Take a good look at the list of governance roles and responsibilities in my previous blog. Think about boards on which you may have served. Is it possible that boards today spend an inordinate amount of time thinking only about themselves and the specific mission of their organization? Boards like to think that they shape the organization and, indeed, they do. However, what is often overlooked, and perhaps not even realized, is that the organization also shapes the board and its individual members. Winston Churchill once said: "We shape our organizations; thereafter, they shape us." Our institutions, our organizations for which we care so much and to which we give much time, informs us, educates us, but also molds us. As we align ourselves with the behaviors for organizational success, and certainly we do so because we are held accountable to do just that, and as we behave in accordance with the accepted standards for boards, do we also lose something in the process? Do we lose the ability to hear our neighbor, do we lose the sense of how a neighbor could help us do what we are now expected to do? A lone rancher thinking he can survive and even thrive against all odds, against the weather, predators, debt, even international prices for meat and grain, is a rancher who thinks that by focusing only on his own, doing it “his way”, and by being the rugged individual that his ranching operation can be a success if he just bears down and applies more grit. But ranchers don't think this way, they know they are, in reality, dependent on others, those “neighboring ranchers”. Sadly, some present day leadership in our organizations would like to evoke this mistaken ethos as a frame for the denial of responding to very real needs—the need to change. They would like to think that by being institutionally-centric, resilient and autonomous, that they can survive against the odds. This thinking is itself against all odds. Our organizations are not so independent and in reality, just like ranchers, they are mutually dependent on others to achieve their mission. As we move to a new place, a new expectation, within our communities-that of being responsible for overall health status (which is imminently more involved and complicated than is just patient care), there is a need for boards, as well as executive leadership, to add to their list of duties, standards, expectations and responsibilities. Just as ranchers have done for hundreds of years; we need an expectation of being a good neighbor and, thereby, live in a stronger society. No one organization can care for a population by itself—caring for large populations of people is a very big deal and will require significant collaboration with a large number of other entities, ie, our neighbors in this community. Boards need to collaborate with others—other health care organizations, insurance companies. schools, worship centers, employers, public safety agencies, and others, in order to solve the huge issues of funding, access and quality in health. Fundamentally, our neighbors are there to help in this time of change and we need to reach out so that all of us can be strong. My grandfather was a teacher from Nebraska and a story told about a Nebraska farmer by an anonymous author is illustrative:
“ A farmer grew award winning, blue ribbon corn year after year. A reporter visited him to understand how this was possible and discovered that this farmer made a habit of sharing his award winning seed corn with his neighbors. The reporter, being surprised at this, asked: ‘How can you share the best seed corn with your neighbors when they are entering corn in competition with yours each year?’ The farmer replied: ‘Sir, don’t you know that the wind picks up pollen from ripening corn and swirls it from field to field? If my neighbors grow inferior corn, cross-pollination will steadily degrade the quality of my corn. If I am to grow good corn, I must help my neighbors grow good corn.’ This farmer is aware of the connectedness of life, he knows that he cannot improve unless his neighbors’ also improve. So it is in other dimensions. Those who choose to live well must help others to live well. Those who work hard in order to be successful must also help others to be successful for the welfare of each is bound up in the welfare of all.”
The smart, efficient, effective delivery of coherent health services and the development of innovations which increase the well-being of individuals for the benefit of the broader community is now our expectation. A broader outlook is required if boards are to move from their current culturally acceptable, organization-centric, don’t make waves posture to one which is more in line with their historical raison d etre…that of being the responsible party which oversees an organization in order to ensure that its services exist and are appropriate for the community at large. It is time to change, it is time for directors to do more than oversight, it is time to broaden horizons beyond the organization and act for the good of the greater society. It is time to share our seed corn.