The healthcare paradoxes of our times: The major challenges for senior healthcare leaders

The Tensions

As a leader of a healthcare organization, is this a time of great potential opportunity or loss?

• Should you play it safe or take a risk?
• Focus on short term profits, or build long term capabilities?
• Do you work across organization boundaries to establish communities of care or do you focus on what is best for your organization?
• Do you do what is best for patients or your providers and staff?
• Do you grow your organization or more effectively manage what you have?
• Do you focus on specialty care or general medicine?
• Do you manage patient populations or do what is best for each patient?
• Do you encourage the implementation of best practices or encourage doctors to implement what they believe to be effective?
• Do you as a leader stay with what you “know” or do you move into discomfort to the unknowable?
• Healthcare as a team sport or healthcare individual accountability?
• Do you move cautiously  or do you move fast to seize the moment?
• Do I focus on what I can control or focus on that which I cannot control, but may be essential?

The resolution

These are many of the healthcare’s most critical leadership challenges. Unfortunately they typically get framed as problems to be solved which creates more challenges. As problems we are compelled to focus on one side of the equation.

Seeing these issues as paradoxes frees leaders to create more possibilities. It means that leaders need to play it safe AND take a risk. They need to focus on short term profits AND long term opportunities. Do what is best for patients AND those who deliver the care.

How can they do both at the same time? It requires some understand of the concept of paradox and the use of several tools which help work through these kinds of issues.

Examples

Role paradox: Leader and/or physician

A very accomplished Family Practice physician decides he wants to lead an organization. If he only does the leadership work, he will lose touch with his people and the practice of medicine. If he doesn’t take the leadership role, he will lose his ability to influence the practice of Family Medicine. He takes the leadership role AND practices medicine one day per week. He is highly respected by the members of his department for doing so. His leadership work has given him national recognition.

Organization paradox: Two feuding healthcare systems

Two healthcare systems exist in the same rural community, each historically vying for market share. Yet one is nationally renowned for its clinicians (it has now hospital facilities) and the other one has both a small group of physicians and the local hospital. Should these two organizations compete or collaborate with one another?

In a carefully set of facilitated sessions both with only the senior leaders and with all the management staffs of both institutions, the decision was reached to do both!! They determined that there were instances when they needed to spar head to head…and that was fair. There were other instances in which they needed to intensely collaborate. It was legitimate to do both at the same time.

Getting Unstuck

Either/or decision making can be debilitating and waste precious time and create needless conflict. The concept of paradox opens new doors. It requires the use of a few easily learned and commonly shared tools and language. The payoff is approaching these conflicting issues from this new perspective provides a critical ingredient in the movement toward healthcare reform.

More on paradox and healthcare paradox will be available in my new book which will be published in 2013. If you want more information, please contact me and I will share additional tools and processes with you.