In Pursuit of T-Shaped Health Care Leaders

When Internal Collaboration Is Bad for Your Company by Morten T. Hansen, appeared in the April 2018 Harvard Business Review and Getting Togetherness was published online on Economist.com on April 7. Both examine collaboration within organizations and both articles are drawn from Hansen’s forthcoming book: “Collaboration: How Leaders Avoid the Traps, Create Unity, and Reap Big Results” which I intend to read as soon as it is available. The interesting news from Professor Hansen (U.C. Berkeley and Insead) is that despite the charge for internal collaboration across industries, it is not a “no brainer” in terms of benefit. So by extension, it may not be the best tool for healthcare leaders in all circumstances.

Collaboration is Not a Freebee

It seems logical that the organization is suboptimized when diverse work areas across an enterprise fail to share best practices and innovative solutions to common problems. Both articles give plenty of credit to this conventional wisdom. But what about the frictional costs of bringing together teams from disparate parts of the company who think differently and solve problems in noncomplementary ways? Hansen does a good job of illustrating when and how internal collaboration can go right and when it can go seriously wrong, using corporate examples. He encourages us to consider a fundamental equation when evaluating the desirability of creating cross-organizational teams which I will term “Hansen’s Equation:”:

“Projected Return – Opportunity Cost – Collaboration Cost = Collaboration Premium”

Hansen reminds us to consider what other things are not getting done as well (“opportunity cost”) while the organization is overcoming the frictional forces (“collaboration cost”) associated with bringing disparate parties together in pursuit of a “collaboration premium.” He urges us therefore to measure not the ROI (“projected return”) but the net “collaboration premium” which more accurately reflects the effort. I think of this in the context of the cross-disciplinary research or clinical programs that are formed – sometimes at a great managerial cost – and that have equivocal results.

In the end, Hansen does not condemn collaboration but reminds us to evaluate the potential for synergy – as we would any other outcome – with the following cautions: “Don’t overestimate the financial return, Don’t ignore opportunity costs, and Don’t underestimate collaboration costs.”

An Open Mind is a Great Thing

Getting Togetherness stresses the upside of collaboration with examples such as Apple’s successful internal collaboration resulting in the development of the iPod. The (unnamed) authors also explore the use of social media, blogs, wikis, and other the low web-based collaboration and information sharing tools which may provide low cost/high yield channels that boost collaboration.

Getting Togetherness also make the distinction between active project collaboration (which can be tricky and expensive as noted above) and idea sharing which can provide the exposure to diverse thinking and result in sharing the raw intellectual material that can be incorporated and applied broadly without specific project-based collaboration. Lockheed Martin and Procter & Gamble have been successfully launched real and virtual “communities of practice” which: “bring together volunteers from different parts of the company and focus on a specific area of expertise, such as packaging, fragrances or skin science. These groups meet and share ideas, and other employees can put questions to them via the company’s intranet.” All highly applicable to the healthcare environment.

Hansen is a proponent of the what he terms “T-shaped” managers: “executives who are equally adept at working across an organization and up and down a vertical niche” who are adept at identifying collaboration opportunities and harvesting them when appropriate. He goes as far as to suggest that executive compensation and promotion be tied to “T-ness” and that organizations should systematically seek to transform their leadership to a high level of “T-ness.”

Imagine turning clinical or operational healthcare leaders accustomed to controlling inputs and outputs of their areas into T’s! Provided they watch out for Hansen’s Equation, they could be great scientific and service line leaders.