Home Organizational Psychology System Dynamics / Complexity The Complexity of 21st Century Health Care

The Complexity of 21st Century Health Care

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The organization is now in the midst of polarization. Someone who recognizes this as a polarity can bring both parties to the table and facilitate a mutual understanding of the respective benefits and possible negative consequences of holding either position to the exclusion of the other. Once the strengths and risks of the two sides are understood, the dialogue is directed to what happens when we try to maximize the benefits of either side at the expense of the other side.

To return to our dancing landscapes, we find (as in the case of dilemmas) that there are multiple mountains to view when we look out over the health care landscape. Once again, as in the case of dilemmas, the landscape is dancing with the impact of VUCA-Plus. However, in the case of polarities there is another force operating that produces the dance. This dynamic is the swinging back and forth between two contradictory and competing polarities. There is oscillation in the dance—with the dancer twirling around to a point of exhaustion or madness.

Back to the mountains. We decide first to climb one of the nearby mountains and then immediately identify the many challenges we would face in seeking to climb this mountain. So, we turn our attention to the second mountain (which is just as tall), yet soon come to recognize that this second mountain has its own barriers. We stand there frozen and stressed. No action is taken and the opportunity to reach either summit is lost. The lost opportunity, in turn, further increases the stress. And the frozen condition seriously damages our personal health as well as our collective organizational health.

For example, let’s return to the conclusion in our centralized organization that centralization will lead to much greater efficiency. It turns out that such unilateral bias to one side of a paradox or dilemma soon causes the downsides of that same force to manifest. In our centralized organization, this would mean that we can centralize everything only if we are willing basically to slept at the office and ignore our family, or if as managers we always drive our subordinates to maximum efficiency. Our nights at the office would eventually lead to divorce, just as a 24/7 romance at the exclusion of work would likely lead to destitution. Total centralization causes the incapacity to customize, but totally giving way to the local interests of a subsidiary would drive up the cost to uncompetitive levels.

Barry Johnson warns us that we should not attempt to maximize but rather carefully optimize the degree to which the parties incline toward one side or the other and for how long. Optimizing means that we must find a reasonable and perhaps flexible set-point as we take action in favor of one side or another. Finding these acceptable optimum responses and redefining them again and again is the key to polarity management.

It is wise to encourage regular checkups with the other side of a polarity in order to evaluate to what degree, with what intensity, or for what time period both sides can reap the benefits of one side. This is particularly important given the interconnected nature of complex, turbulent systems with interdependent subsystems. For example, if work-life balance among dedicated health care workers were the issue, our workers would listen to their family’s feedback, so as not to overshoot their commitment to work. If our health care CEO cared about balancing her company’s financial health with investments for growth, we would encourage this leader to make sure that she regularly brought her conservative CFO as well as her expansionist, visionary head of marketing to the table, agreeing on trade-offs, measurable goals and milestones for evaluating results.

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