Dr. David Stehlik - Integrated Delivery

When Your Best Is Contextual

During the NBA Playoffs of 1988, 1989, and 1990, internationally recognized super athlete Michael Jordan faced a crippling opponent in the Detroit Pistons and suffered sequential defeats. The Pistons were unified in subduing Jordans scoring prowess and used physical and psychological leverage to bind him. With Jordan restrained, the Bulls had little recourse to hinder the Pistons operation. At the time, Jordans game had not matured enough to exploit the weaknesses in the Pistons strategy; instead, he only saw the threat their teamwork posed to his talent; and, he was not one easily given to change. He was the prodigy and this was his domain. One can only imagine how different those three years of almost reaching the finals might have concluded had Jordan grasped the opportunity available and changed his strategic paradigm rather than sticking in his heels to prove his greatnessonly to fall short each time, suffering the Pistons mockery.

As with Jordans predicament, success is not simply a matter of applying more strength to the current lever. Sometimes, success means knowing to change the focal point and leveraging your strength differently. This is the proverbial story of spinning your wheels, a situation where revving your vehicles RPMs does little more than flick and spit mud, sand, and snow rather than offer the needed grip to propel your vehicle forward out of the unintended and discouraging predicament. Most have faced this kind of crisis in both personal and corporate life, and if not, one should count himself fortunate (while also preparing his mind for when it happens). And, this is ultimately about that. Hopefully not, but you might be thinking what this anecdote about NBA gamesmanship has to do with excellent administrative leadership in health care organizations, and the answer is in the principle: your singular strength is not enough. The recipe for excellence is far more complex than a one-person show, and if we forget to approach our organizations with that understanding, then we will likely fare as Jordan did, running into traffic every which way we turn, confused as to why our efforts are stilted and our teammates seemingly uninvolved and checking out. Alternatively, there are other lessons we can learn. From the Pistons we can see that great strategies provide psychological confidence and motivate action. Even individuals not prone to lend a hand get involved if the purpose behind the task supersedes their momentary interest. Additionally, the right execution of an appropriate strategy can nullify stronger competitors. Without direction, talent and potential overpromise. Even innovative organizations are susceptible to industry defeat at the hands of more consistent performers. Why? Outcomes trump creativity. That reality is why change management operations are difficult to execute, because we understand the present and know what workseven if much does not.

Change Begets Change: For Better or Worse

It goes without saying that health care is changing the world over. If nothing else, the global pandemic of 2020 highlights this reality. What is driving this change? While technology is a driver, the matter is far larger than simply computers and scanned documents or mobile measuring devices and iPhones. Social philosophies are changingphysicians are not all-knowing anymore, as what we think we need to know can be found online. Political involvement and governance considerations play larger roles in determining whats safe. Moreover, one cannot ignore the economic weight of the sector, once measuring a full fifth of GDP, and soon far more once the pandemic expenditures are calculated. Truly, healthcarespecifically in the United Statesis changing more from the merging streams of various domain changes (global shifts), and these changes are of differing strengths and speeds. Thus, to identify and propose a solution as being systemic while at the same time focusing solely on the repercussions experienced within a single drivers domain (like technology, energy, or population), is to offer well-intended medicine without accessing the patients history of allergic reactions to the medicines ingredients. To offer half-baked solutions will not help, and could even exacerbate current circumstances, and so I attempt to offer a chance at glimpsing the full picture, from the sectors past to its present, encouraging the application of the best tools for the futures sake.

In the chapters that follow, you will be introduced to a framework that integrates the best business and social dynamics concepts, strategies, and practices to healthcare. Health care has a tricky past. As much as we may want to think the past was golden in some manner or less difficult to manageand that we should return to itthe reality we face is that such desires offer no aid in changing the present except to add discontent to our mounting concerns. Understanding how the old emerged into the new, this behemoth of a social and institutional structure, will act as an important first step as to understanding why health care thinking today is both more flexible than the markets in some areas and less in others. Next, you will discover how transformational changes in technology were nurtured through leadership practices that are often valued in isolation without a unified framework to join them properly. Ultimately, the core issue is only more aggressively highlighted by: