We use autonomy as a defense to the need to appear to be impossibly perfect

Gene Lindsey's weekly email letter invariably contains some gems.  Here's one from this week. He cites Sally Kilgore, president and CEO of Modern Red School House Institute, from her co-authored book Silos to Systems. The book is about how the education system might be improved. Gene says:

Her introduction concludes with insight that is applicable to healthcare.

Envisioned by Donald Schon (1973), a learning organization is one that is “capable of bringing about its own transformation.” But creating that condition requires that we pay attention to how we organize professional life at schools—how information flows, the form in which leadership is shared, the diversity of perspectives we use to solve problems, and the degree to which our interdependence as educators becomes an opportunity rather than a nightmare.

Her words are sweet notes to my ear. I love the construct that in a learning organization, interdependence could become an opportunity rather than a nightmare. Read this next excerpt:

Organizational systems theorists emphasize that solving important problems requires multiple perspectives and seemingly diverse approaches to the solution. Ian Mitroff and Abraham Silvers (2010) find that lacking diverse perspectives, we often solve the wrong problem.

In my own recent thinking, based on observations of hospitals and medical practices across the country, I have evolved an image of the toxic triangle that makes improvement in healthcare so difficult today. Our current sense of despair seems to arise from increasingly negative externalities that we all feel but do not understand. The culture of autonomy and our tendency to be in tribes of various states of understanding preludes progress. We are like a sailor in “irons”.

We use autonomy as a defense to the need to appear to be impossibly perfect, and the result is isolation or the use of silos for protection when the solutions to the problems of our patients, which are our professional responsibility, lie in interdependence.