Leadership for Change: The Rest of the Story

Abstract

If the proverbial man from Mars landed at a U.S. convention center during a typical hospital association meeting, he would have no trouble figuring out that American health care institutions are in crisis. ALL he would have to do is tour the exhibition hall to count the number of consulting firms peddling total solutions for more efficient management. Institutional turmoil brings out the analysis-and-control packages in droves. But, as we learn from enlightened executives like Thomas Chapman of Washington's Greater Southeast Healthcare System, technocratic managerial solutions are not only misguided, they can distract attention from the real need: new leadership with new values that reconnects health care organizations with their customers and their communities. Times of change should indeed bring questions of leadership and values to the forefront. Institutions in turmoil must revisit their basic mandate and purpose. People within them must be led in new directions that reestablish the legitimacy of those institutions in the eyes of their stakeholders. Doing today's work better is not enough when confidence in the institution itself has eroded. The answers lie not in redoubled managerial efforts--o improve operating efficiencies, squeeze out casts, or control internal processes--but in revitalized leadership that reconceives the institution and infuses it with new meaning. Health care is one of many American industries that requires new leadership in order to revisit and reestablish organizational purpose, and there is much that can be learned from successful change in other industries. Still, the significance of the quest to reinvent health care reaches far beyond the need to reinvent auto manufacturing, the computer industry, or pharmaceuticals--to name just a few of the many sectors searching for redefinition. Health care expenditures constitute a major portion of the American economy--enough reason in itself for the health care system to be the subject of one of the most massive government studies since the New Deal. But in addition, health care has a human mission that is increasingly confounded with basic rights guaranteed to Americans by law--life, liberty and the pursuit of happiness--and difficult to distinguish from them. LEADERS--AND GUTS--COUNT Thus, health care executives of the future must be leaders who confront basic questions of human and societal values, in addition to mastering the challenges of leadership for change. That is why Thomas Chapman exhorts leaders to reexamine their inner values and sense of purpose and responsibility, to reassess why they chose to enter this profession--and why they choose to remain. He urges them to be introspective rather than analytical, and to focus more on philosophical and attitudinal than theoretical and scholarly issues. He argues that the current crisis requires of them certain intangible qualities of leadership: knowledge of self, commitment to service, and depth and breadth of vision. To Mr. Chapman, leadership in health care is not a job; it is, rather, a calling. In short, he calls for a gut check. Leadership for change, certainly, is not for the faint-hearted or weakly committed. It is not for those who prefer analytics over action or rote reliance on routines over imaginative new solutions. The road to reinvention starts with leaders whose passion for the cause propels them toward new visions and inspires others to follow. One of our favorite truths of leadership (as well as life) is that everything looks like a failure in the middle. Fundamental change is a long-term proposition. So many roadblocks and obstacles emerge along the road to innovation, or even to modest change, that leaders must be committed to keep the faith, shore up others' commitment, repeat the vision, find new resources, redirect efforts around the obstacles, and persist--or else, by definition, the change effort will be a failure. …