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The Difference is Dollars

According to the 2020 Quality Progress (QP) salary survey from the American Society for Quality, those certified in Six Sigma are paid considerably more than their colleagues.1 In fact, the higher the level of Six Sigma certification the higher the salary.  A master black belt will earn almost $30,000 more than someone without certification and a Six Sigma Greenbelt will earn almost $11,000 more annually.  This increase aligns with the savings an organization can expect from leveraging the expertise of Six Sigma practitioners.  According to iSixSigma, “the median value of ’hard ‘financial savings per Six Sigma Black Belt project is $200,000 across all industries and company sizes.”2  

Considering the results of the salary survey and the potential savings cited by iSixSigma, employees and leaders should be clamoring to reap the personal and organizational benefits Six Sigma certification provides.  But in fact, very few individuals or organizations are adopting the Six Sigma method for process optimization.  We must ask, “Why aren’t there an abundance of trained six Sigma practitioners in healthcare?”  And further, “If the opportunity for savings is so high, why haven’t more healthcare organizations formally adopted this methodology?” 

To answer this question, we turned to a peer reviewed publication from Qianmei (May) FengManuel, Chris M. titled “Under the knife: a national survey of six sigma programs in US healthcare organizations. “This study was published in 2008 to assess the level of implementation of the Six Sigma methodology in healthcare and to identify barriers to that implementation.3   A survey was distributed to 3,261 healthcare organizations.  The goal of the survey was to determine if the organization had adopted Six Sigma.  Out of the 3,261 organizations invited to participate, 56 organizations responded to the survey.  The majority of respondents reported they have not adopted Six Sigma (41 out of 56). 

For those who had adopted the Six Sigma method, the survey asked: “How long has the six-sigma program been in existence,” “What kind of projects are performed?” and “What are the savings?” Only four out of ten Six Sigma organizations answered the savings question.

The final question of the survey, “Do you plan to implement Six Sigma in other facilities in the future?” yielded a perplexing response.  Only six of the 28 organizations who responded to this question planned to implement Six Sigma in the near future; 15 of the 28 provided no answer.

Given the proven potential for cost reduction the method provides, the responses of these organizations is bewildering. The reason most organization gave for not implementing Six Sigma in the near future was lack of leadership support. This lack of leadership appears to be an age-old dilemma faced by historic leaders and especially by W. Edwards Deming in the 1950’s.  Facing significant opposition to his ground-breaking management principles in the American auto industry, Deming took his philosophy to Japan.  Using Statistical Process Control to eliminate variation within manufacturing processes, Deming and his Japanese supporters achieved unprecedented economic success.  If we could replicate the 2006 survey today, I wonder, would we see any change? Have more healthcare organizations adopted Six Sigma methods in the intervening years, and, if not, has the reason why changed?  Sadly, there has been no comparable study.  Antony, et al, (2017) completed a Six Sigma Literature Review in healthcare and published the results in the article “Six Sigma in healthcare: a systematic review of the literature.’

The authors claim “Although Six Sigma has been embraced by a number of hospitals across the world, the authors feel that no standard curriculum has been developed for various systems; moreover, there is no set standard for projects and expectations on the outcomes.” 

Despite the potential savings for organizations and the attractive salaries for certified six Sigma practitioners, can it be true that the Six Sigma method is being underutilized or possibly lack formal organization in healthcare?  Is the dearth of published accounts in the literature an indication that the Six Sigma method is not effectively being implemented in healthcare?  And more significantly, does this still reflect a “lack of leadership” in healthcare today?

Authors: Rita D’Angelo & Bonnie Messinger


  1. Quality Progress, December 2020 Salary Survey
  2. Qianmei (May) Feng, & Manuel, C. M. (2008). Under the knife: A national survey of six sigma programs in US healthcare organizations.International Journal of Health Care Quality Assurance, 21(6), 535-47. doi:
  3. Savings with Six Sigma:
  4. Antony, Jiju, et al. “A Systematic Review of Lean in Healthcare: A Global Prospective.” The International Journal of Quality & Reliability Management37.8 (2019): 1370-91. ProQuest. Web. 26 Feb. 2021.