Embracing Change: Leading Through Transformation

It is often said that the one and only constant in life is change. This is certainly the case in business where every change in the external market or new initiative or idea brings some type of change to the organization. As leaders, our success or failure can hinge upon how well we are able to facilitate change and how well we help our members of our team adapt to and appreciate change.

As president of a large, national health care organization, like many other business leaders, I am involved in important decisions related not only to performance today, but also preparing the organization for what will be required in the future. This means I spend a lot of time thinking about change. What can we expect with change? How will people react to change? How can I help my team work through the change? How will change affect the way we operate or service our members? What will it cost us?

The reality is most people don’t like change because it can be stressful, especially when change happens unexpectedly. Change can be scary, and understandably so. It represents the unknown, taking us out of our comfort zones. Any time an organization embarks on a new initiative there is the risk of failure, which could have significant financial consequences. Yet, if we don’t change, failure is certain. As society evolves, we must too. Organizations that not only understand the importance of change, but embrace change, are the ones that will ultimately be most successful.

Take Starbucks, for example. The company single-handedly changed how society talks about coffee. We no longer order a small cup of coffee with skim milk; it’s a tall, skinny latte. The person handing us our coffee is not a server, but a barista. Even more significant, getting coffee has become a social event with the casual atmosphere, comfy chairs and outlets for laptops in most Starbucks locations. For Starbucks, changing the language was a way to distinguish itself from its competitors, but it was also a risk that could have alienated customers and hurt sales. Few could dispute its risk paid off.

The health care industry has been going through a similar transformation as we change the language of caring for patients. Kaiser Permanente was one of the first health care organizations to move away from talking about health care to focusing on and talking about health. For our members, we are focused on managing and improving health and well-being so people can live the life they want to live. It’s about returning to health if you experience a health issue – and keeping a focus on healthy aging. If we are healthy, we can play catch with our grandson, swim with the dolphins, or take a hike on a sunny day.

We have also been changing to reflect the new age of mobile devices. Several years ago we moved away from paper-based records to electronic medical records. Now using our mobile apps, our members can directly engage with their health care providers using their mobile devices and even access their lab test results, which are available online in just a few hours after the tests. It’s about tailoring how we deliver care to match how our members are living their lives – and sometimes it’s even via social media like Twitter. We are using this change as an opportunity to better engage with our members and improve the quality and accessibility of the care we provide.

Leading through a time of transformation requires us to directly engage with our leaders and employees to help everyone understand the rationale behind the change. We can encourage our teams to look not only at how doing things differently will make their jobs different, but to also ask, “How could this make my job better?” The old way of doing something, doesn’t mean it is the right way or the only way. Understanding that principle can move the needle in helping us embrace change. Our role as leaders is to help our teams see how each individual has an important role in the transformation. This gives everyone a sense of ownership in the process and in the end result.

Over my long career, I’ve come to realize that the one thing we can always be certain of is there is more change to come. Charles Darwin once wrote, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.” The organizations and leaders that embrace change will not only survive, they’ll thrive.

Bernard J. Tyson is president and chief operating officer of Kaiser Permanente.

14 replies »

  1. Congratulations! Policy of discouraging US citizens who are foreign medical graduates , to get residency training with kaiser should be reconsiderd. I am a die hard employee of kaiser for the last 5 years and a foreign medical graduate . There is this red line in Kaiser which I, despite being US citizen ,despite being kaiser employee, despite passing all the licensing exams can not cross ,only because I am a foreign medical graduate. I was however given chance to interview and rotate only to keep me quite about the issue, all due to my personal effort and initiative.Got very good reviews from the physicians I worked with but I was not selected.

  2. Bernard congratulations. I am so proud of you and so happy that Kaiserhasrecognized your talent and contribution. I remember the steady and supportive role you played during the major change of the reorganization in northern california in the mid nineties you are a seasoned leader with an understanding and compassion for people. KP is lucky to have you at the helm. All the best and merry christmas. Denise

  3. My favorite quote: If you don’t like change now, you’re going to like irrelevance even less. – General Eric Shinseki, Chief of Staff, U. S. Army

  4. Thank you very much for your comments. Bernard has asked us to respond on his behalf. Regarding your question about future direction, Bernard discussed this with the San Francisco Business Times last week, reinforcing that Kaiser Permanente is continuing on its current path, which is to show that high-quality health care can be affordable. If you’d like to read the full interview, it is here:


  5. Congratulations…let the auric shield guide and protect you. No one person can stand alone. Hope your team will embrace change and lead each member/employee into a healthy transformation. Strength and peach be unto to you.

  6. Starbucks medicine:

    Standardized, easy access, medium quality, high priced, labor intensive.

  7. Let me add one example. Go to my THCB posting https://thehealthcareblog.com/blog/2011/12/13/medicare-advantage-quality-savings-access-and-satisfaction%C2%A0can-we-have-it-all/

    This is a way to increase Medicare Advantage enrollment by having people enthusiastically join the higher quality health plans, while reducing the deficit and sending checks to seniors. No one — neither at the White House nor in the former Romney campaign — has ever found anything wrong with it. Look at it — you’ll see what i mean.

    And yet it languishes because it is a change and policymakers don’t want to change.

  8. Let me add my congratulations. I hear ya about change. Next month I debut a new show on the NPR affiliate in DC, called The Big Fix, about ideas that can change the country. (www.wamu.org) Policy without the politics, we call it. One thing I have learned is exactly what you say, that change threatens many people just because it’s out of their comfort zone. So no matter how good the idea is — and people are proposing great ones — if it’s change, there will be opposition.

    What we’d like to use as an (ungrammatical) tag line but we can’t because it’s disparaging, is “The average person fears change. That’s why they’re the average person.” I think you”re about to learn who in your organization is average and who isn’t.

  9. Congratulations! It is great to see another capable CEO at the helm of Kaiser. Whether many in the provider and hospital community will like it in the end, there will be many more entities that look and function a lot more like Kaiser in the end.

  10. Bernard,

    Congratulations on your news. Kaiser has a well deserved reputation for pushing the envelope on technology adoption. We all know you’re a national leader in the drive for electronic medical records. That puts you way ahead of the rest of us. You also have a very sophisticated approach to tracking member health and overall patterns within your population. That obviously gives you a real edge in data collection and analytics. Can you tell us if you have any plans to publicly release any of the data you’ve collected? Or is this something you are already doing?

  11. Bernard Tyson–

    What changes do you envision for Kaiser going forward?

    Doc 1 worries about “cookie-cutter medicine.” But the doctors I have talked to at Kaiser are happy to be practicing “evidence-based medicine.”
    As Atul Gawande writes in his most recent New Yorker piece, as we move forward more medical centers and doctors will be practicing increasingly “standardized medicine” based on what works best. (Of course, over time our knowledge of what works best will change, and so “best practice
    guidelines” will change. But we do want everyone following such guidelines, don’t we?

  12. “…gives everyone a sense of ownership in the process and in the end result.”

    We have a far too high and dangerously increasing proportion of citizens who not only FEEL dispossessed, but who ARE in fact dispossessed. We marginalize this cohort at out eventual peril.

  13. Congratulations on your appointment as the new President and CEO of Kaiser. Everyone recognizes how much of a role outgoing CEO George Halvorson played during his tenure with the company. As a person of color, I applaud your selection. However, as a physician, I am concerned about some of Kaiser Permanente’s policies governing physicians. Some critics accuse Kaiser of practicing cookie cutter medicine and in my own experience, there is a real industrial feeling to the care provided there. What plans, if any, do you have to make changes in the culture at the company and more importantly, is it even possible in the new age of medicine?