Health Maintenance Organization: Polarities Management

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Healthcare management has taken leaping strides in the last decade; it has become complex hub of diversified activities and conflicting interests. This requires for close examination to improve the service project and manage the interdependent interests under one mission of enhanced integrated service.. The primary focus of customer service improvement would be to understand the management criteria and relate the importance of service improvement as the key factor which would strengthen the customer satisfaction in the long run. The concept of polarity management coined by Barry Johnson, in his book “Polarity Management” seems to offer a solution to the complex management issues related to healthcare, where it is conglomeration of conflicting interest presented in large group rather than individual case.

Health care management is unique in its needs for management related issues where the opposing views are existing and change is not that easy to implement. There is probability that there does not exist a clear, single solution which is best choice for all. The importance of initiating a requirement for change within the system for the benefit of the customers would require harmony and understanding of the management and the physicians as team. Cost and quality care are two major factors which impact the service improvement for customers in the health care maintenance. The complexity of healthcare management can be evaluated and optimized in the area of customer service by including the strategy of polarity management in the harmonious networking of representatives, physicians and administrations.

Based on the criterion of assessing this healthcare organization based on the fundamental polarity management, the most prominent polarity which is visible is the polarity of centralization and centralization which is very intricately tied in with the cost and quality factors. The health care organization needs to adopt an integrated healthcare system which is built by bringing together various units like hospitals and physicians under one stem to serve the customer. This is necessary to have cohesive force which works together to serve the customer and enhance the customer service. The regional and focus area differences and conflicts do emerge in such conditions. This is caused by the differences in their philosophies and their cultures of work. They operate at different levels.

These polarities need to be judiciously identified by the managers to resolve these conflicting situations. This would ensure success and growth of the organization in the field of healthcare and optimization. The key elements of polarity management have been comprehensively identified in the in the study published by Burns in 1999, in his paper “Polarity Management: The Key Challenge for Integrated Health Systems”. Burns identifies nine polarities, which are prevalent I healthcare systems in Illinois. These polarities merge as the need for numerous entities merge on the competing levels with the framework of the management. The most prominent among them are decentralization and centralization, where the there is conflict between administration seeking interdependence and centralization the physicians seek for decentralization and autonomy.

The team members need to understand the complex scenario under which the objective of optimization of customer service is reached. The biggest challenge for the administration is to identify the centralization and decentralization polarity and to address the issue in the context of optimization of customer service for this large regional healthcare organization. The aim should be to balance and manage the inherent tensions or polarities and to create win-win situation for all the participants present in the form of

representatives from the patient community who want quality care at a good price; physicians who want flexible time with each patient and administration who wants to maximize the patient per physician ratio. Once the polarity is identified, and the fundamental polarity is selected to address for the benefit of the team, which will result in the optimization of the customer service.

The conflict between the physician and the integrated health system is one of the most prominent factor which results in polarity issue impacting the full and optimized customer service to the clients. sought to integrate different professional groups with different orientations. Physicians’ needs and interests were often polar opposites of those of the hospital system, requiring hospitals to develop capabilities in “polarity management” that enable harmonization of radically different cultures and incentives. (Burns, 1999)There is need to integrate different businesses with divergent incentives, scales, and capital requirements—often leading to deteriorating power struggles and conflicts of interest. (Goldsmith,2002) A growing body of research on corporate change has recognized the importance of managing polar opposites, conflicting values, and paradox. (Collins and Porraas, 1994)Successful firms are those that can operate both globally and locally, be both centralized and decentralized, and employ both top-down and bottom-up planning. ( Beer and Nohria, 1997)

The polarity between the healthcare system and the physicians, takes new turn of collective action for safeguarding their interests and rights which guarantees them greater economic security. The effort should be made to bridge the gap between the medical groups and their role in governance. This allows for the optimization of customer service and enhanced benefits for both the administration as well as the physicians.

The Polarity Map

The original source of the concept of polarity map has been Dr. Barry Johnson, who addresses the increasing dilemmas which challenge the unsolved situation by visual concept of the polarity map. He claims that these existing and newly merging problems are related to changes within the system and are real polarities which minimize the optimum benefit to any organization and factors related to the organization. Thus it harms the relationship and the customer service, and in the long run is detrimental to the economic aspect of organization. “This approach assumes that we can manage many apparent organizational problems by achieving a balance between the upsides of two opposite points of view while minimizing the downsides of each.” ( Johnson,1996) The elements which are inherent in this model is based on first determining the opposite poles or points of view. This very progressively impacts the issues related to quality vs. productivity and individual vs. team management. They are represented as individual vs. team issues related to polarity as in healthcare, the individual and team work, worked hand in hand. The system needs to provide service to an individual client and the service itself is effectively given by teamwork of system administrators and the physicians. The figure below presents the polarity map as deigned by Johnson to present the ongoing tensions and their respective solutions.

Individual/ Team Polarity

Application of Polarity Management

In the words of Johnson, the skill of polarity management is one tool among many which help in critical problem solving which enhances and motivates a team to work more productively and harmoniously. A little touch of understanding, listening and persuasion with flexible attitude to embrace new change is what the dynamics related to polarity management has to offer to the organization. In the case of the present health care organization it can help in optimization of the customer service and healthy working relationship administration and the physicians and development of the organization on the optimum scale. This new skill can make our life more simple and conflict free. It offers frce which integrates in the dynamic way with the organization, to enhance the interpersonal growth giving impetus ot optimization of services and advancement of the organization. The ultimate goal is to solve identify, examine and solve the problem.

Work Cited

Burns, L.R. (1999). “Polarity Management: The Key Challenge for Integrated Health Systems,” Journal of Healthcare Management 44, no. 1: 14–33.

Goldsmith, Jeff( 2002). Integrating Care: A Talk With Kaiser Permanente’s David Lawrence.

Collins, J.C. and Porras, J.I. (1994). Built to Last: Successful Habits of Visionary Companies.New York: HarperCollins.

Hampden-Turner, C. and Trompenaars, F. (2000) Building Cross-Cultural Competence: How to Create Wealth from Conflicting Values.New Haven, Conn.: Yale University Press.

Beer, M. and Nohria, N. (1999). Breaking the Code of Change.Boston: Harvard Business School..

Kohn, M.D. Martin S. (2007) “Rapid Change in Healthcare Organizations”, HIMSS. Web.

Kathryn J. Deiss.(1997) A Different Approach to “Unsolvable” Problems by, Senior Program Officer for Leadership Development. Web.

Johnson, Barry. (1996). Polarity Management: Identifying and Managing Unsolvable Problems, HRDPress: Amherst, MA,

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