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August 03, 2021 05:00 AM

What will await the next generations of healthcare CEOs?

Andrew Garman
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    Andrew Garman

    Andrew Garman is a professor in the Department of Health Systems Management at Rush University in Chicago and director of the Rush Center for Health System Leadership.

    What will healthcare look like 30+ years from now? Although it may seem too far off to even think about today, many of 2050’s healthcare CEOs are today’s graduate students and early careerists. In my work with these groups, my hope always is that they can spend their careers pursuing an ever-healthier future for the communities they serve, rather than slowing their decline. 

    An important part of my work involves helping people understand the longer-term context in which today’s events are unfolding. This context is most clearly understood not in fiscal years or even presidential cycles, but in the decades and generations of our human lives. It is only with such a long-term perspective that leaders can clearly see whether we are making real progress, or simply running in circles. I’ll illustrate what I mean with three of today’s most vexing challenges: well-being, health equity and climate change. 

    First, consider workplace well-being. Although COVID-19 thrust this concern into the foreground, it also cultivated a short-term perspective on addressing it. In the years leading up to the pandemic, health system leaders had already been grappling with widespread burnout, focusing mainly on preventing or reducing harm. If today’s leaders continue the business-as-usual approach, the next generations of CEOs will most likely be saddled with a similar agenda: finding the burned-out caregivers and doing what they can to help them. But what if we began focusing on flourishing as the primary goal, and asked how we can best create workplaces to support that goal? 

    Now consider health equity. Recent research revealed the pandemic had a huge detrimental impact on health equity efforts, erasing all recent gains and then some. But even beforehand, our pace of progress had been unacceptably slow. Between 2010 and 2018, the life expectancy gap between non-Hispanic Blacks and whites shrank by just 0.09 years. At that pace, closing the gap would have taken more than 300 years. Of course, healthcare is only a small portion of what determines health. But if we’re serious about our collective missions of health and health equity, healthcare leaders’ roles must continue extending far beyond their own walls, toward the many other factors preventing better health.

    Which leads to the most important factor of all: the health of our planet. Here the directive is far clearer: humanity must move completely away from a carbon-based economy before 2050. This includes health systems, which today are a significant and growing source of carbon emissions. Failure to act risks health and well-being effects even more severe than the pandemic, further undoing any progress made in prior years. Even in the most optimistic forecasts, healthcare leaders will increasingly need to help their organizations and communities adapt to a changing climate in the years ahead.

    If you started this week already feeling overwhelmed by the demands of the present, grappling with still more surges of COVID-19, then the far future may seem well beyond what you care to worry about. But the environment the next generations of healthcare leaders inherit is forged by each decision we make today. With this in mind, below are a couple of strategies leaders at all levels can use to incorporate longer-term perspectives on an ongoing basis.

    The first is a mental time-travel exercise, which can be completed individually but is much more powerful as a team. The goal is to create a living picture of a specific and more distant future, beyond the scope of the group’s normal tactical and strategic decisions. Start by mentally projecting your own life forward to that time, or those of the leaders you work with. Next, repeat the exercise with the communities your organization serves, by trending out demographic, economic and environmental forecasts. Capture the full range of future states that could emerge, from optimistic to pessimistic, as a reference to that could inform your decisions going forward.

    The second involves placing current corporate goals into their broader and longer-term contexts. For example, plotting annual progress targets forward several decades, and/or comparing them to international development goals, may reveal where short-term successes won’t add up to long-term progress. It may also reveal areas where leaders should work together more closely, such as environmental justice.

    Will the CEOs of 2050 spend their time improving health within thriving communities? Or will they be consumed navigating waves of climate adaptations and the human tolls in their wake? Time will tell, as will the decisions we as healthcare leaders and educators make along the way.

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