Editor's Note: Exhaustion

In the middle of any struggle our minds hone only on the end. We reassure ourselves that the trial we are enduring will indeed end someday, and we play psychological games to predict when that might be, even when we realize no one can know for sure how long it will last.

Economists employ spreadsheet alchemy to predict when the gears of our economy will come unstuck, but even the best minds can only guess at how any complex system will respond to stimuli to which it has never been subjected. Even the economic stimulus package is named to convey that all the government can really do is to be that first small rock pushed down the hill in hopes of causing an avalanche.

At HealthLeaders we wanted to do a theme issue to offer guidance on how healthcare organizations could "survive" the current market. But the more I thought about it, the less it made sense to describe the current crisis in terms of survival. Most healthcare organizations—no matter how much uncompensated care shows up at their doors—will manage through to the end. What matters is what kind of industry will be there with them; and it is that insight we have gathered for this "Endurance Guide." In the window of a very few years, we predict in our cover story the impact of a public health plan, that the era of easy credit is gone for good in healthcare, and that despite some pressures favorable to consolidation, the IDS is not coming back.

What we can't supply is what your healthcare organization may need the most: the motivation to overcome the exhaustion. Your organization has probably laid off valuable people. Everyone else is working harder, either for dedication to mission or to avoid the pain of being jobless themselves. Either way the energy reserves required to keep up are running low now more than a year into the recession.

Those who truly endure will be those who manage the mood as much as the money. Leaders have to stay unflinchingly—but always genuinely—upbeat. Find small victories to celebrate. Share the bad news but don't dwell on it. Don't overburden the middle managers who have the most contact with key employees and patients. Do something silly. But above all just don't pretend that the end is in sight. You'll know on the day it is over. Not before.

Jim Molpus
Editor
jmolpus@healthleadersmedia.com