“Healthcare is a Calling More Than It is a Business” — An Interview with Dr. Henry Mintzberg 

Here it is November already, and snow is on the ground in Chicago. In advance of the busy holiday season, I have taken time to reflect on the world, the world of work, and, specifically, the healthcare industry. 
 
I have been involved with this industry for over four decades, and I am hearing from many colleagues of mine that there has never been a more sobering time than now for healthcare. Although we’ve seen promising some signs of healthcare’s recovery in 2023, staff and leaders are departing their organizations and their profession in high numbers. At the same time, costs are escalating, quality of care is declining, and I could become very pessimistic about the future, but I refrain from doing so. 
 
I surround myself with individuals that are forward thinking, optimistic, creative, and have a genuine love for the healthcare profession and industry. After all, the healthcare system needs all of us to influence its future. 
 
One person that I took the opportunity to speak with is Dr. Henry Mintzberg, a Canadian scholar and business management specialist. Dr. Mintzberg is a recognized management theorist and professor renowned for his instrumental work in business strategy, managerial roles, and organizational structures.  He is author of more than a dozen books, including one on the industry titled “Managing the Myths of Healthcare: Bridging the Separations Between Care, Cure, Control, and Community.” This is a fresh, insightful, and, to me, inspiring look at the subject. 
 
I will take a few moments to highlight a few key lessons from our dialogue that gave me great pause. I am hopeful that you can each take time to ponder his perspectives and understand how to most effectively impact healthcare in your own work. 
 
Lesson One: Healthcare is a Calling More Than It is a Business 
 
Unlike other industries, healthcare is essentially a collection of professionals who do their skilled work differently from each other. We can almost think of healthcare organizations as assemblies of highly skilled people intending to do good work. These highly skilled professionals are not businessmen and businesswomen pursuing profit — they are pursuing a calling. 
 
The role of leaders in healthcare is to integrate the work of these individuals into a seamless operation. Integration can be a challenge because healthcare is full of specialists. Specialists diagnose a patient as having a specific illness or condition — it’s all about categorization. 
 
This works well in many cases, but today we see more and more patients who do not fit into a tight category of a single diagnosis or treatment plan. Great medicine is dealing with this. These great professionals go beneath the category, beneath the patient, and beneath the condition to the person. The importance of seeing beneath all the specialist training in conditions to the whole person is one of the themes Dr. Mintzberg stresses. 
 
Lesson Two: The Healthcare System is Not Failing — It is Succeeding Brilliantly in Some Ways 
 
We may agree that healthcare in the U.S. is in a vicious cycle right now, as costs continue to rise, infant mortality increases, and longevity declines. The U.S. used to be the healthiest place on earth. 
 
But, we are now caring for individuals who have more co-morbidities than in the past and are older and frailer. Technology is advancing at the most rapid pace in history, from virtual-care platforms to the use of AI in scheduling and staffing to advancing immunotherapy. 
 
We have evidence on what it takes to be a great place to work in healthcare, and if payors, purchasers, and providers would come together on the cost and incentives of healthcare, we would be more successful. The number of innovative startups and investment opportunities in healthcare has never been greater. We have the elements for sustained success, and we must focus on the people who do the work. 
 
Dr. Mintzberg cautions us against the doomster view that healthcare is failing. We need a more nuanced view that recognizes its successes and embraces a mindset that will make it better. 
 
Lesson Three: We Need More Communityship! 
 
Dr. Mintzberg defines communityship as a practice where community members (geographic communities) take responsibility for that community’s growth and development. They nurture positive relationships between themselves and other members of the community. 
 
Communityship can be recognized in an organization by “feeling” the energy in the workplace, the commitment of its people, and their collective interest in what they do. These individuals are naturally engaged because the organization respects them. These staff and leaders are devoted to the organization. Patients and family members who experience these organizations can feel this devotion in the air. This sets the stage for a great workplace for all. 
 
If you are in a healthcare setting, what vision do you aspire to: being part of a well-oiled machine or being a member of a community? 
 
Lesson Four: Do Not Worry If You Are a Leader — Get Down to Managing! 
 
Dr. Mintzberg believes U.S. organizations have gone “off the rails” in making a sharp distinction between leaders and managers. No one wants a leader who can’t manage, nor a manager who can’t lead. Especially in a complex domain like healthcare, the senior people need to both lead and manage. 
 
Another place U.S. organizations have lost the plot is an overreliance on measurement. There are many aspects of the work that we cannot measure and yet the work needs to be managed. Yes, measurement is helpful, but it only gives a partial picture of the reality of healthcare. 
 
Dr. Mintzberg’s advice for us all is to get down on the ground to see what is happening — don’t micromanage by data but, rather, pay attention to your workplace.  Is there tension in one department vs. another? Are you in touch with your employees and are you visible to them? 
 
Where to Learn More 
 
A special thank you to Dr. Mintzberg for his insights and the reminders of the great things that are happening in healthcare. His many years of research and study give us all hope and optimism to take what we have today and embrace the future. My hope is that some of his insights will nudge each of you to take action in new ways, as we are all one communityship across the U.S. 
 
For bite-sized bits of wisdom, subscribe to Dr. Mintzberg’s blog. To get into more depth, you can read one (or all) of his 15 published books, including the aforementioned book on healthcare.