It’s been said managers maintain order and leaders change it; the best measure of a leader is the breadth and depth of effective change.  In The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and Your World (HBP 2009) Ronald Heifetz, Alexander Grashow, and Mary Linsky suggest that most leaders aren’t adaptive leaders. They exercise authority, power and/or influence, but not adaptive leadership.

When it comes to technical issues, most leaders demonstrate advanced technical skill.  However, when it comes to adaptive challenges, most leaders fall short, either because they fail to recognize adaptive challenges, they fear the costs of exercising adaptive leadership (e.g. losing their job), or they lack the right tools and tactics (so they fail and lose their job).

A table from The Practice of Adaptive Leadership compares technical leadership to adaptive (Figure 2.3:  Leadership from a position of authority  Figure_2_3 ).

Technical problems often involve managerial intervention and systems engineering. Adaptive challenges often involve people and culture. Technical problems are solved fast by a small group.  Adaptive challenges are dealt with over time and involve many people. Technical problems are well defined and contained.  Adaptive challenges are messy and require framing and reframing.  Technical problems are relatively easy.  Adaptive challenges are hard.

For leaders in healthcare this is a time for adaptive leadership and  technical leadership; too much disruption might threaten access to services and erode quality, but not enough disruption and an organization may fail.  Health care reform is necessary given high costs and less than desirable outcomes. Thus adaptive challenges will continue to surface.

Because adaptive change involves people and culture, and requires courage balanced with consideration, a certain collective leadership capacity across the system is needed to meet adaptive challenges.  The physician workforce as a whole is perceived to be resistant to change, overly protective of our self-interests, and lacking a full perspective on the issues.  If physician leaders communicate unilaterally, listen poorly, and learn slowly, they won’t be effective adaptive leaders.  Adaptive leaders can’t be overly dogmatic know-it-alls.  Rather they must possess the skills to effectively participate in constructive conversations about the need to change, how to change and how to help people cope with the losses that come with change.