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The Turbulence of Unbalanced Power


Every so often, Futures Research projects unveil a pervasive challenge that catches our attention. Below is one such discovery.

After completing a series of unassociated projects in public education and healthcare, a meta-theme popped out: the inherent turbulence in the division of labor.

In a nutshell, the theme highlights similarities between education and healthcare organizations. As observed through recent projects, both organization types are similar in the following ways:

  • Mission - Committed to improving human life
  • Value - Access to expertise
  • Advocacy - Actively promotes mission through action
  • Accountable - Upstream budgets, benchmarks, and rules are partly defined externally while job performance metrics are defined internally
  • Leadership - Enlightened, externally aware, internally focused for sustainability; often opaque for reasons of complexity and flexibility
  • Personnel - Educated, confident, and drawn to mission
  • Power - Like many private businesses, the organization's power to define strategy and make budget and process decisions is controlled by a small executive team.

Here's where the theme gets interesting: Our projects detected significant concern affecting trust and respect in how an organization's labor is divided between the deciders and the doers. For both organization types, the division is clear and highly reinforced in titles, information sharing, chain of command, decision making practices, policies, physical arrangements, etc. 

Unlike many private businesses, the people who deliver the value in these organizations (i.e., the "doers") are often highly trained professionals whose job is to make things better. In education, value is conveyed through an instructor with specialized training who applies their expertise to help students grow, learn, and develop. In healthcare, value is conveyed through a credentialed healthcare professional who guides patients to health.

These frontline personnel are smart, observant, and prone to have ideas about how their work can be improved. It is not lost on many frontline doers that those who control the spaces, the schedules, the processes, and the available resources for frontline work are not the people doing the frontline work. This dynamic is a common source for internal turbulence. When decisions are made (or not made) that appear to not improve or even worsen the conditions for frontline workers, the dynamic emerges as an erosion of trust, respect, and confidence.

When discussing this discovery, many leaders of these organizations acknowledge the division of labor between the deciders and the doers can be a source of conflict, but they rather quickly conclude that there really is no other way. I am not so sure.