Two hallmarks of the health care industry are complexity and change.
By complexity, I mean that health care involves many moving parts (clinical care, insurance, research, education, regulation), stakeholders (physicians, nurses, patients, community, government, payers, stockholders), and forms of risk and investment (building capacity, upgrading facilities, liability, partnerships and acquisitions).
And by change, I mean major transformation. U.S. health care costs are widely perceived as being out of control, outcomes need to be better, there are shortages of primary care physicians and of nurses, and some segments of the population don’t have good access to health care. To address these problems, the U.S. health care sector is looking at entirely new models of everything, from how we train and pay doctors, to how we deliver care to patients, to the ways in which hospitals are paid.
The challenges of complexity and change become amplified when the perspective shifts beyond the U.S. Because global collaborative health care efforts combine the work of partners from different nations, their complexity can increase with, for example, the need to meet regulations from other governments, to recruit staff from various parts of the world, and to blend significant cultural differences.
At the same time, managing change can be all the more daunting because the sources may be a mixture of local and global changes in health care, coming from many directions. For example, in the U.S. the government is in the process of playing a bigger role in paying for health care, and there’s an effort to increase access to health care while reducing dependence on advanced and more costly care. But in many countries the government already pays for everyone’s health care, and the challenge is to make more advanced care available, not less. In addition, many nations face rapid and unpredictable social, economic and political shifts.
It’s a lot to handle, and that makes leadership in this new field all the more critical—but not in the way many people might think. Given all the complexity, you might suppose an organization entering global collaborative health care needs a leader who can stay on top of all the different components and keep the many parts moving in sync. You do, of course, need all that—but you need managers to do most of it, not leaders.
Leaders have to step back from all the details to take the broader view. Where will the opportunities be in the coming years? What resources and affiliations will the organization need to take advantage of them? What are the risks of failure, and how can they be mitigated? Integrating answers to these difficult questions into a vision that will guide the organization is the key challenge facing leaders.
There is a severe lack of this sort of groundbreaking leadership right now in global collaborative health care. That’s not a criticism—the field is new, and there hasn’t yet been time and awareness enough to develop leadership. The proof of this shortage can be seen at a glance simply by noticing how few major health care organizations have made significant commitments to the field. At Johns Hopkins Medicine, we’ve seen only a few of our fellow major medical centers step up in any significant way so far, for example. Much the same is true among large health insurance providers and investment firms.
If more organizations are going to contribute to this important field, which is poised for enormous growth, then we’ll need more leaders to direct the charge. Developing those leaders is a real challenge, because conventional health care administration or MBA programs today aren’t necessarily sufficient for the task. We’ll need leaders who can grasp the special demands of both health care and international collaboration, and who can go beyond day-to-day management to set vision and direction.
This new breed of global collaborative health care leader will be able to create excitement and confidence in others, driving organizations forward into unfamiliar territory, armed with an ability to manage risk, and take advantage of opportunity. The beneficiaries will be not only the organizations that will thrive under these new leaders, but the world’s populations, as these collaborative efforts spread access to better, safer, more affordable care everywhere.1 Comment