MERITCARE'S LEADERSHIP CHALLENGE

Recent troubles at MeritCare—layoffs, accreditation issues, and revenue shortfalls/expense overrides—illuminate MeritCare’s more profound issue: how to lead an organization in a chaotic and unpredictable world.

Mort Myerson, former chairman and CEO of Perot Systems said several years ago, “Everything I thought I knew about leadership is wrong.”

Throughout the Industrial Era, managers led organizations as if they were great machines. The emphasis was (and often still is) on top-down control with hierarchal and compartmentalized departments with rigid boundaries. Conformity became the first rule. Creativity, initiative, and innovation came from the top or from outside experts. Human potential was ignored (leave your brains at the door) and most organizations were mediocre with life-spans of less than 50 years.
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A leadership revolution exploded over the past 20 years as the marketplace shifted from stable to chaotic and the metaphor of organizations as a lifeless machine was encompassed by one of a dynamic, potential filled living system. The new metaphor requires new leadership talents, hence the Myerson insight.

Have MeritCare leaders, like Mort Myerson, changed their core assumptions about leadership in today’s world? Can MeritCare employees tell an outsider what MeritCare’s vision, values, and purpose are? Do MeritCare managers know how to lead others through change? Does MeritCare have a culture of high accountability? Do MeritCare leaders realize how much human potential has been lost in the mechanistic model of organizations?

Core leadership practices in a dynamic organization:

See reality as it is. “Thirty to 50 percent of what we do doesn’t add value to patients,” said Dr. Roger Gilbertson, president and CEO in a stunning admission of “remarkable inefficiencies.” Do MeritCare executives receive ongoing feedback on their conduct and initiatives? Are they quick to discard failed programs, strategies, and subsidiaries? Do they explore and bring to light the dark side of the corporate culture and receive ongoing feedback on their leadership impact? Have executives been in denial, slow to respond to issues in recent years?
Create an organizational identity that inspires people: a spiritual purpose for why they exist, noble values to guide behavior, and a vision that provides direction and courage to employees. Is MertiCare’s vision bold enough, its goals big enough?
Practice tough love—a high standard for behavior and performance with a deep respect and compassion for others. People thrive in organizations where responsibility and accountability are valued and where the neurotic, mediocre, immature, irresponsible, and passive-aggressive are exposed, confronted, and held accountable. Does MeritCare invest in the quality supervision needed to retain their best employees?
Involve people in change and require empowerment. Leaders understand that people support what they help create. They require people to make decisions about the work they do. People are often lazy and don’t want to do the work of empowerment. Good leaders don’t let them get away with upward delegation. A stated goal at MeritCare is to have “fewer people and pay them more.” I would add “fully utilize the talents of people” to that objective.
Embrace and go into and through the anxiety, uncertainty, and ambiguity of the chaos of today. This is where people find their creative energy. They “plan, do, reflect, and adapt” constantly. They act boldly and decisively and change everything but their identity as they adapt continually to the world around them.

Efficiency is important at MeritCare and the recent discovery of major inefficiencies (Why weren’t they discovered years ago?) gives MeritCare a great opportunity for transformation.

But efficiency is just one element of an overall leadership philosophy for an organization. Enlightened leadership of people, seeing reality accurately, a tough love culture, imaginative and creative vision and strategies for continued development, and the courage to go into the unknown regularly and courageously are even more important.

It’s always all about leadership.