Healthcare changed. The whole world, too. But how we work mostly hasn't.

And that means how "we" conceptualize, organize, manage, and ultimately do our work is a mismatch for the environment it's happening in.

While we’ve spent our careers believing work takes place in an environment similar to a football field, work is actually happening in something more like a wilderness, where there isn’t a scoreboard, or an opponent, or even a rulebook for that matter.

I call working in this wilderness The Transforming—the always-happening, always-unfolding state of change in our jobs and the result of powerful market forces wayyyy beyond our control.

It's those powerful market forces (a few examples: economic climate, pandemics, government regulation, competitive threats) that require organizations to reorient their strategies and operating plans to adapt, which creates the effect of always-happening and always-unfolding states of change in our respective jobs.

And this is where things start to get a bit messy.

  • Our paradigm of work (our education system, too) is built on the ideas of Scientific Management, invented by Frederick Taylor, and popularized to very profitable effect by Henry Ford (the assembly line), among many others.
  • Industrialized management = much success. But it's reliant on operating environment stability. And no matter how good hearted or human centered an organization may be, this system of work treats employees like interchangeable cogs in a machine.
  • But we don't want to be cogs. And organizations don't want cogs either. Because new problems are always emerging as a result of things always changing. So many problems, in fact, that an industrialized bureaucracy can't keep up. And cogs don't solve problems. People who are skilled at thinking and caring and doing solve problems.

The situation hasn't gone unnoticed. The tension that emerges, I think, is inherently felt in most organizations, if not outright understood. It's the reason workplace practices get zhuzhed—such as

  • leadership development programs that teach treating workers with dignity
  • scribes that lighten the clinical documentation load
  • org-wide mandates to shorten meetings to give people a break between back-to-back meetings.

The problem, of course, is that all of that still happens within the paradigm of industrialized management, and all its shortcomings for operating in this always-changing operating environment. The industrialized bureaucracy's solutions aren't enough (they can never be, see: complexity) to solve the problems emerging in the work, let alone with the problems emerging in how we actually do the work.

On top of that, not everything gets zhuzhed—many industrialized management practices live on and cause more damage and negative effects on org productivity then they create, for instance

  • being constrained by annual budgeting + planning decisions even when the operating environment demands something different from when the budgeting + planning occurred (remember what happened at the onset of the pandemic? budgets and plans were all of the sudden deposited in the trash bin.)
  • check-the-box annual review processes that put people in metaphorical boxes based on the opinion of a single individual, eternalized in a human resources information system (and in some cases, with labels that live on well past their proven untruth)
  • clinical productivity quotas limiting the potential of great patient/provider relationships (not to mention clinician mental health) for the short-term benefit of efficiency, standardization, and productivity
  • etc.

So as our organizations' conventional approach to work is encountering reality, we get a whole mess of problems like bad meetings, insufficient leadership, confused priorities, siloed decision making, overflowing inboxes, too-slow change, questionable decision making, unclear strategy, "do it this way" demands masquerading as training workshops, and an abundance of additional examples ... which all lead to—what else?—job suck.

To be abundantly clear: job suck is happening up and down and all around the org chart. It's a collective ailment. It's also a remarkably personal affliction because no two diagnoses are the same.

Job suck is that creeping to complete feeling of job discontent caused by any number of "how work works" factors, from the small annoyances to total burnout, that has been remarkably present in the thousands of conversations I've had with healthcare pros over the last decade.

And who signed up for a career filled with that? Not you, not me, not any of us.

The solution is to design how we work.

The top down approach, reverse jui-jitsuing industrialized management's s do-as-I-say dictums, is one option:

  1. Understand the shortcomings of our industrialized paradigm of organizing and managing work
  2. Be in charge/have authority
  3. Use that power to make necessary changes

... but until then or unless that describes your current role, we've got the us up approach:

  1. Understand the shortcomings of our industrialized paradigm of organizing and managing work
  2. Get right with ourselves for the world of work as it is
  3. Start designing how we work to make it worthy of our care

With Worthy Work, I aim to help you—as a worker, whether you're an individual contributor, a clinician, or in a management role—do all three.

Because The Transforming creates a choice to show up anew ... and then design how we work, with purpose, for work worthy of our care.