Courage:  Action despite Fear

Over the last 12 months, I’ve taken a deep dive into the healthcare system at the regional non-profit level. Unfortunately, I’ve found a scary level of financially vulnerable systems. Leadership teams at non-profit health systems across the country have over-optimized for operational excellence and regulatory compliance for years. In doing so, each system and the industry as a whole have under-invested in resiliency, strategy, and innovation.  This over-reliance on operations has left our system fragile and unprepared for disruption.

The pandemic caused two waves of disruption. The 1st occurred as a direct result of the new pathogen and the health risks of Covid.  Leaders, physicians, and bedside staff answered the call and worked long hours, accepting personal risks to manage this new virus and provide the best possible care. Yes, there were deaths, but overall the system did an excellent job of reacting quickly, sharing information, and inventing new treatment protocols. Unfortunately, the public health crisis was only the 1st wave of disruption. 

We are now experiencing the 2nd disruption – labor shortages. No longer can health systems attract large numbers of caregivers for relatively low wages. This second disruption is a serious threat to our system. It represents a foundational change in the cost/benefit analysis of pursuing a career in nursing and other essential bedside staff roles. Employees have found that many other career paths pay better with more attractive workplace requirements. Leadership teams understand they can no longer find workers, but they don’t have the experience or background to think strategically and redesign the operating model.

Today, the traditional care delivery model is impaired, with costs exceeding revenues and growing 2-3 times faster. Most systems have some cash reserves but must redesign and innovate to survive over the new 2-3 years. The scale of this 2nd challenge to the US healthcare system is what I find scary.

Fear: A Signal to Act

Fear is a powerful emotion. It is hard-wired in our reptilian brain and often bypasses conscious thought. This was evolutionary valuable. When you sense a dangerous predator in the bushes – thinking is best bypassed. Fear emotions rise up and automatically trigger our fight/flight response. Physically and chemically, our body prepares to fight or to run away by flooding our system with hormones and increasing our heart rate.

Courage is not the absence of fear. This is a widely held incorrect belief. Rather, it is taking action despite our fear.  When we become afraid, the unknown can paralyze us. We must choose to be brave and run toward the challenge seeking to define the issue clearly. Only when the situation is well-understood can we find effective solutions. One of the best ways to be courageous is to understand what you’re afraid of and then refuse to allow that fear to paralyze you. Think about our fear as a signal. It focuses our attention and helps us know what needs to be fixed.

Understanding your strengths helps you to act with courage. Knowing your strengths naturally fosters confidence, which makes it easier to take courageous action.  Many people struggling with fear instead focus on worries, undefined shadows, past shortcomings, and weaknesses. However, doing this just makes it less likely that you will feel courageous. For this reason, it’s essential to think about what you’re good at as a way of building your confidence and your courage. Once you understand where you are strong, Ask for help in other areas. No one person or organization is strong in everything. Find partners to augment your weaknesses with their strengths.

Human-Centered Health Vision

Our vision is to redesign care delivery with humans at the center. We expect it to take many years to achieve this vision for our healthcare future. The healthcare industry is too big and too integral to our society to expect change to happen fast. Legendary UCLA basketball coach John Wooden’s advice: “Be Quick, but Don’t Hurry,” fits well in these times. We must start now and set about making positive change today. While understanding that impatience and unrealistic goals will not be helpful and could be dangerous when human health is at stake. 

Understand that the fear you feel is a signal to act bravely. Work to define the challenges arising from this 2nd disruption to the healthcare delivery model. Then assess your core strengths and seek assistance from others to redesign. Together our healthcare system met the challenge of the Covid-19 virus. Now, We must come together again to redesign our care delivery system for today’s workforce. We can do it, but we need to be courageous and take action together.