Working for Bupa is certainly not a job for the faint-hearted. And especially since the healthcare provider's chief executive, Val Gooding, introduced her own unique, and stomach-churning, approach to encouraging staff to focus on their jobs.
As with most things Gooding turns her hand to, the process is simple but quietly effective. All newly appointed managers and directors are made to watch an operation being performed in one of Bupa's many theatres.
"It is one way of taking people right to the heart of what the business is about," Gooding says. "And they all come away understanding why they come to work every morning."
The chief executive, who replaced the outgoing Peter Jacobs back in 1996, has dedicated most of her career to developing public service companies.
She spent more than 20 years at British Airways, where she was a marketer and subsequently a director of business, and is well versed in what makes a huge corporation tick.
So when, early in the interview at her Bloomsbury offices, she raises the issue of Bupa's "vision statement" - that sterile expression usually tagged on the end of annual reports or, worse still, reserved for the company awayday - one could be forgiven for expecting something trite.
In fact, it's refreshingly logical: "We have a vision statement in Bupa which is taking care of lives in our hands," she says.
"It is a practical statement and something we try to live by because it can only mean something if it is adopted by the front line. It has a bearing on everything, from how our corporate strategy is driven to how we decide agenda items for meetings, because we are focused on making the customer the centre of everything."
Suddenly the importance of making employees watch live operations appears nothing short of a masterstroke.
It is not the only modification Gooding has implemented. Indeed, it is fair to say Bupa, following her arrival, has had a call to arms. And not before time.
It had arguably started to lose its grip within an increasingly competitive market. In its traditional mainstay of medical insurance, its market share had dropped from 60 per cent, established during its supremacy in the mid-80s, to 39 per cent in the late-90s.
Insurance brands including Norwich Union, Legal & General and Royal & Sun Alliance ate away at Bupa's market share, but this has stabilised since Gooding took over and now stands at 40 per cent.
Although Bupa may never again revisit the domination it enjoyed two decades ago, it has clung on to its status as the biggest player in the UK for private medical insurance.
Moreover, since Gooding took the helm, turnover has increased significantly.
In 1996, it was £1.2 billion. This year in comparison it registered more than double that at £3.5 billion.
Amid this, there have been definite moves to develop a stronger Bupa brand through a new and clearer positioning. Indeed, this prompted one of Gooding's first actions as chief executive, which was to appoint a network of top marketers, including the Pontin's former sales and marketing director, Pat Stafford, who was made the marketing director. The highly experienced FMCG marketer Elaine Greenwood was also brought on board.
Meanwhile, little time was wasted in restructuring Bupa into five business units: healthcare, nursing homes, hospitals, its Spanish subsidiary Sanitas and new businesses such as dental and travel insurance.
The reorganisation, which was aimed at moving Bupa on from being seen purely as an insurance company to being a broad-based health and care services company, has been reflected in the healthcare provider's increased emphasis on marketing activity.
Its first advertising campaign for five years in the summer of 1998 was through Ogilvy & Mather, but it parted company with the agency before the year was out.
Creatively, the campaign was a success, and it kept Bupa at the forefront of consumers' minds at a time when its rival PPP was spending three times as much money on its relaunch through M&C Saatchi. Nevertheless, relations with O&M became strained as Bupa searched for something more friendly and appealing.
O&M's "You're amazing. We want you to stay that way" was pulled and Bupa handed its creative advertising account to WCRS following a pitch.
The arresting images that showed how wonderful the human body is disappeared and in stepped WCRS to portray a warmer image using cartoon characters.
Gooding proclaims the success of O&M's "You're amazing" work that won many plaudits for the power and simplicity of its message, but says the time had come for change.
And quite a change it has been. Bupa is running considerably more executions than it has done in the past in a bid to encompass specialist groups as well as a broad consumer audience, while the creative theme of white-coated staff and medical procedures has been dumped in preference to a tongue-in-cheek look at consumers interacting with Bupa.
Each of the 12 executions is based around a specific message, but with an overall objective to build a sense of the range of products and show it is much broader than the public perception.
It may not be vintage work but it's a step in the right direction.
For example, one of the press ads shows a friendly Labrador dog saying to a Bupa representative: "Well, you did say it was for everyone." Another features a feisty woman arriving at her care home asking: "Is it all right if I bring my cat?", as she trails her lion behind her on a leash.
"Often there is not enough humour in our business because we are dealing with people in difficult circumstances," Gooding says. "Also, not many people know what services we offer. Some people think they can only go to a Bupa hospital if they are a Bupa patient, but that is not true.
"What we are trying to do, and what we did in our previous television campaign, but in a different way, is show that we are a people company. We are nothing without our people. They deliver our services, we know they are the ones who make the difference. And I think that is what separates us from our competitors."
Gooding's marketing strategy to try to make Bupa more relevant while establishing it as "the personal health service" represents a rejection of its former status as a service for the elite.
This is even evident in the sponsorship ventures it pursues. For rather than backing professional athletics at the highest levels, as was previously the case, Bupa is now the official sponsor of the Great Runs that are open to competitors of varying abilities.
Robin Wight, the chairman at WCRS, knows Gooding from her time at British Airways and now as the agency's Bupa client. He has nothing but admiration for her, describing her as a "quiet revolutionary".
"She has totally transformed Bupa, which was formerly a conservative, bureaucratic organisation," he says. "What she has done is amazing and it's because she is such a great communicator. She's a brilliant leader and actually very tough underneath it all. But her iron hand is wrapped in a glove that you want to shake hands with all the time."
Gooding may not have a reputation as tough and unwilling to compromise but she gets things done in her own way. Under her watchful eye, the message that Bupa treats you as a person has finally begun to filter through.
The latest set of ads set out to provoke a "I didn't realise they did that" response and they succeed.
There is still a long way to go but she has forged great inroads towards making private healthcare not just something that is seen by the public as for other people.
In Gooding's view, the vision for Bupa comes back to not just saying but to actually making the customer the centre of the business, in everything it does.
She says: "We need to make the brand live internally.
"If people find Bupa to be an uncompassionate machine, then our strategy has failed and we have wasted our marketing money."
Family: Married, two teenage sons
Favourite ad: Changes all the time, currently the Foster's TV commercial
Describe yourself in three words: Determined, enthusiastic, focused
Living person you most admire: Nelson Mandela
Motto: Slow and steady wins the race