The contrast in management competence between industry and health care is staggering. Dr. Gruber's early career focused on industrial companies, in particular, information-intensive industries such as commercial banking, securities, and insurance. Since the initial launch of the S&P 500 largest company list in 1957, only “86 original constituents of have survived through time” as of 2007 (50 years later). The consolidation in a number of industries has been almost 100% from local pharmacies, food shops, and banks to national and global scope of operations driven by competition. This has not happened in health care. Consulting has become a giant industry that enables business adaptation to changing conditions. Many of the early companies in the computer industry have failed as major competitors. This would include Digital Equipment, RCA, Compaq, Control Data, Prime, Data General, and many others.
In this environment of very rapid change and high uncertainty with leaps in competence to deliver value for customers, management of “competitive intelligence” was a critical resource of survival. Competitive intelligence is an essential concept that “essentially means understanding and learning what's happening in the world outside your business so you can be as competitive as possible.” This was the launch of my career; product evaluation, price points, and customer satisfaction. There was little competitive evaluation in health care, a very stark contrast to my industrial experience. Little customer knowledge, even in a hospital specialty-wide range in practice value by a physician within a specialty.
Dr. Gruber's Tools for Competitive Intelligence (partial list)
Structured surveys of health providers of interest
Key competitive factors in exemplar success
 S&P Releases List of 86 Companies in the S&P 500 Since 1957. PR News Wire, March 2007. Accessed on October 19, 2015. Available at:
 "Competitive Intelligence Definition. Small Business Encyclopedia. Entrepreneur.com. 2015. Accessed on November 21, 2015. Available at: