The Case for Disruption in Canadian Healthcare

One of the tasks that I set myself is to do what I can to keep current on issues that matter to my clients. This builds on my lifelong interest in learning.  In doing so, I've increasingly tried to force myself into new areas of learning or non-traditional avenues that can stretch my thinking, establish new thought patterns, and suggest unique opportunities to delivering value.  As I've continued to grow my executive coaching and consulting practices, one of the singular benefits that I've derived comes from working in a variety of sectors that substantially transcend my former career as a senior executive in healthcare.  The experience with so many other sectors has significantly expanded my view of the world, opened up new possibilities, and allowed me to bring greater value to all of my clients.  My own personal disruption - career change - has had significant positive benefits for me.

These positive returns, as with all types of disruption, did not come without pain and challenge.  Indeed that's what we see in all industries that have undergone significant disruption. A new model for product or service delivery is introduced, competitive conflict and "bloodshed" ensues over some period of time, before a new "normal" is established.  Certainly some of the more familiar examples of disruption are often associated with technological innovations, e.g., the automobile, the airplane, the internet.  But just as often, and perhaps more profoundly, we find sentinel disruptions coming from new ideas and new means of delivering products and services like Walmart, Apple and Uber.  In these cases, existing business paradigms are turned inside out, upside down and/or entirely bypassed in order to achieve a position of market dominance including creation of entirely new markets.  Perhaps common to all of these disruptive innovations is a deep understanding and better appreciation of what fundamental customer needs and desires are.

Over the past several decades as concerns about costs in Canada's healthcare system have been debated, as new technologies have been introduced, and as governments and health administrators have attempted to grapple with a myriad of challenges to system performance and sustainability a plethora of studies and solutions have been offered in support of desired outcomes.  Yet for all these studies, changes, and restructuring there are certainly questions about what we have achieved for the significant investment of time, energy and money.  Debate continues around whether we have achieved healthcare's triple aim of improving the patient experience of care, improving the health of our population, and reducing the per capita cost of health care.

Ongoing prescriptions for impactful change - mine among them - call for clear vision, sustained effort towards achievement of a vision, and strong leadership.  I still believe that all of those are necessary prerequisites for a more effective and sustainable health system.  However, I'm also increasingly of the mind that Canada's healthcare system needs its own Uber to break out us of our incremental pattern of change.  Some might take issue with my assertion that we've only undertaken incremental change and note major shifts in health governance and structures in the past number of years.  However, I suggest that while challenging and energy-draining, these changes have not fundamentally altered altered how we deliver healthcare services nor have they changed our bottom-line results.  To my mind, even the advent and expansion of specialized, privately-owned/ operated health services (e.g., surgi-centres) has done little to change the base paradigm for health services in Canada.

Ultimately, what we may need to come to terms with is whether a highly-regulated and bureaucratized system - subject to the whims and foibles of political forces and professional self-interest - is actually able to deliver the significant and widespread innovation necessary to deal with current and future challenges.

As with other disruptive influences and forces that have reshaped other industries the solution may need to come from an outside source.  Perhaps the leadership and disruptive change cannot, in fact, come from our current political parties, pundits, leaders and structures.  We are too bound up in managing the day-to-day challenges, vested in current systems, too constrained by our current view of how things have been and should be.  Perhaps for truly innovative and breakthrough solutions to present themselves we need our own version of Steve Jobs and Uber.  My thoughts and hopes for a vastly improved health care system increasingly lie in this direction and with this hope.

Disruption can often times feel like anarchy and barbarians at the gate (just ask taxi operators about Uber) but in as many circumstances it can be a harbinger of a new industry or reshaping of an existing one to deal with fundamental customer requirements (e.g., cost-effective and timely transportation in the case of Uber?). Is this the path forward for healthcare?  Can some leader or leaders break the mold and pave a path to delivering on our Triple Aim?

Is leadership in healthcare about managing and smoothing disruptive influences for the effective management of the organization or do we need leadership to BE the disruptive force that takes us to a new, impossible to imagine, level of performance that we require.

Either way it's all about leadership. 
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Greg Hadubiak, MHSA, FACHE, CEC, PCC
TEC Canada Chair/Executive Coach/Senior Consultant
hadubiak@wmc.ca

Helping leaders realize their strengths and enabling organizations to achieve their potential through the application of my leadership experience and coaching skills. I act as a point of leverage for my clients. I AM their Force Multiplier.