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Reviewed by Maria Todd

[/vc_column_text][vc_column_text]Feeling a little unwell and enjoying a little down time this weekend, I chose to hunker down in my flannel jammies and read a book I purchased some time ago. My choice was “The Six Secrets of Change,” by Michael Fullan, subtitled “What the Best Leaders Do to Help Their Organizations Survive and Thrive.”  I thought I might start a new section of our newly re-launched website with a Book Review section. I hope you like it.

Healthcare in the US and around the world is complicated and rapidly changing. Healthcare businesses and organizations risk being left behind unless they learn how to adapt. But surviving turbulent times won’t cut it in today’s competitive marketplace. The real art form is making the medical practice or hospital or spa resort thrive in spite of the constant stream of challenges they face. The most successful leaders in any field are those who understand how to manage change well, so it benefits their organization, company, hospital or even the economic development in their community.

So how does one become this kind of health leader? Is there a blueprint to follow? And if so, where is it located?

I work with hospital executives, physicians, and investors almost daily sorting out some challenge or acting as a sounding board.  One approach I share is to look at those leaders who’ve gone before them and learn from their successes and failures. But in “The Six Secrets of Change,” the author argues they won’t discover the formula for long-lasting success simply by charting the same course as everyone else who succeeded in the past. In fact, this copying others can cause a concierge physician or a surgeon with a new stem cell service line addition to face very high risk of failure for several reasons: first, if the market conditions that were paired with the strategy are different where they are – that’s a mismatch headed for doom. Second, the clock keeps ticking and the rapidity of change is such that what may have worked when they told their lessons learned story, may have already turned for the worse.

Instead, I agree with the author that the key to thriving through healthcare reform is much more subtle than this and involves a combination of flexible approaches, good market research, and tossing out all the logical fallacies and trendy solutions you hear. Good research on market sizing and targeting coupled with spot-on market messaging and a minimum viable product (MVP) strategy will serve you better, get you to revenue faster, and for a more sustainable period. This book will help you discover and apply that combination to your business, your organization, your cause, or your life.

The author compiled his ideas into six secrets. These secrets are not unknown or hidden. In fact, the six secrets may sound quite familiar if you’ve read anything about business or change management. He calls them a secret because they’re often harder to grasp at a deep level, to combine successfully and to act on decisively.

If you do need help to master them, the book offers  tools and gives readers more confidence to respond to change and flourish amid uncertainty. If you need one-on-one coaching, we have some excellent change management consultants available for you to ask for help.

So who’s this book for? As the subtitle suggests, it’s primarily aimed at leaders whose job it is to manage change, no matter what field or industry they’re in. You could work in the corporate world, in education, medicine, politics, government or a non-profit organization – these concepts are like chameleons changing color between all sectors.

If you are looking for a style that just dumps the worksheet in front of you like a checklist, “The Six Secrets of Change” isn’t for you. 

The author has an educational background that resonated with my organizational development and educational psych training. He comes at this differently than a “B” school grad. So, while he successfully applies what he’s learned in education reform to the corporate world. You’ll have to take the information in the book and apply it to your particular practical setting.  If you’re more comfortable taking your business tips from someone with first-hand corporate experience, this many not be the book for you.

To his credit, “The Six Secrets of Change” provides a comprehensive study of some of the best-selling business books of recent times so it’s like getting the rundown on a library full of business books. For example, he muses on the ideas of such luminaries as Jack Welch, former CEO of General Electric, and management guru Henry Mintzberg, as well as some classic theories dating back almost a century. His directness also resonates with me: Where he sees gaps in existing literature, he calls them out, and where he finds reliable concepts, he applies lessons from his own work in education and from other studies, drawing some valuable conclusions.

The author has a vast amount of experience in managing change and in helping others do the same, which was what drew me to the book. He is professor emeritus of the Ontario Institute for Studies in Education at the University of Toronto and has worked extensively in education reform in England and Canada, both in the public school system and universities. He advises and consults change projects internationally and has authored two books prior to this one: “Change Leader” and “Leading in a Culture of Change.”

“The Six Secrets of Change” begins by asking what makes a good theory. He says that good theories are grounded in action. Theories taught in abstract, for example within the safe bubble of classroom-based MBA programs, may not make the grade out there in the real world. I’ve found that to be so true that I don’t hire MBAs without at least 15 years of street-wise experience at Mercury Advisory Group.

Fullan also warns readers not to take any theory as an absolute truth or a silver bullet – including his own. Smart people that get to the pinnacle of their career as hospital executives and physicians often stumble when they believe they’re right and refuse to adapt or drop a well-worn theory or strategy, especially in uncertain times.  He is also pretty direct in his admonitions about the dangers of generalizing about what makes a successful business by looking at top-performing companies, as Jim Collins did in Good to Great.  When it comes to what we’ve been seeing out there in the form of advice for concierge physicians in startup strategy couldn’t be more spot on.  The secrets to success, he argues, are much more complex than some authors make out.

His first concept: Love Your Employees. Don’t treat them as replaceable commodities. Employee satisfaction is key to consistent, long-term performance, but managers can lose sight of the well-being of their staff when they’re too focused on earnings and their own merit issues.

Companies that build a culture that ensures employee satisfaction while at the same time inspiring staff members to see beyond their paycheck – to feel a sense of belonging and purpose establish strong and resilient, living brands. The sense of commitment, pride, and purpose felt by employees then overflows to customers and other stakeholders and, ultimately, to the balance sheet.

Some of the companies named in this book include Amazon, eBay, Johnson & Johnson, and Southwest Airlines. These companies treat all their stakeholders with equal importance: customers, employees, investors, partners, and society at large. Often these companies pay their employees higher wages than competitors, helping to boost employee satisfaction, but interestingly, they have lower labor costs overall. That’s because they have less turnover and greater productivity.

Another secret: Capacity Building Prevails. Fallon discusses the importance of treating employees with respect and encouraging them, rather than judging them. There’s substantial overlap between all six secrets. The book can seem repetitive at times but the author frequently points out this overlap is intentional. He never meant the secrets to be applied in isolation. They’re like links in a chain and they all relate to each other. The best leader will know how to combine the six concepts into a fully integrated strategy that can be easily adapted to meet the demands of a healthcare organization facing drastic reform.

Companies that know how to build capacity effectively create a climate in which employees are encouraged to take calculated risks and move out of their comfort zone, without fear of recrimination or judgment.  Building capacity begins with attracting talented people from the start, and helping them develop, both individually and as a team. Capacity development needs to happen on the job, not in a classroom. Again I agree with him because many of the college professors haven’t been out in the trenches in years! He goes further into this point when he talks about another secret: Learning is the Work. This secret stresses the importance of continual learning to improve performance.  So many companies don’t do enough on site training or retreat-based training. They won’t pull nurses, contractors, managers or even concierge membership sales people off the lines to learn new techniques.  For example, ACOs and hospitals often “steal” managed care negotiators from the health plans thinking they just pulled off a coup. Soon they learn that the new has no negotiation skills (they were charged with go forth and bring back signatures, don’t negotiate!) and no contract modeling skills, because they worked off a price list at meetings. Managers and SVPs also find out much to their chagrin that these stolen goods have no clue how a hospital or large medical group really works, so they end up with contracts that can’t be administered.

Fullan names Toyota as a model company for ongoing learning and capacity building. Toyota begins by attracting and employing stars. It carefully screens candidates for their potential to become superstars and it takes particular care in selecting and developing managers and coaches. Some of the attributes the company looks for include genuine concern for others, patience, persistence, and an inquisitive nature.

The author’s final secret: Systems Learn.  When companies struggle in challenging times, they risk falling into the trap of thinking there’s a sole savior out there. The CEO (like the pro football coach) is often the first person to go when a company stumbles (that read like the Dubai Healthcare City playbook to me). That CEO is then instantly replaced by a another charismatic, high profile leader who’s charged with turning the ship around in an instant. This common reaction to problematic times rarely leads to long-term, sustained success.

The companies that perform well over time are those that create systems that are bigger than any one individual, that will survive beyond the inevitable changes at the top. The best organizations have a number of leaders making the big decisions as a well-rehearsed team. Decisiveness in upper management is important, but a more integrated approach will ensure sustainability.

Finally, the last two secrets involve connecting peers and employees with the organization’s overall purpose and acting with absolute transparency around data and communication.

In summary, Fullan offers good advice to readers about the best approaches to take in challenging and uncertain times.

“The Six Secrets of Change” by Michael Fullan is published by Jossey-Bass.  I hope you enjoy it.[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_column_text][/vc_column_text][vc_button title=”Find this book on Amazon.com” color=”orange” type=”square” size=”small” href=”http://astore.amazon.com/askmariatoddc-20/detail/1118152603″][/vc_column][/vc_row]