How One Doctor’s Approach to Change Management Applies to Your Organization (and Saves Lives)

By Marty Graham, Contributor

When radiologist and researcher Dr. Alexander Norbash made his first forays into leadership at pioneering medical research hospitals, he didn’t see this as his last stop. As time progressed, he moved to higher levels of management—first, in Boston and, currently, at University of California San Diego Health, where he is now chairman of the radiology department.

“I saw administration as noble and beneficial, a way to further innovation and the careers of the talented people around me,” he said. “I think the future of medicine is going to be very exciting, and it’s a privilege to lead in that direction.”

Norbash has been instrumental in inventing, introducing, and implementing new technologies, including stents for brain arteries, dissolvable stents, and far less invasive and more effective treatments for strokes and brain aneurysms as part of his active practice. The tools have been tested and launched at teaching hospitals around the country. He also maintains an active practice and teaches, while managing his chairman responsibilities.

But Norbash’s superpower is in administration, where his focus is innovation.

“It is a different path [than traditional medicine] but it’s at the heart of civilization,” Norbash said. “I don’t think it happens accidentally. Everything about our culture is a celebration of innovation and creativity.”

The lessons Norbash has learned—from leadership roles at two prominent medical schools as well as what he learned earning a master’s degree from the Harvard School of Healthcare Management—apply to almost every workplace looking to cultivate innovation.

“I don’t think [innovation] happens accidentally. Everything about our culture is a celebration of innovation and creativity.”
— Dr. Alexander Norbash, University of California San Diego Health

While Norbash’s specific focus for technological innovation revolves around delivering better health care, his experience in change management serves as sage advice for leaders driving digital transformation in any industry.

Make Innovation a Mantra

A recent article written by MIT Sloan professors, based on surveys from 3,500 businesses, states that innovation starts with people. “The strength of digital technologies doesn’t lie in the technologies individually,” the article asserts. “Instead, it stems from how companies integrate them to transform their businesses and how they work.”

Norbash goes a step further to say that innovation starts with the people at the top. And this sentiment has become a guiding principle for how he leads his hospital through technological innovation. To introduce technologies to transform rather than just shift an organization, the people at the top must educate themselves, both on the technologies they want to bring in and on management techniques that reward innovation, he believes.

The good news, MIT Sloan found, is that this doesn’t mean everyone in the C-suite has to be able to use all the technologies they champion. Instead, leaders have to understand and be able to explain the value the technology brings and how it will shape its future.

“Leadership has to understand what’s achievable,” Norbash said. “It must be positive, optimistic, and understandable.” And it must be focused.

The plethora of goals embraced in mission statements and management directives often serve to dilute innovation, Norbash said. To combat this habit, he suggests stripping the goals down to a single idea.

“We don’t have to say over and over that teaching is the most important thing we do, that health care is the most important thing we do. We get that,” he said. “The most valuable thing that we can do is innovate in ways that are deliverable in health care for our patients. Innovation is our mantra.”

Lower the Barriers to Collaboration

For Norbash, in order to create a more innovative environment, leaders have to develop a culture that fosters, encourages, and rewards innovation. One instrumental way of establishing this culture is to lower barriers for collaboration among people or groups of people who normally may not collaborate.

Norbash was among the first interventional radiologists—practitioners who work side-by-side with image specialists to meld imaging skills with the cardiologists’ knowledge—to provide minimally-invasive treatments.

As Norbash continued to developed strong relationships outside the radiology community, it made him think about how a more creative, collaborative, and flexible administration could do more to save money and help patients.

In one instance, Norbash brought medical device engineers to his own radiology practice to see if they could come up with sleeker, more effective devices – and perhaps some that don’t have to be surgically removed later. He was among the first to study lasers and and other mechanical approaches to treating ischemic strokes, reducing the use of sometimes risky chemical treatment.

Those innovations came from collaboration with people in other specialties, he said.

“You have to take each little tribe and help them make the connection to the larger tribe.”

While many managers in medicine tend to make and implement decisions in an authoritarian manner, searching for efficiency and clarity, he and his co-chairs shifted the management style in UCSD’s medical school to a far more participatory approach. Today, leaders make decisions with input from multiple departments; major administrative initiatives are now brought up in monthly meetings with various section heads and vice chairs.

“You have to take each little tribe and help them make the connection to the larger tribe,” he said. “There’s nothing more exciting than a new collaboration and a new set of innovations.”

Challenge the Status Quo

Based on Norbash’s experience, leaders must keep in mind that innovating is a continuous process. “Optimization [should be] a goal that’s never reached,” Norbash said. “You can’t believe that things are optimized, and you should never be satisfied with the status quo.” And that means allowing people to question the status quo.

For instance, although professional medical research tends to drive innovation in medicine, student and teachers in teaching and research hospitals are also poised to contribute to innovation.

“On first glance, you might say teaching and research are different, pulling in different directions, but I see that they are one,” Norbash said. “Both teaching and investigating deal with critical thought, asking questions like, Why are things done a certain way?”

“If you have particularly bright students, they make you rethink why you do things a certain way. And if your focus is on innovation, your students are learning to innovate.”

For Norbash, creating an environment where students, teachers, researchers, and staff can question assumptions, beliefs, and practices is vital to creating a workplace where innovation thrives.

According to the Harvard Business Review, leaders can lose the chance to improve by rejecting and even punishing employees for asking questions that could lead to better ideas and practices.

“That mistakes are valuable can become part of your pedagogy—that critical thinking is central to what we do, whether it’s investigating, teaching, or learning,” he said. For Norbash, commitment to this type of intellectual investigation makes the organizational goal clear:

“A belief system where your people know that open inquiry is more than encouraged, it’s expected.”