American Association for Physician Leadership

Problem Solving

Polarity, Partisanship, and Ongoing Progress

Peter B. Angood, MD, FRCS(C), FACS, MCCM, FAAPL(Hon)

July 8, 2020


Abstract:

Managing partisanship with the intricacy of polarizing influences is a complex undertaking. Leadership can provide the necessary resourcefulness to help create an optimal balance for any organization to move forward constructively and successfully — especially in the complex industry of healthcare.




Remember the first time you played with magnets as a child? You probably were completely mesmerized. Why did they come together in such a tight bond and then repel one another when flipped? Fascinating. Just totally fascinating!

And then some adult tried to explain to you the rationale and science behind magnetism. Do you remember their initial explanation? Nope, me neither — I was too busy playing with them to listen. In fact, I still stop to play with magnets whenever I am in a toy store or happen to see them on someone’s countertop in passing.

As all of us moved through our education, regardless of the field, the concept of polarity became more evident. Science, philosophy, religion, the arts, romance, athletics — they all have components of polarity if you think about it. Good and evil, light and dark, male and female, reason and instinct, yin and yang, consciousness and unconsciousness — pairs of opposites are prevalent everywhere.

Those of us in medicine recognize how the homeostasis of our physiology depends on polarity. The host of electrolytes and their membrane exchange systems are critical and essential… simple anion-cation polarity mechanisms that help keep the majority of our milieu intérieur stable and balanced.

So, in a general way, it is polarity that binds everything together at times. But polarity also can create strong oppositional forces at other times.

When defined as a noun, a partisan is an adherent or supporter of a person, group, party, or cause. Partisanship is the characteristic of a person who shows an especially biased, emotional allegiance and sometimes blind adherence to a particular person, group, party, or cause.

Partisanship, therefore, can effectively represent polarity in opposite directions. When a group of like-minded partisans get together in a community to share, strong interpersonal bonds are created that provide unity of purpose and ideals. However, when a partisan group collides with other groups that hold a different sense of purpose and alternative ideals, partisanship might lead to cataclysmic outcomes.

Is this not what we continue to recognize in healthcare (let alone our federal systems): polarity and partisanship often at odds?

A Changing Landscape

There is no doubt the landscape of healthcare is changing continually. The influences that are creating change come from all directions so, predictably, certain components of partisanship and polarity arise. Intriguingly, there is always a bevy of promises for a better future in some corners and zealots claiming an impending apocalypse in other corners. Fascinating. Just totally fascinating!

Fortunately, smarter heads are prevailing in many other corners as well. Progress is being made at both the individual and the organizational levels. There always will be bell-shaped curves and references to standard deviations from the norm, but the incidence and frequency of successful efforts toward improving healthcare continue to escalate and the entire bell curve of healthcare is gradually moving forward in better directions. This is good news!

But it is also a messy business at times, and this is when leadership must provide the necessary resourcefulness to help generate an improved balance of approach. As a leader, simply asking the question “Why can there not be approaches and benefits to a neutral or more central position?” will often reap the rewards and benefits of polarity and partisanship.

Leading is often more about deep listening — listening to others with a temporary suspension of one’s personal judgment and with a willingness to receive new information. And so, listening closely to the voices of polarity while also recognizing the driving forces behind partisanship circles often provides deeper levels of insightful information on how to achieve an improved balance of attitudes and approaches in finding new ways forward.

The astute leader can then use this information and improved sense of balance among individuals of an organization to develop a new network of partisans. This new network can subsequently facilitate further change and create ongoing breakthroughs for an organization — even create a process of ongoing change management that becomes infectious on several levels.

Restating it for emphasis: Successfully concentrated, it is polarity that binds everything together at times. Not successfully concentrated, partisanship may foster strong oppositional forces that create and even nurture unproductive outcomes.

Creating Balance

Joseph Campbell, author of The Hero With a Thousand Faces, in commenting on a hero’s journey and how emergence across barriers is necessary for ongoing growth to occur (simplistically described as deep-level birth/rebirth experiences), stated: “The hero of yesterday becomes the tyrant of tomorrow unless he crucifies himself today.”

The implication is (and perhaps grossly overstated by this writer) that individuals, and indirectly organizations as a whole, must be cognizant of past behaviors. By doing so, they must remain open-minded toward recognizing and pursuing new approaches that are not necessarily based on premises of prior success…and that difficulties encountered in the process of change often provide deeper insights for achievements in the future. Failing to do so creates the potential for incomplete success over the longer term — an unsuccessful organizational hero journey, if you will.

Polarity is pervasive in our natural worlds. Partisanship is a natural tendency of human behavior. By recognizing the inevitability of both, leaders potentially can better manage the complexity of this duality to create an optimal balance for any organization to move forward constructively and successfully. Other industries harness these influences, why not ours?

In fact, I believe it essential for physician leaders to embrace the responsibility of helping foster an improved balance between polarity and partisanship in this most complex of recognized industries. At some level, all physicians are considered leaders in our society. And there clearly remains opportunity for physicians to grasp the opportunities always available for creating an improved equilibrium in healthcare — our milieu extérieur.

As AAPL continues to maximize the potential of interprofessional physician leadership to create significant personal and organizational transformation, I encourage each of us to also continue seeking deeper levels of professional development — and to appreciate better how we can each generate positive influence at all levels. As physician leaders, let us get more engaged, stay engaged, and help others become engaged. Creating a broader level of positive change in healthcare — and society — is within our reach. Our patients and their families will appreciate the eventual outcome.

Peter B. Angood, MD, FRCS(C), FACS, MCCM, FAAPL(Hon)

Peter Angood, MD, is the chief executive officer and president of the American Association for Physician Leadership. Formerly, Dr. Angood was the inaugural chief patient safety officer for The Joint Commission and senior team leader for the World Health Organization’s Collaborating Center for Patient Safety Solutions. He was also senior adviser for patient safety to the National Quality Forum and National Priorities Partnership and the former chief medical officer with the Patient Safety Organization of GE Healthcare.

With his academic trauma surgery practice experience ranging from the McGill University hospital system in Canada to the University of Pennsylvania, Yale University and Washington University in St. Louis, Dr. Angood completed his formal academic career as a full professor of surgery, anesthesia and emergency medicine. A fellow in the Royal College of Physicians and Surgeons of Canada, the American College of Surgeons and the American College of Critical Care Medicine, Dr. Angood is an author in more than 200 publications and a past president for the Society of Critical Care Medicine.

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