Speaking of… I write this from the emergency department, where Daughter is now observed for an anphylactic allergic food reaction (she’s okay now). *sigh* We do what we’ gotta do–will be here at least another 4 hours.

How do I already do flexibility well?
–I have an agile mind. It freezes occasionally, but most of the time I can assess a fluid situation and work out effective solutions on the fly. Every day in executive health is different and unique, with schedule disruptions from new symptoms, exam findings, test results, and events in other departments. The team, physicians and staff alike, move like gears shifting and sliding amongst one another, keeping the machine running as smoothly as possible.
–I have a low threshold to question and challenge ‘how we have always done’ something, especially when it’s no longer relevant or useful. This includes assessing my default assumptions, especially negative ones, about people. I don’t always do this readily, but more often now than before.
–I can change personal plans without much distress, as long as circumstances allow. I am seldom married to any given itinerary; my greatest sadness is when long awaited meetings with loved ones fall through.

How could I do better?
–I know there are situations where I am rigid, attached to my default assumptions, and not aware. Even when I am aware, I still resist flexing. I’m human. *sigh* So: more mindfulness… Polarity management… Perspective taking… Hmmm… I’m really glad I’ve written these posts this month–they will be a helpful handbook of skills and reminders going forward.
–Sometimes I may be too flexible, which can lead to indecisiveness and meandering. Wide collaboration and flat leadership hierarchy style have pitfalls. I think this is a minor weakness, though. I can sense pretty well when I need to decide something; and since most decisions are two-way doors, my openness to flexibility is still rewarded.

How are we already collectively flexible?

Freedom of expression; innovation. Conflicting opinions notwithstanding, American culture is pretty tolerant of widely varying manifestations of individual and group identity. We are relatively open, I think, to new ideas and creativity. We may not be the most flexible or open, but I think the number of innovations in many domains that originate in the US is a testament to our ability to flex…in technical and commercial areas more than social, in my non-evidence-based observation.

How could we do flexibility better together?

Cull bureaucracy. This feels like chasing a better balance between centralized and decentralized government/management, affording better local responses to acutely changing circumstances and needs. How would this work? Off the top of my head:
–Crystal clear vision, mission, values, goals common to and bought in by all locales
–Concrete, relevant, direct, attributable, and achievable metrics–adjusted to local specifics and still clearly aligned with global mission/goals
–Effective accountability and regular assessment, feedback and remediation as needed
–Balanced interdependence between nodes of the system; stakes for each unit in each other unit’s success

Promote experimentation, pilots, start ups. We facilitate flexibility when creativity and innovation is low risk and low cost. Manage sunk cost biases, apply iterative learning, practice seeing more doors that swing two ways. Collaborate and integrate between disciplines.

Stop punishing the masses for transgressions of the few. Regulation is complex. At least in medicine, the vast majority of practitioners make an honest living, making occasional accounting mistakes. My impression is that sporadic examples of fraud, admitedly severe, incite layers of global stricture on billing and verification, strangling all of us with at least as much time spent on paperwork as on face to face patient care, fueling burnout and alienating patients from their care providers. David French has written that it is not the severity of punishment that deters crime; it is the assuredness of it. I will park illegally if I think I won’t get caught, even if the ticket is $100. But if I know I’ll be charged $20 every time I do it, I won’t. So, maximize accountability and optimize systems for members to self-regulate effectively.

I hope you all had a Thanksgiving that fulfilled at least some hopes of communion, connection, and joy. Living with high risk medical conditions, when sudden and severe episodes trigger acute, indiscriminate, and impactful changes in plans, makes us even more flexible than we may already be. It’s useful, if painful, training. I am always grateful to walk out intact on the other side.