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Leading Change in the American Healthcare System

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The American healthcare system faces many challenges including shifting to value-based models, containing operational costs, aligning financial outcomes with clinical outcomes and growing market share — to name a few. But, one of the biggest challenges is the development of healthcare leaders who can drive sustainable change and balance the competing needs of stakeholders.

Leading with Effective Change

Healthcare professionals and, as retired Army Gen. Mark Hertling, senior vice president of Florida Hospital and a member of the President’s Council on Fitness, Sports and Nutrition suggested in his book Growing Physician Leaders: Empowering Doctors to Improve Our Healthcare (New York: RosettaBooks, 2016), doctors in particular must lead the charge. Leaders must think differently, act differently and deliver a different result than in the past. Leading the changing business of healthcare requires leaders who have a more comprehensive skill set than most have today. If we are to institutionalize a patient-centric system that delivers on the promise of a more effective and efficient healthcare system, we need effective leaders, and we need them now!

To denote uncharted territories, ancient mariners marked their maps with the Latin phrase Hic Sunt Leones, whose literal translation is “here are lions.” The phrase was used to designate an area of great danger where only brave pioneers dared venture. The brave souls who did venture into uncharted territories were, for the most part, never heard from again. Either, it was believed, they fell off the “flat” earth or they were swallowed up by ravenous monsters.

Leading change likewise requires brave pioneers willing to test the institutional waters, challenge the “flat earthers” and risk being swallowed up by the ravenous monsters that defend and protect the status quo. There is danger in undertaking change because the majority of change efforts fail, and they fail primarily because of poor leaders or ineffective leadership.

Challenges for Change Leaders

The primary challenge for change leaders is to overcome the natural organizational elasticity that resists change and focus the effort, attracting enough followers to tip the scales in favor of a new direction.

Leaders often search for the latest model, newest construct, flow chart or improved process as a means to overcome organizational inertia and achieve the desired vision. The good and the bad news is that there is no shortage of theoretical frameworks, constructs or models. And, when change is viewed from the lens of one of these models, it makes perfect sense. But, theory is one thing; practical application is another.

Overcoming the Challenges of Change

In the end, effective leadership can overcome the challenge of change. Despite some organizational success stories, the practical fact remains that few companies actually manage to achieve what they start out to do and pull off their change initiatives. Leadership and change expert Dr. John P. Kotter, writing for the Harvard Business Review in an article titled “Leading Change: Why Transformation Efforts Fail,” suggested that 30 percent of change efforts fail. Corporate change and organization effectiveness expert Michael Beer and Harvard Business School Dean Nitin Nohria, writing in ”Cracking the Code of Change” in the HBR, cited data that suggested that more than 70 percent of change initiatives fail. Whether 30 percent or 70 percent, it’s a big number. The questions are why, and what can we do about it?

Scott Keller and Carolyn Aiken, researchers on leadership and change management, suggested this: Effective leadership is the keystone of change management, but effective leadership is as “uncommon as it is essential.” Regardless of how much change may be needed or even recognized, leading change can be dangerous territory. As the pace of change in healthcare accelerates, and the industry transition from “fee-for service” to “fee-for-value” becomes a reality, the need for transformational leaders at every level in the healthcare space has never been more acute.

Healthcare Leadership Program at UT Dallas

In response to the burgeoning healthcare market and changes driven by the Affordable Care Act, The University of Texas at Dallas Naveen Jindal School of Management is launching a new master’s degree program for healthcare professionals who are seeking additional education to help boost their careers and lead these significant changes.

The Executive Master of Science in Healthcare Management degree for healthcare professionals is geared to accommodate the busy schedules of working professionals, with classes meeting two days a month on a Friday and Saturday, and requiring four hours of online work between class sessions. The curriculum is designed to complement existing professional development programs along the entire continuum of care. It debuts next January.

The new program will be taught by seasoned business leaders, experienced healthcare professionals, medical school faculty and a select group of experienced physician executives. Its approach will be based on intense student interaction, real-life case studies and leadership problems, and it will provide opportunities for students to create and apply action plans for immediate use in their own job situations.

Learn more about the Executive MS in Healthcare Management and contact Keith Thurgood, PhD and director of the program, at or by calling 972-883-5859.

Keith Thurgood

Keith Thurgood is a clinical professor of healthcare leadership and management at the Jindal School, where he also leads the executive MS program in healthcare leadership and management and is an adjunct professor of marketing and entrepreneurship. In addition to his responsibilities at UT Dallas, Dr. Thurgood is a faculty member and senior advisor for the Thayer Leader Development Group in West Point, New York, and a retired Army major general. Read more articles

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