Recently, I’ve started asking new employees to consider the following question: What can only you do, given your unique gifts, history, knowledge, personality, and passion, to contribute to our team and the clients we serve? I want them to swim with the current of who they are from day one to challenge and transform us, even as they grow themselves.
This question also applies to organizations, such as actors at the intersection of healthcare and social services today. Focusing on an organization’s distinct niche, on what only it can do, provides a jumping-off point for an adaptive approach to strategy, teamwork, and leadership that works like magic when the positive feedback loops kick in.
We need to build such momentum and resilience from the ground up in healthcare today more than ever, community by community, to support whole person health. As we know in our field from working with dynamic biological and social systems, small changes can lead to big outcomes, and every niche contributes to the whole.
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Adapting in your niche
No two organizations are the same. Whether hospitals, clinics, local or state government, community-based organizations, technology companies, or associations, they often have taken courageous steps to deliver unique value to their clients and communities in changing circumstances. This adaptive process of specialization, which includes both competition and cooperation, makes our field vibrant and diverse.
Consider a community health center (CHC) in California. Today, the CHC likely provides Enhanced Care Management (ECM) through Medi-Cal — the state’s Medicaid program — to coordinate services among clinical and social care providers for high-needs populations. This new role creates value for partners throughout the community who are cooperating to care for shared clients and creates value for the CHC by placing it at the center of distributed clinical-social care networks. If located in Los Angeles, the CHC may now operate a school-based clinic facilitated by the Los Angeles Trust for Children’s Health, which in turn adds its distinct value at the intersection of health and education.
Inspired by the adaptability of our partners contributing to their communities, we should seek to embody a growth mindset that asks: “Where is value unexpectedly bubbling up? What are the surprises, and how do they challenge our assumptions?” A strategic orientation that leans into emerging value, even when this challenges our assumptions about who we are and what we do and the niche we do it in, enables organizations to make distinctive contributions sought by others in their landscape as that landscape evolves. The magic of leaning into your niche as it evolves day by day transforms unique capabilities into renewed value.
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Teamwork
The magic of the team, in contrast, transforms vision into reality. Collaborative teams are the foundation of productive human activity, and management is the attempt to channel and shape the living potential of teamwork without killing the creative spark at the center. It’s a fine balance, hard to achieve and harder to maintain, but the positive feedback loops of finding “just right” magically spiral out to clients and stakeholders.
In my experience, and as studied in organizational research, the ideal project team size is four to eight people, small enough to collaborate effectively and large enough to have boundaries between roles. Traditional teams are composed of a supervisor and their direct reports. Today, team structures are just as likely to be established outside of reporting relationships, whether in matrix organizations, on interdisciplinary teams, or across organizations. In our field, we are even seeing care teams that cross organizations and sectors emerge at the intersection of health and social services, empowered by shared technology, aligned incentives, and patient-centered workflows.
As the book about Netflix, No Rules Rules, argues, talented people want to work on teams with other talented people. To me, what resonates here is not the dubious categorization of talented and non-talented people. Instead, it is a charge for leaders and organizations to create teams where the authentic talents of each person rise to the fore and enable distinct contributions that drive the team forward — often in wonderfully unanticipated ways. With the classic foundations for effective teamwork like psychological safety, trust, and a shared mission, empowered teams magically transform vision into reality through the joy of mutual contribution, renewing organizations from the inside out.
Existential leadership
If people want to work with other people who bring their unique talents to the team, they have an equally deep need to engage with existential challenges. In other words, they don’t want to waste their time checking boxes; they want to work creatively on challenges and opportunities of supreme importance for their organizations and communities. Dedicated and courageous clinicians are no different.
Existential leaders guide teams to face up to such challenges, to lean into profound opportunities with unknown outcomes. I once had a brilliant professor who, after one of us made some grand claim, would stroke his beard and ask us, “Well, what’s at stake?” It’s a magically illuminating question. What’s at stake in a decision to address or not address an issue? What’s at stake in our analysis of a given topic or how we engage stakeholders? What’s at stake in the outcome of a pilot, a system implementation, or a quality-improvement cycle?
Existential leaders ask themselves this question all day long, and they steer their teams to invest time and effort in the most consequential areas, where the answer is: The very existence of our organization as we know it, or of our team, or of our community initiative is at stake. For clinicians, the question is even more profound: What’s at stake is the survival of a person. By asking themselves and their teams this simple question — “What’s at stake?” — existential leaders magically harness our natural impulse to contribute to what matters most.
The integration of healthcare and human services has moved toward the existential heart of both sectors with the centering on health equity and social-related health needs. More and more organizations are embracing distinct niches to advance community health transformation, renewing their value to their clients and partners. What I have learned is this: Embrace the existential risk of action because there’s so much at stake. Swing open the door to an unknowable future, step out today to share your distinct value, and you’ll find plenty of talented teammates on the road to renewal. Then do it again tomorrow. Trust me, it’s magic.
Picture: marchmeena29, Getty Images
As CEO of Intrepid Ascent, Mark Elson leads a dynamic team empowering community collaboration for health. Each year his company builds new connections between more than 500 partners, supporting coordinated, equitable health and social services for seven million or more people. With an interdisciplinary background in anthropology, technology, and policy, Mark sparks integrated local approaches to address global challenges.
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