Lead to Adaptability

Thursday, June 4, 2020 | Joel Sauer

MedAxiom has long espoused the importance of effective governance and leadership for healthcare organizations and high-functioning cardiovascular programs. We consider it a bedrock foundational element for organizational success. One aspect of leadership that has taken on greater importance in recent years is the ability – or better stated – the intent to adapt.

In my last blog I wrote about how critical the element of timeliness is for organizational survival. Never has this been more poignantly illustrated than during the pandemic. Healthcare needed to pivot – and pivot fast – or simply turn out the lights. While this story is far from its conclusion, the early indications show that the provider community did indeed quickly adapt.

Adding another level of responsibility for becoming adaptable is the growing concern for clinician burnout, illustrated beautifully by my colleague, Ginger Biesbrock, in her recent blog. One of the main drivers of clinician burnout, she points out, is a sense of disconnectedness from control of one’s own destiny; in other words, some level of personal and professional authority. How frustrating is it to recognize an organizational problem and perhaps even have an identified solution, only to have that fix take six, 12 or even 18 months to work through a decision process? Yet all of us industry insiders know this can often be the case.

Create a Culture of Adaptability

It is imperative that healthcare leaders embrace a culture of adaptability, including the inherent necessity of timeliness that is implied. A great solution that arrives too late is a failure of leadership. A culture of adaptability recognizes that not all decisions can emanate from the top of the organization or require its approval. Instead an adaptable culture trusts its providers and care teams – those working on the front lines with intimate knowledge and understanding of the real world – and empowers them with the ability to make decisions in real time. In healthcare, as in most industries, our largest investment is our human resources. We need to learn to set free that collective wisdom. Turns out this is not only the smartest way to run our businesses, it’s also what our providers and associates crave. That’s a win, win! 

A culture of adaptability considers slow, methodical decision making a form of business malpractice, not an indispensable virtue. It means analyzing quickly and expertly, experimenting with solutions and adjusting as needed. An adaptable culture recognizes and embraces that it’s not enough to simply do what you do well. As the COVID-19 pandemic has taught us, we may have a beautiful office with immaculate aesthetics, physical design that promotes maximum patient flow and have created a staffing model that operates at peak efficiency. Then suddenly the world changes and patients don’t want to (or can’t) come to an office to be seen, no matter how well run that setting might be. In their 2011 Harvard Business Review article,  “Adaptability: The New Competitive Advantage”, Martin Reeves and Mike Deimler summed it up this way, “Instead of being really good at doing some particular thing, companies must be really good at learning how to do new things.”

For most of our organizations we’re largely built around looking backwards to project forwards. The annual budgeting ritual is a perfect example of this. We use historical performances and experiences to predict our coming year(s), even with new products or services. There is certainly strong logic for doing this – history often repeats itself – particularly in a stable environment that is experiencing incremental change. Does that sound like healthcare?

A culture of adaptability, what some have coined strategic adaptability, has hard wired the unexpected into their leadership and decision making. This is not a system designed to predict the future; that’s clearly impossible. Instead it’s a system designed to get inputs from a very broad coalition of allies – providers, care teams and front-line associates – that increase the odds of seeing important trends and, when those are missed, reacting quickly.

No one could have predicted a global pandemic with an almost immediate near total shutdown of our offices. What was known, however, was the delivery of goods and services via virtual and other electronic means. It’s all around us, trusted for sensitive financial transactions to touring prospective home purchases to communicating with distant loved ones. Some in the MedAxiom membership community embraced this trend long before COVID, despite the dearth of reimbursement, and deployed it extensively around innovative outreach or cost avoidance strategies. They weren’t predicting the future pandemic; they appreciated a valuable trend around them and embraced the change within their own organization.

Now before I’m labeled an anarchist or simply a looney, I’m not saying we should abandon our budgets, planning and forecasting. Those are all important and have their place in our governance structures. What I am saying, borrowing from Captain Hector Barbossa in Pirates of the Caribbean, is they should be “more of a guideline than a rule.” Those traditional processes are meant to manage and propagate the status quo. They are not designed or effective at helping us anticipate change, to see important trends and how they may apply to our business now or in the future.

Conclusion

Creating a culture of adaptability emanates from leadership embracing change over the status quo, not just in soundbites or posters, but in processes and governance infrastructure. It is a belief that the wisdom of the many, our workforce, is better than the few, no matter how smart or talented these few may be. Harnessing this collective market prowess is not only smart for business, proven by successful organizations like the Walt Disney Company, it can also alleviate clinician burnout.

The simple truth is that even before the pandemic the U.S. healthcare system was on an unsustainable economic trajectory. In 2020 the Congressional Research Service reported to Congress that at the current pace Medicare would become insolvent in 2026 – this calculation made before the impact of COVID-19. Now in order to keep the economy afloat the U.S. government has issued $2 trillion (a lot of money) in borrowed relief, with a big chunk of that support going to healthcare. As an industry we are going to need to learn fundamentally new ways to deliver our services at a much lower cost point. This is the essence of adaptability! 

As healthcare leaders, we must instill in our organizations a culture of adaptability. The ability to adapt is not just about vitality, it’s about viability.

Learn more about the MedAxiom Consulting Team and how we can help you and your organization tackle issues such as effective leadership, staffing/operational efficiencies, adaptability and more.

You can also visit our COVID-19 page where we have compiled and developed resources for navigating this pandemic and the complex challenges practices and hospitals are facing.

Illustration: Lee Sauer

About the Author
Joel Sauer

Joel Sauer, MBA, is Executive Vice President of MedAxiom Consulting. Joel consults around the country in the area of value-oriented physician/hospital partnerships preparing health organizations for the value economy. His work includes vision and strategy setting, creating and implementing effective governance and leadership structures, co-management development, joint venture and other innovative partnerships, and provider compensation plan design. Beyond the above, Joel has a wealth of experience in service line development, clinical strategy development, provider workforce planning; including care team creation and physician slow-down policies, MACRA and bundled payment planning, and operational assessments.

To contact, email: jsauer@medaxiom.com



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