Fern EPC Blog

“We’ve been to the battlefield and met the enemy. He is us.” A modernized version of this famous paraphrase: “We have been to the battlefield and met the enemy. The enemy is the way we’ve been interpreting the challenges we face.”   Technical development teaches you things to know. Adaptive Development facilitates better ways of…

You assume the brilliant surgeon will be a brilliant leader. You promote or onboard your most talented people to positions of authority. Then, because they are indeed brilliant, you set them free to do the job with little or no developmental support. “I call it cruel and maybe the root of all crueltyto know what…

Don’t let your most valuable resource go to waste! Fern EPC founder and president Brad Fern shares insights on how organizations can help their people reclaim wasted cognitive and emotional energies. In his latest video, Brad describes the importance of the Challenger, the Attuned, and the Contributor in forming the ego strength necessary to lead…

Do you have your strengths, or do your strengths have you? Michael Watkins teaches that what got you where you are won’t necessarily serve you there. “Success often requires us to stop doing some things we’ve been doing and to embrace new competencies.” The surgeon leader who tells herself, “To meet expectations, I must do…

The Spanish poet Antonio Machado wrote, ‘I caught a glimpse of him in a dream, expert hunter of himself, always in ambush.’ Machado reminds us that the self is perpetually incomplete. Growth is not just what we can do. It’s what we can be. The idea of self-growth can be daunting, but courage is not…

“Mankind owns four things That are no good at sea: Rudder, anchor, oars, And the fear of going down.”[i] In leadership, we are often responsible for things we don’t completely control. Some refer to it as the Authority Paradox. The more authority we have, it seems, the less we can rely on authority to get…

When leading or generally interacting with others at work, consciously or unconsciously, we choose default “relational modalities.” In other words, we act passively, assertively, or aggressively. Awareness of your default mode will increase your relational agility and leadership efficacy. Passivity, on the far right of the Assertiveness Spectrum, is a fear-based state in which ego…

CME-for-Fern-EPC-Coaching-2

“My people!” Almost any CEO will say this when asked what their most valuable resource is. But it’s not necessarily true.  “The cognitive and emotional energies of my people are my most valuable resource” is a more specific and accurate answer. The Bad News: loads of this valuable resource are wasted every day in healthcare…

When catastrophe is a minor blunder away, when you could amputate the wrong leg or remove the wrong kidney, for instance, it’s easy to get people to embrace High Reliability principles. Give a speech about HROs to a room full of O.R. docs and nurses, and you might see a lot of nodding heads. Give…

If you aspire to be a High Reliability Organization, your primary obstacle will be the adaptive limits of your staff. To be an HRO, your leaders must commit to zero harm. Your board must commit, your C-level leaders must commit, nurse leaders, physician leaders – leaders all the way down the line must commit to…

You should have grown wise before you grew old! This is a paraphrase of King Lear’s fool admonishing him for being naïve. Lear had come to the threshold of a grand transformation, and he assumed the skills and vision that got him there would serve him once he crossed it. Worse, he expected the old…

“Sometimes I feel the physicians demonize us for the decisions we make because they don’t understand why we’re making them.” This quote is from a healthcare administrator lamenting the tension between his department and his physicians. Several colleagues of mine and I conducted 25 administrative interviews. As a professional listener who specializes in physician and…

Careful! So you think you’re looking at a remedial circumstance because one of your physicians or executives is behaving poorly. Behavioral issues are often developmental needs in disguise. When dealing with “problematic behavior,” consider instead that you’re dealing with a normal human being who needs support.   No one got up one morning, rubbed their…

Your leadership team does not have a brain. It does, however, have shared perceptions, shared biases and memory, collective thinking, and mutual assumptions. In other words, just as individuals have minds, so does your leadership team have a mind. Many leadership teams are too busy to objectify and examine their own collective mind. The price…

Shame is antithetical to effective leadership. It’s a fear-based emotion that keeps you thinking about yourself. Competent leadership requires altruism. Shame, sometimes referred to as insecurity, can impede or debilitate new, young, and sometimes even seasoned leaders. Worse yet, shame will prevent some of your most talented people from stepping up, speaking out, leaning in,…

Physician leaders and healthcare executives sometimes speak of creating oases of efficiency and people-centeredness within organizations or systems they consider dysfunctional. Get enough people together for long enough, they say, and years of good policy intentions turn redundant, excessively complicated, and wasteful. Dysfunction in healthcare systems (often pejoratively described as “healthcare bureaucracy”) is especially problematic…

It’s a forest-through-the-trees kind of thing. You don’t see your thinking because you’re using your thinking to see. Perception begets interpretation > Interpretation begets emotion > Emotion drives behavior. Many physicians, physician leaders, healthcare executives and leadership teams don’t take the time to examine these perception-feeling-behavior progressions and their impact on performance. Yet failure to…

Physicians dedicate their young lives to technical growth: pre-med requirements, preparing for and taking entrance exams, medical school, passing boards, residency, and so on. Often, the price of this laser focus on technical growth is neglected adaptive growth. Adaptive growth is associated with wisdom, gravitas, maturity, courage, complex thinking, governance, vision, competent leadership, and confidence. Adaptive…

What about the colleague who is willing to sacrifice the truth if being truthful means being wrong? What about the boss who has no concern about the consequences of his or her manipulative style? What about the employee who is a stranger to empathy and has no problem hurting others? What about unreasonable people?

Power, Control, Revenge, Avoidance, and Attention. These are Rudolf Dreikurs’ five motives for troublesome behavior.[i] We can use them to gain insight into ourselves and to understand some of the difficult behaviors we see in others. Dreikurs taught us to look beyond problematic behavior, identify the unmet need, and resist the knee-jerk urge to use…

Fear of being dispossessed was and is a biological brain function promoted by natural selection. Subsequently, we’re hardwired to fear social estrangement. (In other words, you’re normal.)

This video shows a high-functioning team in action. (I purposely chose a video in a language other than English—in this case French—to ensure we don’t get lost in words.) Notice how the two client-facing team members support each other, blend their voices, yet set each other apart. Watch their eyes as they look to the…

To better understand physician disengagement, discouragement, and burnout, we can turn to the work of Alfred Adler and the foundational concept of Adlerian theory, Gemeinschaftsgefühl, loosely translated as “Social Interest,” the belief that humans have a primary need for social connectedness and to feel that they are contributing to the wellbeing of others. Adler taught…

My wife risks blindness without her glaucoma medication. A month’s supply is 3 ml. That’s barely enough to fill a thimble. It was priced at nearly $300. On vacation recently, she bought the same 3-ml of medication from a Parisian pharmacy for 11 Euros (about $11.50). We walked in, presented an outdated prescription from the…

Know how to gauge the complexities you face; the four types of challenges[1] faced by Physician leaders and healthcare executives. It matters because simple thinking applied to complex circumstances squanders opportunity and creates dysfunction.[2] 1.) Known Challenges: Known challenges are the simplest of the four types because cause-and-effect are repeatable, perceivable, and predictable. If you…

“Is there a way to provide mental health services to medical professionals under the guise of coaching?” A colleague posed this question in an email voicing his concern about physician suicide. He asked me because I am a licensed therapist in addition to being a coach who specializes in physicians and healthcare-industry executives, and he…

Primary care burnout results in $969 million in excess annual spending: Mayo researchers analyzed the financial impact of primary care physician burnout and turnover using American Medical Association Masterfile data October 12, 2017, and March 15, 2018. (Primary care was defined as family medicine, general internal medicine, general pediatrics, geriatrics, general medicine, general preventive medicine,…

In an ordinary organization, most people are doing a second job no one is paying them for. In businesses large and small; in government agencies, schools, and hospitals; in for-profits and nonprofits, and in any country in the world, most people are spending time and energy covering up their weaknesses, managing other people’s impressions of them, showing themselves to their best advantage, playing politics, hiding their inadequacies, hiding their uncertainties, hiding their limitations. Hiding.

Know the difference between technical capacity and adaptive capacity: Which filters do you use to make meaning? Carol Sanford says, “[Most] approaches to change are all working from an old mind. We’ve modified what we do, but we haven’t addressed who we are. It’s no accident that nearly every philosophical and spiritual wisdom tradition teaches…

“As we orient on what we most want, we face what we most fear.  Always this energy smolders inside.  Always the spark of our purpose and passion awaits our commitment.”

There are two general approaches to solving the problem of physician burnout.  One side—typically administrators, managers, and wellness advocates—says healthcare organizations should provide resiliency training to physicians. Teach them mindfulness. Coach them to develop their sense of insight. Teach them to “reframe” their perceptions and objectify their thinking. Provide Employee Assistance Programs and offer counseling.…

COVID 19 is imposing transformations on nearly everyone on this Earth. Whether it brings out the best or worst in us will depend on the maturity of our response. To better understand, we must first define something called “Formlessness.” Formlessness is the keystone segment of any significant transformation arc. It is the portion of the…