The Dangers of Turning Inward, published in the print edition of the Weekend Wall Street Journal on Saturday, February 28, presents a chilling scenario for the potential demise of globalism as a result of the current economic crisis. As I read, it occurred to me that health care leaders may face some similar choices as we select strategies to combat the inevitable "other shoe" - when the full impact of this recession is felt in our industry. Please read the source article and, of course, continue further in this commentary for my perspective on the connections it suggests for health care leaders...
In his provocative essay, Jeffrey E. Garten, a former Dean of the Yale School of Management, discusses the current manifestations of "economic nationalism" around the world - efforts by countries to protect their own economies by "hunkering down" and focusing on national self interest while abandoning - or actively undermining - the mutually beneficial economic relationships between nations that capitalize on shared solution strategies and sow long term common benefit. Instead they are driven by fear of short term economic imbalances one way or the other that may occur. It gets really scary when Garten extrapolates this tendency towards economic xenophobia forward. Looking far ahead he sees an increase in national isolation, mistrust, internal political extremism, repression, and, potentially escalating global conflict.
Is the Road Runner a Health Care Leader?
I've already said many times in this nascent blog that we in the health care delivery world have been somewhat shielded from the harshest manifestations of the economic downturn. And that we should be doing some anticipatory planning for when the time comes to us. Given the scale of the global economic problem as we are beginning to comprehend better daily, we would be wise to be rapidly readying strategies for a fall of our own. At some point, like the cartoon Road Runner, might we soon look down and find out we ran out of cliff a while ago?
What Happens to the Boats When There is No Rising Tide?
So what will be our strategy? It's worth asking this both at the micro level (program, Department, site of service) and at the enterprise or industry level. Instinctively, leaders tend to favor "organizational or programmatic nationalism" in the form of protecting our important human and programmatic assets. That might be a good leadership strategy in normal economic times. Under those conditions resources are relatively plentiful and encouraging program areas to flourish using local vision and talent is likely to yield results and benefit others: "... the rising tide that floats all boats....." This time of limited and shrinking resources may call for different health care leadership strategies to share what is increasingly clear will be a shrinking pie.
Develop a Navigational Strategy for Shallow Economic Water
Mr. Garten makes the following observation on industry and governments in the current crisis: "Most officials don't know what to do because they haven't seen this level of distress before. They are living from day to day, desperately improvising and trying to hold off political pressure to take severe measures they know could be satisfying right now but cause bigger damage later." So, is this a time for health care leaders to look outward beyond their programs, Departments, or institutions. To reach out (even to competitors) in the broader community or industry to develop a collaborative survival strategy for catastrophic economic collapse? Would it be wise to preemptively consider radical post competitive contingency strategies? Can we do this and absorb the risk of present or future competitive consequences? When is the right time to plan? Is now too early or too late?
Field Notes
Here is a small example of "outward" thinking put into action. I'm currently coaching senior leaders at an academic medical center (AMC). An historically financially weak Department at this AMC recently become an economic powerhouse. The Chair faces the pleasant dilemma of how to spend new and significant revenues as well as the less pleasant prospect of a feeding frenzy for a share of his wealth to support the survival of members of the faculty practice already experiencing economic hardship.
This Chair wisely, and voluntarily, developed a formula to make "corridor based" contributions to the Dean and to important related programmatic initiatives outside the Department in order to ease their pain and to invest in their survival. This approach provided him with a level of control over the amount and direction of his philanthropy, gave financial support to crucial clinical services that his Department requires for its own maximal effectiveness, and built strategic relationships with erstwhile competing Departments that will likely be remembered in the future.
Looking outward, in this case, turned out to be a strategy for internal success.
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