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The Seven-Year 'Itch' in Companies

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Medical Technology

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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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4 months ago

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Transforming MedTech: A CEO’s Playbook

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The MedTech sector has a value gap between high-growth innovators and stagnant legacy companies
Successful transformation requires leaders with deep regulatory expertise, a strong focus on patient-centred innovation, and adaptability that goes beyond traditional leadership skills
Achieving sustainable growth demands bold innovation and strategic agility, prioritising long-term impact over short-term gains
The Commentary offers an actionable roadmap for CEOs to build a patient-centred culture, embrace digital transformation, and capitalise on global market opportunities

Transforming MedTech: A CEO’s Playbook

An October 2024 McKinsey Report highlights a growing divide in MedTech value creation: "The top value creators have outpaced the S&P 500, while the rest of the industry has struggled. . . . investor behaviour has revealed just how wide of a gap they see between these cohorts." The US, as the largest MedTech market, represents ~40% of global trade in the sector, with AdvaMed, the American MedTech trade association, reporting ~6,500 MedTech companies across the nation. Most of these firms are small to medium enterprises, consistently maintaining a trade surplus that exceeded $1.1bn as recently as 2017. The industry’s contributions range from ground-breaking advancements in nanotechnology, imaging, and genetic testing used by international healthcare leaders to everyday essentials like bandages, thermometers, and catheters. As emphasised by AdvaMed, innovation remains at the heart of this sector’s growth and resilience.

However, the landscape is shifting. Many MedTech firms are anchored in legacy products and slower-growth markets - what McKinsey dubs the “have-nots”. These companies face stagnating innovation pipelines, flat revenues, and declining valuations. The stakes for MedTech leaders of these enterprises are high: the need for innovative growth is urgent, and competition is fierce, both from traditional MedTech players and from emerging digital health disruptors.

Leading a successful MedTech transformation demands more than standard CEO capabilities. The regulatory, ethical, and operational needs specific to MedTech set this industry apart, making general CEO guidance inadequate. Traditional leadership advice often overlooks sector-specific nuances, such as stringent FDA compliance, prioritising patient safety, and navigating extended R&D cycles. For a new MedTech CEO aiming to lead a transformation, mastering these elements, and cultivating an adaptable, future-focused approach is crucial.

In this Commentary

This Commentary explores the challenges and essential strategies for a new CEO aiming to transform a traditional MedTech company. It examines the current industry landscape, marked by a divide between high-growth innovators – “the haves” - and stagnant companies – “the have-nots” - and outlines the specific capabilities a MedTech CEO must develop. These include visionary leadership, patient-centred innovation, and adaptability to regulatory demands. Emphasising long-term growth over short-term gains, this guide serves as a practical roadmap for driving sustainable success and redefining leadership within the MedTech sector.

Beyond General CEO Playbooks: MedTech-Specific Leadership Needs

Two widely recognised resources for new CEOs are CEO Excellence: The Six Mindsets that Distinguish the Best Leaders from the Rest (McKinsey & Company, 2022) and The New CEO: Lessons from CEOs on How to Start Well and Perform Quickly by Ty Wiggins, an advisor specialising in CEO transitions. While each offers valuable insights, neither fully addresses the unique hurdles MedTech leaders face. CEO Excellence emphasises results-oriented mindsets, customer-centric strategies, and team building, all beneficial in traditional industries. However, MedTech requires specialised strategies to manage regulatory compliance, prioritise patient safety, and navigate lengthy R&D cycles where even minor compliance lapses can jeopardise patient outcomes and regulatory standing.

Similarly, The New CEO offers insights on avoiding pitfalls and making swift impacts, yet this general approach disregards specific risks in MedTech, such as navigating complex sales channels, managing extensive clinical trials, and adhering to rigorous safety standards. Rapid transformations, encouraged in this book, may be hazardous in MedTech, where safety and regulatory compliance demand a more cautious, strategic approach.

Both books emphasise innovation as a priority, but in MedTech, this is a high-stakes, long-term investment requiring regulatory validation. Thus, frameworks built around short-term profitability and agility fall short of addressing patient-centred, outcomes-focused approaches. Leaders must appreciate that in MedTech, patient safety and long-term investments outweigh short-term gains.

The Strategic Roadmap to Transforming a ‘Have-Not’ MedTech Company

For a new MedTech CEO, guiding a company from a “have-not” status - marked by bureaucracy, slow growth, and operational challenges - toward becoming a “have” requires a dynamic blend of strategic foresight, cultural reinvigoration, and operational precision. This transformation demands reshaping the company into an agile, innovation-driven leader capable of meeting the complex demands of the modern healthcare landscape. The following outlines the essential capabilities and leadership qualities necessary to drive a successful transformation, fostering a culture that embraces adaptability, enhances performance, and positions the company for sustainable, long-term growth.

1. Visionary Leadership and Strategic Foresight

Market Vision: Innovations have reduced hospital stays by 38% since 1980, underscoring the transformative potential of emerging technologies. In 2023 alone, FDA approvals for MedTech AI rose by 43% reaching record highs. Advanced solutions like AI, generative AI, Internet of Things (IoT), digital health, and personalised medicine are reshaping the industry. The CEO must anticipate these shifts and position the company as a leader in new care settings, from remote monitoring to AI-powered therapeutics.
Strategic Agility: A flexible, forward-thinking strategy is crucial. The CEO must adapt to evolving patient needs, regulatory landscapes, and market trends, ensuring the company remains resilient and competitive.
Growth Mindset: Driving market expansion and creating new revenue streams through disciplined M&A, strategic partnerships, innovative solutions and services and global initiatives will be key to sustained leadership and success. A future Commentary describes a process for disciplined M&A.

2. Innovative Thinking and R&D Transformation

Product Innovation: Shift the R&D focus from incremental improvements to ground-breaking innovations that address significant, unmet patient needs. The CEO should champion a patient-centric, outcomes-oriented strategy that not only enhances care quality but also ensures accessibility and affordability. Emphasising bold, differentiated solutions will position the company as a leader in transformative healthcare.
Technology Savvy: A visionary CEO must adeptly integrate cutting-edge technologies to drive innovation and maintain competitiveness. Key areas include digital health solutions like telemedicine, remote monitoring, and patient engagement platforms, alongside advancements such as AI, machine learning, robotics, and 3D printing for precision and personalised care. Expertise in IoT for real-time health monitoring, cloud computing for secure data management, and augmented and virtual reality (AR/VR) for medical training and treatment is crucial. Familiarity with regenerative medicine, genomics, biotech, and blockchain ensures readiness to navigate the evolving MedTech landscape effectively.
Design Thinking: Embedding a design-thinking mindset throughout the organisation can transform the R&D process. This approach emphasises empathy to deeply understand patient and clinician needs, rapid prototyping to accelerate iterative development, and continuous user feedback to refine products. This framework fosters responsiveness, creativity, and alignment with real-world healthcare challenges.

3. Cultural Transformation and Diversity Leadership

Diversity, Equity, and Inclusion (DEI) Leadership: Building a culture that embraces diverse perspectives and backgrounds is crucial to foster innovation. The CEO should champion structural changes to attract talent with fresh perspectives, particularly appealing to Gen Z’s values.
Empathetic Leadership: Cultivating an environment of empathy and psychological safety not only strengthens team morale but also unlocks creativity, fosters trust, and enhances employee loyalty.
Change Management Agility: Driving cultural shifts within established organisations requires dismantling silos and addressing resistance to change - particularly challenging with an average C-suite executive age of ~56 - to foster a more agile, collaborative environment.

4. Global and Patient-Centric Orientation

International Market Insights: Familiarity with global regulatory, cultural, and market demands is invaluable, especially in high-growth regions beyond the US.
Patient-Centric Perspective: Deeply understanding patient needs and outcomes on a global scale enables the development of tailored innovations that enhance both the quality of care and its accessibility, ensuring solutions are inclusive and impactful.
Customer Engagement and Brand Building: Establishing a patient-centric brand that embodies the company’s dedication to innovation and exceptional care quality creates a compelling differentiator in a competitive market, fostering trust and long-term loyalty.

5. Digital Transformation and Data-Driven Decision Making

Digital and Data Literacy: Proficiency in data analytics, AI, and digital technologies is essential for leveraging insights from patient data and operational metrics, enabling informed decision-making, and driving innovation.
Operational Excellence in Digital Health: Knowledge of telehealth, digital diagnostics, and wearable technologies equips the CEO to drive initiatives that improve patient outcomes, optimise operational efficiency, and position the organisation at the forefront of digital health innovation.
Digital Communication: Mastery of digital platforms to effectively engage external stakeholders - such as patients and clinicians - and connect with internal teams, particularly digital-native employees, strengthens the company’s innovative image and fosters a cohesive, forward-thinking culture.

6. Talent Acquisition and Development for the Future

Attracting and Developing Gen Z Talent: Building an authentic employer brand that aligns with the values and priorities of younger professionals is key. Focus on promoting opportunities for growth, flexibility, and meaningful social impact to engage and retain the next generation of leaders.
Upskilling and Reskilling for Future Readiness: Designing and executing comprehensive training initiatives ensures that employees remain competitive in an evolving landscape. Emphasis on cultivating advanced digital proficiencies and strategic capabilities is essential for driving long-term organisational success.

7. Resilience, Adaptability, and Ethical Stewardship

Adaptive Leadership: Excelling in dynamic environments requires a leader who can anticipate and respond to market shifts with agility and foresight. The ability to embrace ambiguity and recalibrate strategies swiftly is essential for navigating the complexities of the MedTech industry.
Ethical and Regulatory Expertise: A robust ethical foundation is indispensable, particularly in safeguarding data privacy, ensuring patient safety, and fostering trust. Navigating healthcare regulations demands a deep understanding of compliance frameworks and proactive risk management.
Commitment to Sustainability: Embedding sustainable practices into every aspect of the business - from operations and sourcing to product innovation - demonstrates alignment with Environmental, Social, and Governance (ESG) imperatives. This approach not only addresses investor and patient priorities but also solidifies the company’s reputation as a responsible industry leader.

8. Collaborative Ecosystem Building and Strategic Partnerships

Cross-Industry Collaboration: Historically reliant on banks to facilitate M&A, "have-not" MedTechs often overlook the transformative potential of broader partnerships. Establishing alliances with technology firms, research institutions, start-ups, and healthcare organisations can drive co-innovation, unlock new capabilities, and enhance competitiveness.
Ecosystem Strategy: Moving beyond traditional product-focused models, a robust ecosystem strategy integrates offerings with digital health solutions and complementary services. This holistic approach enhances patient outcomes, creates synergistic value, and reinforces the company’s leadership position in an increasingly interconnected healthcare landscape.

Takeaways

Transforming a MedTech company requires more than replicating traditional CEO playbooks; it demands a multifaceted approach rooted in innovation, patient-centred priorities, and operational adaptability. As the industry faces heightened competition and pressure to innovate, a successful CEO must leverage both strategic foresight and an understanding of sector-specific challenges. Building a future-ready company goes beyond finance, regulatory compliance, and incremental improvements - it requires visionary leadership that anticipates technological advancements, cultivates a culture of inclusion, and prioritises patient outcomes over short-term gains.

A MedTech CEO must embody resilience and agility, ready to navigate the complex landscape of regulatory frameworks, extended R&D cycles, and a digitally transforming healthcare environment. By championing cultural shifts, fostering global patient-centric innovation, and building strategic partnerships, the CEO can guide the company from stagnation to sustainable growth. Ultimately, achieving transformation is about creating an organisation that not only thrives in today’s competitive market but also sets a new standard for quality care, innovation, and ethical leadership that will resonate across the healthcare ecosystem for years to come. This roadmap is not just a guide for success; it is a call to redefine what leadership means in the MedTech industry.

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4 months, 2 weeks ago

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A Wake-Up Call for US Corporations in Fast-Changing Industries

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Today’s workforce and consumers expect corporations to stay responsive and forward-thinking, echoing voter sentiment in the 2024 US Presidential Election
The Election outcome highlights the risks for healthcare and MedTech firms that remain attached to outdated practices in fast-changing markets
Traditional executives may lack the digital fluency needed to keep pace with technological and market advancements
By embracing varied perspectives and future-oriented strategies, corporations can better align with evolving employee and customer expectations

A Wake-Up Call for US Corporations in Fast-Changing Industries

Donald Trump's victory in the November 2024 US Presidential Election suggests lessons - not only for the political sphere but also for corporate leaders, particularly in fast-changing sectors like healthcare and MedTech. While a range of factors contributed to the former president's decisive win, this Commentary focuses on a few themes that stand out for their relevance to business: the weight of legacy issues, the disconnect between leaders and their broader constituencies, and the perils of overconfidence and resistance to change. By addressing core concerns like inflation, economic security, and future opportunities, Trump’s platform resonated with voter priorities, highlighting a gap between traditional leaders and the public. This shift underscores the risks faced by established institutions, both political and corporate, when they fail to respond to legitimate concerns and adapt to dynamic environments.

Much like the political elites, corporate leadership in healthcare and MedTech - especially within conservative firms - risks being disconnected from the shifts of their industry and workforce. In these sectors, rapid innovation and changing market demands are reshaping the landscape. Yet a significant proportion of large companies remain anchored to legacy products and structures, headed by leadership teams largely comprised of US-based senior executives many of whom are nearing retirement. These digital migrants, whose careers were well established before digitalisation, may lack fluency in the latest technological advancements and market shifts, risking a strategic blind spot that leaves them vulnerable to more agile and innovative competitors. Drawing a parallel between the political and corporate worlds, it seems reasonable to suggest that ignoring changing demographics, employee needs, and technological trends introduces risks for corporations just as it does for political entities.

In this Commentary

This Commentary highlights how Donald Trump's 2024 Presidential election win serves as a cautionary tale for corporate leaders, especially in fast-evolving sectors like healthcare and MedTech. By drawing parallels between political and corporate spheres, it emphasises the risks for established firms that are slow to adapt to rapid changes in technology, market demands, regulations, and workforce expectations. Through analysis of healthcare trends and leadership dynamics, it provides insights on fostering adaptability, inclusivity, and a forward-thinking culture to stay competitive.

Legacy Leadership and the Risks of Inertia in a Fast-Paced Industry

Healthcare and MedTech, more so than many other sectors, are undergoing rapid and transformative changes driven by advancements in biomedical science, artificial intelligence (AI), value-based healthcare, and shifts in care delivery models. New technologies such as AI, machine learning, telehealth, and remote monitoring are driving innovation, as are changing consumer preferences and a growing emphasis on preventive care and patient-centred models. For traditional firms, adapting to these trends is challenging, and demands a readiness to embrace both internal and external changes swiftly and effectively.

Many large MedTech corporations are led by well-established leadership teams composed primarily of American males many of whom have established careers in a more predictable, slower-paced environment. These leaders, often digital immigrants, may lack the skills and cultural agility needed to navigate today’s digital-first landscape. In an industry where start-ups and smaller, more agile companies are increasingly setting the pace, being overly reliant on legacy products and markets and slow to innovate can create significant vulnerabilities.

Just as US voters in November 2024 demonstrated a desire for change by voting for populist policies, there is a growing segment within healthcare and MedTech firms - ranging from early-career employees to mid-level managers - who may feel left behind by leadership that appears out of touch. Such employees may feel that their aspirations, frustrations, and innovative ideas are overlooked, resulting in disillusionment that ultimately stifles creativity and limits the company’s ability to innovate.

Misalignment with Market Realities and Employee Expectations

Much like the dissonance between voter priorities and political platforms that played a role in the 2024 American Presidential election, traditional healthcare leaders face the risk of alienating their workforce by not aligning with their evolving expectations. Today’s employees seek flexibility, inclusivity, and growth opportunities, yet many corporate hierarchies remain anchored to legacy mindsets, appearing resistant to the innovation employees value. Amidst inflation, economic pressures, and a rapidly changing healthcare landscape, there is an expectation for companies to prioritise meaningful, sustainable changes over unwavering adherence to past practices.

Such a disconnect can lead to disengagement among skilled and innovative team members who feel side-lined in decision-making processes. In an era where top talent is essential to maintain competitive advantage, traditional corporations must cultivate an inclusive, agile, and future-oriented culture. Failing to address these demands risks losing valuable talent and diminishing the company’s ability to remain competitive.

Strategic Blind Spots: The Cost of Ignoring Innovation

Another parallel between the political and corporate spheres lies in the risk of overconfidence in legacy strategies. Just as political analysts underestimated the former President's appeal by relying on inadequate polling methodologies, traditional healthcare companies often misjudge market shifts by relying on legacy product lines and ignoring emerging trends. Such overconfidence in established offerings and processes can be costly in healthcare, where technology-driven innovation has opened new avenues for preventive care, personalised medicine, and outpatient services.

Firms that fail to recognise these shifts risk being blindsided by competitors who are more attuned to the demands of modern consumers. Smaller, more innovative firms are seizing opportunities in areas such as digital health, telemedicine, and wearable technology - offering patients and providers new ways to manage health conditions. These firms are not bound by legacy structures or outdated decision-making processes, allowing them to respond quickly to emerging trends and customer needs.

The trend toward outpatient services and home healthcare is especially significant. As healthcare delivery moves increasingly out of hospitals and into homes and community centres, traditional healthcare companies must rethink their approach to service delivery. A company that remains fixated on hospital-based care or physical products while ignoring digital health services or home-based solutions risks missing the next wave of healthcare innovation.

Embracing Change to Bridge the Divide

Trump’s 2024 victory draws attention to the risks of remaining wedded to the past. In his campaign, he demonstrated an ability to connect with voters by focusing on practical solutions to their everyday concerns. Healthcare corporations should consider adopting a similar approach by investing in solutions and services that address the needs of patients and employees. This could involve not only expanding product lines to include digital health tools and preventive care but also restructuring the organisation to make it more agile and responsive.

For corporate leaders, the takeaway is clear: organisations must prioritise responsiveness and agility over rigid adherence to traditional methods. Just as Trump’s victory revealed the risks of political elites being out of touch with public sentiment, corporate leaders risk alienating their workforce and missing growth opportunities by ignoring employee concerns and market trends.

Building a Culture of Inclusivity and Innovation

In a dynamic healthcare and MedTech landscape, companies need more than just technical expertise and financial acumen to stay competitive; they must foster a culture that values inclusivity, adaptability, and continuous learning. Just as well funded political institutions can lose touch with the needs and concerns of their constituents, corporate leaders risk disconnecting from the aspirations and behaviours of their employees and patients. By aligning more closely with different voices across the organisation - particularly younger, diverse employees and those with digital expertise - companies can tap into a broader spectrum of ideas, unlocking innovation that reinforces their market position.

To achieve this alignment, leaders should actively seek input from employees at all levels, appreciating that crucial insights often emerge from minority voices. This inclusive strategy not only drives engagement and fosters a culture of innovation but also positions the organisation to respond more effectively to both employee and patient needs.

The Path Forward: Adaptation as a Core Strategy

The lessons from the American 2024 Election suggest that political and corporate leaders alike must adapt to rapidly changing demographics and expectations. For healthcare and MedTech firms, this means developing strategies that are not only grounded in today’s market realities but also flexible enough to evolve as those realities change.

Adaptation in the healthcare sector could involve investment in new technologies, partnerships with innovative start-ups, and a willingness to experiment with new business models. Companies that can pivot to meet new demands - whether through expanding digital health capabilities, embracing remote monitoring, or exploring personalised medicine - will be better positioned to succeed in a rapidly changing market.

Takeaways

The 2024 US Presidential Election results suggest a lesson for corporate leaders: in a fast-paced world, adaptability and responsiveness are key to staying relevant. Just as political leaders risk losing public trust by holding onto past ideas, corporations that resist change undermine their competitive edge and risk alienating both employees and customers. For healthcare and MedTech companies especially, the path forward requires a commitment to innovation, inclusivity, and real-world impact, ensuring resilience in an era defined by continuous transformation.

The stakes are clear: just as political leaders risk losing public confidence by holding onto outdated platforms, companies that cling to legacy practices risk losing valuable talent and market share. Ultimately, the parallel between politics and business underlines a truth: in a world of change, the only sustainable strategy is a commitment to evolution.

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11 months, 3 weeks ago

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Reimagining Boards

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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.

21^st 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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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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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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