Authored by Leslie Ann Fox

As a recently retired CEO (2 ½ years ago), and currently a faculty member of the Center for Family Consultation,  I have been using the lens of Bowen family  systems thinking to reflect on the evolution of my thirty-nine year old healthcare consulting company, founded by myself and two partners in 1976 and sold in 2015. With the benefit of some distance from the organization, I am working to better understand my evolution as a leader, and how the performance of our leaders, managers and employees working in the company also evolved over that period of time.

Like all businesses, we had our challenges. From time to time, events occurred that caused seismic shifts in the services we offered, or changed our organizational structures, business processes, and financing. These nodal events impacted how well we performed our individual jobs, and on how well the business as a whole performed. The events were the result of both internal and external forces, such as key people entering or leaving the organization, significant changes in regulations, new technology, innovative competition and the ebb and flow of the US economy over four decades. Specific nodal events included the death of one of the three founding partners in 1979; a major change in reimbursement regulations in 1983; the entry of a new partner into the business in 1986; the retirement of a founding partner in 1996, and the transition from paper medical records to electronic medical records in the early 2000’s. The final nodal event was the transition that occurred when the company was sold and merged into a much larger organization in 2015. Today the legacy organization continues to grow and thrive within the larger organization, led by our company’s last President.

Acute anxiety usually spiked around the nodal events I noted above, but chronic anxiety, as I experienced it and as I observed it in the company, was fairly constant throughout the life of the company.   As one would expect in an emotional system, the anxiety played out in triangles and interlocking triangles among and between individual employees, departments and clients. It sometimes resulted in people quitting or being fired. We had our share of conflicts, cliques and gossip, failed projects, and unhappy clients, all symptoms of chronic anxiety in our system, and in the systems of those with whom we worked.  Alas, I describe the “human condition”. None-the-less we also had our successes, enough to be leaders in our field, create a good reputation in our industry, have long-term clients and employees, and  thrive for thirty-nine years.

As the only founding partner that remained with the company for the entire thirty-nine years, it is safe to assume that my own chronic anxiety and my efforts to manage that anxiety impacted everyone in the system, for better or worse on any given day. I began studying Bowen theory in 1988 and thereafter continuously worked to improve in my role as a leader, manager, and collaborator with staff and clients. This involved becoming more aware of the emotional process in our company, and being more present and accounted for in the system. It also entailed seeing and taking responsibility for the role I played in our difficulties as well as successes. I tried to think long and hard to express clearly my positions on the issues and challenges that arose, while allowing others to hold their own positions as we worked to observe and gather facts that would point the way for all of us to embrace new and wiser positions.

Ultimately I learned that my effectiveness as a leader was at its best when I formulated and clarified for myself the principles that guided my decisions, and the way I wanted to engage with staff and clients. The next important step for me was communicating frequently about those principles with others in the company, and working hard to live by them. In my final years of leading the company, I made it my mission to share my leadership journey with every employee, as well as to listen to their stories, learn about their hopes and dreams for the future, and challenge them to develop their own leadership skills and paths to success.  It was perhaps late in coming, but it was during those years that I became the leader I wanted for our company.