The Future of Work with Heather McGowan

In this SoundPractice episode, future-of-work strategist Heather McGowan explores the profound impact of technology and artificial intelligence on the workplace, with a particular focus on healthcare. She emphasizes the importance of resilience, human connection, and hope in navigating changing environments. McGowan discusses how leaders can foster purpose and community, ways to balance technological advancement with the human touch, and the critical need to rebuild trust and combat loneliness in the modern workforce. Her optimistic perspective highlights the potential for AI to augment, not replace, human creativity and care.

This transcript has been edited for clarity and length.

Mike Sacopulos: My guest today is Heather McGowan. Ms. McGowan is an expert on the future of work. She is a nationally known speaker. She has written national bestselling books including The Adaption Advantage: Let Go, Learn Fast, and Thrive in the Future of Work. Heather McGowan, welcome to SoundPractice.

Heather McGowan: Hey there. Thanks so much for having me.

Sacopulos: Oh, it is my absolute pleasure. So, before we get into the future, I am interested in your past. How did you end up in this line of work?

McGowan: I always joke with people, I saw an ad for a future work strategist, and I fit the qualifications. Now I find myself here. None of those dots would make sense if I connected them ahead of time, but looking backwards, they do make a lot of sense. I started by going to art school. I did my undergraduate degree in industrial design, which if you don't know what industrial design is, it is really product design, design strategy, design thinking. It is understanding how to do what is called a white space exploration. How do you create a product or service that nobody asks for? Because as Steve Jobs said, "It isn't the customer's job to tell us what they want or need." So, it has a lot of elements of psychology and anthropology and understanding people and what they need and don't know how to ask for and how to probe and find and frame challenges.

I did that work for a while, brought 25 products to market, baby products, sporting goods, medical products, and then I found myself asking a lot of business questions like, why are we doing this? This doesn't seem like a good business solution. And they said, "Well, you really should go study business if you want to ask those questions." So, I said okay. I went and got an MBA in that process, met a bunch of people and found an interesting project where they were trying to create a private stock exchange for socially responsible investments; that never ended up working out the way we thought, but I learned a tremendous amount, did some boutique investment banking along the way. Then I had lunch with somebody who said, "We have created this center and design and business at Rhode Island School of Design," which they had at the time conceived of teaching business skills to designers when in reality the greater power play would have been teaching design thinking to business.

So that is how we pivoted it. I worked on that for a while. Then one of my mentors became president of a college, a university rather. And he said, "I am trying to reorganize some of these colleges within the university, and I really think we ought to bring together design engineering in business and I want to create the first college focused on innovation. Will you come do that?" And so, I was hired to do that. In that process and in the process of all the white space exploration work I had done; I found that we were neither creating nor hiring nor nurturing the talent we really needed for the future. And this was about 2008 or so when I came to that conclusion and I realized that most of the work I was doing was explaining to whether it was my academic clients because then I went on to a couple of their academic institutions after that, or my corporate clients, what was really happening with work because nobody seemed to be getting it. Everybody was driving it looking in the rear-view mirror.

So that became its own thing, and it spun off and I became a speaker on the future work and wrote books on it. Because I found that people who really should be understanding it were not. The people who were creating the supply of talent from academia and the people who were generating the demand for talent in corporate really didn't understand how the world was changing and had changed.

Sacopulos: Excellent. Well, set the stage for us. We are talking about healthcare, how far into the future, what is our time horizon when we are talking about the future of work?

McGowan: I think it is Margaret Hefferman, she is a brilliant thought leader who said something like, "The longer somebody goes out on the time horizon with a greater level of specificity is how little you should trust them essentially." So, if I say in 15 years 47% of the jobs will be automated, then you know that I am just speculating as a parlor trick. So, I think we can look out in shorter increments. In 2022, we first got a glimpse of all of us experiencing a large language model like ChatGPT. And now that we have had it for a couple of years, we are starting to understand the things that it can and cannot do, but more importantly what it does to humans. Some of the research so far has shown that it can take a B or a C player and make them a B or a B plus player, but it is not going to take a D player and make them an A player.

That is one thing we discovered. The other thing we discovered is that when you give people these tools and you don't teach them to be mindful of what they are automating, because one of my expressions is what we automate atrophies. So, we don't write by hand as much as we used to. Our handwriting is all declined. We don't remember 10-digit phone numbers anymore. So therefore, none of us can remember a 10-digit phone number even for a second. When is the last time you dialed the number? Mostly you click on something, or it is already on your phone. We cannot navigate with stars; we cannot navigate with maps. It is done for us. So, the early research they have seen in incorporating large language models like ChatGPT into the workplace, they have found that after removing that it will increase the baseline of your performance while you are using it, but then you'll drop below that baseline when it is taken away.

So, we are atrophying relatively quickly to these new technologies. So that is something I think we need to be mindful of. When it comes to the world of healthcare, the other thing I think we have to be really careful of is a couple of things. One, learning to trust when the automated system is right. There was a study, I don't think it has been peer reviewed yet, looking at doctors making diagnoses with and without ChatGPT or the equivalent. And those who used it with it had lesser performance than the ChatGPT alone because they didn't trust the answers they were getting and they were skeptical of them. So, we have to find a way to know when we defer to an automated or an augmented system as opposed to when we just reject it because we feel like we need to be right. We feel like we are the experts. The other thing is that when we brought electronic medical record systems, the ERPs, is that what they are called?

Sacopulos: EMR.

McGowan: EMRs, yes, EMRs. I always get the acronyms wrong. When we started using EMRs, we thought it would be a big-time savings, but what we have seen for a lot of clinicians is this is one more thing to do. So, when we look at putting technology in, our clinicians should be spending as much time as they can with the patient making that human connection. Because it is the behavior after whatever the diagnosis or the procedure is, which really defines your success, like how the patient changes after a surgery or after a diagnosis. And that is really going to come from having that human interaction supported by other technologies. So, when we look at adding technologies, when we cannot add one more thing for a clinician to do, they are already burnt out. And two, we have to know when we defer to it for a time savings without someone feeling like their expertise is threatened.

Sacopulos: As you know, this is the podcast, The American Association for Physician Leadership, so it will not surprise you when I ask a leadership question. What leadership traits will be most critical for physicians in the future of work?

McGowan: I think if you look at just the moment we are in right now, and this is a tough moment in a lot of places in the world and particularly in the U.S., we have a loneliness epidemic. We have political and social polarization. We have a lot of fear, we have a lot of anger, we have a lot of heightened human emotions. I don't think we have processed COVID at all. We wanted it to be over and forget about it, but there are a lot of things we could learn from it. And given that, I think one of the most interesting things I read in the last couple of weeks was one of Gallup's studies on leadership that said, what is the number one thing people are looking for from leaders? The number one thing today is hope. People are feeling lost. And I think that is particularly true in healthcare where you have a broken system.

I spoke to the largest collection of emergency room physicians, and that is a tough area where you are losing people all the time because it is the last end of the broken chain of our healthcare system. Anybody can go to the ER, and they will get treated eventually, but then their nerves are shot by the time they do get treated and there are a lot of assaults. So, I think the number one thing that physician leaders need to do is lean into being human, provide that hope, provide that connection to a sense of purpose. People go into the healthcare field because they want to care, they want to serve humans, they want to improve the human condition. That is one of the motivating drivers. But that gets lost in the how many minutes did you do this and how many minutes did you do that? And what your efficacy rates were and etc. When really it should be focused on what is the care you give? How did you improve the human condition and helping people feel a connection to that, which I think is part of hope.

One of the things I say about work is that we used to trade our loyalty for security. We would trade our loyalty to some organization for the security of employment. Now, that promise was broken 30-40 years ago, but we have not replaced it with something else. And what I think we need to replace it with is what I call the five Ms. First is money, need to pay people fairly. That is table stakes. Most of us are not heiresses or trust fund babies. So, we work for some economic security. Next is mission. People want to be part of something bigger than themselves, and that is huge in healthcare. Mission, serving humanity. Then it is meaningful work. So, what you do is meaningful towards that mission. What you do every day, your activities feel like self-expression, feel like you are bringing your own time, treasure, and talent to things. Then it is membership, feeling like you belong. And mentorship because learning is as important as earning. That is how you become more valuable tomorrow than you were today. So, I call them the five Ms.

Sacopulos: Excellent. Very interesting. With AI and automatization accelerating, how can physicians balance embracing technology with maintaining the human touch and patient care? It seems to me medicine is art and science, and we have been heavy on the science and kind of light on the art. Do you agree?

McGowan: Yes. We need to figure out by using the electronic medical records as an example, where is that a time and efficiency saving versus where is that one more thing we are doing that gets added to the pile of our day without providing some relief. Where are the places where we can find relief so that the physician or the clinician can be more human and be more connected? So, letting technology do what technology does well and save time for us, whether it is on supporting diagnosis and helping us with the decision support where it can be done in automated scheduling or automated record keeping or note-taking. Or use it in every single place you can to make the human more refreshed and productive and increase the performance of the individual as opposed to pitting them against the individual.

I think we have been lazy in my view, in our aspirations for AI because all we talk about is what is it going to replace and who is it going to displaced. And while that is important for us to proactively re-skill and up-skill people for changes, it is really a lazy aspiration. If all we do today is replaced by AI, it is a failure. It should be extending our human potential, extending our capabilities, and relieving some of the burnout, not contributing to it.

Sacopulos: Does the AI process eliminate creativity?

McGowan: No, I think it should augment it. I mean, if you are not playing right now with AI, why not? Even if it is in your personal life, have it make a logo, have it write a poem. Have it write a difficult email to someone, put it in ChatGPT or cloud or one of those and ask it to rewrite it in a friendly but assertive tone or something like that. And it will give you options and it will make you realize that it isn't a tool that you have to learn in order to use, but it is a tool you can learn from and with and you can extend your creativity by collaborating with it, but you got to not be afraid of it. You have to play around with it. You have to try it, understand what it can do, understand how it can help you. I think it is going to extend our creativity.

Sacopulos: What lessons from other industries can healthcare adopt to create more resilient and high performing teams?

McGowan: Resilience comes from hope, feeling like you have some agency. Sven Hansen of the Resilience Institute out of Australia says there are five points to building resilience. The first is getting good sleep. And I know this is a big problem in healthcare. I wish we could do something about the hours that we prioritize good sleep, so much evidence that sleep and performance are connected. And when you are deprived of sleep, you don't make good ethical or empathetic decisions. And those are exactly the kinds of decisions we need our healthcare professionals making. So, sleep. Next to that is overcoming adversity and that is not just bouncing back to your new place, but it is learning from adversity. How do I come back from that? Next, it is focus. Our focus is getting worse and worse and worse. And I am a candidate as long as everybody else. We need to set aside 90 minutes a day for point number four, which is feeling attainment on something, feeling like you are working on something that matters. You are not running every 15 minutes and shifting because that depletes our ability to perform. It depletes our overall resilience. And then the last point is teenagers today are switching focus something like every 18 seconds. So, it is getting worse with each generation.

So, we need better sleep. We need to attach to projects we feel a connection to, and we feel agency over. We need to have great sleep, we need to have focus, and we need to have that ability to bounce back. And one of the things healthcare leaders can do is share their own experiences bouncing back. I often use an image of Kintsugi, which is the Japanese art of mending broken pottery by using gold or silver to highlight the cracks and imperfections rather than conceal them. And it makes a more beautiful object, but it also shows the history and the resilience of the object.

Leaders need to think about themselves that way as well. So instead of presenting yourself as a perfect person who has never made a mistake, share your imperfections and what you learned from them. Steve Jobs said being fired from Apple was one of the most important moments in his trajectory as a successful professional. It made him a better CEO. He learned so many things, more people who can lean into what was a big moment of failure that you learned from most of us were forged from the difficult moments, not the easy ones. So, sharing that with your people so that they know one, that you are human and they can connect with you, but also that they know that there are going to be bumps along the way in their own professions and that they will make them better, not less.

Sacopulos: Are AI models and futurist predictions based on the assumption that people are rational? Recently we have seen parents fail to immunize their children from measles. Many if not most people would view this failure to immunize children as irrational. How do we predict seemingly irrational behavior's impact upon healthcare in the future?

McGowan: That is going to be a tough one, and I am troubled by that. I was recently reading a book called Fluke that talks about how so many things in our history that we think were rationally led in a linear fashion really had to do with chance. And one of the things they point out is that the human brain likes certainty, we don't like uncertainty. So, if someone can present even a conspiracy theory that makes us feel certain; the more stuff I am reading about COVID, we really don't know if it was the Wuhan market or a lab leak. We don't know. We don't have enough evidence either way. I mean we had a lot of scientists saying, "There's no way it could have been a lab leak," and I hope that is true, but then there are enough cracks in that to say, well, maybe it was true. I don't think it was a diabolical plot. And that is how it has been elevated to a conspiracy theory. I just think there are sometimes we just don't know, and our brain doesn't like not knowing. So, our brain goes to lunge at a conspiracy theory that makes us feel better and makes us feel certain.

And I think that is what is happening around some of the vaccines. It is easier to think that Bill Gates is planting something in us to try to control us or that Anthony Fauci was benefiting from it in some way, and so it was a big plot to enrich him or whatever it may be. In reality, we are imperfect, and we live in an uncertain world, and we are not comfortable with that. So, our brain lunges at conspiracy theories that seem even ridiculous just so we can feel like we know. We don't like not knowing. And that is troubling me right now, it is the decline in trust, which comes from the loneliness epidemic. Decline in trust in our institutions, particularly our scientific institutions. So, it is very troubling, but understanding that it is a human phenomenon to want certainty at least explains why people fall for these conspiracy theories.

Sacopulos: How can we help physicians transition from traditional models of care to more technology-enabled approaches?

McGowan: I think if we can show them that it is not one more thing to do, that is what I really feel from everything I have read is they are just so exhausted from having to do one more thing and one more thing in a shorter amount of time and see more patients, et cetera. If we can show them that technology can be a time saver and an efficiency saver so they can do more of what they went into this business to do, which is care for humans, I think we will have a greater advantage. When they see I am providing better care, I feel better about my interactions. I mean, we get rewarded when we serve another human. It is like that is why people go into nonprofit businesses or go into lower paying jobs that are human centric.

They get something back from that care that I think has been stripped away from a lot of healthcare. So, the way we can get back to a doctor sitting down and talking to a patient for more than three seconds to give them the diagnosis. Because some piece of technology is handling some large part of what they used to do so they can do what they went in this business to do.

Sacopulos: You have mentioned several times since we have been talking about the epidemic of loneliness. How do you feel that that impacts the future of work?

McGowan: I think it is a bigger threat to us than artificial intelligence. And I am digging deeper and trying to figure out how we got to this moment. Now, certainly COVID was an accelerant because we were isolated. Certainly, social media, it was an accelerant because it led us into little bubbles. But a book I am reading right now called Stuck talks about how we moved geographically had a big hand in that too. So, in the 1920s, about 20-25% of us moved our address every single year. Fewer of us were homeowners, we were renters. And renting a new house or renting a new apartment was part of moving up. So, you were going into the bigger apartment and then someone was coming into your apartment which was bigger than the one they had before, or house. And part of that process was you were putting yourself into new experiences, you are putting yourselves into new neighborhoods and new cities, and when you did that, you had to make a new community.

So, we had higher levels of people belonging to rotary clubs and book clubs and churches and bowling leagues, et cetera, because that is how we made a new community. We didn't have a high level of distrust for each other because we were going in to make these new communities. Those communities are really important to driving trust. Now we have a situation where fewer people move. I think we are at about 8% or 9% annually. They think it is linked to rules we have put around homeownership, making home the biggest asset that you have and regulations that we put in to make certain neighborhoods go up and be exclusive and harder to build houses. And that may be. The other thing is that that led to a higher level of entrepreneurship because when we move, we are open to more newness. We come up with new ideas, we take more risks.

So, we were on a high level of social mobility. We had a high level of geographic mobility. We had this new community, we were forming community, we spent more time with each other. Now we are having lower levels of community, spending less time with people unless we already know them. We are isolated into our bubbles and some of them conspiracy theory based on social media and we are starved. Humans are starved for attention. Get in an Uber or a cab, just start talking to the person if you share the same language. Most people are starved for a connection in conversation. So, it is going to have a huge impact because when you are lonely, your amygdala goes into overdrive. You go into fight, flight, or appease. You go into us versus them, which further polarizes us, increases the level of distrust including trust in science and our healthcare system.

I think we have to rebuild some of our social fabric and find new ways of creating community. And right now, it has become work. Work is the number one place most people have some sort of community. I think that is important. I don't think that it is good, but it is a place to start. I think we are going to start seeing, I hope we will start seeing more folks, young folks in particular building new types of social media that are not, some of them are online, but also offline and in-person, and then we are talking to each other and we start building back some of that level of trust.

Sacopulos: That is fascinating. Let us shift gears. This is a concern of mine. I am interested in privacy. Are patients and providers going to have to abandon some degree of their privacy that they currently or have enjoyed in the past?

McGowan: I don't know why they need to. I mean, I can understand how we would contribute our data if it were anonymized. The more data we have to look at why this person gets Alzheimer’s, or this person has obesity, or this person needs a knee replacement. What are the factors? The more we can crunch the data, getting more and more better data to understand those things. But I don't understand why we have to give up privacy in that process. Why do you think we do?

Sacopulos: Well, let us look at it from the employee’s point of view. From the provider’s point of view. We know that the vast majority of physicians today are employed and are not self-employed. And this would seem to occur in other industries as well. Is there a loss of privacy or some degree of autonomy when it comes to working for an organization that is studying your behavior with AI?

McGowan: I see. Yes, I understand that concern. I am a belligerent optimist. I have come to believe that we will use this AI to increase human potential, and human potential doesn't get increased by oversight. I think that you look at the companies that are doing all sorts of surveillance on their employees and they think they are going to catch that 2-5% of people who are lazy liars and cheaters. And we designed the system for that minority of people if we focus more on how do we unleash more potential, how do we increase folks’ agency, how do we increase the time people want to give to your organization. You give time when you trust and you feel like your organization is worthy of that. You violate that trust with surveillance, however you do it, and you are eroding that, and you are going to erode that performance. So hopefully that will be seen soon.

Sacopulos: I love the term belligerent optimist. That is absolutely fabulous, as was your answer. So as our time together, Heather, comes to an end. I am interested in what you see workers today looking for in the future of work.

McGowan: Yes, it is the five Ms. It is money, mission, meaningful work, membership, and mentorship for sure. It is also feeling like that sense of hope and feeling like a connection to things. We are also just hardwired to care for each other, but we don't know that. I spend a lot of time in airports because I fly every week, sometimes every day, sometimes multiple times a day. When you see it in an airport, that is the most anonymized group of people you could find. You would say that would be survival of the fittest, right? So, two incidents recently in the airport. I shared them with friends of mine; they absolutely believed things would go one way and they did not. So, I was rushing through an airport, I was in, I don't know, Texas or something, and about 15-20 feet in front of me, an elderly woman fell to the ground. Everyone is rushing out of the gate, what do you think people did? Their answer, "Oh, they stepped over her." I said, "Absolutely not. Every single person knew how fast they were running, stopped, and helped that person up. There were actually too many people trying to help her up." So that gives me a sense of hope. It is in our intention. There is always one person who might walk by.

And then I was in a food court in Boston, and that is even worse. I think food courts, people are hungry, and they are trying to get to their gate, so they are going to elbow each other out of their way, whatever. And the lines were long, and it was like peak time. And this woman had walked away with her bagel sandwich, which had a lot of stuff on it, just a lot of messy stuff. And she tripped, and the bagel sandwich went everywhere. Now, if people helped her pick it up, she is not going to eat the sandwich. So, there is no recovery there. Everybody got out of line and helped her pick that sandwich up, lost their space in line, helped her with something that is not ultimately going to help her, but felt bad and tried to help her up. And then someone else gave her their spot in front of them in line.

So, I have to tell you, I am a belligerent optimist for a reason. I have told this story before. When I was 18 years old, my brother was diagnosed with a rare form of leukemia and he needed a bone marrow transplant, and he is adopted from Korea, so it did not look bright for him. We did testing drives all around the country. This was 1992 before cell phones, before the internet, before any form of social media to help us, person to person, almost 8,000 people rolled up their sleeves to give a vial of blood to try to save the life of someone they never met. You cannot have that experience and not be an optimist.

Sacopulos: This is one of the most hopeful interviews I think I have ever done, and I really thank you for that. Heather, if people wish to reach you, how can they contact you?

McGowan: Two ways. So, I have a website, heathermcgowan.com, and you can put it in the show notes.

Sacopulos: Absolutely, we will.

McGowan: Yes. And then you can find clips of me speaking topics, how to reach me if you want to have me speak at an event, my books, all that stuff. And then I am very active on LinkedIn, which is for some folks, it is a place to find a job. For me, it is a big learning community. So, I post on there what I am reading, who I have talked to, some interviews, people post and tag things for me to read. So, it is helpful to me. So, it is a learning community. So please join me there and I can give you that link as well.

Sacopulos: Excellent. My guest has been the belligerent optimist, Heather McGowan. Heather McGowan, thank you so much for being on SoundPractice.

McGowan: Thanks so much for having me.

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