HomeHealthcareAu Contraire – The Well being Care Weblog

Au Contraire – The Well being Care Weblog


Final week HHS introduced the appointment of its first Chief Competitors Officer. I most likely would have usually skipped it, besides that additionally final week, writing in The Well being Care Weblog, Kat McDavitt and Lisa Bari known as for HHS to call a Chief Affected person Officer. I’ll contact on every of these shortly, however it made me take into consideration all of the Chiefs healthcare is getting, comparable to Chief Innovation Officer or Chief Buyer Expertise Officer.  

However what healthcare may have much more than these is a Chief Contrarian. 

The brand new HHS function “is accountable for coordinating, figuring out, and elevating alternatives throughout the Division to advertise competitors in well being care markets,” and “will play a number one function in working with the Federal Commerce Fee and Division of Justice to deal with focus in well being care markets by data-sharing, reciprocal coaching applications, and the additional growth of extra well being care competitors coverage initiatives.” All good things, to make sure.

Equally., Ms. McDevitt and Ms, Bari level out that giant healthcare organizations have the workers, time, and monetary assets to make sure their factors of view are heard by HHS and the remainder of the federal authorities, whereas: “Sufferers would not have the assets to rent lobbyists or high-profile authorized groups, nor have they got a big and well-funded commerce affiliation to symbolize their pursuits.” They go on to lament: “Due to this lack of entry, assets, and illustration, and since there isn’t any single senior workers member within the federal authorities devoted to making sure the voice of the affected person is represented, the wants and experiences of sufferers are deprioritized by company pursuits.” Thus the necessity for a Chief Affected person Officer. Once more, bravo.

The necessity for a Chief Contrarian – and never simply at HHS – got here to me from an article in The Dialog by Dana Brakman Reiser, a Professor of Regulation at Brooklyn Regulation College. She and colleague Claire Hill, a College of Minnesota legislation professor, argue that non-profit boards have to have “designated contrarians.”

They suggest:

We imagine nonprofit boards ought to require their members to take turns serving as “designated contrarians.” When it’s their flip for this function, board members could be accountable for asking essential questions and pushing for deeper debate about organizational selections.

Their thought attracts upon analysis from Lindred (Lindy) Greer, a professor of organizational habits then at Stanford GSB and now at Michigan Ross. Her analysis prompt that groups want a “expert contrarian” to enhance its effectiveness. “It’s essential for groups to have a satan’s advocate who’s constructive and cautious in communication, who rigorously and artfully facilitates dialogue,” Professor Ross concluded.

Her analysis, carried out with Ruchi Sinha, Niranjan Janardhanan, Donald Conlon, and Jeff Edwards, discovered that groups with a lone dissenter outperformed groups with no dissenters, or groups the place everybody dissents. The important thing, they imagine, was to not create battle however to assist establish variations and resolve ensuing conflicts in non-confrontational methods.

Professors Reiser and Hill fear that “board members usually fail to ask arduous questions and problem the group’s paid workers – particularly when there are greater than a dozen or so individuals serving as administrators.” They may assume everybody shares their “good intentions,” or they may simply be uncomfortable “rocking the boat.”

I might argue that the identical is true all through most organizations, whether or not within the C-Suite or in the remainder of workforce. Who’s asking the arduous questions?

Professors Reiser and Hill imagine they’ve an answer:

We suggest that trustees take turns being a delegated contrarian, quickly turning into a satan’s advocate obliged to problem proposed board actions.

To be clear, they wouldn’t be naysayers out to dam every thing. They’d as an alternative ask probing questions and supply suggestions on stories by executives and officers. They’d additionally provoke essential discussions by difficult typical knowledge.

The purpose, they are saying, “could be to encourage debate and reflection in regards to the nonprofit’s selections, slowing – or halting, if crucial – the approval of enterprise as regular.” Once more, there’s nothing distinctive about non-profits and even about boards right here.

When you have a staff, a administration workers, a C-Suite, a board (non-profit or not), or a federal company, you want a contrarian. Somebody who will not be afraid to level out when, as they are saying, the emperor has no garments. Who will not be afraid to ask these arduous questions, to rock that boat. Who realizes the established order will not be solely not adequate but in addition by no means goes to final.

Organizations whose boats don’t get rocked sufficient are more likely to capsize in the end.

Choosing the right particular person(s) is essential. Somebody who is simply too abrasive will simply create extra battle and can ultimately get frozen out. Then again, as Professor Reiser factors out: “Serving a time period as contrarian won’t magically rework a passive and deferential particular person into somebody who actively challenges dominant voices or forcefully advocates alternate options. And administrators sporting the contrarian hat could also be too simply discounted if others understand them as merely mouthing their assigned traces.”

It’s not a job that anybody can fill, or that everybody ought to, however a job that’s essential which somebody does.


It has been stated that organizations that want innovation items or a Chief Innovation Officer aren’t really progressive; it must be baked into the tradition. Equally, needing a Chief Buyer Expertise Officer means buyer expertise will not be integral to the mission. If HHS wants a Chief Competitors Officer or a Chief Affected person Officer, it’s validation that HHS has been coopted by the particular pursuits that healthcare is stuffed with, and people pursuits aren’t primarily about sufferers. We have to mirror upon that; merely naming these Officers received’t be sufficient.

By the identical token, in case your group wants a Chief Contrarian or designated contrarians, which means it doesn’t encourage wholesome dissent or search concepts that don’t mirror present paradigms. That’s an issue.

I’m, I’ve to confess, one thing of a contrarian by nature. I by no means had an official function as such, however I by no means shied away from talking up (even when it wasn’t in my greatest profession pursuits).  However, boy, if I’d had the prospect to be a Chief Contrarian or a delegated contrarian, I’d have cherished it!

Kim is a former emarketing exec at a significant Blues plan, editor of the late & lamented Tincture.io, and now common THCB contributor

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