Effective Leadership In Unprecedented Times

Not all storms come to disrupt your life, some come to clear your path. ~Anonymous

The first half of 2020 has been quite turbulent to say the least. From stay-at-home orders and furloughing staff to a reduction in patient volume and applying for the Paycheck Protection Program (PPP) these uncertain times have created fear, anxiety and new norms.

In 1987, Warren Bennis and Burt Nanus, two thought leaders in the business world, coined the acronym ‘VUCA’ to describe organizations that are volatile, uncertain, complex and ambiguous.¹ The United States Army War College later used this term after the collapse of the Union of Soviet Socialist Republics (USSR) in the early 1990s.² Currently, it is common for this acronym to appear in corporate settings, education, leadership and other relevant areas affecting society today. 

These are VUCA times. Constant and ongoing change is the new normal. Neuroscience teaches us that people resist change for several reasons. First, people are creatures of habit and routine, and feel secure when they are able to predict when how things will happen. For example, where do you sit at the dinner table each night? How do you feel when a guest sits in your seat? When change occurs, it throws people out of their comfort zones. Second, when change occurs, be it positive or negative, it creates a loss, a loss of routine, loved ones, comfort zones, etc. Third, with this loss comes stress and unhappiness. Consequently, one way to avoid the negativity associated with change is to avoid making the change. In today's world, that is not a workable strategy.

Since our brains are wired for survival, most change is seen as a threat. At this point, the body retreats into a defensive mode, preparing to defend itself physically, psychologically and emotionally. Consequently, one's decision-making ability may suffer. This is why psychologists recommend not making a significant decision when one is in a highly emotional state.  

The COVID-19 pandemic changed the landscape of our world, our work sites and how we socially interact. The emotional upheaval during these difficult times is upsetting at best. People can experience triggers for stress, anxiety and even depression when their lifestyles are turned upside down. For some physicians, practices have closed down, entire staff have been let go and there has been a lack of services rendered, all of which have a significant impact on the bottom line as well as our mindsets. When attempting to move from the once "thrival" state to a "survival" state of mind, impulsive or ineffective decisions often result.

Instead of giving in to our initial primitive feelings, it may be helpful to step back for a moment and allow the rational and logical parts of our brain to emerge. Start by examining and applying the reality of our VUCA times.

Volatility. Volatility refers to the speed, volume, nature and magnitude of a phenomenon that may or may not be in a pattern form. Volatility increases complexity.³

The COVID-19 virus is volatile. It moves fast and has infected thousands of people around the globe. Instead of reacting to the unfortunate consequences of the pandemic, respond with a strategy and clear vision. Create a picture of how you want your business to run and function during these conditions and future norms. Identify reasonable action steps to protect your business, staff and patients. Remember, tough times do not last forever, tough and resilient people and practices do. 

Uncertainty. Uncertainty occurs when there are no concrete trends or patterns. This makes it challenging to establish what will happen next and to base decisions on those future events.³

Since change creates uncertainty and a lack of predictability, which in turn leads to stress and anxiety, it is essential not to quarantine in one’s current mindset. The mental and emotional despair many face during these uncertain times creates frightening and catastrophic thoughts. You may be one of the many who ruminate about catching the virus, paying bills, keeping the practice afloat and experience other distorted and/or irrational thoughts. 

Instead of allowing the merry-go-round of anxiety and despair to circle in your head, begin to focus on what you can control. Refocus your thinking process by asking yourself five questions:

1. What are your goals?
2. What can't you control?
3. What can you control?
4. What choices do you have?
5. What are the consequences of my choice?

Here is one example of working through these questions.

1. What are your goals?

• I want to keep myself, my family and my practice healthy during these tough times.
• I want to keep my business financially stable.

2. What can't you control?

• I can't control the virus, pandemic or governmental restrictions.

3. What can you control?

• I can control finances, safety measures and how I think about the pandemic.

4. What choices do you have?

• I can follow the Centers for Disease Control (CDC) guidelines to best protect myself, my family and patients.
• I can become more creative and promote and market the practice. For example, instead of going to an emergency room for an injury, encourage patients to come to the office for treatment. Another approach may be offering same-day X-ray, wound care, laceration repair and same-day durable medical equipment (DME). 

5. What are the consequences of my choice?

• I am going to remain healthy, physically and mentally.
• I will continue to provide quality care.  

Complexity. Complexity describes the amount of different states a system can get into at a certain point in time. The more states a system can get into, the higher its complexity and the harder it gets to manage.³

Running any business is complex. Many tangible and intangible factors are inherent to any practice, regardless of the size. During these uncertain times, a leader needs to be agile. In other words, a leader needs to be fast, focused and flexible. This is not the time to be caught up in the minutia of the business. Instead, keep it simple by applying the KISS acronym (keep it simple, stupid). 

Next, apply the ‘AGILE’ model.4

• Anticipate change. Interpret the potential impact of business turbulence and trends on your practice (i.e. consult with your accountant and communicate openly to your employees).⁴
• Generate confidence. Hold weekly meetings, listen respectfully to your staff and maintain morale.⁴
• Initiate action. Don’t procrastinate. Demonstrate a sense of urgency in your behavior for achieving results.⁴
• Liberate thinking. Exhibit behavior that encourages innovative solutions. Hold brainstorming meetings with associates and other physicians. Take steps to create a risk-free environment.⁴
• Evaluate results. Utilize your electronic medical record (EMR) system and other tracking methods.⁴

Ambiguity. Ambiguity describes a situation in which multiple interpretations are permissible and equally valid. This makes it hard to decide what to do to achieve the desired outcome.⁵

The VUCA world we face today consists of new situations on an increasingly frequent basis, leaving leaders in an unpredictable state. Many physicians feel "stuck," not knowing what moves to make. Some leaders fall into the "victim" mindset and make some of the following mistakes. They … 

… wait and see.

… are confused and look for others to tell them what to do.

… believe that it's not their job.

… just ignore or deny.

… point fingers.

This is the time to be personally accountable and shift your focus to what you can do. Instead of seeing the VUCA times myopically and dichotomously, begin to look for opportunities. Allow your mind to innovate and create. Maybe it is time for that new EMR system, to hire a new associate, update the office, etc. If not now, when?

The VUCA times is the new norm. Things you did pre-COVID-19 may or may not work today or tomorrow. Leaders who continue to do the same things they have always done with the hope of achieving the same results may be missing opportunities. As Steve Smith, a Canadian comedian, once said, "If it ain't broke, you’re not trying hard enough."⁵

References

1. Bennis W, Harper BN. Leaders: Strategies for Taking Charge. New York: Harper and Row; 1985.
2. U.S. Army Heritage and Education Center. Q. Who first originated the term VUCA (Volatility, Uncertainty, Complexity and Ambiguity)? Available at: https://usawc.libanswers.com/friendly.php?slug=faq/84869 . Published May 7, 2019. Accessed June 23, 2020. 
3. CQ Net. Strategic management: how and why to redefine organizational strategy in today’s VUCA world. Available at: https://www.ckju.net/en/blog/strategic-management-how-and-why-redefine-organizational-strategy-todays-vuca-world/58699 . Accessed June 23, 2020. 
4. Horney N, O’Shea T. Focused, Fast and Flexible: Creating Agility Advantage in a VUCA World. Oceanside, Calif: Indie Books International; 2015.
5. Smith S. How To Do Everything From The Man Who Should Know: Red Green. Toronto: Doubleday Canada; 2010.