Laggards/Homebodies
What about those folks who remain back home? They won’t move West under any conditions. They can’t be convinced, bribed, or cajoled. In many instances, they are actively engaged in efforts to discourage the widespread adoption of an innovation. They might be silent at first; however, once the innovation begins to pick up steam and threatens to be accepted by the Early Majority, they may become quite vocal. In many instances, the objections of the Laggard to a specific innovation can be attributed to their differing perspective regarding this innovation. They may view the innovation as being representative of a subculture in their organization that is alien to the subculture they prefer (Bergquist, Guest and Rooney, 2002; Bergquist and Brock, 2008). The discarding of managerial “fads” is illustrative. Laggards are likely to assign this term to those who are promoting a “management improvement” or “organizational reform” strategy.
There is yet another source of Laggard opposition to a new healthcare procedure or program. Their objections, in many instances, don’t arise from the flaws and threats associated with the innovation—after all, we all appear to be Laggards about certain new ideas that we consider ill-advised or oversold. For many true Laggards, the issue is much more personal. These men and women were innovators themselves many years ago and were unsuccessful or burned out regarding their innovation.
The Laggard led a major initiative looking into the reform of some outdated practices. However, they never witnessed the enactment of this reform. They championed the use of a major new technology, only to see their colleagues casually dismiss this technology as a gimmick. They devoted many hours to designing a new training program that was thrown out only two months after being installed in their organization. If a new initiative is successful, then what does this say about a Laggard’s past failure(s) as an innovator? An important lesson can be learned from the passionate objections voiced by Laggards. When we isolate or dismiss an innovator, we not only lose this person’s ideas and potential leadership but also create a Laggard who can be a persistent enemy of innovation for many years to come. Many of the barriers to innovation that were identified by Frist and Shumway may be erected by burned-out innovators who have become Laggards.
What to do with the Laggards
How should physician leaders engage those Laggards who oppose an innovation for very personal (and usually undisclosed) reasons? We can try to isolate them, but this is rarely effective. Alternatively, we can bring in Laggards as historians and advisors: “What can we learn from you about what happened many years ago? What can you teach us? If you were to plan for the successful use of this new procedure or program, what would you do?” Yes, this is a co-option strategy. Laggards will see right through it if this request isn’t legitimate and if one doesn’t seriously consider the advice they offer and listen patiently to the stories they wish to convey. There are certain repeated patterns (fractals) that are found in most organizations (Weitz and Bergquist, 2024). We can identify these patterns with the assistance of our colleagues, who happen to be Laggards, and can effectively leverage these patterns to our advantage and to the advantage of the healthcare organizations in which we work.
What about providing a Laggard with assistance? We first have to ask why a Laggard would ever seek out assistance. We suggest three reasons. First, we can provide a safe setting in which the Laggard “vents” their frustrations. An organizational consultant or coach can serve as a witness and empathizer. Second, a setting can be provided in which the Laggard can tell “their side of the story,” having often been turned off (as a bore) by their colleagues inside the organization. The organizational consultant or coach doesn’t just listen. They offer their own reframing of what has occurred (Bandler and Grinder, 1983; Bergquist, 2025b). They can encourage an exploration of the identified Laggard’s role in past innovations.
