Terrariums in the Weedy Garden. (Not Fiefdoms!)
I spoke to a health insurance executive several years ago. Smug, entitled, proud . . . in denial. “We identify waste in healthcare. We help keep healthcare costs low, and we make a lot of money doing it.”
A sophistry to justify immorality.
The squeeze our kakistocracy puts on healthcare acts like a pressure cooker with the patients and providers inside. Policy makers, health insurers, and big pharma are incented to do the wrong thing. So, this is not going away. It’s going to get worse.
Despite its immoralities and dysfunctions, our healthcare system remains a complex series of interdependent systems. Physicians, nurses, administrators, patients, departments, hospitals, payers, and policy makers all forming streams of exchange.
The temptation for healthcare leaders is to form islands or pockets where “our” people can succeed “against them.” Fiefdoms in which adversarial lines are drawn and psychological energies are spent in contention, resentment, and/or passive resistance.
Since reciprocity is foundation to living systems theory, the operative questions for leaders in healthcare are “How do I function or even thrive in a dysfunctional system? How can I create a subculture in which people feel respected, supported, challenged, and empowered? How can I set reasonable limits and boundaries? How do I attend to the sustainability of our people and my own psychological and emotional equilibrium?
We offer the analogy of the terrarium in the weedy garden. A combination of asserting while staying connected.
Terrarium Checklist:
- Put on your own oxygen mask first. Secure the emotional and psychological support needed to persevere.
- Don’t attack the others in the leaky boat. The people around you are carrying the burden, too.
- David, be ready to say “no” to Goliath. Set reasonable limits and boundaries around workload and processes. Don’t feel victimized because you must keep resetting them.
- On behalf of the people you lead, see clearly how the systemic disfunction intensifies everything from marital strife to, to depression and anxiety, to burnout and suicidal ideation.
- Keep the lines of communication open in all directions while monitoring the giving and receiving.
- Transparency, solidarity, and clarity!
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Fern EPC is the Adaptive Development Fast Track for physicians and executives.
