Some days, it seems like healthcare in the United States has it all backwards. As if the forces driving 20 percent of our economy aren’t moving in the direction of humanism and care, but instead, they’re dragging us towards corporatism, cold standardization and disconnection.

Think about it: Technology has put screens between patients and doctors during office visits. Administrators have cut the length of those visits down to single-digit minutes. Community hospitals are managed from afar as they are acquired by health systems, pitting local culture and needs against system-wide considerations and financial constraints.

It’s the way of our world right now. And even as medicine advances and individual clinicians provide compassionate, skillful care, so much of the infrastructure we see in healthcare can feel inauthentic. Even soulless.

Whom do you trust?

Contributing to this feeling is a general uneasiness across society. While we’re not quite at gas lines and a crisis of confidence, folks aren’t entirely comfortable with the current state of things.

Need proof? According to Edelman’s Trust Barometer, only 20 percent of global respondents agree that “the system is working for them.” Only about half of US respondents think things will be better for them and their families in five years. And in a through-the-looking-glass sort of result, only 40 percent of Democrats trust the government while a shade over half of Republicans do. Subjectively speaking, we are bombarded with negativity, mistrust and inauthenticity, and it’s polluted our view of life, including healthcare.

All of this is happening at the same time that many hospitals and health systems are in survival mode, trying to adapt to a rapidly changing world and not always succeeding – if they were, this series wouldn’t exist. Healthcare is hard because it is intensely personal and, simultaneously, constrained by economic and political realities. Healthcare executives today are being pressed from all sides – from boards, competitors, employees, patients, and communities. Hopefully, many of those relationships are positive and collaborative. But they’re still tough and leadership can be lonely.

Accelerating change and managing the impersonal forces of healthcare start with decisions and behaviors by individual leaders. Fortunately, we’re in a good time for leaders to step up. Going back to Edelman’s Trust Barometer, people want CEOs to lead. Seems obvious, doesn’t it? In fact, 76 percent of the 2019 survey respondents said that “CEOs should take the lead on change rather than wait for government to impose it.” Almost as many people want that kind of leadership from their own employers.

So what’s a leader to do?

Be authentic.

Wait, hang on, don’t go yet. We heard that eye roll all the way from Jarrard Inc. headquarters. Give this a chance.

Let’s set a few expectations up front. We’re not talking about “authenticity” as a smoke-blowing buzzword. We’re not talking about “authenticity” as plastered smiles, hugs and handshakes all around. We’re wasting everyone’s time if we’re not clear about what authenticity means.

Schatzlein

Dr. Michael Schatzlein, principal at The Schatzlein Solutions Group and former regional leader at Ascension and CHS said that he is “naturally skeptical of leadership fads.” However, the conversation is worth it “if the authenticity meme gets us thinking and talking about ways to improve leadership style.”

“I use the word ‘style’ advisedly, since the substance of leadership is integrity, which is by definition immutable.  Without integrity, a leader is hopeless, and it is a quality that is displayed over time by consistent behaviors. People can tune their leadership style, though, and thinking about being authentic might help some of them.”

Doing the work

Drane

Alexandra Drane, CEO and co-Founder of Rebel Health and ARCHANGELS, wasn’t too far off this opinion. You remember Drane. She is the visionary health tech entrepreneur who got in touch with America by ditching her suit and tying on a Wal-Mart cashier’s vest to see how healthcare affected the daily lives of everyday people:

“I was on a panel and the moderator asked, ‘what was the moment you realized you’re a leader?’ she said in a recent interview for this article. “I was like, wow, I don’t think of myself as a leader.”

It wasn’t some “aw shucks” false humility from Drane. It was, in fact, a very practical attitude.

“Every single time in my life that I’ve begun to think that I had it all going for me, it was right before I got punched in the face,” she said. “Because I stopped having an edge, I stopped being alert, I started being entitled.”

Being responsibly transparent

Keeping that edge takes humility and transparency. Otherwise, we start to believe our own hype and think we can do no wrong. Drane pointed to psychology studies that suggest power causes changes to the brain mimicking brain damage and leads to a loss of empathy. Note that this theory is controversial and open to over-interpretation. But the point remains: Never hearing “no” and believing our own press changes the way we view the world and our place in it. If this wasn’t true, we’d lose an entire genre of TV shows based on the spoiled kid suddenly thrust into a challenging environment. Whether or not that technically qualifies as “brain damage,” it’s not a healthy way to live.

In addition, “It’s isolating when you pretend everything is awesome,” said Drane. “You rob people of the chance to support you and to feel better themselves. The more supposedly powerful we become, the more we forget that.”

So how do you combat this problem and drive transformation? Drane suggested healthcare executives begin by talking about failure.

“An executive often gets up in front of an audience to talk about the next new thing everyone needs to get behind,” she said of healthcare leaders. “They might want to start by telling a deeply personal story related to the change they’re trying to get everyone rallied around. A story about something they completely screwed up (professionally or personally). It’s a great approach to showing how deeply real and personal this is, and how they as an executive see and own their own imperfections as well. The data is clear that being averse to failure is an obstacle to transformation, while cultures that celebrate the iterative process prevail.”

From there, she recommended being totally open about the weight of responsibility. It’s ok, even good, to say things like, “I was stressed thinking about this meeting today because the things we are trying to do are hard – but they matter SO MUCH. When you get worried or nervous, think of that as an indication of how much you care. Because what we are doing is incredibly important and of course it’s not easy.”

Put another way, it’s addressing and normalizing people’s fear. Drane called it the Facebook Self versus the Google Self. Whereas your Facebook Self is all smiles standing on a Caribbean beach, the Google Self is who you are in the dark of the night. It’s what you worry about at 2 AM, the things you’re searching on Google when you’re alone. In our personal lives it’s “Am I about to get fired?” or “Is my partner cheating on me?”

Translate this to the concerns a healthcare leader can face on any given day:

• Will this strategic initiative succeed?
• How will we survive these new regulations?
• How do I help my employees through these staffing changes?

While leaders must be responsible (some information cannot/should not be shared, after all), admitting the personal emotional weight of a situation can be extraordinarily powerful.

The result of showing such vulnerability? According to Drane, it’s that people see themselves reflected in you and want to support you more.

Does it matter?

So, is the issue with authenticity that we all need to talk about it less, worry less whether we are authentic… and just do it? That might be the case. In fact, one source for this series – a highly respected and successful healthcare executive – took it even further and asked to remain off the record. Why? Because he felt that talking about authenticity was inherently inauthentic.

Call it the Jarrard Theorem: Your level of authenticity is inversely proportional to the number of books about the subject on your shelf. One or two and you’re probably doing ok, trying to pick up a few tips to lead well. Nine? You’re missing the point, trying to check boxes and cobble together behaviors that are supposed to make you look good.

On the other hand, maybe it’s irrelevant. As another source pointed out, there are a lot of successful “jerks” out there (feel free to imagine the original language). We only have to go back a couple of weeks to see a perfect example.

Adam Neumann, formerly of WeWork, stepped down after investors finally tired of his smoke-blowing talk about “elevating the world’s consciousness” and questionable business deals. But not before he sold shares worth around $700 million, according to reports. And, despite its massive devaluation, WeWork, built on Neumann’s ideas, remains an intriguing business with significant potential for success.

Other examples? A certain Hollywood mogul and a New York financier come to mind as horrible people who were absurdly successful. Certainly more mundane examples exist. We all know of that mom-and-pop business owner who yells at his employees, but is all smiles when it comes time for a photo op handing over a check to the local library.

Yes, you can be a jerk and be successful. You can recruit people with promises of glory – Lord Acton’s statement that “power corrupts” applies to the people around the person with power, as well. But there is a difference between “success” and “impact.” Authenticity, we believe, leads to impact because it creates an environment of shared interest, shared belief and collective vision. This unity can produce longer-term results than if people are motivated by power and money, which will eventually result in infighting and fragmentation.

“Stay humble,” said Drane. “Sometimes people will follow a jerk. But for the most part, they follow a human that they believe is doing good in an area where they also want to do good.”