Dear friends and colleagues,

As the COVID-19 pandemic escalates all around us, I can’t help but notice how very important relationships are in finding our way through, for both the community at large and people who work in healthcare.

We are all sustained by support and compassion, by feeling that others know us, understand us and care about us. The need for connection is quite literally hard-wired into our neurobiology; our survival as a species has always depended upon it. (Over the last few years I’ve been worrying that our lack of compassion and connection might actually be putting our survival at risk, but that’s a story for another time…) 

Given our shared interest in improving the quality of relationships and culture in healthcare organizations, I thought you might be interested in the article on physicians' trust of one another that I wrote with Rich Frankel and Ginny Tilden. It was just published in JAMA as part of a series of articles about trust in healthcare more generally. The series grew out of a 2018 conference on trust sponsored by the American Board of Internal Medicine Foundation.

Welcome to the third installment in our series on avoiding common pitfalls in organizational change.This blog describes what is arguably the most under recognized yet absolutely essential function of a change leader - holding the tension of change.

There is no change of any consequence that does not involve anxiety and conflict. Tension is intrinsic to change; it's normal, you can count on it. But it's also something that must be attended to. How you and everybody else deals with that tension has a huge impact on the outcome...

Given the magnitude and importance of the changes that are needed in healthcare right now, we cannot afford to waste time, money and human spirit on ineffective change projects, however well-intentioned they might be. So over the next few months, I'd like to offer a series of brief blogs describing some of the most common pitfalls I've observed and how to avoid them.

The topic for this first installment is "how we think about change." The conceptual models and metaphors we use filter our perceptions, frame our planning and shape our expectations in a powerful but subliminal way; we can be entirely unaware of how our thinking is being influenced...