Physician Leaders Benefit From Revisiting “The Fifth Discipline”

by Francine Gaillour, MD

in Aligning With Values & Purpose,Transformational Leadership

A  conversation with a leader this week prompted me to recommend Peter Senge’s excellent classic, The Fifth Discipline: The Art & Practice of The Learning Organization.  Originally published in 1994, Senge introduces the concept of “the learning organization.’

I recall health systems were enthusiastic about this concept many years ago, and I discern an uptick in interest again as leaders began grappling with the intricacies of an integrated healthcare organization and culture.

In Senge’s model, there are five disciplines that a learning organization must master:

1. Personal mastery — clarifying personal vision, focusing energy, and seeing reality
2. Shared vision — transforming individual vision into shared vision
3. Mental models — unearthing internal pictures and understanding how they shape actions
4. Team learning — suspending judgments and creating dialogue
5. Systems thinking — fusing the four learning disciplines; from seeing the parts to seeing wholes

These disciplines are eye-opening in their relevance for healthcare providers today.  In looking at what is required to achieve Personal Mastery, Shared Vision and Team Learning,  it becomes the leaders’ job, then, to engage or guide  members of the organization in a coaching process. Coaching communication skills will be an important proficiency for healthcare executives, physician executives, nurse executives, department chairs, clinic chiefs, and the front line team leaders.

The unique aspect about healthcare organizations is that in many ways we already master these disciplines, BUT in only a narrow  way.  Physicians and nurses, in their interaction with patients, can easily suspend judgment and create a forum for open dialogue. Furthermore, the practice of medicine is the ultimate in systems thinking.

The challenge we have as leaders and clinicians is to extend this capacity we have for compassion, trust and big-picture thinking outside of our narrow, self-referential experience.


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