Changing Health Care
Beware the cheap thrill of “being right”
Now that President Obama’s historic health care bill has been passed, the real work begins. Here’s why. Thirty-two million people will soon have health insurance who didn’t have it before. That’s the good news. The bad news: if all of them tried to get medical help tomorrow they wouldn’t be able to. Why? The system doesn’t exist to provide it.
That’s why the real work of reforming American health care has only just begun. What will the system look like that will deliver the health care we all want? No one knows. The answer is too impossibly complex for any one brain to figure it out.
We’re going to build the health care system we want by trial and error, over time, working together. We need more doctors, which means we need better high school science instruction, which means we need to do a much better job teaching young children to read…
So where do we start? The first emergency facing America’s health care system concerns its health care leaders. The transition we are about to attempt is going to be very stressful. That means it’s going to trigger a lot of fear. It already has.
Every time you hear someone yell out, “You lie!” during a State of the Union address, or call someone a “Baby Killer!” or threaten violence against those with whom they politically differ, you’re witnessing fear. Stand by. There’s more to come.
So the first item on every health care leader’s agenda today is to respect the complexity of the task ahead. The second is polishing their ability to manage their own fear. Every health care leader will have his and her fears triggered, because this challenge is scary.
Example: to create the health care system we want, clinical work processes will have to change. These are the processes by which suffering is reduced and eliminated and lives are saved. We have the processes in place that we do because they have worked well enough. Start proposing changes to these delicate arrangements and you’re going to scare a lot of providers who really don’t like to see their patients suffer, and who really do like to save lives.
A word about fear in the executive suite. It typically shows up in the camouflage of defensive routines. We all have them. They’re subtle behavioral reflexes woven into the subconscious, and they show up as “civilized” forms of fight and flight.
FIGHT expressions of defensive routines include:
* Interrogating others to force them to surrender.
* Using “evidence” to “prove” the superiority of one’s views.
* Using directive questions.
* Personal attacks on those holding opposing views.
* Speaking as THE authority.
FLIGHT expressions of defensive routines include:
* Superficially agreeing with critics just to placate them.
* Hiding motives behind questions.
* Glossing over problems or appeasing the opposition.
* Using jokes, sarcasm, and snide remarks.
* Avoiding those with differing views.
It’s critical to understand that, far from being signs of weakness, such responses are normal and ubiquitous. As human beings, we aren’t organically capable of banishing fear. We wouldn’t want to even if we could. In extreme cases, fear keeps us alive. We are supremely capable of mastering fear, however, and optimum performance requires that we do so.
Two simple tools every health care leader can use to defuse the fears that will inevitably be triggered as the field changes its vital work processes are curiosity and requests.
Curiosity entails cultivating genuine inquisitiveness about the points of view of those with whom we disagree. Collective wisdom is the Holy Grail in building the health care system we want, and it can be nurtured only with genuine intellectual curiosity.
So the first step to take when faced with a differing view is to generate honest interest in it. The second step is to request a full explanation of it.
Leaders who do that are using proven tools to manage their defensive routines. They are also choosing to wake up and offer conscious leadership over the cheap thrill of “being right.” (The cheap thrill of “being right” comes from a little brain hit of the chemical serotonin, which is why self-righteousness is actually a kind of chemical dependency.)
In any case, conscious leadership is not merely inspiring leadership, it is life-giving leadership because it creates outcomes that are otherwise impossible.
Tags: Health Care, Healthcare, Michael O'Brien, Quicksilver the book
July 1, 2010 at 9:34 pm |
I do not think the reform bill will stimulate demand since the bill is less abut healthcare reform and more about payment reform. It might redirect some patients from a county hospital, for example, to a neighborhood clinic but many of the uninsured are getting care now, albeit more expensive care in EDs across the country.