A month ago, I was talking with my editor about my next article. I’ve never written a typical healthcare prediction article, so we thought maybe this would be the year to try (cue laugh track). I could cover big topics like staffing, vaccines, technology, new delivery models, policy shifts, money shifts. But when I sat down to think about what I wanted to say that might be of actual value, I came up blank. Nada. Not a single prediction that I felt safe putting out in the world.

The problem is that my crystal ball has spikes … protein spikes. I don’t even want to touch it, never mind put my face close enough to gaze into its depths.

In the last few weeks in healthcare, we’ve seen the rise of a new COVID-19 variant, workplaces bringing employees back and then sending them home again, lawsuits, more trouble accessing medical supplies, and other “disruptors.” Put a handful of experts on any of these topics in a room and you’ll get five different opinions.

If I had tried to share predictions, they would have sounded like a Hollywood fortuneteller’s cliches. You will soon find something you lost (hopefully staff). Someone close to you will offer advice you should heed (possibly contradicted a day later). And a secret admirer will soon be revealed (fingers crossed that it’s a swarm of happy patients telling you what a great job you’re doing).

Surprisingly, what I discovered instead of predictions was clarity. It’s clear that a greater level of uncertainty will be our constant, probably for the next few years. Will our conferences in the spring be held in person? I don’t know. Will our hybrid workplace strategy play out as we planned? I don’t know. Will we be able to attract and retain all the staff we would like? I don’t know.

I’ve long been a believer that a leader’s most important job is managing ambiguity. To do the job well, we have to leverage both flexibility—being agile and adaptable to changing circumstances and new insights—and certainty—focusing on what we know now and what we can control to make the best possible decisions. When we’re low on one, we need more of the other.

The next year will test our capacity for flexibility as much as the last two years have, at a time when our desire for certainty is high. I don’t mean workplace flexibility. I mean leadership and organizational flexibility. The best thing we can do to prepare for a good 2022, in which we keep our organizations and teams moving in a positive direction, is to increase that capacity. How?

First, get very clear on what matters most.

Being flexible requires strength in our core, as dancer and social psychologist Jennifer Jordan has explained. As leaders of organizations, we have to strengthen the core by becoming crystal clear on what matters most and where we can and cannot bend. Then, we can use our greatest priorities and values to drive every decision and strategy. We might have to change course a month or three down the line, but if the original decision brought us closer to our highest goals, we’ll have made the right kind of progress.

Second, invite more opinions and perspectives.

The human brain “perceives ambiguity as a threat,” wrote sociologist Christine Carter. And then it tries “to protect us by diminishing our ability to focus on anything other than creating certainty.” When we’re in the midst of a mental threat response, we have a tendency to develop tunnel vision, which narrows our information gathering. We fall victim to confirmation bias, turning to sources we think will likely confirm what we already believe.

To make the best decisions, we need to fight that tendency. When fear threatens to dominate, we need to focus on creating psychological safety in our teams instead. We can do this by putting systems and people in place that help check our biases.

Third, be prepared to abandon “how we do things.”

I’m writing about healthcare, so I feel the need to follow that headline with, “Don’t abandon any process that ensures the safety of patients.” But in a recent Harvard Business Review article, Amy Edmondson and Ranjay Gulati revealed that the key to responding well to an unforeseen challenge or opportunity is to “deviate from conventional ways of doing things.” The companies they studied were agile in important moments because they abandoned how they typically operate and did something fast and different, but not sloppy or haphazard.

In healthcare, process is king for good reason. But that doesn’t mean our leadership processes should be, especially when we need to be flexible.

Finally, do whatever it takes to battle burnout.

In 2022, burnout will be our greatest leadership challenge, because it’s the root of so many others. A recent MGMA Stat poll found that in 2021, 33 percent of practices had physicians leave or retire because of burnout. Constantly trying to overcome or tamp down the brain’s threat response and tendency to hyper-focus on certainty only increases our mental and emotional exhaustion.

At times like these, it becomes more important than ever to take care of ourselves and our teams. We need to give ourselves a break and a bit of grace. We need to focus on building cultures that breed support and wellbeing. And we need to honestly examine what’s happening in our organizations that’s making the problem worse.


Your crystal ball for your organization might be sharper than mine, but I wouldn’t count on anything you see in its swirly center. Instead, focus on those things you can control now, and replenish your capacity for adjusting and adapting as you move forward. With the high levels of uncertainty sure to stick with us, it’s your best bet for a successful year.