December 23, 2021 HCMatColumbia

[PERSPECTIVE by @katharinajanus] ON TOGETHERNESS

As I’m writing my Christmas letter the night of winter solstice and in the light of a still very bright almost full moon, I can’t help but be optimistic that as the days are getting longer again the world will find a common sense of operation. This maybe utterly forward-looking while governments are discussing next lockdowns and we do not know what kind of sense or direction exactly the world is taking, but the truth is: we must find that modus operandi and adjust our expectations because this pandemic will not be the last one and there exist other more unmanageable challenges to tackle such as the climate crisis for which there will be no “vaccine” but a fundamental change of human behavior and operating procedures will be required. We are all in this together for good.


 We will continue to experience moments of “weirdness”, of non-rational priority setting of governments and institutions and a lack of civic and personal responsibility & respect for fellow citizens, human beings, and our immediate and larger contextual setting. I continue to be amazed about the failure of the – from my perspective – most important tool to manage “anything”: thoughtful and purposeful communication. On a recent flight to the US passengers were reminded to always keep their mask on unless they are “actively eating or drinking”. How could I possible drink or eat passively? Instead of applying to common sense and evidence that “keeping your mask on” protects yourself and others a new terminology has emerged that makes you feel like an idiot and might entice some passengers to even find more insidious ways of “eating or drinking behavior” to just break the rules.
 
Have we lost the ability to execute and understand clear communication? Is “protecting oneself and others” not enough of a rationale to voluntarily do the “right thing”? I believe it is time to move from prescription & punishment to positive motivation, explaining rationales and talking to the good sense of being a human being, a citizen, and part of a community. Human beings have a natural predisposition to contribute voluntarily more than what you can enforce because they are social “animals”. This original and intrinsic motivation, however, is harmed once you “change the game” to pay-for-performance and punishment for disobedience. This is almost ancient management practice but surprisingly still favored by major institutions and governments. If you can’t motivate for performance or rule-following you must pay for it – and more detrimental: you change the social contract in the long term and thus the modus operandi. To the contrary if you build your strategy and communication on “nudging” – a positive reinforcement consisting of indirect suggestions as ways to influence behavior and decision-making – you can leverage human beings’ natural predisposition.
 
This fall past by in a second but was extremely rich in terms of collaborative projects and experiences that made me reflect fundamentally on the above-mentioned social contract that underlies a functioning global society and a healthy economy and well-being. Three happenings stand out in my memory and learnings that I would like to share with you.
 
Fall started with a visit to Venice – a city I love for its beauty and fatalistic sense of optimism but also as a reminder that “touristic prostitution” needs to come to an end and action is required immediately to address climate change if we wish to save it for generations to come. Besides arts and culture, it was a major mercantilist driver for centuries and shaped trade around the world. It is maybe because of this history that I perceive the atmosphere of the sinking city not as melancholic but rather inspiring and amazingly strong. The French would call it “debrouillardise” (“smartness”) how the venetians deal with ever deteriorating circumstances. I remember being in a shop for wool and knitting materials where the owner proudly presented us a shelf mechanism that automatically lifts the merchandise if “acqua alta” occurs. Brilliant! Venetians have learned to deal with difficult circumstances, they adapt and find a solution.
 
More importantly, this visit to Venice was dedicated to the Biennale 2021 that dealt with the timely topic: How will we live together? While architectural concepts of future living were already impressive, I was even more intrigued by the curation’s focus on health and healthy living circumstances, providing ample insights how we can all contribute to a sustainable “togetherness” on this planet. Most compelling was the integration of “thoughts” translated into meaningful communication via various means. What has failed so often over the last two years in politics and management was conceived as an intelligent way of getting the message across that was received and perceived by attendees. Communication is what is understood and perceived – not what is being said. The contextual underpinnings of the Biennale made it clear that we all must be part of the solution together as a collective – the individual must reconsider his or her role to allow for collective survival: from ego to eco was the clear message communicated and understood.
 
This brings me to the next happening of this fall: the retirement of our long-term chancellor Dr. Angela Merkel. As a German citizen not living in Germany, I frequently consume news second-hand but also with the external perspective that gives you a more impartial view and review from a distance. As of late summer, my friends around the world were reflecting on Ms. Merkel and her contributions to world policy, Europe, and finally German history. In general, people were talking about her with great respect and with admiration for her leadership style. It was interesting to listen to their perspective, and I started looking up documentaries and reactions from fellow politicians that captured her signature style. Jean-Claude Juncker put it nicely when he said: “She did not think of herself as important as the German Chancellor. She joined the circle of leaders and towered over it. She listened to all EU members with the same respect and interest – be they small or large countries. They felt comfortable with her.” I must say I felt a sense of pride for our former chancellor. She represented the opposite to many leaders today who lead with fear, without evidence and truly emotionally – only to serve their own egos. I’m glad she proved that a different leadership style is possible and can be successful and integrative (and be perceived as such). Bravo Angela!
 
Nevertheless, not all her decisions remained undisputed: most prominently her decision not to close German borders to refugees in 2015. Her motivational slogan “Wir schaffen das!” (We’ll make it happen!) became historical and created a sense of togetherness although also contrary reactions. However, she was smart to understand early on that “closing borders” would not solve the problem. Similarly, we should have learned in this pandemic that building walls or closing borders will not save us but just postpone the problem. If we do not vaccinate the world we will not succeed. Just taking care of ourselves and our own population is not enough. We are in it together. From ego to… ?
 
Third, I returned to the United States this fall and found a country that has dramatically changed from the time when I left in early March 2020. The way that general life and the ability to support livelihood for the average American has deteriorated left a deep impression on me. This is not known and presented in general news around the world. You must experience it. Driving through downtown San Francisco feels like driving through a run-down campground: tents everywhere – those are not the “typical” homeless but white middle-class Americans who cannot afford their life anymore. Old people in wheelchairs begging for money. It is sad and deeply disturbing. I have lived through the dotcom boom and crash in the Bay Area and the financial crisis in New York (The Trump Years I mostly lived in Europe luckily). All of this and the pandemic might have contributed to this development. But I have never seen anything like this in a Westernized “rich” country. You always judge a country based on how it takes care of the weakest parts of society. There is not a grade for this – it is just disgraceful how an ever-deeper civic divide has dismantled a society that was driven by optimism, ambition, and innovation. It remains to be seen where the country goes from here.
 
On the positive side of my trip, I was happy to reconnect and work again with my California healthcare colleagues and friends which reminded me why I got fascinated with and started a career in healthcare more than twenty years ago. The US may not be in the best shape currently but there are people in healthcare organizations that put their energy and intelligence to making healthcare provision and people’s lives better. They could maybe make more money in other industries, but they choose to care for others. This is encouraging and was a truly enjoyable experience. There is hope for a joint understanding and civic and human togetherness.
 
So, what is this togetherness about that moved me this fall? It has obviously many dimensions: civic, personal, global, professional… It is one of these intriguing phenomena that we all aspire and want but do not necessarily know how to approach or commit to. As a “feeling” it is essential for a well-functioning social contract in a society. It is the natural response to the need of belonging I talked about in my last perspective.
 
As the holidays are approaching each of us has his or her own sense of togetherness or a personal wish to be together with loved ones. Again, the pandemic or rather the pandemic’s circumstances interfere with this ever so essential human need that has become an endangered species as described above. More than ever the awareness of a collective togetherness is needed while people are being challenged on the individual level to respond to this intrinsic human need.
 
Again, governments are responding with rules and restrictions – for example a maximum of x people (not counting kids) can come together. I have heard this frequently as a justification in the last couple of days: “we stick to the rules and see only x number of people”. The danger here is that it takes responsibility away from people and makes them feel save. Of course, if you see fewer people your risk to get infected is lower in general – it is a numbers game. However, to believe that following the rules is a save harbor and protects you is naïve. One infected person in your entourage is enough to infect everyone else. So instead of talking about numbers and rules please focus on protection and respectful behavior: it is not offensive to wear a mask when you are not (actively 😉 eating or drinking. Putting a sweater on and letting fresh winter air in is revitalizing. Keeping a bit of a distance does not mean that your heart is not close to someone. Getting tested despite being vaccinated is a matter of respect and creates the basis for experiencing “togetherness” again in times when it is more needed that some people might believe – on the personal, civic, and global level.
 
My Christmas letter always circles around the larger state of the world and is not the moment for talking about the work we did. But I would like to close this perspective by saying that I am deeply thankful for our clients’ appreciation, trust and collaborative communication that made this year special in many ways – exciting, inspiring, and also and always a great learning experience. Many new encounters crossed our path and made 2021 a very busy and enjoyable year. To all of those goes my gratitude! We are always here for you and happy to help if we can.

As always take care, be safe, and enjoy what you can in this holiday season and beyond. Stay tuned for any updates @KatharinaJanus!

Prof. Dr. Katharina Janus
Founder and Managing Director of the Center for Healthcare Management, Paris, France and at Columbia University, New York, NY, USA
President and CEO, ENJOY STRATEGY, Europe & US