The challenge is great in addressing a schizogenetic split within a health care system. It requires that multiple polarities are managed and that the diverse perspectives found in a well-functioning team be fully deployed. The pull toward one side or the other will be great. It is hard to be reflective and appreciative of both sides as they charge against one another on a frozen battlefield. Difficult though it might be, there is no other option than to advocate for slow thinking (Kahneman, 2011) and to facilitate the engaged of an appreciative perspective (Bergquist, 2003) regarding the valid perspectives and values to be found among those dressed for battle on both sides.

Conclusions

It strikes us that people’s yearning for certainty makes complexity management particularly challenging. People will choose a bad certain reality over a complex, uncertain more positive one. We saw that very clearly with Covid-19. Even “herd” oriented folks refused vaccinations for political reasons it seems, even-though the hero they were following got his own vaccines promptly and saw rapid vaccine production as a great victory for his administration.  That was a very odd twist to the tale. The hero had battered the scientists so much that I think that message penetrated more firmly than his own self-worshiping “I made the vaccine happen faster” narrative.

Unfortunately, leaders in Health Care can convert “traditionalists” and “skeptics”/ “pragmatists” into Opponents, Rivals, and Enemies. This is either/or thinking taking over. We must instead invite skepticism—we must encourage it—for skeptics are often highly pragmatic folks who know exactly how to make things work as long as their concerns are listened to and incorporated into the design, etc. All too often we tend to push them out, dismiss their concerns, etc. So-Called “visionary” health care leaders all too often ridicule skeptics—thus driving them underground to become saboteurs in many instances.

It is to safe, supportive teamwork that we must turn. We must be open to new ideas and new perspectives on the complex world of health care in which we are working. Such support, safety and openness is not easy to find or maintain in an anxiety-filled world that is swirling with VUCA-Plus challenges. Yet, we must find the courage to engage with other people in the midst of these challenging conditions. We must be curious precisely at the moment when we might wish instead to hide in a corner, silo – or cave. Perhaps there are some tools and strategies that help us with our courage and curiosity. We introduced one of these strategies (polarity management) in an earlier essay (Fish and Bergquist, 2022) and expanded on it in this essay. We also provided several tools and strategies in other essays in this series (such as the preliminary steps suggested by David Snowden and Ralph Stacey, as well as Miller and Page in working in and with complex, adaptive systems).

In the fourth and final essay in this series we provide several additional tools and strategies—and relate them to concepts of effective leadership that is needed when navigating the dancing landscape of contemporary health care. We are fortunate to have received several comments regarding the use of concepts, tools and strategies we introduced in our previous essays. We include these comments and our reflections on these comments in this final essay. As we have repeatedly noted, it is great to get “a little help from our friends (and teammates).”

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