Adaptive Leadership in Healthcare

I just listened to an interesting podcast from Plexus Institute in which Dr. Marcus Thygeson discusses the application of adaptive leadership to healthcare.

Several years ago, I discovered Ronald Heifetz in this article on leadership in Fast Company magazine.  I can remember sitting beside the trail above Bear Creek in the Wallowa Mountains reading this article and resonating so much with his concept of leadership that I went out and bought and read his book, Leadership Without Easy Answers.  In 1999, that was no small thing as I was only reading a couple of books per year (yes, I am grateful for so many changes over the past decade).

The theme in this book is that the goal of leadership is not to solve problems even though that is what managers are continually reinforced for doing; the goal is to provide the context within which adaptive change can occur.  Adaptive change is that deep, real work that changes behaviors and perspectives in fundamental ways.  I recall Heifetz’s description of civil rights legislation being an example.  Adaptation, of course, is that same process that is inherent in complex adaptive systems (CAS) which is just another word for living systems.  So, following the thread, adaptive change is the process by which life sustains itself and this is the process that any living system – whether a human body or an organization or a community – needs to be involved in.  No wonder, I was attracted to it – this resonates with all of my experience in working with systems and with all that I found unsatisfactory about traditional change management.

Adaptive change as contrasted with technical change requires the leader to create a safe holding container that will allow all of the competing voices to be heard.  The leader then asks the difficult questions which creates enough stress to fuel a conversation in which all of the perspectives are represented and in which real listening and understanding takes place.  From this process (as also described in Engaging Emergence and other studies of complexity) new solutions will emerge.  Such solutions come from a different level of order and consciousness and ultimately transcend the differences that created the conflict.  Since reading this, I have repeatedly returned to this understanding of leadership and when I discovered the Art of Hosting I found tools I needed for practicing adaptive leadership.

Heifetz has a more recent book, The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World in which he further develops the concept of adaptive leadership and provides supporting practices.  I’ve not yet read this book but from the podcast and this set of powerpoint slides from Dr. Thygeson, it is apparent that Heifetz has continued to develop his understanding of adaptive change and that they have a direct implications for healthcare at the individual and larger systems levels.

Recently in conversations about health, healthcare and wellness, I keep coming back to the idea of individuals taking responsibility for their own health and lifestyle choices. From my perspective, our current system of healthcare is unsustainable and unaffordable.  Our expectations are unrealistic.  These issues need to be part of any conversation about transforming our system from healthcare (aka illness care) to wellness.  That would be adaptive change!  I am grateful to Dr Thygeson for connecting these dots for me.  He describes much of modern medicine as attempts to apply technical solutions (medication, surgery, etc.) to adaptive problems (obesity, stress, relationships, etc.) and suggests that the role of a healthcare professional is to be an adaptive leader who creates the safe holding environment, asks the difficult questions and supports the patient in making adaptive changes in lifestyle.  Yes!  This is the connection that I have been sensing the need for.

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