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The Complexity of 21st Century Health Care

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Implications

We believe that it is particularly important to properly identify and discern between solution-accessible puzzles and more elusive problems and polarities. Rather than “seeing the world as a nail, because I have a hammer” we must recognize that there is much more facing us than a nail and that we need multiple hammers and many other tools regarding health care perspectives and practices. The focus on nails and hammers happens when we distort complexity into simple puzzles and simply problems that can readily be fixed or solved.

Successful mid-21st Century leadership in health care also requires that we shift from either/or thinking to both/and. We must navigate on “turbulent’ seas using maps and compasses, rather than right/wrong rules.  We must zoom outward and think slowly when facing VUCA, rather than zooming inward toward fast thinking, reductionistic approaches to problem-solving and decision-making.

Perhaps it is most important for our own personal health (and sanity) as leaders in contemporary health care systems that we acknowledge our engagement in a domain of life (and death) that is saturated in mystery. We have always been dancing with the angels and the devil when helping our patients address issues related to their own mortality. In this world of existential threat and profound angst it is particularly seductive to believe that we can overcome death (at least for a while)—or that we can at least be “experts” on what it means to be mortal. The mysteries that we face in the domain of health care have only become even more elusive and complex as we gain more knowledge of and appreciation for the complexity of the illnesses and injuries we are treating.

It is indeed ironic that we know less and less as we learn more and more. Under these ironic conditions it is tempting to adopt a fundamentalist perspective requiring that we accept one right answer and one version of truth and reality. The alternative is to be courageous in the face of multiple right answers and many alternative versions of truth and reality. These answers, truths and realities must all be acknowledged and incorporated in our perspectives regarding and practices engaged in the field of health care.

What then is the source of this courage? We believe that it is somehow embedded in the foundational commitment we have made as professionals in the field of medicine. There is indeed another irony inherent in this commitment: it seems that the very notion of ‘profession” is founded in the mysterious realm of spiritual practice. We “profess” our commitment to a specific set of ethics and desired outcomes. In doing so, we join other professionals in a spiritual alliance on behalf of the welfare of all human being. Our world is indeed mysterious—and ultimately quite spiritual in nature.

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