Change is The One Constant...
I have worked in healthcare since 1977, when I received my doctorate in psychology. I was pretty young at the time, only 26 years old. I went straight through college and graduate school, largely because of the recession in 1973, one of the worst economic downturns since the depression. Since jobs were very scarce, I figured that finishing my schooling, which I wanted to do anyway, made good sense. In the last 37 years, I have seen many changes in how health care is delivered. I have also experienced many changes in how mental health professionals view mental health problems. For example, when I was in graduate school, we were taught that mental illness (schizophrenia) was a result of dysfunctional parenting. Our views about these matters have changed dramatically with new technology, and greater understanding of the brain and genetics. Many strongly held beliefs turned out to be wrong.
Over these last three decades, I had a variety of work experiences. I had the good fortune to be at the forefront of several transformations—deinstitutionalization, where individuals with psychiatric disabilities were treated in the community rather than in the hospital, the advent of shorter term, focused psychotherapy as opposed to long term psychoanalytic therapy, and pre-paid healthcare where medical organizations received a monthly payment for providing patients with all the care they needed. When I first came to The Everett Clinic in 1993, I had the task of starting a behavioral health department that would provide mental health care to patients who were part of this pre-paid health care experiment. Over eight years, TEC went from having 10,000 patients in pre-paid health care to 50,000 patients! During those years, our goals were to provide the care that patients needed in the most appropriate setting. We were pretty good at it. Then overnight, we decided to end this arrangement with insurers. The financial incentives changed. This was a huge adjustment for our department, and I worried that we would not survive. We had to lay off staff and reconfigure our services. It was a tense time for all of us. My experiences over nearly four decades have taught me several important lessons.
- Don’t hold on to the past. Most frequently, external circumstances force a change in the way we do things. Holding on to the past is a recipe for disaster! As a species, human beings have done well because we are so adaptable to changing conditions. Don’t be a dinosaur!
- Think ahead. Of course none of us have a crystal ball—but it is still important to try to discern what conditions may prevail in several years. Plan for these possibilities.
- Try new ideas. Experiment. Can you think of a better way of doing something? Can you think of a different way of doing your job? What about a crazy, zany idea that is totally outside the box? Be creative! Think about Steve Jobs and the iPhone! Who thought that a phone could be a camera, a compass, and a newspaper—all at the same time!
- The external environment can change on a dime. The Berlin Wall falls, marijuana is legalized, apartheid ends, Nelson Mandela becomes the President of South Africa, gay marriage becomes legal, the Soviet Union falls apart, and an African-American becomes President of the United States. Technology, culture, customers, the economy, and beliefs change instantly and overnight. Bend or be broken.
- Don’t get too comfortable. That’s dangerous! Just when you start to settle into your workstation, put your feet up on the desk, it will disappear! The walls will be broken down, you will have to move to a new location, and learn a new way of doing things.
- Don’t put all of your eggs in one basket. Don’t invest all of yourself into any one enterprise, company, job, or way of doing things. Diversify. If one involvement goes up in smoke, you have other connections.
Despite our amazing adaptability and ability to innovate, most of us don’t embrace change. We want to be as comfortable as we can. We are skeptical of new ideas and new ways of doing things. We want to retain the illusion that we are in control of the world around us. We are not. What’s your attitude about change? How have you adapted in the past?