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The Complexity of 21st Century Health Care

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One of the minds is rational and driven by data. As health care professionals we are scientific and in search of reality—an objectivist perspective. The other mind is very emotional, meaning-driven, and comfort-seeking. It rejects any objectivist perspective. There is no objective reality. There are only narratives that can be healing or hurtful. It is up to us, as physicians—and even more importantly, as patients – to make the right choice between these contradictory narratives.

We can learn to accept both aspects of our very human nature. Mother Nature can be our teacher. Perhaps we will find new and creative ways to cohere and align when facing ongoing viral pandemics and idea-demics now and into the future. That is the greatest hope and desire of the two of us, as authors. We would like this essay to contribute in a small way to a journey toward more integrated, accepting, and wise approaches to the puzzles, problems, dilemmas, polarities and mystery of our world.

What are the requirements to successfully navigate the VUCA-Plus world as leaders of a health care system? We suggest that successful navigation begins with recognition that each of the VUCA-Plus challenges exists in the contemporary world of health care. Complexity, in particular, is facing us as we make difficult decisions about health care priorities and delivery. Thank you, Mother Nature for offering us the lifelong learning opportunities of COVID and for being our co-author and teacher. We just wish that the lessons you are teaching us could have been and still could be less harsh. Perhaps, the harshness was needed to get our attention.


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Miller, John and Scott Page (2007) Complex Adaptive Systems. Princeton NJ: Princeton University Press.

O’Neill, Ed (2020) Quick-Takes for Medicaid Leaders Amid COVID-19. Addressing VUCA as a Leader #5. https://www.chcs.org/media/QuickTakes-VUCA_070120.pdf

Quinn, Robert (1996) Deep Change: Discovering the Leader Within. San Francisco: Jossey-Bass.

Quinn, Robert (2004) Building a Bridge While You Walk on It: A Guide for Leading Change. San Francisco: Jossey-Bass.

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