Absurd Change

Absurd change is a high-risk procedure: A doctor gets frustrated with her clinic, hospital or LHIN.

She decides to fix it. She attends all the right meetings. She writes letters and calls important people.

After 6 months, she quits in frustration.

She then shares her experience at medical staff meetings: The system was too corrupt. No one wanted to change. No one would listen.

Farson and Crichton wrote a great little book called, Management of the Absurd. Chapters include: “Big changes are easier to make than small ones”, and “Planning is an ineffective way to bring about change”.

After many attempts, false starts and unexpected successes, I offer the following absurd advice to fight for change.

Absurd Change

Experts say, “Start with a vision”. They are right, but we misinterpret what they mean in two ways. Continue reading “Absurd Change”

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Change & The New OMA

People say that they hate change. But it’s not true.

We love babies, weddings and graduation. We love new homes and cars and retirement.

Everyone loves positive change that we control, but we get stressed when other people make us move.

So most of us avoid asking for change. We know it threatens people. Asking for change means we want something better, or different.

Change & The New OMA

The OMA started renovation this spring: a new group of Board members, a governance retreat/renewal and then a major strategy planning session. Now the hard work begins.

Change means we find new and better ways to act. It means we work in concert.


Change interrupts usual workflow. We stop doing some things, start doing others and redefine ourselves in the process. Change is scary.  If it isn’t, it probably isn’t real change. Continue reading “Change & The New OMA”

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Governance Renewal – Ask Why Before How

Action expresses priorities – Ghandi

Every doctor has seen or done something horrible to an old, dying patient.

Armed with good intentions, we spot a gasping 95 year old and jump into action. We snap open a laryngoscope blade, hoist her jaw into the air and shove in a tube to relieve her “upper airway obstruction”.

Our technical prowess is matched only by our moral purity. But we accomplish something grotesque and wrong.

Doctors must learn to identify sick patients and how to resuscitate them. But these skills cause harm if doctors do not learn what comes between diagnosis and treatment.

Before treatment, we must ask: Why?  

Purpose Before Process

A governance expert entertained a large group of doctors in Toronto this weekend. He summarized a graduate textbook on board governance in 40 minutes, for a group who had very little board experience.

It was brilliant, funny and almost useless. Continue reading “Governance Renewal – Ask Why Before How”

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