My New Book: We Can Fix Healthcare

February 17, 2017

Healthcare seems never to drift far from the front pages, physical or digital, and, if it ever left, it has now returned with a vengeance as a new waves of sturm und drang surround the handling of the Affordable Care Act (aka Obamacare).  As many of you know, I have spent over two decades working with healthcare organizations, especially healthcare provider organizations, both in America and abroad.  Healthcare carries a special significance for me because of its importance and because both my mother and her twin sister were Registered Nurses.  I thought that I might pass on a thought or two about leading change in healthcare which is both similar and different from leading change in other industries in which I’ve worked such as manufacturing, telecom, technology, financial services, power generation and distribution, and specialty chemical.

First, complexity makes change difficult and healthcare is complex.  Some of healthcare’s complexity stems from the often complex work of actually providing healthcare by blending multiple medical specialties through the process of diagnosis and treatment.  However, much of healthcare’s complexity stems from the byzantine interconnections of seemingly countless moving parts (insurance companies, national and state government, pharmaceuticals, universities, and medical device providers).  This complexity can overwhelm consumers and would-be change leaders alike.  It can also lead to non-systemic approaches or whac-a-mole solutions which are nearly guaranteed to fail.  Bruce Gresh and I wrote a two part article in Healthcare Transformation laying out the value of stepping back from the fray to exam the system before wading in to change the parts.  Part 1   Part 2    The problem is more pronounced in healthcare, but it exists in most large organizations-focusing on changing a part in the hope of changing the whole amounts to thinking backwards.  Rather, to change a part such as the patient experience focus on changing the whole.

Second, deeply worn groves maintained by self-interest and deep emotional investment block change, especially when we lose the ability to even see them.  Steve Klasko and I tried to make this healthcare reality playfully accessible to the lay reader in our book …  These types of groves exist in many well-established industries and organizations.  Naming them and understanding them can go a long way toward freeing systems up for change.  Restated, looking clearly at what is can begin the journey to what might be and that clarity can come from getting far enough away from existing reality to gain the perspective to see it clearly.