I attended the Becker’s Hospital Review Annual Meeting in Chicago recently. One of the keynote speakers was Michael Dowling, CEO of North Shore Long Island Jewish Health, the largest health system in New York. I worked with him briefly on a project years ago. He’s a dynamic individual and passionate leader. His keynote was a highlight of the event in Chicago. A few of my notes:
We don’t know if the changes we are making to our healthcare system are going to work. We are actually going through a “series of experiments” and will need to quickly sort through the successes and failures. He quoted Churchill here saying that, “Success is going from failure to failure without losing enthusiasm.”
We need to balance the need for creative solutions with the reality of standardization, regulation and compliance.
We need to foster innovation in organizations that value tradition.
We need to think differently about the leadership skills of the next generation of leaders, because they will be vastly different than past generations.
We need to develop the skills for a team-based approach to problem solving and patient care – moving from traditional, siloed, structures and thought processes.
Interestingly, we’ve done little of the work necessary to make these changes, yet, we continue to throw highly skilled professionals, trained to value autonomy, in a room and tell them to collaborate to solve complex problems!
A recent piece in the New York Times highlighted the issue with regard to physicians (although it’s the same for other professionals). While new models of care delivery increasingly require collaboration, medical education doesn’t teach aspiring doctors how to work effectively with a team of caregivers, writes Dhruv Khullar, M.D., a resident at Massachusetts General Hospital and Harvard Medical School. Medical students neither study nor work with nurses, physician assistants, social workers or other non-physician professionals. Young doctors don’t even understand their fellow clinicians' roles and limitations.
It’s not just collaboration with other professions. Physicians often struggle to collaborate with their colleagues and administrators. Research and observation continue to show that the characteristics of physicians and their training can actually discourage development of collaboration “reflexes.” Even if educators and physician leaders recognize the importance of these behavioral skills, the demands of clinical training and academia often compete for the time necessary to develop collaboration and leadership skills.
Dowling, in his keynote, noted that much of the conference was the about operational strategy – how to form and run an Accountable Care Organization, respond to reimbursement changes, population health, and so on. But, success or failure in this “series of experiments” will depend, to a large degree, on our ability to change the way we think, as an organization, and as an industry, and that means how we think and behave individually. Can we create a culture that overcomes the limitations of the traditions of healthcare, including the tradition of valuing autonomy over collaboration?