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Writer's pictureJonathan Burns

Light or Dark?



There’s an old bar in New York City called McSorley’s. It is one of the oldest bars in the city. It has sawdust on the floor and an unpretentious air about it. If you were to go up to the bar and ask for a beer, they’d ask you if you’d like a light or a dark. If you ask for a cocktail or a different type of beer, say a Coors Light, hazy IPA, or a martini, they would ask you if you would like a light or a dark. McSorley’s is an old-school ale house established in 1854 that only accepts cash, only serves salted pretzels, mustard, and raw onions, and only serves two types of beer, light and dark.

So how does an old ale house survive in the competitive bar and nightclub environment of New York City for over 100 years serving only two types of beer? McSorley’s has specialized their beer selection and have kept the food menu simple in their establishment. It seems like they are severely limiting their options for customers and therefore limiting their financial success. But there is some elegance in the straightforward business plan of McSorley’s – they only make two types of beer and that is what they sell. If you don’t like it, well, you can find something else somewhere else. The customer knows they can only get a light or dark beer and that is that. Simple and straightforward. McSorley’s specialization allows them to focus on their craft brewing and improve their business efficiency.

Such specialization works well for many companies. McSorley’s is an extreme example, but it is definitely a strategic decision to stick with what works and make that the focus of your business. This business strategy occurs in medicine also. Certain surgeons only work on certain body parts. Some pain management doctors only treat certain pain syndromes or certain body parts. Doctors and surgeons focus on their specific procedure or technique and become the best in their region and well-known and well-regarded for their specialty.

Of course, this strategy doesn’t always work. If you are too specialized, you will miss quite a few customers or patients who need more comprehensive treatment or more options. This is a significant challenge to the physician to train and become proficient in different diseases, procedures, techniques, and treatments. This takes time, effort, and additional training. There is a sweet spot between offering what people need and want and spreading your business too thin. The art is finding this sweet spot and maximizing it for your particular skillset or capabilities of your practice. Of course, the choice is up to the individual physician. Personally, I work hard to maximize options for my patients so they have the best chance for pain relief and improved function.

I like beer, too. Sometimes I only want a light or a dark and going to McSorley’s makes sense. But other times I want a variety to choose from and having more options is fun and interesting. Providing few or many options is a business decision based on many different factors and really works best when you know your customer preferences. So what do you think, light or dark?

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