Jeremy Fish, M. D. and William Bergquist, Ph.D.
We identify specific challenges and specific models of leadership in this fifth in our series of essay regarding adaptive complexity in contemporary health care systems. Our exploration of leadership begins with a consideration of ways in which health care leaders can benefit from not only receiving coaching services but also serving in a coach-like role when working with others in their organization.
We suggest that coaching to a team rather than an individual might be particularly appropriate in health care given the complexity of challenges being faced and the need for multiple perspectives in addressing these challenges. We also focus on the empowerment that comes with effective team coaching and with the way(s) in which health care issues can be added in an “emergent” manner.
In the second half of this essay, we turn to the fundamental nature of the challenges that a coaching and team-oriented health care leader is likely to face in the middle of the 21st Century. While there are many challenges (such as those related to volatility, uncertainty, complexity and ambiguity: the so-called VUCA conditions), we focus on two additional challenges that are closely related to and exacerbate the intensity of the VUCA conditions.
These two additional challenges are turbulence and contradiction (yielding a VUCA-Plus environment). Leadership in a VUCA-Plus environment requires balance and agility in a world that is turbulence and contradictory, in part, because of the varying conditions of change in contemporary health care and because of the presence of six sub-cultures in health care that each contains its own version of reality and its own set of needed.
Coaching the Leaders
The authors have long believed that teamwork in healthcare will struggle to manifest until a sufficient and sustainable coaching bench is developed. When we look at the world’s most successful teams, we often find a pattern of outstanding coaches who travel to develop one remarkable team after another. In basketball, one can trace the careers of Phil Jackson and Gregg Popovich. We find dynasty after dynasty moving right along with both of them.
College basketball has seen many coaches with truly stunning lifetime records of national championships year after year after year. One of us (JF) was a varsity oarsman for the University of California Lightweight Crew in the 1980’s. With amazement, he watched first-hand the career of Steve Gladstone who established dynasty-level National Championship crews at Cal (6), Brown (5), and Yale (3) throughout his 50+ year Coaching Career.
