We often hear from healthcare leaders who feel out of control, despite all their experience and past high performance. In the fast-paced and high-stakes environment of healthcare, autonomy — the feeling of having control over your decisions and actions — is a critical factor in building resilience and preventing burnout.
The SCARF model (short for Status, Certainty, Autonomy, Relationships, and Fairness) identifies autonomy as one of the five domains influencing human behavior and social dynamics. Understanding and leveraging autonomy can significantly impact how leaders, teams, and healthcare professionals thrive under pressure.
Why autonomy matters in leadership and teams
Autonomy isn’t just a preference for humans; it’s a fundamental psychological need. When individuals feel a lack of control, they may experience stress, disengagement, and burnout. These are some of the leading dissatisfiers in healthcare worker surveys. A lack of autonomy is also an area where people often feel stuck and resort to unhealthy coping mechanisms or ultimately leave the organization. This is very costly to healthcare organizations, resulting in critical staffing shortages, driving recruiting expenses, and slowing progress on key strategic initiatives.
For healthcare leaders, clinicians, and teams, autonomy directly influences:
- Resilience: Their ability to adapt, recover, and thrive in the face of challenges, stressors, and high-pressure situations.
- Engagement: Their emotional commitment and motivation toward their work, peers, patients, and organizational goals.
- Team Dynamics: Their interpersonal relationships, communication patterns, and collaboration strategies that influence how effectively teams work together.
The “Do More with Less” challenge in healthcare
As complexity and ambiguity grows, healthcare workers often face the relentless demand to “do more with less.” Whether it’s meeting higher patient quotas, managing with reduced staff, or navigating an ever-growing list of administrative tasks and digital clicks, these pressures can erode one’s sense of control over their schedule and projects.
Adding to this challenge are the financial and operational constraints driving these demands. Rising costs, staffing shortages, and performance metrics tied to reimbursement exacerbate stress for clinicians, hospital administrators, and other healthcare professionals. These systemic pressures often push individuals to work beyond their capacity, threatening their ability to practice or lead at their best abilities. The offshoot is often intense burnout, disengagement, or even departure from the organization.
Regaining autonomy amid constraints
It’s not reasonable to expect things will get any easier in healthcare. Healthcare leaders, teams, and professionals must actively seek ways to regain control and foster a sense of balance, despite the chaos around them.
Four simple questions can help you clarify your situation and potential solutions:
- What can I control in this situation? List actions or decisions within your influence.
- What aspects are beyond my control? Recognize these without fixating on them.
- How can I frame this challenge differently? Shift your perspective to focus on opportunities rather than obstacles.
- What resources or support do I need? Identify tools or individuals who can help.
Next, we recommend seven helpful practices:
- Reevaluate priorities.
Determine which tasks truly align with your core responsibilities, and advocate for streamlining or delegating non-essential activities. - Optimize workflows.
Collaborate with your team to identify inefficiencies and suggest practical solutions. - Set realistic boundaries.
Learn to say “no” when additional responsibilities could jeopardize your well-being or effectiveness. - Advocate for resources.
Work with leadership to communicate the impact of financial and operational pressures on care delivery and staff well-being. - Focus on your strengths and values.
Align your efforts with areas where you can provide the most value, ensuring you work at the top of your abilities. - Fuel momentum in small steps.
Start with small, achievable goals to build your confidence and momentum.
Helping others build their autonomy
Resilient teams are, by definition, more resistant to chaos, complexity, and burnout. As a leader, here’s how you can strengthen your team’s resilience:
- Set clear expectations: Provide structure without overmanaging.
- Encourage problem-solving: Allow individuals to explore solutions before stepping in.
- Cultivate a culture of experimentation: Make it safe for individuals to innovate, try something different, and make mistakes.
- Celebrate successes: Recognize and reward autonomy-driven accomplishments.
- Exchange constructive feedback: Use feedback as a tool for growth, not criticism. In turn, encourage others to give you feedback as well. When they do, listen with respect and curiosity.
- Challenge micromanagement. Recognize that micromanagement stems from a fear of losing control. As a leader, ask yourself whether you’re stepping in to guide or assert control.
Building resilience as a leadership muscle
Resilience isn’t a static trait. Rather, it’s a skill that can be developed over time. At the same time, changing behaviors and mindsets — our own or others’ — can be incredibly difficult. For healthcare leaders and teams, external coaching can be invaluable in making those changes stick.
In the context of autonomy and resilience, your executive coach can help you in four ways:
- Identifying and addressing triggers that threaten your sense of autonomy.
- Developing strategies to manage stress and maintain composure.
- Building awareness of how your behavior impacts others’ autonomy and engagement.
- Permanently changing how you react to stressors, and how they affect you.
Developing this leadership muscle requires awareness, intentional adjustments, and repeated application over a long period so changes become permanent. If you feel you could use the guidance of an external coach, we’d love to be a sounding board and help you clarify next steps.
In any case, I encourage you to take a meaningful step today by reflecting on your own sense of autonomy and how you can enhance it — for yourself and those you lead.
