Health System Leaders Face Disruption and Uncertainty in 2024

Doctors and health professionals looking over a clipboard together in a hospital setting

Senior health care executives recently shared their predictions for both challenges and opportunities in the year ahead. They include persistent issues such as evolving business models, high labor costs, talent retention, and new factors including virtual nursing and customized patient experiences. The bottom line is that leaders in health systems will be navigating turbulence and change ahead. 

The views, shared in an article in Chief Healthcare Executive, reflect the need for leaders ready to embrace complexity, make tough decisions amidst great ambiguity, and prioritize personal and organizational resilience. Dr. Leonard J. Marcus of Harvard T.H. Chan School of Public Health and Co-Program Director of Leading in Health Systems: Activating Transformational Change, noted that issues in the article, such as “overcoming the technological and cultural silos” within organizations, are not new.  

The ‘Meta-Leadership’ Approach in Health Care 

“Executives should picture themselves in the middle of the situation, not atop a hierarchy,” Dr. Marcus said. “This reveals the need to lead up to whomever they are accountable, across to their peers, and beyond to patients and other external stakeholders, as much as they lead down to their teams. It’s a multi-dimensional approach we call ‘meta-leadership’—and it is particularly useful in times of significant change. 

Dr. Marcus also noted that this meta-leadership perspective allows a leader to see the larger system, including opportunities to link and leverage expertise, resources, and innovations. It makes it easier to generate unity of mission and purpose while enabling necessary freedom of action throughout the enterprise.  

Ongoing Impacts of the Pandemic and Rise of Technology 

Eric J. McNulty, also of the Harvard Chan School and Co-Program Director of Leading in Health Systems, said that the pandemic’s lingering effects and the rapid rise of artificial intelligence (AI) tools are fundamentally altering the health care landscape.  

“We are seeing a historically tight labor market with rising costs, demands for remote work options not always compatible with health care, and continued difficulties attracting workers,” McNulty noted. “Stress among both worker and patient populations continues to rise. New technologies offer both hope and peril.” 

“Meeting the moment is not about picking the right software program or device. Leaders are being called to engage in the very hard and very human work of bringing people into an uncertain future with hope and confidence. They need to demonstrate both character and competence.” 

Developing Negotiation and Conflict Resolution Skills 

Dr. Marcus noted that one aspect of the curriculum that he and McNulty teach in executive education programs such as Leading in Health Systems is negotiation and conflict resolution.

“When you are faced with stakeholders with differing interests and perspectives, leadership is negotiation,” Dr. Marcus said. “That’s why we incorporate pragmatic techniques useful in any meeting or interaction. Participants report that this is a valuable addition to their change leadership toolkit.” 

Investing in the Future of Health Care 

“It is important to realize that leadership shouldn’t be limited to the C-suite,” McNulty said. “The health systems that survive and thrive will be those that develop leadership capacity throughout the organization because it will make them more responsive and resilient. And investing in people makes them more likely to stay and be highly engaged.” 

Demand for quality care will continue to rise. The economic, technological, and social pressures on healthcare organizations and their leaders will increase as well.  

“This is what we call a ‘you’re it’ moment,” Dr. Marcus noted. “You have to make sure you have the right leaders in place, and that they are recharged and equipped with the mindset and skills to see a future as exciting as it is daunting.” 


 Dr. Leonard J. Marcus and Eric J. McNulty are founding director and associate director of the Program on Healthcare Negotiation and Conflict Resolution at the Harvard T.H. Chan School of Public Health. They are program co-directors of the Leading in Health Systems: Activating Transformational Change executive education program offered by the Harvard Chan School. They are also co-authors of Renegotiating Healthcare: Resolving Conflict to Build Collaboration.