This article was originally published in H&HN Most Wired Online, a publication of AHA Health Forum.
You’ve probably heard that one definition of insanity is doing the same things over and over and expecting different outcomes. In today’s turbulent and hyper-competitive healthcare environment, though, insanity is more likely to be doing the same things over and over and expecting the same outcomes. Many of the left-brain techniques that have dominated management thinking for the past half-century are reaching a point of diminishing returns, and fail to create competitive distinction because everyone else is doing them. The next frontier for improving productivity, enhancing patient satisfaction, and earning employee loyalty won’t be more controls, greater accountability, better execution and other such left-brain techniques, as important as they are. Rather it will be working on the “invisible architecture” of core values, corporate culture, and workplace environment. This is substantially a right-brain activity.
In Part 1, I’ll contrast left- and right-brain characteristics and suggest why this should matter to you as an IT leader. In Part 2, I’ll share practical skills and strategies for enhancing the right-brain domain of leadership. We colloquially use the left-brain / right-brain dichotomy to describe personality traits or professional interests: left-brain is the bean-counter, right-brain is the poet. But it’s also a useful construct for thinking about organizational transformation. For example:
Left-brain is linear, right-brain is relational. In sales, left-brain is going for the close; right-brain is building relationships. In healthcare, left-brain is fixing a broken body; right-brain is healing a hurting soul.
Left-brain is rules, right-brain is values. When people buy into a common set of values, you don’t need many rules (for example, the famous one-sentence employee policy manual of Nordstrom); in the absence of shared values, you need lots of rules (the IRS comes to mind).
Left-brain is management, right-brain is leadership. Management is a job description; leadership is a life decision. Some of the most effective leaders in any hospital don’t have a management title – they lead through effort and example. In today’s complex and competitive world, hospitals need leadership in every corner, not just in the corner office.
Left-brain is accountability, right-brain is ownership. Of course, hospitals must hold people accountable, but that’s not enough. Nobody changes the oil in a rental car – they’re only accountable for filling the gas tank. Without a spirit of ownership, people are just renting their jobs, doing the basic minimums. People who have pride of ownership don’t need to have their feet held to the fire (think about the metaphors we use – is it any wonder people rebel at the word accountability?). In the competition for scarce talent, hospitals whose people own their jobs will be winners, hospitals where they’re renting their jobs will be losers.
Left-brain plans, right-brain inspires. One reason so many strategic plans fail to fulfill expectations is that the left-brained managers who put them into three-ring binders never visit the shop floor to inspire people to own their part of “the plan.”
Left-brain optimizes, right-brain innovates. Creativity rests on a foundation of curiosity and courage, which are both attributes of the right brain.
Left-brain can be measured but not seen, right-brain can be seen but not measured. What does a bottom line look like? You can’t see it, it’s just a statistical abstraction on a piece of paper. What does enthusiasm look like? You can see it (or its absence) the instant you walk into a department. That’s why W. Edwards Deming (he of statistical TQM fame) said the most important number in your organization cannot be counted.
Left-brain is a given, right-brain is a choice. You cannot wake up in the morning and decide to be an accountant or a brain surgeon that day. Except over the long term, left-brain qualities are fixed. But each of us chooses the attitude with which we approach our work, and the emotions we project onto coworkers. This is especially important to understand because you can much more quickly and effectively influence choices than you can givens.
Left-brain is inert, right-brain is contagious. I recently spent four days traveling with the senior IT executive of a Fortune 500 company; I did not “catch” one iota of IT ability. But we’ve all seen someone walk into a room and almost instantaneously infect everyone else with their emotions, for better or worse.
Left-brain is work, right-brain is life. You can leave the briefcase unopened in the corner while you read a book or play with the kids, but it’s almost impossible to leave behind the exhilaration of a great day or the frustration of a terrible day. And, of course, people don’t leave stresses and emotions of the home front behind when they come to work. The workplace climate you create can thus foster either a virtuous or a vicious emotional cycle.
Left-brain is what you do, right-brain is who you are. If I move to a new community, I might go to the yellow pages to find a doctor or insurance agent. But over time, I’ll stay with them because of who they are, not because of what they do. Likewise, I’ll take a job with your IT department because you happen to have a vacancy in my specialty area, but I’ll decide to stay or not because of the workplace environment you offer me – because of who you are.
Left-brain recruits, right-brain retains. You recruit people with the “honey” of pay and benefits, responsibilities and opportunities for advancement, and the other left-brain qualities of the job. But you retain them because they have work they’re passionate about, they love the spirit of fellowship in their work unit, and you’ve made them feel important. A carpenter might leave a construction company for more money, but he won’t walk away from a Habitat for Humanity project because he’s not being paid.
All left-brain is boring, all right-brain is chaos. One of the reasons companies like Motley Fool and Geek Squad (now part of Best Buy) are so successful is they inject a spirit of whimsy and fun (right-brain) into personal finance and computer repair, left-brain subjects the average mortal finds painfully boring.
So what? The left-brain / right-brain dichotomy has important implications for you as an IT leader. First, in a world where there’s more off-the-shelf, user-friendly software, the role of the IT professional inevitably shifts from technical expert to coach, which requires right-brain as well as left-brain skills.
Second, as the electronic health record becomes a reality, we have an unprecedented opportunity to use this as a tool to empower patients to be active participants, and not merely passive recipients, of their healthcare. Planetree has pioneered this philosophy by advocating that patients be encouraged to study their own medical records. With evolution of the EHR, IT professionals can become more integrally involved in the patient-centered care movement.
Third, and perhaps most important, the collective right-brain characteristics of your people constitutes an invisible ceiling on the performance potential of your department, and your hospital. Given the same left-brain qualifications, a department where people have positive self-images and are enthusiastic about their work will outperform one where people are plagued with low self-esteem and are disengaged from the mission. I was once speaking with the senior HR executive for a client hospital that was in serious financial trouble. I asked him how long it would take to erase the red ink if we could simply increase the overall enthusiasm level of the staff by ten percent. He thought for a moment, then replied “about six weeks.”
An essential element in the art of leadership is integrating left- and right-brain qualities. Ironically, many healthcare leaders have overdeveloped left brains and underdeveloped right brains. This isn’t surprising, perhaps, given the monumental responsibilities imposed by regulatory agencies (not to mention the severe consequences for patient health and safety if left-brain systems fail). But quantum leaps in productivity, patient satisfaction, and employee engagement are more likely to be gained by promoting right-brain qualities than by more effectively executing left-brain strategies. In Part 2, I’ll share ideas for applying this right-brain power to the invisible architecture of your organization.