healthcare leadership tribal in TED talk

As David Logan mentions in the 2009 TED talk called “Tribal Leadership,” most people are in what he called Level Three Tribes: functioning at a high level of personal and professional performance but lacking the broader visions that can unite people and change the world. Reflecting on Logan’s message, I have become more aware of the ways I remain stuck at either Level Two or Level Three throughout my life but am passionate about moving up and into Level Four and hopefully, Level Five. The tribes I belong to are many, including more than one at the professional level. For example, I am a member of several different professional organizations, am a team leader in a healthcare institution as well as in class, and am also a member of an extended group of healthcare workers and patient advocates in the community. In my personal life, I am also a member of various tribes including those that intersect with ethnicity, socioeconomic class, and religion. My goal is to focus more on the visions, values, and principles that can bring together disparate people from various walks of life and interest groups. I am a tribal leader now, but know that I can be a more effective and highly functioning tribal leader when I aspire to shift focus from Level Three to Level Four.
If I want to move my Level Three tribes forward into Level Four, it requires the leaders to engage in gentle nudging of tribal members, as Logan (2009) points out. Each member of the tribe needs to come to a personal realization of the need for change, motivated intrinsically. In healthcare, one of the catalysts for both individual and tribal change has been legislation and shifts in the public paradigm related to social justice in healthcare. The Affordable Care Act (ACA) dominated discourse in healthcare reform, creating a new set of values that have motivated members of my professional tribe to reach and strive towards the next level. In fact, research shows how the ACA has loosened barriers to change and promoted higher-level thinking in healthcare (Delmatoff & Lazarus, 2014). As a result of the ACA and the ensuing discourse on social justice and public policy reform, healthcare managers and leaders have started to envision themselves as part of Level Four tribes with shared values rather than emphasizing our competitive worth in a “I’m Great and You’re Not” mentality (Logan, 2009). Unfortunately, the prevalent tone in scholarly discourse related to nursing leadership has generally not moved from Level Three tribal identifications, with “leaderism” and old modes of division and competition dominant still (Hyde, Bresnen, Hodgson, et al., 2017, p. 1).
However, there are some promising moves within healthcare, such as the shift from focusing on leader or manager core competencies towards a greater emphasis on the organization’s competencies and how to best meet patient care objectives (Krawczyk-Soltys, 2017). The shift from manager competencies to organization competencies may seem merely like a shift from Level Two to Level Three tribes, but in fact these types of small, incremental changes are the only way to achieve overall objectives of taking humanity to Level Five, using Logan’s (2009) terminology. As Logan (2009) points out, people do not make exponential shifts in their tribal affiliations but make smaller steps between levels. As a leader, I need to be able to reach out to all stakeholders and constituents in the community including patients and colleagues at various levels. Without isolating or judging anyone, I can bring all stakeholders into the forum to engage in discussions about what each person can do to create mutually beneficial outcomes. For instance, if improving patient care or reducing medical errors is an intended objective, I can work with leaders at various levels of the organization in addition to leaders in the community to discover our shared values, needs, and concerns. Then through the creation of a committee or action group, I can become a catalyst for change, taking Level Two tribes to Level Three or Level Three to Level Four.
My tribe has values embedded in the ACA model of social justice, with many members eager to take this Level Four thinking to the next stage. With my Learning Team, I have realized ways to connect and unite people from around the world who share in common a collective vision for action and social justice within the realm of healthcare. Yet to truly reach Level Five, we need to reach beyond our limited thinking and extend our outreach beyond healthcare. Working with policy analysts and legislators in target markets, we extend our reach into politics and social activism. Beyond that, we can work with scientists and social scientists to build on the existing database of research to come up with concrete recommendations for strategies of implementing change. Throughout the world, we are all dedicated to alleviating suffering, discovering innovative healthcare solutions that radically transform healthcare operations and systems, and to manifesting policies and programs that promote social justice in healthcare. The Level Five vision includes working with people outside of our sphere of influence who nevertheless have shared values and concerns.
Conceptualizing healthcare leadership in terms of the five stage model of tribes Logan (2009) presents in the TED talk has helped change the way our Learning Team thinks about strategic management. Focusing on grander visions and bigger picture issues, we can remember that healthcare is a growing field, not just in terms of service delivery to improve patient care but also in terms of research, development, and innovation. As we partner with stakeholders in medical technology and pharmaceutical firms, as well as community activists, social workers, and policymakers, we can create Level Five tribes committed to shared values like equality, justice, and holistic care.




References

Delmatoff, J. & Lazarus, I.R. (2014). The most effective leadership style for the new landscape of healthcare. Journal of Healthcare Management 59(4): 245-249.
Hyde, P., Bresnen, M., Hodgson, D.E., et al. (2017). Leadership talk. Academy of Management Proceedings 2014(1):https://doi.org/10.5465/ambpp.2014.13925abstract
Krawczyk-So?tys, A. (2017). From healthcare manager’s competencies to healthcare organization’s competencies. Journal of Management 7(2): 9-15.
Logan, D. (2009). Tribal leadership. TED. https://www.ted.com/talks/david_logan_on_tribal_leadership?c=150195