Productive Disruption – Are We There Yet?
by Ronald N. Riner, MD, FACC

The current “in phrase” in healthcare and many other business arenas remains disruption. Leaders are admonished to engage in “disruption” and to disrupt all manner of past thoughts, plans, strategies and relationships in the name of advancement and evolution. This lexicon has evolved against the backdrop of rapid transformation in almost all industries, especially healthcare. SO . . . what’s a leader to do? Hundreds of self-help and strategy books or articles tout the successful ways one should disrupt their organization in order to guarantee its future. As the leader of our organization that has had the pleasure, privilege and accountability associated with strategically advising healthcare C-suites and boards for over 30 years, I would offer the following in an attempt to provide some semblance of order.

•  Be pragmatic – Not everything we have done in healthcare delivery to date is wrong or in need of change, although media hype and some self-anointed soothsayers (many of whom have never been inside a doctor’s office or had the learning experience of being hospitalized) would believe you have to do such. We can be very proud of our heritage and the many wonderful accomplishments of our healthcare therapies that have led and continue to lead to immense improvements in longevity and the treatment of disease. In our haste to disrupt and endorse change, let’s be as selective as possible. There is enough chaos, bureaucracy and poorly functioning processes as a result of the current structure and bureaucracy. Those in leadership need to focus on being more selective. Attempt to pick the few goals and objectives for the organization that will likely to be of consequence – those activities that will inspire and energize people. Some of that selectivity might include, but not be limited to:

• Projects that matter or will make a major difference – transformational projects that will be consequential.

• Projects that promote purpose and make people feel that they are doing purposeful work.

• Projects that are not superficial but those that one would label as absolutely necessary.

• Talk positives and set future vision and emphasize less compliance rhetoric (not that attention to compliance can be ignored)

• Embrace and court outsiders – Outsiders frequently bring beneficial perspectives – especially those who have credibility and special knowledge of healthcare delivery. Every business has its rules, nuance and anchors. I’m not saying those “outsiders” without healthcare experiences aren’t potentially beneficial, but their perspectives need tempering in light of their naiveté about healthcare. Their suggestions will need interpretation by those in leadership and that leadership needs to be open-minded and themselves have broad enough healthcare exposure to recognize appropriate, beneficial input.

• Fight complacency – This is the other side of the ‘endorse all disruption’ script. Leadership’s role is to galvanize the talent of an organization toward change – when it is appropriate. Successful organizations have a tougher time with complacency issues in light of their success. You know the old adage – “Heck, if it ain’t broke, don’t fix it!” The challenge is to remain nimble and flexible. No one can absolutely predict the future but knowledgeable leaders know the environment and operational platforms will, of necessity, evolve. Leadership style and engagement has much to say for the organization’s ability to monitor the future and engage in change as needed.

• The power of purpose – Probably the most important element of aligning talent and workforce revolves around having a meaningful purpose. Having a few well-defined, significant values serves as a touchstone for the organization as it pursues goals and objectives. A lengthy list of motherhood and apple pie type values does no harm except that it does not focus. It becomes incumbent upon the leadership to keep the purpose (mission) of the organization activities in the forefront. (Indeed, the great dissatisfaction of many in healthcare today stems from a loss, perceived or real, of purposeful, meaningful work.) This sounds astounding to an outsider looking in, but so many healthcare providers express and manifest burnout due to ridiculous bureaucracy, administrative burdens, etc. that fail to appear to be significant or beneficial. At the very least, these issues are detractions for work that in previous times would have been looked upon as the pursuit of a noble cause with definite significance.

• Engaging younger colleagues and talent – Organizational cultures that are rigid or don’t provide opportunity for younger individuals to work at significant levels within the organization are disadvantaged and will not have access to new talent and perspective that younger individuals bring to their activities. The culture must be rich and deep enough to inspire alignment with the mission, vision and values across generations to undertake their purposeful work. Ultimately, responsibility for adopting and adhering to the mission and values of an organization resides with the leadership. Adherence to and cultivation of the organizations values ensures that those values remain within the DNA of the organization. It should be the leadership’s responsibility to energize and challenge the organization to pursue whatever appropriate opportunities present and fit their future and their culture.

In summary, disruption for the sake of disruption, especially in healthcare – I don’t think so. Keeping an eye to the future, watching events, markets and structure evolve and keeping an open and vigilant mind to the basics that anchor a noble profession in what it has done successfully and what it is challenged to do better as we look to the future – that type of disruption with an eye to pragmatic disruption – a definite yes. - originally released November 2017