AHP Connect Articles

Change Your Outlook on the World to Lead More Confidently

Today I want to spend some time talking about leading in the great unknown.

Recent and current world events, particularly Covid-19, have taught all of us a lot about the unknown—and the characteristics we need to be leaders in an age of the unthinkable and statistically improbable.

I believe that the unknown will be our greatest leadership challenge.To meet it head on we must be explorers, embrace curiosity, be daring, experiment. And we must look up and to the edges for innovation and meaningful change.

We are at a tipping point.

By all observations we are leaving a period of fundraising stability that spanned several decades and that was marked by growth in healthcare spending and of a donor base that was fairly homogenous and relatively easy to reach. By contrast, today's donors are increasingly concentrated among the very wealthy. There has been a steep decline in the number of people who subscribe to world religions, which is relevant because of the correlation between religion and giving. Young people, when polled about charitable interests, do not list healthcare among their top three causes. And the pandemic and the recent heat waves, forest fires, hurricanes, and droughts illustrate that environmental crises are a constant occurrence in every region of North America.

We can no longer deny that the unknown, the unthinkable, and the statistically improbable are the norm. But in the words of Marie Curie, “Nothing in life is to be feared. It is only to be understood."

So as leaders how can we develop within ourselves and our teams the talents and style to face the unknown. We must become masters of uncertainty, who can confidently confront situations where traditional sources of insights may not be reliable, and where assumptions may carry little assurance. 

We must be genuinely curious about the future.

We may not be able to predict the unknown, but in our organizations we must take it seriously. It must become a major topic of discussion and planning. As leaders, we must routinely ask ourselves how we can prepare our organizations, our teams, and our donors for the unknown.

We must develop early-warning mechanisms to alert us to unforeseen developments and rigorously apply foresight to identify and alert leaders to "what-if" moments. Keeping an eye on the future while almost everyone else is preoccupied with the present will be the hallmark of effective leaders.

We must look upstream.

Downstream leaders react to problems once they occur. Upstream leaders aim to prevent those problems from happening.

Healthcare is steeped in downstream thinking.

Consider Covid-19. At the outset of the pandemic we were all so preoccupied with available PPE beds and ventilators that we did not plan for the exhaustion of our human resources, the great resignation, and the long-term impact of that oversight.

Think about how foundations determine priorities. We ask hospitals how we can help fix their problems, often by purchasing equipment or constructing buildings. The perennially congested ER and our constant campaigns to build bigger are classic cases of looking downstream.

 Resist the temptation to look back. Look up. Think: how can we be disrupters and make investments that keep people healthy and at home? How do we convince our communities that more beds does not mean better health?

We must be experimental and daring.

COVID showed us that, when confronting the unknown, investing in a single solution can prove fatal. Instead, we must find ways to allot a greater percentage of our revenues to pilot projects, fund multiple and contrary approaches to the same problem, and change how we measure and report success.

We must boldly articulate and pursue our organizational ambitions.

Hospitals and health systems are hierarchical and painfully slow to change. The absence of a national EMR even in a universally funded system like Canada is just one stark example.

Foundations are well situated with the right leadership to be daring to take risks and to challenge the status quo in our politicized health funding environment. But it will take courage and daring to speak up—to stand up when all around us are seated.

Hesitation in the face of the unknown is the worst choice of all.

We should look to the edge.

Research shows that innovation starts from the edges, particularly in mature industries or sectors like healthcare.

Consider new partnerships- with new players- invest in new technologies, provide seed funding for incubations.

Never underestimate the importance of innovative energies, especially from unexpected places and people—such as young, internationally trained clinicians and researchers from countries where resources are scare and creativity is rewarded.

We must be Explorers (not Discoverers).

In this book The Discoverers, Daniel Boorstin coined the phrases Explorer and Discoverer to describe ways of looking at the world and leading. He tells us that Explorers open up conversations, ask questions, and create entirely new possibilities. This type of leader learns more, and so do their organizations.

Discovers “solve” things. They close down conversation. They ask fewer and less daring questions. They learn less and so do the organizations they lead.

Undoubtedly it will be challenging to foster an Explorer mindset in a system that is time strapped and always teetering on a crisis. It will take imagination, courage, and kinship. We will need networks inside and outside the walls of our organizations to keep our internal Explorers alive and curious.

But I know we can do it.