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  • AI isn’t failing - our organisations are. The productivity drought is a leadership and structural problem, not a technological one
  • We’re performing AI, not adopting it. Pilots succeed, scaling fails, and cosmetic innovation masquerades as transformation
  • Efficiency ≠ productivity. Incremental automation delivers convenience, not the step-change gains many industries promise
  • Rigid 20th-century institutions can’t absorb 21st-century intelligence. Stagnant data estates, siloed structures and risk-averse cultures sabotage AI’s potential
  • The oasis exists - few have reached it. Outliers in healthcare like Mayo, Moderna and Kaiser prove that AI delivers only when organisations rebuild themselves around continuous learning and adaptive design

The Great Productivity Mirage

Spend ten minutes with today’s headlines and you will be assured that healthcare, pharma, biotech and MedTech stand at the dawn of an algorithmic renaissance - an AI-powered golden age promising to collapse cost curves, accelerate discovery, liberate clinicians, smooth supply chains and lift productivity to heights not seen since the invention of modern medicine. Tech CEOs describe this future with evangelical conviction. Governments publish forecasts with a confidence outpacing their comprehension of the technologies they reference. Investors declare that artificial intelligence will eclipse every previous technological revolution - from electrification to the internet - propelling the life sciences into an era of significant growth.

A future of abundance is presented as inevitable. To question this narrative is to risk sounding regressive. To express doubt feels irresponsible.

And yet, against this rising tide of triumphalism sits a stubborn, increasingly uncomfortable fact: the much-promised productivity boom is not materialising. Not in health systems straining to meet demand, where administrative drag still consumes up to half of clinicians’ time and waitlists continue to grow. Not in pharmaceutical pipelines, where development cycles have lengthened as R&D spending reaches record highs. Not in MedTech manufacturing, where efficiency gains remain incremental. Not in biotech labs, where experiments still unfold at the pace of manual workflows rather than automated discovery. Everywhere you look, productivity curves remain flat - barely flickering in response to the noise, investment and rhetoric surrounding the AI “revolution.”
A new episode of HealthPadTalks is available!
 
Should MedTech leaders be evaluated with the same rigour as airline pilots? Pilots undergo intensive, twice-yearly assessments because lives are at stake. Yet executives making life-impacting decisions are judged largely on short-term financial metrics. Pilot-Grade Leadership, the new episode of HealthPadTalks, argues for a pilot-inspired, holistic appraisal model - spanning ethics, crisis readiness, communication, compliance, and teamwork - for the MedTech C-suite. 
 
This is not a hidden truth; it is visible. Despite years of accelerating AI adoption, expanding budgets and soaring expectations, productivity across advanced economies continues to hover near historical lows, and healthcare is no exception. The gulf between AI’s transformative promise and its measurable economic impact widens each year, creating what might be called the Great Productivity Mirage - a shimmering horizon of anticipated progress that seems to recede the closer we get to it.

This paradox is not technological, but organisational. AI is not failing. We are failing to adopt it properly. And unless healthcare and life sciences leaders confront this fact with strategic honesty, the industry will continue pouring billions into tools that produce activity without impact. AI does not generate productivity. Organisations do. AI does not transform industries. Leaders do. AI is not the protagonist of this story. We are.

 
In this Commentary

This Commentary is a call to healthcare leaders to reconsider the foundations upon which AI is being deployed. It argues that the barrier to productivity is not the algorithms but the surrounding environment: the leadership mindset, the organisational architecture, the culture of work, the data landscape, the talent pool and the willingness to embrace disruption rather than decorate the status quo.
 
The Mirage in Plain Sight

Across advanced economies, productivity growth has been slowing markedly since the mid-2000s - a trend that has persisted despite rapid advances in digital and AI technologies. In healthcare and the life sciences, decades of technological advances have done little to shift the underlying reality: performance and productivity metrics have remained largely stagnant.

Hospitals continue to buckle under administrative load; workforce shortages deepen; and clinicians often spend more time navigating digital systems than engaging with patients. Supply chains remain opaque and fragile, while clinical-trial timelines stretch ever longer. R&D spend rises faster than inflation, and manufacturing operations still depend on legacy systems that resist integration. Meanwhile, the overall cost of care marches steadily upward. Perhaps most striking is the endurance of Eroom’s Law - the paradoxical pattern in which drug discovery grows slower and more expensive despite significant technological advances, a trajectory that still defines much of today’s R&D landscape.

This should not be happening. Historically, when general-purpose technologies reach maturity, their impact is unmistakable. Electricity radically reorganised industrial production and domestic life. The internal combustion engine reshaped cities and mobility. The internet collapsed distance and transformed nearly every aspect of organisational coordination. These technologies did not nibble at the edges; they delivered abrupt, structural changes.

 
By that logic, AI should be altering the trajectory of health and life sciences productivity. The data-rich, labour-constrained, complexity-intensive nature of the sector makes it theoretically ideal for algorithmic acceleration. Yet the promised boom fails to materialise. The needle barely flickers.

It is not that organisations lack enthusiasm. Everywhere you look, AI is showcased with confidence. Press releases trumpet “AI-enabled transformation.” Board presentations glow with colourful dashboards and heatmaps. Strategy documents overflow with algorithmic ambition. Conferences are filled with case studies describing pilots that “could revolutionise” clinical pathways, drug discovery, trial recruitment or manufacturing efficiency. But speak to the people doing the work, and the illusion begins to fracture.

The AI-enabled triage system that once dazzled executives now triggers alerts for almost half of all cases because its decision rules fail to capture the complexity and textual judgement inherent in clinical practice.

The predictive model that appeared infallible in controlled testing collapses when confronted with inconsistent, delayed, or missing patient data. The documentation automation designed to save time generates drafts that clinicians spend longer correcting than they would have spent writing themselves. The MedTech manufacturing optimiser that performed flawlessly in simulation proves brittle the moment an exception or unexpected deviation occurs. Hospital workflows splinter as clinicians move between multiple systems, attempting to reconcile conflicting outputs and unclear recommendations. The pattern repeats across organisations: AI is highly visible, yet the productivity it promised remains stubbornly out of reach.

In most cases, the technology is not the failure. The environment around it is. AI shines under controlled conditions but struggles in the complexity of real operational systems. What organisations interpret as an AI problem is nearly always an organisational one. The productivity mirage is not a technological paradox. It is a leadership and structural paradox.

 
Performing AI Instead of Adopting It

Most organisations are not implementing AI - they are performing it. They deploy AI as a theatrical signal of modernity, an emblem of innovation, a cosmetic layer added atop processes whose underlying assumptions have not been reconsidered for decades.

This performative adoption follows a familiar script. Leaders announce an AI initiative. A pilot is launched. Early results are celebrated. A success story is published. Keynotes are delivered. The pilot is slightly expanded. And then . . . nothing meaningful changes. The system remains structurally identical, only now adorned with a few machine-generated insights that rarely influence decisions in any significant way.
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This cycle generates motion but not momentum. The organisation convinces itself that it is innovating, when in fact it is polishing pieces of a system that should have been redesigned. These incremental steps shave minutes off processes that need reengineering. They create pockets of efficiency without generating productivity. They allow organisations to appear modern while avoiding structural change.
In healthcare and the life sciences, this incrementalism is seductive. The sectors are risk-averse by design, bound by regulatory scrutiny, professional norms and institutional inertia. Leaders often seek the illusion of progress without confronting the complexity of change. But incrementalism is not neutral - it is a trap. It creates a false sense of advancement that prevents transformation. The result is an economy overflowing with AI activity but starved of AI impact.
 
The Leadership Gap: When 20th-Century Minds Meet 21st-Century Intelligence

A driver of the productivity mirage is the leadership mindset that dominates healthcare and the life sciences. Many senior leaders built their careers in an era that rewarded mastery of stability, long-range planning, controlled change and carefully optimised processes. They succeeded in systems where efficiency, predictability and compliance were the keys to performance.

But AI does not behave according to these rules. It is not linear, stable, predictable or controllable in the ways earlier technologies were. AI thrives on ambiguity; it improves through experimentation; it evolves through iteration; it rewards rapid learning and punishes rigidity. It is not a tool to be installed but a capability to be cultivated. It does not fit neatly within pre-existing governance frameworks; it demands new ones.

To leaders trained to minimise variability, AI’s adaptive nature appears chaotic. To leaders comfortable with regular, fixed decision cycles, AI’s dynamic responsiveness seems reckless. To leaders schooled in long-term planning, AI’s iterative experimentation feels unstructured. The consequence is significant: leaders often misunderstand what AI requires. They treat it as a procurement decision rather than an organisational transformation. They expect plug-and-play solutions when AI demands a rethinking of workflows, culture, incentives, governance structures and talent models. They look for quick wins while ignoring the long-term capability-building necessary to unlock value.

This leadership-capability gap is one of the most significant obstacles to realising AI’s productivity potential. AI punishes the wrong kind of intelligence - the intelligence optimised for linear stability rather than exponential change.

 
The Structural Incompatibility of AI and Traditional Healthcare Organisations

Even the most visionary leaders face a second barrier: the structural design of healthcare, pharma, biotech and MedTech organisations. These institutions were built for a world defined by control, standardisation and incremental improvement. Their architecture - hierarchical, siloed, compliance-heavy, process-centric - served them well in an era where efficiency was prized above adaptability.

AI, however, requires a different organisational substrate. It requires a system capable of continuous learning, not fixed processes. It demands fluid collaboration rather than rigid silos. It relies on rapid decision cycles rather than annual planning horizons. It thrives on cross-functional problem-solving rather than vertical escalation. It depends on an environment where data flows freely, not one where they are trapped in incompatible systems. It benefits from cultures that treat mistakes as learning events rather than career-damaging missteps.

In essence, AI requires organisations capable of adaptation. But healthcare organisations have been engineered for predictability. Their structures assume that change is the exception, not the norm. Their governance models assume that the safest decision is the slowest one. Their cultures reward caution, not experimentation.

This structural misalignment explains why so many AI initiatives collapse when moved from pilot conditions into real environments. Pilots are protected from organisational reality. Scaling exposes the system’s fragility. An organisation built for stability cannot suddenly behave like a learning system because a new technology has been introduced. You cannot place a learning system inside an organisation that has forgotten how to learn.

 
Data: Healthcare’s Silent Saboteur

Nowhere is the structural challenge more visible than in the sector’s data estates. Healthcare and life sciences organisations often insist they are “data rich.” In theory, this is true. But in practice, the data are fragmented, inconsistent, incomplete, duplicated, outdated, poorly labelled, or trapped in incompatible systems that cannot communicate.

In hospitals, critical patient data are trapped in electronic health records designed for billing rather than care. In pharmaceutical R&D, historical trial data are scattered across incompatible formats or locked within proprietary vendor systems. In clinical trials, important operational data are captured inconsistently across sites. In MedTech manufacturing, aging systems and paper-based records - often still maintained in handwritten ledgers - capture only a narrow view of what modern optimization requires. In biotech labs, experimental data are often stored in ad hoc formats or personal devices, rendering them unusable for machine learning.
Most organisations do not possess a unified, clean, connected data infrastructure. They possess industrial waste - abundant but unusable without extensive processing. And when AI systems fail, mis-predict, hallucinate or degrade, the blame is usually placed on the model rather than the environment. But intelligence, whether human or artificial, cannot thrive on contaminated inputs.
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MedTech’s Comfort Crisis

The data problem is not a technical issue. It is an organisational one. It reflects decades of underinvestment in foundational infrastructure, incompatible incentives between departments and a cultural undervaluing of data governance. AI will not fix this. The environment must.
 
The Efficiency Trap: When Convenience Masquerades as Productivity

Healthcare organisations often conflate efficiency with productivity. They celebrate time savings or task automation as evidence of breakthrough transformation. They introduce AI-enabled documentation tools, intelligent scheduling assistants, automated reminders and workflow streamliners, believing these conveniences signify strategic progress.

But efficiency reduces cost; productivity increases value. Efficiency optimises the existing system; productivity redefines it. A hospital that automates documentation but leaves its care pathways unchanged has not become more productive. A biotech lab that accelerates data cleaning but leaves its experimental design untouched has not significantly increased discovery throughput. A pharmaceutical company that uses AI to scan chemical space more quickly but retains the same decision frameworks and governance structures has not accelerated R&D.

Convenience is not transformation. Marginal gains do not accumulate into structural change. The efficiency trap convinces organisations that they are evolving when in fact they are polishing the familiar.

 
Why AI Pilots Succeed but AI at Scale Fails

The healthcare and life-sciences landscape is strewn with promising AI pilots that never progress beyond their contained proving grounds. Pilots often succeed because they operate in isolation: they are sheltered from the organisational realities that determine productivity. In these controlled environments, teams can bypass inconsistent workflows, fragmented responsibilities, conflicting incentives, regulatory drag, brittle data pipelines, legacy IT constraints, procurement bottlenecks, risk-averse governance structures, and the professional identity concerns that shape day-to-day behaviour. A pilot succeeds because it is allowed to ignore the messy context in which value must be created.

Scaling, however, removes that insulation. When an AI system is introduced into routine operations, it collides with the frictions the pilot was designed to escape. Variability in clinical practice, the politics of cross-departmental collaboration, the inertia of entrenched processes, and the anxieties of staff asked to change their habits all reassert themselves. Data quality deteriorates once curated pipelines give way to real-world inputs. Compliance questions multiply. Accountability becomes ambiguous. What once looked like a technical victory is revealed to be an organisational challenge. The algorithm did not fail. The organisation did - not because it lacked technology, but because it lacked the conditions required for technology to take root.

 
The Hard Truth: AI Will Not Rescue Rigid Organisations

Many executives take comfort in the idea that the productivity gains promised by AI are deferred - that the next generation of models, the next leap in computational power, or the next wave of breakthrough applications will deliver transformative impact. This belief is understandable, but it is wishful thinking.

More powerful AI will not save organisations whose structures, cultures, and leadership models are misaligned with what AI needs to thrive. In fact, greater model capability often exposes organisational weaknesses rather than compensating for them. As AI systems become more capable, they demand clearer decision rights, cleaner data, faster iteration cycles, cross-functional cooperation, and leaders who can tolerate ambiguity and distribute authority. Where these conditions are absent, improvement stalls.

AI is an accelerant, not a remedy. It amplifies strengths and magnifies dysfunction. It rewards organisations that are adaptable - those willing to redesign workflows, challenge inherited norms, and cultivate teams able to integrate machine intelligence into everyday practice. But it punishes rigidity. Hierarchical bottlenecks, siloed teams, slow governance, and cultures resistant to experimentation become more obstructive when AI enters the system.

The result is divergence, not uplift. A small subset of organisations use AI to compound capability and pull further ahead, while many others - despite similar access to technology - see little return. The oasis of AI-driven productivity is real, but it will not materialise for organisations that attempt to modernise by applying new tools to old logic.

 
The Outliers: What Real Success Looks Like

Across healthcare, a handful of organisations - from Mayo Clinic’s AI-enabled clinical decision support programmes to Moderna’s algorithm-driven R&D engine and Kaiser Permanente’s predictive-analytics-powered care operations - have escaped the productivity mirage. They succeeded not by installing AI, but by rebuilding themselves around AI. Their trajectories offer a blueprint for what healthcare and life sciences could become.

These organisations treat data as a strategic foundation rather than an operational by-product. Moderna, for example, built a unified data and digital backbone long before it paid off, enabling its teams to iterate vaccine candidates in days instead of months. They collapse unnecessary hierarchy to accelerate decision-making - much like the Mayo Clinic task forces that integrate clinicians, data scientists, and engineers to deploy and refine AI safely inside clinical workflows. They empower multidisciplinary teams that blend domain expertise with technical skill, and they redesign workflows around intelligence rather than habit. Kaiser Permanente’s reconfigured care pathways for sepsis and hospital-acquired deterioration, guided by real-time machine-learning alerts, illustrate what this looks like in practice.

They manage risk through rapid experimentation rather than rigid prohibition, piloting fast, learning fast, and scaling only what works. They build continuous feedback loops in which humans and machines learn from each other - radiologists refining imaging models, or pharmacologists improving compound-screening algorithms - allowing both to evolve. Their gains are structural. They compress cycle times. They open new revenue streams. They elevate customer and patient experience. They increase innovation capacity. And critically, their employees feel more capable, not displaced, because AI augments human judgment rather than replaces it. These outliers prove the oasis exists. They also show how rare it is - and how much disciplined organisational work is required to reach it.

 
Healthcare’s Path Out of the Mirage

If healthcare, pharma, biotech and MedTech are to escape the Great Productivity Mirage, they must accept a truth: technology alone does not create productivity. The barrier is not the algorithm but the conditions into which the algorithm is deployed. Escaping the mirage requires a shift in leadership logic, organisational architecture, cultural norms, data discipline and talent models. It requires leaders willing to embrace ambiguity, nurture continuous learning and redesign the foundations rather than the surface. This is not an incremental challenge. It is a generational one.
 
Takeaways

The Great Productivity Mirage does not prove that AI is overhyped or ineffective. It proves that we have misjudged what AI requires and misunderstood what transformation demands. We have sought impact without capability, intelligence without redesign, revolution without revolutionary effort. But the promise remains real. The oasis is not fictional. It is visible in the healthcare organisations that have already rebuilt themselves around intelligence. The question now is whether others will do the same. AI is not the protagonist. We are. The future of healthcare depends not on the next breakthrough in models but on the next breakthrough in leadership. The productivity revolution is waiting. It is time to stop admiring the mirage - and start building the oasis.
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  • In 2024, Gen Z surpassed Baby Boomers in the US workforce, triggering cultural shifts
  • Their emphasis on flexibility, purpose, and mental health may amplify professional restlessness, pushing organisations to adapt
  • Gen Z employees may seek change after a few years, driven by unmet expectations, a desire for impact, and a need for novelty
  • Addressing this "seven-year itch" through growth opportunities and meaningful engagement can help retain top talent
  • This Commentary provides actionable strategies to align with Gen Z priorities, essential for attracting and keeping young leaders
 
The Seven-Year 'Itch' in Companies

The workplace is undergoing a generational shift, with Generation Z (Gen Z) surpassing Baby Boomers in 2024 as the largest group in the US full-time workforce. This transformation introduces a new set of values, expectations, and behaviours that challenge traditional workplace norms. Gen Z’s ethos - characterised by a strong emphasis on purpose, flexibility, and inclusivity - may accelerate cycles of professional restlessness, reshaping the structures and dynamics of modern organisations.

The concept of the "seven-year itch", often associated with phases of dissatisfaction in personal relationships, finds a parallel in the corporate world. Employees, particularly those who feel their career trajectories have stagnated, frequently experience similar restlessness after years in the same role or organisation. This professional “itch” often arises from unmet expectations, a lack of growth opportunities, and the intrinsic human desire for change.

For leaders, this turning point can prompt a reassessment of goals, ambitions, and alignment with organisational values. Without meaningful challenges or a clear path forward, many employees are driven to explore new opportunities - not from disloyalty, but from a need for professional fulfilment and purpose. Like personal relationships, professional careers often begin with optimism and ambition, yet can become routine as visionary goals give way to operational demands. Recognising and addressing this restlessness is essential not only for individual growth but also for sustaining long-term organisational success in an evolving business landscape.

 
In this Commentary

This Commentary explores the concept of the "seven-year itch" in professional contexts, examining why employees often experience restlessness or dissatisfaction after a period in a role. It delves into the expectation gap, the search for impact, and the human need for novelty, highlighting organisational implications. The Commentary also considers how Generation Z's workplace values - such as flexibility, purpose, and mental health awareness - may accelerate this phenomenon, urging companies to adapt for sustained engagement and retention.
 
The Expectation Gap: A Key Catalyst for Discontent

The "seven-year itch" in a professional context often arises from a growing disparity between employees' aspirations and the realities of their role. This disconnect is likely to intensify as Gen Z increasingly replaces Baby Boomers in the workforce, reshaping workplace dynamics. For high achievers, who are accustomed to consistent recognition and advancement, such misalignment can be disheartening. Career trajectories often serve as a cornerstone of identity and self-worth, making stagnation - whether due to organisational barriers, limited promotional prospects, or uninspiring projects - feel personal. This divergence between ambition and reality fosters frustration, gradually eroding both satisfaction and motivation.

A Quest for Meaning and Impact
For many Gen Z employees, titles and compensation alone are insufficient; their drive is fuelled by the desire to create meaningful change. Yet, as time passes, some may find their influence waning, their ideas side-lined, or their contributions no longer yielding significant outcomes. This reduction of impact can lead to a sense of disillusionment, sparking a  search for roles or organisations where they can regain a sense of purpose, reconnect their efforts to meaningful outcomes, and align their work with their core values.

The Draw of Novelty and Renewal
Humans thrive on novelty, and employees are no exception. Just as personal relationships can lose their spark without renewal, professional roles can grow monotonous when stripped of fresh challenges. Many people excel in dynamic environments that require innovative thinking and problem-solving. When their roles become predictable or routine, the allure of a new setting - one that offers variety, fresh perspectives, and opportunities - becomes irresistible, compelling them to seek renewal in their careers.
 
Organisational Implications of the Professional Seven-Year Itch

Just as the "seven-year itch" can lead individuals in relationships to reconsider their commitments, a similar phenomenon in the corporate world prompts employees to question their professional loyalty. When growth, impact, and variety are lacking, talented individuals may feel driven to move on, seeking roles that better align with their aspirations for personal and professional fulfilment. Recognising this tendency is valuable for organisations, as it offers an opportunity to structure career paths that maintain people's engagement and satisfaction, potentially reducing turnover among high performers.
 
A Generational Shift: The Influence of Gen Z on the Seven-Year Itch
 
Smart leaders will recognise this shift as an opportunity rather than a disruption, proactively aligning organisational practices to these emerging priorities. By fostering purpose-driven cultures, embracing flexible work arrangements, investing in skills-based development, and prioritising mental health and wellness, forward-thinking executives can engage and retain Gen Z talent. Organisations that anticipate and respond to these expectations with agility and authenticity will not only adapt to the changing workforce but position themselves as employers of choice in an evolving business landscape. To assist in this regard, here are the changes Gen Z are expected to bring to workforces.

1. Purpose-Driven Work and Social Impact
Gen Z places a premium on purpose-driven careers, seeking roles that enable them to create a meaningful and positive impact. For this generation, work transcends financial security - it serves as a platform for driving societal and environmental change. Employers will increasingly face pressure to implement and transparently communicate socially responsible initiatives that resonate with these values. To attract and retain Gen Z talent, companies must embed these priorities into their operations, demonstrating a commitment to sustainable and ethical practices.

2. Digital Native Advantage and Technology Expectations
Raised in a tech-driven era, Gen Z has an innate proficiency with digital tools and a strong expectation for workplaces to match their technological fluency. They are drawn to companies that embrace innovation, prioritise cybersecurity, and adopt advanced, tech-enabled work models. Organisations slow to adapt risk losing out on this digitally savvy talent pool, as Gen Z seeks employers that leverage cutting-edge technologies and foster forward-thinking, agile environments.

3. Flexibility, Autonomy, and Work-Life Balance
The traditional 9-to-5 schedule often holds limited appeal for Gen Z, a generation that values flexibility, autonomy, and work-life balance. They are advocates for hybrid and remote roles, which empower them to manage their time more effectively and work in ways that align with their personal and professional priorities. To attract and retain this talent, companies must rethink conventional work structures, offering adaptable schedules and redefining career pathways to foster environments that prioritise individuality, productivity, and wellbeing.

4. Career Growth and Development Focus
Gen Z challenges the traditional career ladder by prioritising skills-based growth, lateral moves, and opportunities for continuous learning over hierarchical promotion. They value environments that provide regular feedback, mentorship, and diverse development opportunities, seeking roles that allow them to build adaptable, future-ready skill sets. This generational mindset motivates companies to rethink professional development strategies, investing in training programmes, mentorship initiatives, and personalised growth pathways.

5. Diversity, Equity, and Inclusion as Non-Negotiables
Diversity, equity, and inclusion (DEI) are non-negotiables for Gen Z, who expect meaningful and authentic efforts rather than gestures. This socially conscious generation values workplaces that champion inclusivity, representation, and fairness at every level. Companies that fail to cultivate a genuinely inclusive culture risk disengagement and high turnover among Gen Z employees. To meet these expectations, organisations must prioritise diverse hiring practices, implement impactful DEI training programmes, and establish equitable policies that foster belonging and promote long-term cultural change.

6. Mental Health Awareness and Wellness
Mental health is a priority for Gen Z, a generation that actively advocates for workplace wellness and openly addresses mental health challenges. They seek employers who normalise conversations around mental wellbeing and demonstrate a commitment to supporting it. To meet these expectations, companies must create a culture of psychological safety, offering comprehensive wellness programmes, flexible mental health days, and access to professional counselling as part of standard benefits. By prioritising mental health, organisations can foster a more engaged and resilient workforce.

7. Transparency and Trust
Transparency is a cornerstone value for Gen Z, who tend to be sceptical of organisations that operate without openness or clarity in decision-making. This generation seeks employers who foster trust through honest communication and actively involve employees in shaping workplace policies and strategies. To engage and retain Gen Z talent, companies must prioritise transparent leadership, encourage open dialogue, and create opportunities for meaningful employee input. By adopting these principles, organisations can build trust and strengthen their connection with this discerning workforce.

The findings from the 2024 CYPHER Learning study underscore these seven needs, revealing that tailored learning, supportive management, and trust are essential to retaining younger talented employees. By investing in customised training and development programmes, fostering transparency, and supporting mental health and wellness, companies can create environments that meet the evolving expectations of Gen Z, fostering long-term engagement and satisfaction in the workforce of tomorrow.

 
Takeaways

The "seven-year itch" in the workplace may be taking on a new, accelerated meaning as Gen Z reshapes workforce dynamics with their distinct values and priorities. This generation, entering their careers with a strong emphasis on growth, purpose, autonomy, and inclusivity, is driving an era where job satisfaction and organisational alignment are reassessed more frequently. Unlike previous generations, Gen Z's expectations for meaningful work and rapid professional development create a challenge - and an opportunity - for companies. Employers who embrace this shift by fostering environments of transparency, inclusivity, and flexibility will not only navigate higher turnover rates but also build stronger, more resilient teams. By prioritising professional development and aligning with the evolving expectations of their workforce, organisations can position themselves as leaders in attracting and retaining top talent in an era of dynamic workplace transformation. Recognising this shift is not optional but essential to thriving in the modern world of work.
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  • Amidst rapid technological advancements, shifting demographics, volatile markets, and geopolitical turbulence, corporate boards grapple with multifaceted responsibilities to steer their enterprises towards sustainable, long-term growth
  • The relentless pace of change demands directors to be adaptable and strategic 
  • Given these dynamics, traditional approaches to board effectiveness should be re-evaluated and enhanced to equip directors with the essential tools for enduring success in today's business environment
 
Reimagining Boards
 
The role of boards of directors has been transformed since their inception in the late 18th or early 19th century. Initially tasked with safeguarding shareholder interests during nascent industrialisation and within smaller-scale enterprises, boards now face additional challenges. The 21st century is marked by rapid technological advancements, significant demographic shifts, volatile global markets, and geopolitical turbulence, all of which converge to test organisational resilience and innovation. Despite this evolving landscape, boards continue to have a fundamental duty of protecting shareholder interests. Directors are elected by shareholders to provide guidance, set strategy and oversee management. Thus, they shoulder the responsibility of ensuring sustained growth and vitality for the entities they govern. However, the accelerating pace of change on many fronts requires boards to manage with agility. Effective communication between executive and non-executive directors, as well as among the latter, is crucial in this endeavour. Notwithstanding, the perception of harmony among corporate colleagues may mask underlying areas for improvement that tend to surface during moments of crisis. Against this backdrop of increasing complexity and the pervasive influence of advancing technologies across all sectors, complacency in communication poses a threat to governance effectiveness. Thus, there is a need to reimagine board strategies to align with the demands of a rapidly changing business ecosystem. Cultivating a culture of mutual respect, agility, and innovation is essential for directors to effectively manage uncertainty and foster sustainable growth. Such a proactive approach not only shields directors against unforeseen obstacles but also positions them to seize emerging opportunities, thereby enhancing their resilience in the face of volatility, and promoting enduring prosperity for the organisations they represent.

 
In this Commentary

This Commentary explores the role that public company boards play in corporate governance. It delves into the obstacles facing directors in today's evolving business terrain, emphasising the need for adaptability and innovative governance practices. It suggests strategies to strengthen boards, including education initiatives, diverse board compositions, and strategic planning retreats. It sheds light on the limitations imposed by directors' time constraints and board meeting schedules, highlighting the potential impediments to gaining a comprehensive understanding of crucial enterprise dynamics. Furthermore, the Commentary examines the implications of aging boards and advocates for the integration of digital natives, suggesting a blend of seasoned experience and technological fluency in governance structures. Through analysis and actionable insights, we endeavour to provide boards with suggestions to help navigate contemporary business ecosystems.
 
21st Century Boards of Directors

Today, corporate leadership is characterised by a complex interplay of various factors, including technological advancements, demographic shifts, market dynamics, geopolitical intricacies, and evolving societal expectations. Compounded by the relatively short tenures of large company CEOs and C-suite executives, averaging ~5 and ~4.5 years respectively, the challenge for directors and boards becomes even more pronounced. The turnover in leadership underscores the need for agility and foresight in governance and strategic planning processes. Entrusted with the task of charting a course for their companies' future prosperity and sustainability, boards must adeptly manage these hurdles. To succeed in this endeavour, non-executive directors must possess a deep understanding of the forces shaping the business environment and possess the flexibility to adapt to emerging trends and challenges. By doing so, boards can ensure that their organisations remain resilient and responsive among the ever-changing milieu of the modern corporate environment.
 
At the forefront of this task is the speed and extent of technological disruption. Numerous 21st-century technologies have reshaped societies, economies, and everyday life. Smartphones and mobile telephony have transformed communications, entertainment, commerce, and productivity, becoming indispensable tools globally. Social media platforms like Facebook, X, (formerly Twitter), Instagram, and TikTok have radically changed communication patterns, influenced consumer behaviour, and shaped political discourse. Cloud computing services such as AWS and Azure have disrupted data storage and software access, driving efficiency and innovation in businesses. E-commerce platforms like Amazon and Alibaba have radically changed traditional retail models, offering convenience and global reach. Artificial intelligence (AI) technologies automate tasks, analyse data, and power innovations from virtual assistants to medical diagnostics. The Internet of Things (IoT) enables interconnected devices to optimise processes in healthcare, manufacturing, and transportation. Big data analytics unlock insights from vast amounts of information, driving innovation and enhancing competitiveness. These technologies present opportunities and risks. Corporate boards must fully comprehend their implications, urging companies to harness them for innovation while fortifying defences against emerging threats such as cybersecurity breaches.
 
Geopolitical uncertainty presents another substantial challenge for leaders. With trade tensions and regulatory hurdles, directors must possess a nuanced understanding of global markets and exhibit agility in adapting to shifts in international relations. Navigating such volatility demands strategic prowess and capabilities to react swiftly. Moreover, addressing evolving consumer preferences requires cultivating diversity within corporate governance structures. By developing leadership teams that encompass a range of perspectives and expertise, organisations are better positioned to drive innovation and ensure well-informed decision-making processes that connect with stakeholders. 
Equally crucial are environmental, social, and governance (ESG) considerations, which have surged to the forefront of corporate agendas. Rather than treating sustainability and ethical practices as add-ons, leaders must integrate them into strategic planning and risk management to safeguard long-term value and reputation.
 
In the digital age, cybersecurity and data privacy pose threats to businesses. Boards must exercise decisive oversight to protect critical assets and uphold stakeholder trust amidst escalating cyber threats. Collaborative efforts between directors and management are essential to assess risks, implement policies, and integrate cybersecurity into broader strategic initiatives. Proactive measures can mitigate challenges, preserve customer trust, and ensure sustainable growth.
 
In today's business environment, the responsibilities of board directors extend beyond attending meetings and responding to market fluctuations. While these short-term considerations are essential, directors must also recognise the importance of enhancing their comprehension of factors that influence longer-term strategies pivotal for sustainable growth. The traditional format of board meetings, and the competing interests of non-executive directors, may inadvertently foster a superficial approach to governance and the formulation of long-term strategies. Directors play a crucial role in steering their organisations towards sustainable growth and competitive advantage. This necessitates a comprehensive exploration of all facets of the corporation and its industry, coupled with a continuous awareness of emerging technologies and the growing influence of emerging economies.
To adeptly address both short-term pressures and foster sustainable growth, boards must reassess the regularity and structure of their meetings. Increasing their frequency facilitates prompt decision-making, encourages deeper engagement and strengthens problem-solving capabilities among directors. Furthermore, aligning the frequency of meetings with strategic priorities ensures that time is allocated effectively, laying a robust foundation for long-term success.
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The Power of Corporate Culture

Directors must balance oversight and intervention while fostering adaptability, innovation, and embracing change as an opportunity for growth, instilling forward-thinking mindsets, and empowering management. Expertise, vigilance, and adaptability are indispensable traits for effective board leadership.
 
Communication challenges

Effective communication is a cornerstone for boardroom success. Nonetheless, nurturing relationships is a task that demands both time and resources. Disregarding such endeavours can lead to issues, ranging from ineffective management practices to organisational breakdowns.
 

Executive-Non-Executive Communications
One main obstacle to effective communication is the inherent information asymmetry between executives and board directors. The former often possess more detailed knowledge about the organisation's day-to-day operations and challenges, leaving directors at a disadvantage. This information gap can result in misunderstandings or misinterpretations during board iterations. Executives may withhold information due to concerns about reputation or personal interests, while directors may lack the depth of understanding to fully comprehend the implications of certain decisions.
 
Further, communication between executives and non-executive directors is susceptible to confirmation bias and groupthink. Executives may present information in a way that aligns with their preferred course of action, while directors may feel pressured to conform to the consensus within the boardroom. This can stifle dissenting opinions and critical evaluation, leading to suboptimal decision-making. A lack of accountability compounds these challenges. Without transparent communication, directors struggle to hold executives accountable, which can encourage a culture of complacency, allowing misconduct to go unchecked.
 

Overreliance on PowerPoint Presentations
Personality conflicts, power struggles, and divergent communication styles present barriers to the flow of information within organisations, hampering problem-solving efforts and eroding trust among stakeholders. Moreover, an excessive reliance on PowerPoint Presentations (PPPs) can exacerbate these challenges, as they often fail to stimulate meaningful dialogue. Executives must engage in frank discussions with their board colleagues to tackle complex issues, fostering an environment of openness and transparency. Effective communication between executives and board directors demands strategies that encourage genuine engagement and facilitate transparent dialogue. This not only strengthens relationships but also fosters a culture of trust, collaboration, and collective problem-solving. Jeff Bezos, known for his emphasis on effective communication and decision-making within Amazon, has notably instituted a practice in company meetings where executives must read and internalise a memo, which serves as the basis for discussion, rather than relying on PPPs. This approach is thought to encourage more thoughtful analysis and in-depth understanding.
 

Kingdom Building Among Middle Managers
Boards across industries might draw on the strategic manoeuvres of tech giants like Meta and Google, who are simplifying their organisational structures by eliminating layers of middle management. It is at these levels where internal kingdom building occurs, leading to bureaucratic hurdles and siloed operations. By flattening their hierarchies, these tech firms aim to boost transparency, agility, and collaboration. Boards representing other industries might take note of the potential inefficiencies and communication bottlenecks stemming from excessive middle management layers and consider similar initiatives to bolster organisational efficiency. A more streamlined and agile enterprise can help boards to drive innovation, adapt swiftly to market changes, and sustain growth.
 

Communication Among Board Directors
Effective communication among board colleagues is essential for fostering mutual respect and a shared commitment to the company's vision, mission, and strategy. When directors comprehend and endorse the organisation's goals and purpose, they can utilise their diverse expertise to collaboratively drive strategy. This alignment encourages unity within the board, ensuring decisions are made in the best interest of the company's long-term success. Through exchanging insights, providing feedback, and engaging in constructive dialogue, directors can identify trends, assess risks, and make informed decisions that contribute to sustainable success. Conversely, inadequate communication among directors can lead to conflicts and impede the board's ability to make timely decisions. Disagreements and misunderstandings can undermine trust and cohesion, ultimately jeopardising the company's competitive position.
 

                   Strengthening Boards for Dynamic Governance

Directors juggling competing interests often face heightened demands, which may compromise their effectiveness, particularly when they hold multiple board positions. While enriching their experience and expertise, multitasking can strain their time and focus, hindering their ability to prioritise effective communication within individual affiliate boards. To address this challenge, implementing limits on the number of boards directors can serve on becomes essential to ensure that their attention remains focused and their commitment undivided. In the US, institutional investors have voiced their opposition to the appointment of directors sitting on >5 boards. Notably, BlackRock, an investment management firm, cast dissenting votes against 163 directors across 149 companies between July 2020 and June 2021 due to concerns of over-boarding. 
 
Continuous education and training programmes for executives and board directors are essential for improving their grasp of roles, and responsibilities. These instil a culture of constant learning and flexibility, equipping participants with the skills needed to tackle modern challenges. Additionally, by promoting diversity of thought within the board, discussions and decision-making become more vibrant, and encourage innovative solutions to current problems. Evaluating executives' performance, particularly their communication abilities, enhances accountability and contributes to ongoing progress.
 
Careful structuring of board committees ensures oversight and dynamic discussions. Regular rotation of committee members safeguards against complacency and brings in fresh perspectives, invigorating the board's decision-making processes. While organising retreats involving both executives and board directors may disrupt the usual rhythm of board meetings, such initiatives are instrumental in reinforcing alignment with corporate goals and strengthening communication channels. By incorporating workshops, inviting guest speakers, and facilitating open forums during board meetings, the focus shifts towards promoting creativity and embracing diverse viewpoints, rather than perpetuating conventional thinking. Such initiatives help to shape and reshape the mindsets of executives and directors, stimulate innovation, and facilitate active engagement.
 
Beyond Boardrooms

Sticking strictly to the traditional approach of holding board meetings exclusively at the company's headquarters could inadvertently limit directors' understanding of the operations they oversee. In an era marked by interconnectedness and diversity, it is crucial for directors to move beyond these physical confines and actively involve themselves in the varied operational landscapes of their enterprises. This fosters a deeper understanding of the challenges and opportunities encountered by the company, cultivating a more nuanced perspective essential for informed and effective decision-making.
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Forging a path for digital excellence in the MedTech Industry

When board directors acquaint themselves with facilities and locales crucial to operations, they gain insights into quality control protocols, potential bottlenecks, and opportunities. Armed with such knowledge, they are better positioned to identify avenues for improvement. An understanding of supply chain dynamics is also essential for effective risk management and protection against disruptions. By increasing their knowledge of key suppliers, directors strengthen their ability to navigate challenges and cultivate agility and adaptability.
Furthermore, the operational footprint of international corporations often spans diverse regions characterised by unique cultural, economic, and regulatory frameworks. Venturing beyond the headquarters helps board members gain first-hand exposure to these varied geographies, enhancing their ability to contribute to strategies tailored to local contexts. Such knowhow proves invaluable in understanding key customers, navigating complex regulatory spheres, and seizing market opportunities.
 
Embarking on exploratory journeys into potential regions and markets equips directors with insights necessary to make more informed strategic decisions regarding expansion initiatives, mergers, or acquisitions. Through experiences in new regions, directors develop the ability to assess market potential, recognise competitive dynamics, and determine the viability of investment ventures, thereby mitigating risks inherent in moving into unfamiliar territories.
 
In the late 20th and early 21st centuries, a significant shift occurred, with ~80% of the global population transitioning from poverty to middle-class status and from ignorance to enlightenment. This period witnessed the transformation of once nascent markets into economic powerhouses. Despite comprising >75% of the world's population in 2000, developing economies were responsible for only ~40% of global GDP. By 2010, this share had risen to ~50%, and projections indicate it will reach ~60% by 2025. No longer low-margin commodity exporters, emerging markets now serve as growth opportunities for Western corporations, with tech giants like Apple and Microsoft also leveraging them for innovative R&D. In today's setting, it is essential for directors of Western enterprises to broaden their horizons beyond their advanced home economies and gain exposure to the conditions, economies, business practices, and opportunities of emerging markets, where an increasing percentage of future global business and innovations lie.
 
Board Demographics

The median age of public company directors, which is ~65, holds significance for the effectiveness of corporate boards, particularly within fast-paced technology sectors. This demographic influences decision-making, strategic planning, and governance, thereby shaping the path of organisations. While the expertise of older directors contributes valuable experience and institutional insight necessary for understanding industry shifts and overcoming obstacles, it also presents constraints.
 
One important advantage derived from senior board members is the depth of experience and institutional memory they inject into boardroom deliberations. They serve as custodians of industry dynamics and historical perspectives, illuminating pathways for informed decision-making and strategic foresight. Their tenure promotes stability and continuity within the board, instilling confidence in shareholders and stakeholders regarding consistent leadership aligned with the enterprise's long-term objectives. Also, age does not necessarily correlate with either a lack of mental agility or technological acumen; many senior directors remain actively engaged, continuously updating their knowledge base, and contributing meaningfully to board discussions on market trends and technological advancements.
 
However, some seniors may lean towards a cautious approach to risk, potentially reducing innovation, and adaptability. While this approach may mitigate immediate risks, it could impede agility in responding to emerging business opportunities. A technology and innovation gap among seasoned directors may also hinder their ability to grasp evolving trends critical in today's competitive ecosystem, such as social media's influence. Boards lacking expertise in this area may struggle to manage online reputation and engage stakeholders effectively. Knowledge gaps could dilute the board's evaluation of risks and opportunities, affecting the company's competitiveness. This is especially critical in rapidly changing industries like agriculture and healthcare, where failure to leverage developing technologies can result in missed growth opportunities and loss of market relevance.
 
Digital Natives

Large company boards are comprised predominantly of digital immigrants, individuals who have been shaped in an era preceding the transformative influence of the internet on communication and information dissemination. We have suggested how this demographic has implications for how boards confront the challenges presented by an ever-evolving business ecosystem. Given the rapid pace of technological advancement, boards must not only draw upon the wisdom and stability offered by senior directors but also recognise the importance of integrating digital fluency into their ranks.
 
The integration of digital natives - individuals who have grown up in the information age - onto boards seems a strategic necessity. Their presence offers fresh perspectives and technological expertise essential for navigating the complexities of today's digital era. By broadening the scope of diversity beyond factors like ethnicity and gender to encompass age, boards can ensure they possess the skill set needed to thrive in a rapidly and perpetually evolving business environment. Actively recruiting individuals steeped in the information age can infuse boards with innovative thinking and technological prowess.
 
Moreover, embracing age diversity supports a collaborative environment wherein insights from both digital immigrants and digital natives are leveraged to maximum effect. This synergy between different generational mindsets encourages a deeper understanding of emerging technologies and market trends and thereby supports more nuanced and informed decision-making processes. Harnessing the collective wisdom of both cohorts amplifies the board's capacity to anticipate disruptions, identify opportunities, and devise strategies that resonate across diverse consumer demographics.
 
However, the integration of digital natives necessitates a commitment to foster an inclusive culture that values and empowers their contributions. Boards must provide opportunities for digital natives to express their perspectives freely and actively seek their input. Encouraging cross-generational mentorship and knowledge exchange initiatives can further enhance collaboration and facilitate the integration of digital fluency into boardroom discussions and decision-making processes.
 
In essence, bridging potential technology gaps within corporate boards through the inclusion of digital natives enhances the board's capacity to navigate the complexities of the modern era and reinforces its relevance and competitiveness in an increasingly dynamic marketplace. It seems reasonable to suggest that embracing diversity in age and thought is a pathway to sustained innovation, resilience, and long-term success in an ever-evolving business ecosystem.
 
Takeaways

The evolving landscape of corporate governance demands a re-evaluation of traditional board practices in the face of the rapid changes in technology, demographics, markets, and geopolitics. As guardians of corporate strategy and sustainability, boards must possess adaptability and strategic insight to navigate these complexities effectively. In this context, reimagining the role of boards extends to innovative approaches, including enhanced communication strategies, continuous education initiatives, and promoting age diversity. Furthermore, expanding board activities beyond the confines of corporate headquarters offers invaluable insights into operational realities and diverse markets, facilitating informed decision-making. By fostering collaboration, embracing digital fluency, and leveraging the collective wisdom of diverse generations, boards can navigate uncertainty, drive innovation, and ensure enduring success in today's dynamic business environment. Implementing these principles positions boards as architects of their own evolution, empowering them to lead organisations towards resilience and sustainable growth amidst the relentless pace of change.
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