Role of Physician Leader
How might a physician leader best address the needs of the Innovator/Explorer? First, we know that all learning and new ideas emerge within a threshold between profound challenge and substantial support (Sanford, 1980). On the one hand, if there is a great deal of support and not much of a challenge, then the person dwelling in the threshold is unlikely to find much motivation to take a chance. He might remain contented on the threshold or is more likely to grow bored and return home. This is rarely the condition being faced by the Innovator/Explorer. It is much more likely that there is too much challenge and not enough support. If there is nothing but challenge, then the anxiety can be overwhelming.
The person dwelling in the threshold is overwhelmed with anxiety and the desire (perhaps need) to survive; “The wilderness is too much for me. I’m being attacked on all sides.” What is the response to this challenging condition? Sometimes it is counterattack: “I will have to spend all my time and energy fighting off the attackers.” This is the response, as the old saying goes, when someone spends all their time fighting off alligators and soon forgets that they were sent there to clear out the swamp. A second response is also common. This is the flight (rather than fight) response: “I need to get out of here!” Or there is the freeze response: “I won’t survive unless I sit absolutely still, and maybe they won’t see me.”
Under these challenging (and often overwhelming) conditions, a primary role to be played by a physician leader is the provision of sufficient support to counter the challenge. This doesn’t mean taking over from the Innovator/Explorer: the leader can’t take on the Innovator/Explorer challenge; however, it does mean the leader can provide assurance, can point out where small successes have already been achieved, and can help members of her healthcare system craft a strategy for something more than just survival.
The physician leader and other members of the healthcare organization can be a bit more realistic and a bit more focused regarding the direction in which their organization is moving. This strategizing often involves moving through three domains: (1) the domain of information (where the organization is right now), (2) the domain of intentions (where the organization wants to be at some point in the near future) and (3) the domain of ideas (how the organization can get from where it is right now to where it wants to be) (Bergquist and Mura, 2011).
The Innovator is often comfortable dwelling in the domain of ideas. They frequently love to generate many new ideas. On the other hand, the Innovator is frequently indifferent to or even uncomfortable dwelling in the domains of information and intentions. They aren’t very realistic or practical, nor do they have a clear direction. While a physician leader doesn’t want to take away the spirit of adventure and the willingness to journey out into the wilderness, this leader can help temper the Innovator’s (or the organization’s) inclinations to stay only in the domain of ideas. The leader can ask something about the resources the Innovator is bringing with her into the wilderness, while other members of the organization might identify resources that the Innovator might need to survive their journey.
