Innovating Leadership:
Co-Creating Our Future
Hosted by Maureen Metcalf
Conversations with global thought leaders on leadership, culture, and innovation—designed for executives navigating complexity and building resilient organizations.
High-Performance Medicine: Healthcare’s Lesson for Your Elite Teams
Episode Description
This episode reframes burnout as a leadership and system design challenge rather than an individual failure. Maureen Metcalf and Brian Ferguson draw on lessons from elite military units, professional sports, and high pressure healthcare environments to examine how resilience, learning cultures, and human performance systems sustain excellence. The conversation offers practical insight for leaders in any demanding field who must redesign organizations to support performance, adaptability, and long term effectiveness under constant pressure.
Key Takeaways
- Healthcare professionals operate in life‑and‑death environments yet often lack the resilience tools provided to elite military and athletic teams.
- High‑performance medicine focuses on equipping frontline teams with tools to manage stress, recovery, and decision‑making under pressure.
- Humility and structured learning practices, such as after‑action reviews, are foundational to trust and continuous improvement.
- Burnout is a systems failure, not an individual weakness, and leaders must address it through culture, tools, and feedback loops.
- The future of world‑class performance lies in developing resilient human systems, not just advancing technology or policy.
Why This Episode Matters
Burnout and failure under pressure are often the result of system design, and this episode points leaders toward partnering with Innovative Leadership Institute to build leadership systems and performance practices that sustain excellence without exhausting people.
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Episode Content:
The Hidden Cost of Personal Sacrifice at Work
How ‘Martyr’ Leaders and Sustained Pressure Are Burning Us Out
Burnout has become so common that we talk about it as if it’s inevitable. And it comes at a high cost: Many of the people burning out are the most capable, committed, and conscientious in our organizations.
We, as leaders, don’t set a very good example. Execs are burning out, too, often because we are “martyr” leaders: Loyal to the organization and/or our teams, we overwork, suffer constant pressure, and spend more time on the job than at home. Our teams feel like they must follow our example.
If burnout were simply a matter of individual weakness or poor coping skills, it wouldn’t show up so consistently among high performers. But it does, which signals that we’re misdiagnosing the problem. Uninformed leaders say burnout is a personal failure, but in truth, it is far more often an inevitable outcome of poor system design.
Ignoring the Obvious
Burnout should surprise no one. When people operate under sustained pressure without adequate recovery, clarity, or support, the result is depletion.
This isn’t about effort. It’s not about commitment. And it certainly isn’t about caring less.
Burnout emerges when the demands of a system consistently exceed the capacity of the people inside it. When that imbalance persists long enough, something has to give…and it’s almost always the person, not the system.
As leaders, we don’t intend this. But intention doesn’t change outcomes. If the only way a system works is through personal sacrifice, it is fragile, no matter how noble it appears from the outside.
The Quiet Cost of the Martyr Model
We tend to reward work habits that look like endurance, praising those who stay late, take on extra work, step in without complaint, and power through it all. Over time, these behaviors have become signals of commitment and competence.
But there’s a hidden cost.
Our podcast guest, Brian Ferguson of Arena Labs, saw it first in the healthcare sector. Service-oriented people compensate for broken systems with personal sacrifice for far longer than they should. They do it because they care. Because the work matters. Because walking away feels irresponsible. Until they can’t do it anymore.
At that point, poor leaders frame the burnout as a personal issue: low stress tolerance, teetering work-life balance, or inadequate resilience. But what we’re really seeing is the delayed impact of a culture that quietly requires martyrdom to function.
Leadership Morphs Under Pressure
Much of our leadership language assumes one of two conditions: normal operations or acute crisis. But a growing number of us are operating under a dark new condition: sustained pressure.
Sustained pressure comes in many forms, often piled one upon another, including long periods of uncertainty, complexity, financial constraint, and human strain with no clear endpoint. This is harder on people than short bursts of crisis because it erodes capacity slowly and invisibly. Systems designed for short-term surges don’t hold up under long-term strain. And leadership approaches built for emergencies fail when pressure becomes the norm.
This is where burnout actually develops…not in moments of intensity, but in long stretches where there is no meaningful release.
What Leaders Miss (Even When They Care)
Good leaders care deeply about their people. Burnout doesn’t happen because they’re indifferent. It happens because:
Silence is mistaken for coping
Adaptation is mistaken for capacity, or
Extra effort is mistaken for sustainability.
When people quietly absorb stress to keep things moving, leaders may not see the burnout until performance drops, health suffers, or valued talent leaves. The damage is done.
Cooling the Burn(out)
For too long, we’ve pushed “resilience” as a panacea. But resilience implies the ability to bounce back after a crisis. That’s difficult to do when the crisis is never-ending and the pressure is permanent.
Instead, dig deeper into why that resilience is needed in the first place. Look long and hard at your team. What gaps in your system and workflow are causing people to compensate with personal sacrifice?
That question changes the conversation.
It shifts attention away from fixing individuals and toward examining design. It opens space for learning rather than defensiveness. And it acknowledges a truth many leaders already sense but haven’t named: We’re hurting our people.
Burnout is not a moral failing. It is a signal. It tells us something is broken in how work is structured, how pressure is distributed, and how recovery is no longer built into the system. To stop the harm, we must fix our unwritten cultures and our unconscious reward of martyrdom.
And that starts by telling the truth about burnout.
Thank you for reading our newsletter, where we bring you thought leaders and innovative ideas on leadership topics each week.
We strive to elevate the quality of leadership worldwide. Are you ready? If you are looking for help developing your leaders, explore our services.
Resources:
Brian’s company, Arena Labs, has more information on their high performance work at https://arenalabs.co/.
The company Brian referenced with whom Arena Labs works to help organizations optimize is McChrystal Group: https://www.mcchrystalgroup.com/. The Santa Fe Institute, which developed the concept of consilience, has more information at https://www.santafe.edu/. And the wearables Arena Labs worked with to gather sleep and other health data on hospital staff is Whoop; learn more at https://www.whoop.com/us/en/.
Our host Maureen Metcalf posts a newsletter every week on LinkedIn. You can subscribe here.
Maureen’s latest book is Innovative Leadership & Followership in the Age of AI. You’ll find details about it at https://bit.ly/LeaderInAI, or check out the Kindle version at https://amzn.to/44buVz8 . The audiobook version is now available at https://amzn.to/4dTCleZ.
Other episodes you’ll enjoy:
– Leveraging Tech to Deepen Human Performance with Brian Ferguson
– The End of Stability: Leading in a Disrupted World with Robert Bush, Jr.
– The End of Control: Leadership Trends for 2026 with Christopher Washington
Her other 10 books are available on Amazon here.
Guest(s):
Guest(s) Bio:
Brian Ferguson has spent his career working in high-performance organizations, learning from leaders and decision-makers in national security, the military, and technology. He used those experiences to build Arena Labs, a company pioneering the field of High Performance Medicine®️. Arena Labs uses state-of-the-art training and technology solutions to bring the science of peak performance, creative mastery, and elite teams to modern healthcare and surgical teams.
Before founding Arena Labs, Brian served in the military as a Navy SEAL and as a civilian in national security working on matters of global security policy. He received an MSc from the London School of Economics.
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Our Podcast Team:

Maureen Metcalf
Podcast Host

Dan Mushalko
Editor & Producer

Jenna Reik
Podcast Manager
Transcript
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Maureen: [00:00:00] Hi, welcome to Innovating Leadership Co-creating our Future. I’m your host, Maureen Metcalf. I’m the founder and CEO of the Innovative Leadership Institute. With me today is returning guest Brian Ferguson. We ask a lot of our nurses, doctors, and frontline medical staff who shepherd our communities in times of public health crisis. And while they’re required to step into high pressure and high stress work, we don’t equip them with the same tools and resilience that we do for professional athletes and elite military units.
These same tools and techniques we can use for the medical arena also apply to leaders across other fields.
So Brian, welcome.
Brian: Thanks, Maureen. Good to be back.
Maureen: What do you wanna share with our listeners about your background before we jump in?
Brian: The first part of my life and really my first passion was in national security.
In the time that I was in that world, just after nine 11, it was an extraordinary time to see how large [00:01:00] organizations, or in this case the US government, made decisions of consequence at scale in an increasingly overwhelmed information environment. So make faster decisions with more information. And as it turns out, that ends up probably being one of the bigger challenges of the 21st century.
And then I went into uniform and I had the privilege of serving in the military in the special operations community. And in the course of my last job in the military, I met a heart surgeon at the Cleveland Clinic, Heart and Vascular Institute. And he introduced me to the world of cardiac surgery. I had gone into spend some time with him I, I think to understand how that particular institution was thinking about risk and performance in the context of 21st century technology.
So as you might imagine, the modern operating room, particularly for heart surgery, is very sophisticated. There’s a lot of technology and, and you still have a team of eight to 12 people who are making time sensitive consequential decisions in that environment. And so in looking to understand that environment and how it might apply to the military, I was exposed to the reality that on one hand we have this [00:02:00] amazing world where medicine has become incredibly advanced.
And on the other side of that, there is very little focus on both the human and individual level around performance and stress and the collective team, frontline surgical team. And that was really serendipitous because it introduced me to the healthcare environment and, and that began the birth of my company now, Arena Labs, and our focus in healthcare.
Maureen: Yeah, it’s interesting. My kitchen table was military intelligence, so we, we had different conversations than many kids did.
Brian: I’m sure that the geopolitics of the time were made you more enlightened about the world than most kids.
Maureen: Yeah. I remember a conversation about assassinating foreign leaders, and that’s probably not what most kids’ parents were talking about at the dinner table.
Brian: An early introduction into philosophy and ethics. That’s fascinating.
Maureen: Yeah, it led me to think my dad was really James Bond.
Brian: He couldn’t tell you if he was, anyways.
Maureen: Yeah. So he said he is not. Anyway, onto our topic. You named your company Arena Labs. Why is that?
Brian: So there’s a, a quote that I, it is increasingly. What I’ll call mainstream in, in modern culture, colloquially referred to as the man in the [00:03:00] arena. Quote, everyone from Brene Brown to LeBron James have popularized it, but it comes from Teddy Roosevelt.
And so, so Roosevelt, after he finished his presidency, he was for, for those who are interested in these things a fascinating character who actually I think is one of the few modern characters who’s transcendent, meaning, you know, he certainly had parts of his life that we can, you know, through the retrospective history, examine more deeply and question.
But in general, he’s a fascinating person who really, you don’t see mired in a lot of the same challenges that people at that time were through their legacy. One of the things Roosevelt really believed in was his idea of what he called the strenuous life, doing hard things and not letting the trappings of success inhibit your continued growth.
In 1910, he goes to Paris to the Saral and he’s giving a speech to a group of very accomplished French leaders. It’s called Citizenship in a Republic. It is beautiful and it is perhaps more relevant than it was in 1910, but there’s a paragraph in that speech again that that many people have heard.
But I’ll, I’ll just read it because I think it’s inspiring for this time. “It is not the critic who counts. Not the man or woman who [00:04:00] points out how the strong man stumbles or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood.
Who strives valiantly, who errs, who comes short again and again because there is no effort without error and shortcoming, but who does actually strive to do the deeds. Who knows great enthusiasms, the great devotions, who spends himself in a worthy cause, who at the best knows in the end, the triumph of high achievement and who at the worst, if he fails, at least fails while daring greatly so that his place shall never be with those cold and timid souls who neither knew victory nor defeat.”
That has always really been in the DNA of something that’s inspired me about a way to live. And frankly, the people who inspire me, especially in today’s world, where in a digital age, we can very easily be on the margins of life or be trolls on the internet, but the people who are in the, the arena of the operating room, in the arena of the battlefield, in the arena of the boardroom, doing hard things, building, [00:05:00] creating.
I’ve always been inspired by that DNA of what that means. And so Arena Labs is really this idea of a laboratory of that idea of being in the arena, not on the sidelines of life. And so really proud, we’ve built a company of people who come from those types of backgrounds, be it in medicine, in the military, in the creative arts, or any other endeavor that that really requires that that worthy commitment and service.
Maureen: This gets to something I think is crucial with leadership right now: you’re saying in the arena and in the laboratory of the arena that there is no longer an operating manual for what happens in the arena. We are writing it right now. Yeah. And that requires a scientific mindset or a laboratory mindset, not a, a lockstep follow the rules mindset.
Brian: A hundred percent, Maureen, and, and actually the subtext of what you just said, I think is what we call our, internally our most important operating principle, which is humility. And I often say that the definition to me of humility is, is not the absence of braggadocio or [00:06:00] being overly or unnecessarily humble.
It is the idea that no matter how much you’ve learned, there’s more to learn, there’s, there’s more to understand about the world. It’s a, It’s a learner’s mindset. And when you think about the context of the 21st century and how much dynamism in change and complexity and in a lack of predictability, there is, if one can truly build a humble learning organization and be humble, I, I truly believe that that is the key to successfully navigating mm-hmm such dynamic times, whether you’re in business or medicine. And so the idea of laboratory is exactly what you’re focusing on. It’s learning, applying those lessons and iterating and, and doing that constantly.
Maureen: Humility means I, if I am experimenting, I have to admit that I didn’t get it quite right, a
Brian: hundred percent
Maureen: right.
And if I am afraid of acknowledging, falling short of my own standards or yours, that I’m in the game of covering it up.
Brian: Yes. You know, it’s, it’s one of the reasons that I often talk about this. If I think about the military culture it often, I think can be over overly [00:07:00] mythologized, especially in business culture in terms of the analogs and how we apply certain parts of the military culture. But the one thing the military does unequivocally better than any other organization I’ve ever seen is what is known as after action reviews or debriefs. Mm-hmm. And that is simply putting structure on what you just talked about, whether it’s at the individual level or at the collective slash team level.
How do we take what we learned from a training event, maybe a real world mission, an entire entire cycle of operations, and be ruthlessly introspective. About where we stand and what we could have done better. What did we do well? And when an organization can reach, frankly, this is what we talk a lot about in healthcare.
That is the bedrock of trust. Trust is not the touchy feely, what I often refer to as sort of the, the way it’s been popularized today and, and and, turns a lot of people off. It’s the ability to be openly critical and honest of yourself and of your teammates or your colleagues. And if, if you have that, that is true humility and allows that learner’s mindset to be [00:08:00] present.
Maureen: And it seems like you have chosen the two professions that are truly life and death professions.
Brian: Yeah. And, People in medicine often refer to military and they say, “Hey, no one’s shooting at us.” And I often say that, you know, the ex the idea of an existential life and death event doesn’t make one more consequential than the other.
That, you know, anyone who is dedicated their life to something that the idea of not living up to that level of service mm-hmm in a way becomes an existential threat. So it’s, it feels equally consequential. The thing that is, I, I find very parallel between the two cultures. This is what we often say in healthcare is that if you sit down with someone in serving in the military or serving in medicine, if you really strip down why they’re there or, or why they chose to be there, there’s three reasons for it.
One is they want to do hard things, they want to be challenged. And they wanna feel like that challenge matters. Second, they want to do things of consequence to the world. They wanna impact society. And the third is they wanna save lives. And that shows up very differently. but however, everyone philosophically thinks about saving lives [00:09:00] in, in the military or in the medical environment, there’s a lot beneath that’s powerful and one can harness that in a team environment. It leads to what we call the inspired soul: People doing things that transcend themselves and, and that are bigger themselves.
And that’s, that’s a really powerful human experience.
Maureen: I’m working right now with an oncology organization and, they are in fact using some of the newest technology right now to deliver radiation in a way that will potentially cure.
If this proves out, our world will be different. It is through the dedication of folks who put every bit of their soul into delivering that outcome.
Brian: Yeah. I mean, you wanna talk about matters of consequence.
I mean mm-hmm. I think most people have been touched by cancer in some way, and you think about perhaps like the most vulnerable of, of human emotional periods and, and to be able to affect that time. I mean, that, that is changing the course of lives at scale. And that’s perhaps a, at a high level, a way to wrap up why we, our team, most people are not from healthcare, [00:10:00] and so we feel a real privilege to be in that space, and we always talk about mu working from a place of mutual respect of people doing hard things and then contributing to what we call the sacred world of medicine. The genesis of our work, frankly, is this notion of high performance medicine, which put very simply, most people listening here are in some way likely inspired by someone who is in the world of elite athletics.
Maybe they’re an Olympian, maybe they’re on professional sports team, someone who’s a creative performer, perhaps in Cirque de Soleil, or a famous musician or someone who serves in the military. And when you think about those three disciplines, the creative arts, sports, and the military, there is an extraordinary amount of money and investment that goes into making sure that those athletes, those performers, and those soldier sailors or airmen are prepared for a career that is high pressure and high stress.
And in order to do that, they’re given typically a set of tools. Some training and, and oftentimes in, in today’s world, technology to, at the end of the day, show up and do their job to the best of their ability when [00:11:00] it matters most. And high performance medicine is the idea of bringing that entire way of thinking and that set of tools, technology, and training into healthcare, because amazingly, this is an oversimplification, but, but as a generalized truth, healthcare does not think the same way. People do incredibly hard things, but they typically are focused on technical training. And so what we often see is in a world of elevated medical operations in a demanding environment, on the front lines of healthcare, we’re seeing higher levels of stress and you increasingly see burnout be a massive issue.
If you talk to most healthcare leaders, burnout is. One of the number one concerns, and it, it costs annually about $4.6 billion, which is people turning over, people leaving their jobs or medical errors. So in general, that, that became the, the foundation of how do we go at that problem and provide frontline teams some real value to begin alleviating that pressure and burnout.
Maureen: Mm-hmm.
Brian: There are people who go into healthcare knowing they’re gonna do really hard things, in fact, my [00:12:00] cousin is a prime example.
She’s a an ICU nurse in the Washington DC area, and she suddenly finds herself early on in COVID before we knew a lot going in to take care of these patients. Not really sure what that meant for her or her family. And without some of those tools to manage that level of stress and pressure, that’s incredibly consequential at the human level, individually and then at the collective level.
And we start thinking about our healthcare system and the stress it puts on the overall architecture.
Maureen: With that as the context then how are hospitals dealing with the stress , both to the individuals and to the larger system.
Brian: The bigger concern is that there’s really two buckets.
One, how do we take care of people who are impacted in really significant ways and, and dealt with a lot of loss and pressure they didn’t expect?
And then how do we think about preparing our staff for an environment where most hospitals today are frankly trying to survive in, in economic terms? And what that means is that.
And that means, means increasing elective procedures, increasing operational tempo so that [00:13:00] that staff’s coming out of a stressful time going into a higher state of work. At the end of the day, the question is how do we give our staff the tools and training to be ready for that and to be resilient in the face of what’s gonna continue to be dynamic times?
Frankly, for people listening in business or who are teachers, I suspect you have some element of that same narrative at play in your current craft.
Maureen: For the same budgetary reasons you just mentioned, they’re cutting staff, they’re cutting additional services that support staff.
And so folks are already being asked to elevate the volume of work in a time that is more emotionally stressful than traditional.
Brian: Absolutely. What I often say is that healthcare right now is a microcosm of society. It is, of course, a bit more acute, in some cases, a lot more acute in terms of that day-to-day stress.
But people in healthcare are having to navigate new and uncertain times and restructure organizations and personnel. And I see it, our friends who are teachers or who in education are in, in, [00:14:00] in similar times of uncertainty. And you throw in the news cycle and information comes a level of stress. And so what we focus on is how then do we start to focus on the tools that allow us to navigate And what can we learn here to, to make our teams better on the backside.
Maureen: What organizations or leaders are you seeing that are doing the best and what are they doing?
Brian: In healthcare, if I’m being honest, I still have not seen a lot of institutions that at a collective level really commit to doing this.
And that is oftentimes not because of an unwillingness to do so. Mm-hmm. But because of cultural norms that often focus on the need to take care of the issue of the day. Heads down, we have work to do. We don’t have time to stop. It’s counterintuitive, but. It’s actually the most important thing you have to do because if you keep doing what you’re doing without stopping and learning those bad habits, those, those opportunities to learn and evolve are missed.
Generally speaking, smaller teams tend [00:15:00] to do this well. Where there is that prevalence of humility, and this is part of the culture. As I said earlier on, the military does this better than any organization at scale. So we’ve worked, done work with an organization called the McChrystal Group for those who are really interested in mm-hmm the after action process. They’ve written prolifically about it. What we really focus on is, is bringing this into a frontline environment where, you know, it’s, it’s frankly not hard, Maureen, it’s actually a basic process, but I would say basic doesn’t mean easy and cultural change to get a team to stop and learn and give everybody a, a voice at the front line.
That’s a major culture shift. And so what we end up seeing is we say the front and the back end of the bell curve. So organizations that wanna stay world class and push the envelope, they know they have to evolve and do things that are new. And then organizations that are, that are really struggling and failing and recognize they don’t have a choice, but the middle of that curve you tend to see people wanna stick with the status quo.
Maureen: One of the frameworks we use looks at what do [00:16:00] I believe? How do I behave? What’s our culture, and what are our systems and processes? And to your point, if you’re not changing all of those concurrently, the misalignment creates churn and loss of productivity.
Brian: There’s gotta be nuance. But if I was to offer an observation that we see not only in healthcare, but is very prevalent in business and even in sport, I think there is a growing, I don’t wanna say tension. The tension is natural. But if we think about frontline people who are truly on the frontline in sport, that’s the players on the field in the military, that is your platoon, that is deployed, boots on the ground in the military.
That’s your frontline staff. You, you have these people who are heads down doing the thing, whatever that thing is, and then you have people who are very well intentioned, who are trying to strategically plan the future. In a dynamic, unforeseen environment. These are the people in the boardroom. This might be your CEO, your leadership team. And so the real question I think to ask yourself is, what is the [00:17:00] connection between our frontline personnel and the strategic decision makers, our leadership team, and more importantly, how are we getting raw, honest feedback about what’s working and what’s not? Because it’s very natural in a time of crisis, certainly in national security, but we’re seeing this in healthcare for the people who are working hard to think about the future in budgets and resources and jobs to be heads down thinking about that.
And then the people in the operating room to be heads down taking care of patients and that bridge is missing. Mm-hmm. And so what that lends itself to is people starting to move into silos. And if you don’t have very structured processes to be openly critical and learn, those worlds start to grow apart.
And that, that is really where you, I think that’s the absence of, of that real humility and opportunity to learn.
Maureen: We may say we have an open door policy or whatever you call it, but for most people, the frontline supervisor does not go into the head of strategy or the CEO’s office to say, this isn’t working.
[00:18:00] Having worked in organizations where C-level folks said they had open door policies, and then one of them particularly would come into my office and say, who’s that guy and why does he work here? It is career limiting if one is not careful how the input is solicited and how it’s delivered.
And that’s part of what inhibits the bridge.
Brian: It’s an important point because this moves from the theory into the practice.
Maureen: Mm-hmm.
Brian: What I’ve. Observed in a number of disciplines, both again in government and in healthcare and business, is that you can have a cultural norm and you can say, we’re a learning organization and we debrief.
But the question is, what are the mechanisms in play? And we talk a lot about style and mechanism. As an example, one of the limiting factors that you see very present. So in the military as an example, you have classified information in business mm-hmm mm-hmm you might have financially sensitive information. [00:19:00] In medicine you have very sensitive patient information.
Maureen: HIPAA.,
Brian: those things often become an ex. Exactly. They become excuses that limit how information moves. And so organizations, back to your question that are doing this really well, I think are being most creative in two elements. One is the style. How is it that we’re getting? How are we reaching our frontline staff to get that insight and input so we’re not putting them in the example you give and the awkward position of over overstepping and overreaching and putting their jobs in the line.
The more important part is mechanism, and this gets to, it feels overly simplistic, but if, if anyone listening thinks about how most people on their team, particularly the new hires at the lower level who are younger, they’re operating on their phone, they’re, they’re absorbing information through social media, et cetera, how do you touch and meet people there so that you can elicit feedback? You know, whether that’s YouTube, I mean, it, it sounds overly simplistic, but what often happens is we build these really complex intranets internally and no one uses ’em. Mm-hmm. And, and we suggest that people are [00:20:00] giving feedback on them and then, and we don’t ever actually get what we’re after.
And so building those mechanisms and those processes is really critical. In order for that bridge to, to be at play.
Maureen: The divide is not only senior, junior, it’s also even within a same department, older, younger at times. Or technology proficient and technology uncomfortable. And I realize some of our technology proficient can be older folks as well. So it’s not an age issue, but it is a, certainly a comfort with technology.
Brian: And this is where leadership is consequential. I mean, we can, we can talk the technical side of any craft and we can talk debriefing and, and what do we need to do in a crisis. At the end of the day, success is predicated on leaders who understand those nuances, who say, look, I’ve got a wide demographic of people in my organization.
I’m being lazy if I’m saying. A town hall is the only solution. I need to think about some other mechanisms in order to get a wider range of inputs and elicit feedback. And the leaders who do that creatively and proactively you, that that’s [00:21:00] where you see organizations thriving and growing.
Maureen: Brian, how is this time period changing medicine? What’s your research telling you?
Brian: The quote unquote research we’re doing really is applied, I suppose, of, of the conversations we’re having, the people we are around in healthcare who are giving us feedback on what’s working, what’s not, what are their challenges, and if we zoom out, I, I think there is to. To the front end of our conversation a necessary way. The narrative around stress and the relationship between performance tools and health of frontline teams and healthcare has been elevated in extraordinary ways.
Mm-hmm. Um, what that means for the future of medicine is the future world class healthcare is not in regulatory solutions, policy or technology. It’s in building high performing teams. And that’s a, that is equipping people with these tools to manage stress and pressure and feel resilient, whether it’s a pandemic or any other public health crisis.
So what does that actually mean very tactically. You are going to continue to see an investment in equipping teams with tools around [00:22:00] resilience That’s at the individual and at the team level. It’s very interesting, Maureen. It’s parallel, I would argue to what you saw in the military community over the last 15, 20 years.
That is the, the intensity of, of two wars, very high operational deployment schedules. It took a real human toll on people who. Willingly dedicated themselves to something larger, but were giving up more than they could afford. And so those tools around mental health, around recovery, the proactive side of stress, I think is gonna continue to be the cachet of the future in healthcare.
I had a conversation with a good friend who’s an ER doc in New York City, and he said this, this is really gonna be a moment of reckoning in healthcare. And there’s gonna be a lot of leaders who we’re gonna see go away because they didn’t lead when it mattered.
And it’s not to put blame on people, but it’s to say how when it mattered, did you leverage your human capital and look out for them and take everything you were learning to improve. And so what we see are these leaders who are emerging, who are creative, who have a fresh approach and are multidisciplinary in thinking about how they [00:23:00] develop human systems. And the 21st century in healthcare in a way that, that allows them to be more resilient. And there’s a lot we can unpack in that, but at the end of the day, I think this is, you know, this is gonna sound cliche, but I really think it’s a paradigm shift in healthcare in a, in a much needed way.
Maureen: It makes perfect sense. And, and we have seen for decades the impact of resilience on the health of the person. The health of the organization. And when assuming I am not resilient, it means I am less effective in my job, the days I show up, I am more likely to be sick and absent and potentially exit. So all of those, back to your point of it’s the individual and it’s the collective that even one person on the team not doing their job because they are overwhelmed. They’re giving all they’ve got and it’s not enough.
Brian: This is a really important point that I’m gonna ground in medicine, but it applies to anyone listening who’s a leader. If we go to the front end of our discussion around healthcare and that it is, you know, my, the [00:24:00] conversations I had around my dining room table growing up and my mom who’s a nurse.
Maureen: Mm-hmm.
Brian: It’s comprised of people who wanna do hard things. They wanna impact the world and they wanna save lives. And the archetype of that personality, it someone who is service oriented and service minded when you are a leader. If you don’t protect and look out for the realities of, of how that person will overcommit and overserve, what you set yourself up for is an organization that becomes very broken because people go beyond, they go as far as they can until they burn out.
Mm-hmm. Or they do get sick, or they’re not taking care of themselves. And this is why leadership right now matters so much across the board, but I, I think we see it in a more acute way in healthcare. And we certainly saw it in the military. This was the greatest, I think, sub narrative of the last 20 years in the military mm-hmm.
It was evolving around how do we take care of our people in high pressure, high stress environments, and, and we saw the mental health cost that it played out
Maureen: and the family cost. I had a personal friend who deployed six times. Six times I saw the impact on my family growing up with just two deployments.
Six means his son barely knows who he is.
Brian: It’s a, it’s a [00:25:00] really important point and, and one of the things that we talk about is if you think about, you know, if you’d been on the front lines of, of COVID d I mean, there’s no doubt that affected your attention at home, your ability to be present at home, your own health, and these things play out in real ways in our community.
It’s interesting you bring that up. We’re running some larger data collection right now and, and one of the things we just were interviewing about 50 frontline healthcare workers in an institution and each day they’re asked a series of question, one of which is, what’s the biggest stress of your day?
67% of them said it was, it was, it was the demands of my job, as you might imagine, but the next largest answer at 15% was the demands of my family and most of those people, it is struggling to balance, and that is interestingly, again, very parallel to what was seen in the military. And to the credit of, of the special operations community, there was a massive investment made in what we called resilience programming.
And that was investing in families. Children, babysitters, resources for families [00:26:00] and it, and had a, you know, played out in a very positive way, but it takes a lot of time.
Maureen: Well, and even things like mindfulness training, right? That the individual was given additional skills that are probably not traditional for special ops.
Brian: That is a critical point because if we, again, zoom out, we’re, what we’re talking about are parallel environments that are high stress and demanding in a service oriented culture. Mm-hmm. And so we’re seeing that play out in healthcare where it is about the tools. So you mentioned mindfulness, we teach breathing, visualization.
How do you give someone an ability to ground themselves and feel a sense of stability in an unstable environment? And then we start looking at what are the things you can control? So in our, in the data that we gather, we look at alcohol consumption. We look at caffeine consumption, how much are you sleeping?
And then more importantly, what we wanna do is help you see that data and help the people you work for. See that data, not at the individual level. This is all blind to leaders, but it’s so that they can start to understand trends in their organizations and then give those people tools. Like this is something that the military [00:27:00] did.
How do you teach a family, not just the individual soldier? To optimize sleep. How do you have an optimal sleep environment? Because we know the most important tool that you have for performance is sleep. And so we start to invest in these very tactical tools and training around those tools that gives people a sense of being more empowered about their own health and performance rather than showing up and grinding in a high operational and tempo environment.
Maureen: So you control what you can. Mm-hmm. I’m heavily focused on sleep, eating healthy food and working out, and spending time in nature and meditating. Mm-hmm. Because otherwise I would be significantly less effective.
Brian: It’s a really important perspective.
If you take that at a higher level, that’s the, those types of resources. Now, there’s a practical reality here, if mm-hmm. You know, if someone works in healthcare, they don’t have time to, to work out every day, what, what are the things that we can think about? For an individual that give them that, to your point, that sense of controlling some factors that really matter, and more importantly, looking out for their long-term health.
Because from the start, we’ve seen this is not a short-term crisis we’re talking about mm-hmm a longitudinal challenge here [00:28:00] that we have to be conscious of. And so that’s why we’re seeing this really for us, exciting focus on resilience, employee health, you know, stress mitigation, et cetera, at the, at a very tactical way.
Maureen: We live in a world that whose culture is, we reward martyrs. And encourage people to go well beyond their limits, so I may already be in, inclined to go beyond my limits, and everyone around me rewards me for, for that behavior.
And so finding ways in 10 minute increments for mindfulness, for working out, for picking up a, a glass of water rather than a cup of coffee says the woman who’s recording in the afternoon with a whole mug of coffee.
Brian: You could do hundreds of podcasts with a lot of experts on this. That, this, it’s a passion of mine.
I, I don’t wanna pretend to be an expert in it, but I will say what I find is a, is a societal trend fascinating, is everything you just described, you know, most people listening feel this, this elevated sense of stress and pressure and complexity. And so you see in societal consciousness, this desire to return to [00:29:00] ancient rituals.
And so there’s this resurgence in yoga, ice, cold baths in the evening, and these things to relax. And these practices have been around for thousands of years, but we’re seeing them show up because people are frankly grappling for a way to return to that basic sense of health. And I, I do think the archetype of the martyr, as you put it, is eroding a bit in at least mainstream thinking in a good way.
Maureen: That is beneficial. So Brian, can you give our listeners some very practical activities? We’ve talked about the personal resilience on the more organizational side. What can our organizations do or our leaders do that will help during this time?
Brian: So three tools to make it very practical.
One we talked about, which is this idea of what is the learning mechanism you have implemented for your own team and for your organization. An after action review, a debrief, whatever you may call it, however that makes sense.
The big question is, does that exist and is it serving you well? Uh, that I [00:30:00] think that is paramount right now in a, in a time of dynamism. The second one is, this may not seem as profound, but I will tell you the leaders I have been most impressed with in healthcare business or otherwise are the leaders whom are grounded in consilience. That sounds like a very fancy term, I guess it is in a way, but I, I learned that from a friend of mine, Michael Mauboussin, who is the chairman of the Santa Fe Institute on Complexity, and consilience, is the idea that people from two different disciplines with a shared set of challenges come together.
And through a conversation, they reach epiphanies because they’re talking about the same set of challenges through different language and different angles. And what I believe is in a world that is incredibly dynamic and moving so quickly, it is in very diverse networks of how people think their exposures.
Where you see leaders, leaders who have those networks do very well because they’re able to pull on different perspectives rapidly. And so organizations that are bringing in outside speakers that are [00:31:00] approaching. Their own craft through the fresh lens of external or, or, or people who are not rooted in that group, think.
Mm-hmm. I, I see that as being invaluable is frankly what’s allowed us to be effective within reason and healthcare. We are people who are grounded in a perspective around teams and performance, but don’t have experience in healthcare. So the, the second one I’d say is, how are you really assessing not only your, your own ecosystem internally, but the people you bring into that ecosystem to challenge the way that you think and the way that you’re evolving doing that through a multidisciplinary lens is I think paramount.
And then the last one is, what data do you have on the health of your teams? Uh, in hospitals, we partner with a company called Whoop. Which is a wearable device that measures sleep. It measures overall activity and stress. We marry that with other data that we gather, so that we can build dashboards for hospitals to understand at the frontline level, how rested are my teams, how stressed are my teams, how resilient are they?[00:32:00]
And that is just as important if you run a, a small business or a large organization . And I think it is an incredibly exciting time to be alive because these tools have been democratized. They’re reasonably cheap and affordable, and they’re scalable.
So there’s no reason you can’t get really good data on your teams. And what’s important about it, not only does it give you as a leader insight into the overall health of your team, it gives those individuals data that is a feedback loop for them to learn how they can be better at taking care of themselves in a time that is, frankly for everyone.
I think uncertain and, and stress inducing.
Maureen: So as we wrap up, let our listeners know how they can reach Arena Labs and what tools you have on the website.
Brian: ArenaLabs.global (or .com). That’s our, our main web domain.
You’ll find there a lot of resources about how we think, the work we’ve done. We can get you plugged into the monthly resources, newsletters we send out and the types of tools that we’re offering to frontline teams.
Maureen: Thank you. And to our listeners, thank you for joining.
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