The Bump Nobody Warned You About

A webinar this week about the evolution of a rural residency program inspired this week's reflections. In addition to the successes and growing pains, the thing that caught my attention was the sheer number of changes they had both created and endured.

In just 11 years, the program had 4 Chief Medical Officers, 4 Primary Care Section Chiefs, 6 Designated Institutional Officials, 4 Institutional Coordinators, and 7 Clinic Managers.

The contrast was equally striking. During those same 11 years, they had 1 Program Director, 1 Associate Program Director, 1 Program Manager, and 1 Pharmacist Faculty.

There are so many lessons wrapped up in those numbers: the importance of a committed core, what becomes possible when people stay the course, the adaptability and flexibility needed to navigate inevitable change, and the unwavering commitment to a mission that even led the Program Director and Associate Program Director to move across the country to build the program.

But the idea that I’m camping out on is this: What do we really mean when we say an organization is "stable"?

Leadership turnover is commonplace, even at the top. Maybe, in modern terms, stability simply means there are a few people who remain deeply committed to the mission and weather the all the changes.

Of course you know I'm not saying we should stop striving to build a positive team culture or investing in the people and resources that make people want to stay.

But, I think we can do both: build organizations people want to be part of and recognize that change happens even in healthy systems.

That shifts the question beyond "How do we prevent personnel turnover?" to "What does it take to become someone (or some organization) who can weather the changes without losing sight of the mission?"

That question followed me onto an airplane.

If you've flown much, you've probably heard the pilot make an announcement before landing:

"Folks, we're expecting a little turbulence as we begin our descent..."

Most of us don't think much of it. We straighten our seat, fasten our seatbelt, and go back to our book, movie, or computer. When the bumps come, we think, There it is. The pilot knew it was coming. It's part of flying.

Recently, though, I had a different experience.

It was a beautiful, clear day. There had been no announcement. Then, without warning, the plane suddenly jerked and dropped. It wasn't severe, but it caught all of us off guard. I remember feeling a rush of anxiety.

The turbulence wasn’t any different.

But my expectations and experience were.

Organizations have turbulence too. People resign. People retire. Leaders move on. Funding changes. Priorities shift. New opportunities emerge. Healthy organizations experience change because healthy organizations are made up of people whose lives and careers continue to evolve.

We don't always know when changes will happen or exactly what they'll look like. But if we embrace that change is part of the journey, we're less likely to lose our bearings when it happens.

So, here's my announcement to myself as much as to you:

"Folks, we're expecting some organizational turbulence ahead. Colleagues will come and go. Leadership will change. Staff will move on. Someone won't meet your expectations. Plans will change. Funding priorities will shift. We don't know exactly when or how much, but we'd appreciate your cooperation in staying focused on the mission."

Expecting some organizational turbulence doesn't make the bumps disappear but i can change how we experience them.

Reflection:

1. What expectations about stability might be worth reexamining?

2. What helps you stay focused on the mission when the people, plans, or priorities around you change?

3. If you were making the pilot's announcement to your own team, what organizational turbulence would you normalize?