Transitions and Transformations: Our Choice?

We cannot become what we need to be by remaining who or what we are.

— Max De Pree

Our lives are a series of transitions, coupled with the occasional significant transformation. Successfully identified, embraced, and effectively managed, our lives may become rich and fulfilling. If not managed fruitfully, our lives may take a course toward frustration and disenchantment. Managing our expectations for success is pivotal in how we approach opportunities.

The healthcare industry is also a series of transitions coupled with occasional significant transformations. Each of us in healthcare has navigated a host of transitions in our attempts to keep pace with market forces; some of us have undergone significant personal and professional transformations in the process. To quote leadership guru Forrest Gump, “Life is like a box of chocolates. You never know what you are going to get.”

As physicians, we have been able to craft or navigate the necessary large-scale transformations in healthcare by using the platform of physician leadership. Physician leadership has been linked to more profitable, higher-quality healthcare delivery at the organizational level, as well as better patient outcomes, increased provider satisfaction, decreased physician burnout, and improved performance of basic clinical skills. As the recent pandemic unmasked numerous vulnerabilities in the industry, from my perspective, the pipeline for physician leadership has never been more important. Newer and younger generations’ approaches to physician leadership are sorely needed.

It takes time to create a significant transformation. Total experience management is a relatively new business strategy that aims to create a better, holistic experience for everyone who engages with a brand program or business offering (e.g., customers, employees, users, partners), fusing the voices of customers and employees with the ability to deliver extraordinary customer, employee, product, and brand experiences. It does this by combining four key experience disciplines(1):

1. Customer experience (CX): how a customer interacts with and feels about a brand;

2. Employee experience (EX): how an employee interacts with and feels about their company;

3. User experience (UX): how a user interacts with and feels about a product or experience, especially in the digital realm, as well as face-to-face interactions; and

4. Multiexperience (MX): how an experience is enhanced and delivered simultaneously across multiple devices, modalities, and touchpoints.

As we consider the potential of a total experience approach in healthcare, patient-centered/person-centered care (PCC) is a priority as well. The challenge with PCC is that many systems and process changes are required across the clinical delivery systems and inside the various industry sectors before true PCC is possible. Transforming healthcare to PCC requires significant and sustained efforts over time. This is where the opportunity lies for physician leadership: leveraging the recognized platform of physician leadership to create the change needed.

Surprisingly, transformation requires only three things: recognizing what the current situation is; knowing what is needed or desired; and having the determination required to make the change. The challenge for healthcare is that we have only two of those three elements: we know who we are, and we seem to have the resolve required for real change. What we do not yet know, or have not adequately defined, is what healthcare should become during its next major transformation. We can, and must, do better on this latter point.

Transformational leadership is defined as a leadership approach that causes change in individuals and social systems. In its ideal form, it creates valuable and positive change in the followers, with the end goal of developing followers into leaders.(2) Physicians are naturals for developing transformational leadership approaches within a variety of healthcare systems and processes.

Gary Yukl suggests several important aspects of successful transformational leadership(3):

1. Develop a challenging and attractive vision with employees;

2. Tie the vision to a strategy for its achievement;

3. Develop the vision, specify, and translate it to actions;

4. Express confidence, decisiveness, and optimism about the vision and its implementation; and

5. Realize the vision through small, planned steps and small successes in the path toward its full implementation.

Andrew Newberg, MD, and Mark Robert Waldman state, “A single word has the power to influence the expression of genes that regulate physical and emotional stress.”(4) With enough sustained positive thought over time, changes in the parietal lobe functions occur, which result in changed perceptions of ourselves and others.(5) Viewing ourselves in a positive light trains our brains to also view others in a positive light. Thus, by keeping our thoughts and speech positive, we change not only our self-perception, but also our perception of the world around us, which ultimately enables us to change our reality, and the world, for the better.

Aaron Barnes, CEO of BRM Institute, provides examples of this reshaping of reality by using different types of words(5):

• Capability instead of Process;

• Convergence instead of Alignment;

• Shared Ownership instead of Accountability;

• Demand Shaping instead of Demand Management; and

• Business Capabilities instead of Services.

Simply changing the words we use to express ideas creates a culture that does not single out or place blame on anyone within an organization. Rather, it “aims to promote transparency, elevate communications, and appreciate individual value.”(5) This shared positive language promotes effective communication and collaboration, which then breeds innovation, success, and organizational value.

The medical profession is viewed as a leadership profession not only by our industry, but also by general society. Consequently, the opportunity always is available to exhibit some version of transformational leadership in our practices, in our communities, in our organizations, in our volunteer activities — essentially, in all aspects of our lives. We can, therefore, use this distinct privilege by speaking about healthcare in a positive way and by focusing on positive transformation rather than on negative market force transitions.

Unfortunately, current approaches to medical education and specialty training do not effectively incorporate exposure, nor training, in the various aspects of leadership development, change management, customer (patient) experience, or even practice management principles. It is largely left to the individual to develop knowledge and experience on the array of leadership strategies and tactics, how to consider the optimal approaches for transformational change at any level, and how to best ensure optimal patient experiences by facilitating a positive culture within the various care delivery environments. There remains much to be learned yet, and accomplished, but each of us has a responsibility to create the change wherever we have a scope of influence.

Excerpted from Inspiring Growth and Leadership in Medical Careers: Transform Healthcare as a Physician Leader (American Association for Physician Leadership, 2024).

References

1. Zande JV. What is customer experience? CX defined. The Future of Commerce and Customer Engagement. www.the-future-of-commerce.com/2019/06/13/what-is-customer-experience .

2. Transformational leadership. www.langston.edu/sites/default/files/basic-content-files/TransformationalLeadership.pdf .

3. Yukl G. An evaluation of conceptual weaknesses in transformational and charismatic leadership theories. The Leadership Quarterly. 1999;10:285-305.

4. Newberg A, Waldman MR. Words Can Change Your Brain: 12 Conversation Strategies to Build Trust, Resolve Conflict, and Increase Intimacy. New York: Hudson Street Press; 2012.

5. Horton L. The neuroscience behind our words. BRM Institute. August 8, 2019. https://brm.institute/neuroscience-behind-words/ .