Learning Into The Future

VUCA-Plus Conditions in Health Care

How can our healthcare leaders build the right new skills to lead healthcare in the future? How is complexity confronted in the world of mid-21st Century health care? What puzzles, problems, dilemmas, polarities and mysteries are revealed in contemporary healthcare and how can we harness these opportunities to continue innovation and transformation in healthcare? What is the nature and impact of Volatility, Uncertainty, Complexity, and Ambiguity in healthcare settings? What type of leader will emerge to effectively navigate a turbulent world that is filled with contradictions and polarities?

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Challenges of the Present

Complex Adaptive Systems in Health Care

Com-Col Mission: Strengthen Communities

We seek to unweave the gordian knot that is to be found in what has recently been described as a complex, adaptive system.  It is this type of system that is predominant in and is often dominating the operations of mid-21st Century health care organizations.

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Leading into the Future

Strategies for Reform and Development in Health Care

Theory and models are important as we seek to make meaning of the events we have experienced in contemporary health care. It is only after we have made meaning of experiences that we are able to trace out their implications. Furthermore, while we can use theory to bridge the gap between our own experience and interpretation of our experience and the experiences and interpretation of experiences found in the perspectives of other people, it is through the use of case studies that we can learn (vicariously) most directly from the experiences of other people. Numbers can help us determine if a specific procedure has been successful; however, to discover WHY a specific procedure has been successful usually requires the intense study of specific experiences in the use of this procedure. In this section of the Salus Forum, we turn to case studies that have been offered by our colleagues in the Salus Forum who hasve been serving in a leadership role in specific health care systems.

Health Care Collaborations

Diverse communities of thought aided by constructive dialogue often bring about new perceptions and practices in the field of health care. We offer a series of recorded dialogues and interviews among those participating in the Salus forum.

Requesting information regarding ways to participate in the collaboration among health care communities


The Health Care “Soap Box”: Right Train? Right Track?

Four Cultures of Health Care?

In this section of the forum, we will begin to describe core dynamics that may lie at the heart of health care.  We will present a model (The Four Cultures of Health Care) which provides a potential framework for understanding the complexities of contemporary health care systems, and perhaps generates new ideas about how we can come together to heal the people and the system of which we are all a part. To begin this discovery process, we start with what lies at the core of health care: anxiety.

Anxiety and Health Care

We go on to identify four cultures that we believe emerge in response to the anxiety and operate in contemporary health care systems. The first of these cultures is professionally oriented. Here is a description of this culture and its historical roots:

The Professional Culture

Health Care, Psychology and Coaching?

Can mid-21st Century health care benefit from a dose of psychology and behavioral medicine? Is there a place for health-based coaching in contemporary health care institution? We proposed that the emerging field of health-based coaching can be of great benefit if it focuses on psychology-informed strategies associated with empowering individuals to make lasting health behavior changes.  These changes are the cornerstone in defining a sense of well-being.

The health-based coach can assist their client to bridge the gap between and integrate several different disciplines: psychology, biology, environmental studies, neurobiology and spirituality. Together, these interwoven disciplines provide what might best be called a biopsychosocial perspective on health.

Health-Based Coaching and a Biopsychosocial Perspective

Library One: Recommended Resources

Gilstrap, Donald (2005) Strange attractors and human interaction: Leading complex organizations through the use of metaphors. — Complicity: An International Journal of Complexity and Education, v.2 no.1: pp. 55-70

Johnson, Barry (1996) Polarity Management: Identifying and Managing Unsolvable Problems. HRD Press.

Meadows, Donella (2008) Thinking in Systems. White River Junction, Vermont: Chelsea Green Publishing.

Miller, John and Scott Page (2007) Complex Adaptive Systems. Princeton NJ: Princeton University Press.

Snowden, Dave (2023) Cynefin Framework. Retrieved from: https://thecynefin.co/about-us/about-cynefin-framework/

Stacey, R.D. (1996), Strategic Management & Organisational Dynamics, Pitman, London

Brief Biographies of Salus Forum Members. 


The following link provides information on Salus Forum Members.

Jeremy Fish

William Bergquist

Forum Members

Library Two: Documents Published by Participants in Salus Forum 

Christie Lewis, Kendell Munzer and William Bergquist (Editors)

Pathways to Health

William Bergquist (Editor)/Library of Professional Coaching/Future of Coaching:

Health-Based Coaching and Wellness

Communitas: The Three Cs Newsletter

Jeremy Fish, MD
Jeremy is a Family Medicine Specialist practicing in the State of California with over 31 years of experience in the medical field. Dr. Fish serves as program director


Library of Professional Psychology

Library of Professional Coaching