Leaders of the future must grab the opportunity of change

Leading a hospital may not be very different from other service sectors but the intensity of involvement and the commitment to be harnessed from one’s team members is of an entirely different level says Brig Joe Curian, as he proceeds to discuss the aspects of leadership in healthcare.

Healthcare industry is a unique service sector. It differs in products it offers, the processes, structure and high level of technology. Due to this, the criticality of decisions in a hospital are incomparable with any other business.

While on the face of it, the organizational structure of a hospital appears identical to the standard hierarchical organizations, in effect there is a lot of flexibility. I would say that the structure is neither pyramidal nor steep nor flat.

To my mind it is a spherical structure consisting within it, a number of small spheres and blobs. And the locus of control keeps shifting. This calls for mission oriented task forces in a ‘mix and match’ approach, which may consist of different specialists, doctors, technicians or nurses - everytime.

The fact that no two patients are alike is the reason that there is seldom any repetition in service mixing and matching. Products/services are decided only after the customer arrives. At every point of decision, there are different treatment options and use of different levels of technology. Consumption of one product leads to another and there is considerable uncertainty for a prolonged period of time. Thus service every time is in the form of a flexible yet graduated response of higher technology and more intense interventions leased on the outcome of the previous product/service.

Against all this comes the technology onslaught. Close to 50 per cent cost of setting up a new hospital goes into technology. Over 80 per cent of the technology has a very small life cycle. Expensive equipment like linear accelerator, gamma knife, MRI etc. will need replacement, may be, within 5 to 6 years. The consumables and disposable are largest in the healthcare industry as compared to any other.

Leader required to drive an industry of this nature

Leadership qualities may not be different as compared to others, but the intensity of involvement and the commitment to be harnessed from one’s team members is of an entirely different level, since he is dealing with human life. When we talk about leader, most people somehow talk about one or more of the following three aspects What he is, What he does and What he achieves.

A leader is first and foremost a dreamer. A creative thinker, constantly conjuring up new forms, patterns and colours of systems, processes, products and new models of business. He is an artist who uses scientific and methodical practices for implementation for realizing his dreams.

Leaders see events ahead of time and when the time comes look prepared. Many of us are unable to look ahead in time and therefore not true leaders. The other side of the coin is space. Some of us look at our own near environment - own house, own family, own courtyard or property. Some other go beyond the boundaries of one’s own little Kingdom and may look at the village or the town or the district as a whole. Great leaders see the whole country and at times the whole world in its entirety and see the emerging needs and opportunities.

To my mind, understanding and sustaining the needs of the society or other business entities and creating products and services tat fill this void is what enterpreneurship is all about. These products and services are yet to be made - let alone tried or tested. True leaders come up with pioneering efforts with such products and services that get lapped up by the community.

Every need of the society is an opportunity. Every void is a challenge and an invitation. Leaders who understand these voids which they themselves dream up grab the opportunity and come out with innovative ideas that translate into products and services ultimately. In all these, healthcare is no exception. The typical functional cycle of leadership is:

• Perceive - Question - Communicate (PQC)
• Conceive - Question - Communicate (CQC)
• Deliver - Question - Communicate (DQC)

Leader must also have pride of oneself, pride of one’s people and value system, pride of one’s profession and Pride of the institution or the team that one is working for.

True leaders remain focussed not just on the organisation goals, but also equally on the individual goals and constantly endeavour to bring these two in conformity with each other. Decisions are never either in black nor white. If so it is not a decision meant for the leaders. Leaders deal with decisions in the grey, often between conflicting choices. This is the eternal truth in a hospital for the doctors, the executives or the CEO. A leader must learn to delegate. Only through delegation, can he find time for dreaming. He should be approachable and accessible to get involved if the situation cannot be handled by the subordinates. Similarly a leader must have sufficient skill in conflict resolutions. Dissonance can occur within the team as well as between teams or team and the external environment. A true leader must be able to negotiate. Often its conflicts between the leader and his peers or superiors or other team members. Leaders separate issues from individuals and then amalgamate issues with individuals.

Leadership of the future

Leadership styles have to change with time. The traditional feudalistic societies and paternalistic families are breaking down. Knowledge gap between the old and the young is narrowing. In fact in many respects young is more knowledgeable than the old.

This is true also in business organisations. Therefore leadership of the future to my mind will not lie at the top but throughout the organisation. Tomorrow’s leader may not have all the answers but should have all the right questions. For the future leader, technology and people management will be the most important issues.

Tolerance to ambiguity will be an essential trait. He should create new processes based on co-operation rather than competition.

Leaders of the future should think of integrating internal process and systems as per external needs. Pace of business is getting faster. Life cycle of products is getting shorter, while markets are expanding breaking boundaries of nations. A leader of the future should be prepared to mass customize products and yet tailor make products and services where desirable depending upon the opportunity for larger market share or better margin.

Leaders of the future are the ones who would grab the opportunity of change. I would recommend two concurrent approaches of assuming leadership. Put down things that you observe in your present leader and hate the most. Keep compiling the list till leadership position is given to you. Keep the said list on your desk all the time and practice what you believe in. It could be that many things which you did not believe in or like in your past leaders sometimes, may get deleted as you mature in life and get tempered by experience. Yet, a sufficiently long list would be left as the residue which should sever as a ‘beacon light’ for you to follow. This is one of the best ways for you to uphold integrity and avoid hypocrisy.

The next approach is after you assume the responsibility of leadership in an Organisation or an institution. As you get to know the new environment and understand the new institution, prepare a ‘List of impossibles’. This list would serve as your immediate battlefield. Challenge those myths and you would soon realise that these were indeed just myths sustained by the mindset of people who were low risk takers. More than 50% of these ‘impossibles’ would get resolved within a year. If you are a little more pushy, they will get resolved earlier. Another 25% may take a little longer and the balance is just a matter of time. Ultimately you would be able to resolve well over 90% of the initial “impossibles”. The credit for this must be passed on, and that is how you convert ordinary performers feel like heroes.

(The author is CEO, P D Hinduja Hospital and Research Centre, Mumbai. He may be contacted at joecurian@ hindujahospital.com)