A Journey to Pathology 3.0: Post-consolidation Blues

Many of us wonder why the odds seem not to stack in our favour as we progress with pathology transformation. We have already mentioned some who hope to autopilot the system into a new state through the magic of ‘muscle memory’. It just does not work.

Also, I am not going to waste my time talking about the minority with interests vested in the status quo. However, I would like to draw attention to a silent but significant number in the transitional no-man's land. Many of them may be compressing their transitional anxieties by over-romanticising the past when everything was small, simple, and familiar; remember the proverbial ‘watercooler conversations’ and other retro bliss that we cannot replicate if we are to operate services at the scale that we have to.

However, the maladaptive patterns described above are natural and powerful; every one of us was there at some point in our lives. Many of us who fancy ourselves as innovators and champions of change may treat colleagues who show them contemptuously and view ‘change resistance’ as an ideological asylum for those lacking the imagination or competencies to be part of the progress. This misplaced elitism is dangerous; see how this type of intellectual snobbery backfired on the other side of the Atlantic.

Unfortunately, contemporary social and cultural trends– and we cannot escape them in our professional environments – favour segregation of views in self-amplifying silos. ?To manage this – and these are fundamentals of managing transitions- we must provide a shared cultural space- a set of common values, meanings, beliefs and norms that connect people with different opinions to a shared reality.

A safe starting point for managing acculturation and innovating simultaneously is to shift the attention outwards by investing the team’s energy in understanding and delivering on the needs of service users. This has a powerful impact on the team's internal dynamic.

Our Clinical Biochemistry team experienced quite heavy post-consolidation blues a couple of years ago. Clinical Scientists from four distinct organisations, each with unique working practices and vastly different cultures, additionally burdened by high anticipatory anxiety, needed to coalesce into a high-performing team. Innovation therapy worked well; it required positive internal adjustments and intellectual stretch beyond the comfort zone, but it re-energised the team and turbo-charged regional integration. Departure from the traditional hospital-based generalist to a cross-organisational subspecialist model with a user-centric agenda moved the Clinical Scientist team into a new space. It forged new clinical connections across a wider geography.

The organisational development programme was purposefully named “Next-generation Clinical Biochemistry for Black Country” to send a positive signal that the emphasis is on the long-term approach and the commitment to integration of care. ?It enabled Clinical Biochemists to redefine their professional roles, reignite their career ambitions, and gain a sense of agency rather than feeling marginalised by the laboratory merger.

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