You’re an hour into yet another debate over a problem that won’t budge, and every executive at the table wants the same outcome. Every option carries real risk, and every argument has merit. Nobody is being difficult, yet the meeting ends right where it started, and the same item lands on next month’s agenda.
I’ve watched that scene play out from both sides of the table. I spent years inside health systems leading marketing, strategy, communications, and organizational change. Today, as an executive coach, I sit beside healthcare leaders as they work through some of the hardest stretches of their careers.
Recently, I’ve been reading Shifting Toward Unorthodoxy by Michael (Mike) Hein — a physician, seasoned healthcare executive, and fellow MEDI Leadership coach. I kept stopping to underline passages. The book gave me language for patterns I had seen for years without a name for them. Two of the book’s 10 mindsets explain why capable, committed leaders end up stuck: the difference between Complicated and Complex systems, and the difference between a problem and a polarity.
Solutions that don’t stay solved
Looking back on my years inside health systems, I can name countless moments when we believed the right plan, process, or data would fix a problem for good. Yet those solutions rarely stayed solved. One improvement exposed three new challenges, and a decision in one department created unintended consequences in another.
So we refined the plan. We held more meetings and gathered more data. And we kept wrestling with the same issue.
Mike’s first mindset, grounded in Complexity science, explains why. A car is Complicated: It has many parts, but you can take it apart, understand each piece, and put it back together with predictable results. Rush-hour traffic is Complex: weather, accidents, and thousands of individual decisions interact in ways no one can fully predict.
Healthcare organizations behave far more like traffic than like a car. Yet as Mike points out, most are still organized, led, and run as if they were Complicated machines. Apply Complicated tools to Complex challenges, and you can do everything right and still watch the problem return in a new form.
That cycle wears leaders down, and many start to wonder what they’re doing wrong. Often, the answer is a mismatch between the tool and the terrain.
When a stalemate is really a polarity
Back to that executive team. Mike’s second mindset offers a better way to read what’s happening in the room.
In the book, an impasse is a problem that has hardened. Stakeholders dig into their positions, and the goal shifts from finding a solution to winning the battle. The meeting I described feels different, because everyone is still acting in good faith. What looks like an impasse is often a polarity.
Mike defines a polarity as two seemingly contradictory forces that depend on each other. His example is breathing. Nobody chooses between inhaling and exhaling, and nobody solves breathing once and moves on. Both are essential, and they work in harmony.
Healthcare is full of these pairs: quality of clinical care and cost-effectiveness, access and excellence, and personalized care and standardization. Treat one of them as a problem to solve, and you end up picking a side. Mike warns that this mistake leads leaders to make choices that undermine organizational performance.
This doesn’t make standardization the enemy. Plenty of challenges in healthcare are Complicated, and they call for best practices, protocols, and disciplined execution. The skill lies in recognizing which kind of challenge sits in front of you, and noticing when the approach that served you well no longer fits.
A different set of questions
As a coach, I don’t see my role as handing leaders answers. Healthcare already has plenty of experts. What many leaders need is room to think, challenge their assumptions, and notice patterns that are hard to see from inside the work every day.
Over time, “How do I fix this?” gives way to questions like these:
- What kind of challenge am I actually facing?
- What assumptions am I bringing into this conversation?
- Who else needs to help discover the answer?
- What conditions will allow better thinking to emerge?
Those questions often change the conversation long before they change the outcome. And the leaders asking them build their own resourcefulness, so they can navigate the next uncertain moment long after a coaching engagement ends.
From the page to the boardroom
Shifting Toward Unorthodoxy resonated with me because it named what so many healthcare leaders are already living. Reading it is a starting point. Applying it takes practice: slowing down long enough to recognize a Complex challenge, catching yourself reaching for yesterday’s playbook, and staying curious when certainty feels safer.
So the next time your leadership team circles the same decision for the third month running, try a different first move. Before debating the options again, ask whether you’re facing a problem to solve or a polarity to hold.
Related reads:
- A Practical Guide for Healthcare Leaders Navigating Complexity
- Leading in Complexity: 4 Critical Implications Every Leader Must Know
- Decision Making in Complexity
- Key Leadership Competencies: Complexity Fit
- Shifting Toward Unorthodoxy: Ten Unconventional Mindsets to Help Healthcare Leaders Succeed in a Complex World
