business School, which values both basic and applied research as long as it reflects sound thinking and good science. Work that clearly focuses on service to society is celebrated. Other business schools around the world have similar research cultures, and the momentum in this direction is strengthening, in part due to the growing influence of RRBM—a long-overdue big idea.
Leonard Berry is a University Distinguished Professor of Marketing, Regents Professor, Presidential Professor for Teaching Excellence, and M.B. Zale Chair in Retailing and Marketing Leadership at the Mays Business School, Texas A&M University. He is a former National President of the American Marketing Association, a Senior Fellow of the Institute of Healthcare Improvement and an Adjunct Professor of Health Sciences at the University of Southern Denmark. He is the most frequently cited scholar at Texas A&M University.
