We Need More Connection, Community, and Vulnerability

Our message about the importance of Relational Leadership™ seems to be gaining more traction. This week, PCP was honored to have our work featured prominently in two places: a NEJM Catalyst piece I co-wrote with colleagues about the importance of community-building within our clinic walls as a piece of the overall strategy to address clinician burnout, and an opportunity I had to present at the American Board of Internal Medicine Foundation (ABIMF) Forum about our promising Relational Leadership Institute at OHSU and the key role of psychological safety in team-building efforts. The response to both has been great. People seem genuinely excited to be discussing the relational aspects of their work, feeling that an exclusive focus on technical aspects of change (policies, structures, and workflows) has been missing something.

What most struck me at the ABIM Foundation conference was how hungry many of these various industry leaders are for this relational work and support themselves. To be sure, they’re looking for ideas and strategies for managing complex change at their hospitals and organizations, bright spots of innovation and the necessary policy, process, and structural changes. But I also saw - and felt - their deep yearning for relational work: to feel able, and frankly safe, to be vulnerable and real in their own professional circles to talk about their true challenges and questions and ask for help. I saw relief on their faces when group facilitators modeled vulnerability and practiced Relational Leadership™ by inviting others to be real and air what’s really going on. They left the conference not only understanding the importance of psychological safety in their heads, but having felt it in their bones. We need both right now.

Increasingly, we're seeing more and more evidence suggesting that psychological safety, trust, teamwork, and effective collaboration are directly tied to team performance and retention of staff. The connection seems to be that these are essential behaviors and conditions for effective group learning, and therefore, are prerequisites for being able to draw on the full repertoire of skills, passion, ideas, and insights of all members of a team to quickly respond to and adapt in complex systems. They’re also essential for team members to feel understood, respected, valued, and leveraged - critical for their engagement and retention. These are basic evolutionary drives that we all have, regardless of rank or title. Simply put, when we receive the message that we belong, we show up more. When we don’t, we disengage and our commitment lags.

Our article in NEJM Catalyst and the ABIM Foundation Forum are two ways we continue to move the conversation forward about the power of connection and how vulnerability builds teams. More and more leaders are starting to understand this intellectually. They’re seeing the connection between burnout surveys and turnover rates. They’re also recognizing the way that performance and innovation tracks with group cohesiveness, and how this all comes back to their bottom line. We need to keep making that case, in a way healthcare’s leaders can hear and understand, with the hard data that will get their attention. And, where possible, we need to find opportunities for those who are willing among them to experience what collaboration, vulnerability, and psychologically safe environments actually feel like. That way, they know where true north lies and can better foster the relational dynamics necessary for engagement and collaboration. Despite what so many in the trenches have come to cynically believe, we can pursue innovation and improvement in a way that energizes and connects everyone in healthcare, instead of demoralizing and isolating them.