Jos de Blok on Buurtzorg and the virtues of humanising, not protocolising

Lisa: So Jos, thank you so much for coming on the podcast. I’m really excited to get the chance to talk to you.

Jos: You’re welcome.

Lisa: And we were just talking about before I started recording that I met some of your colleagues in the Houghton team a few years ago and interviewed them in the garden. We had cups of tea, kind of true Buurtzorg style, and so it’s really fun to now get the chance to talk to you as the founder and CEO and the person who started it all. So yeah, thank you for being here.

Jos: You’re welcome.

Lisa: So I thought maybe we could start in the present moment. If I ask you what’s giving you energy at the moment, what are you working on that’s really sort of energizing you?

Jos: Oh, we just had on Thursday and Friday, I had two days with the project team. Those are around 10 people who are doing all kinds of projects within Buurtzorg, and we were thinking about this situation of course with COVID and what we can do so that the teams feel that they are inspired and supported. Because it’s difficult—people are tired, it’s exhausting people to have almost two years of dealing with COVID. A lot of people have been ill. I have had Corona. So there is a lot of pressure.

And one of the things we try to do is say: okay, it’s there so we have to deal with it, but let’s find ways so that there is a kind of new optimism, that there are ways to let people get inspired. We say okay, everybody has seen the consequences in their environment or in their team. We have had a lot of patients who had Corona. But now let’s find ways how we can deal with the circumstances in a way that it doesn’t give us too much pressure, that we can take care of ourselves as good as possible, and that we can keep on improving ourselves, taking care of personal development, for each other—not only focusing on COVID because it will be there next year too. But how can we create an environment where people can keep on learning, keep on developing themselves, and also taking care of each other?

So these two days were amazing with the project team, and that was very energizing for me. We talked a lot about all kinds of personal things. Everybody has things in their environment that are influencing their ways of looking at the world. So it was a kind of reflection, new ideas, trying to focus also on what will happen in the coming five to ten years, how we see the world, and then how we can—with what we want to achieve—how we can focus on the patient care on one side, but also care for ourselves on the other side, and also deal with the system besides. Because it’s always complicated—we are in a very complicated environment at the moment where the ministry and the Care Authority are making plans which are not really based on a vision and on content. So it’s really a system thing which can also create a lot of bureaucracy again.

But it feels like we are a collective, and that feels very good that we are aligned, that we like each other. We even said we love each other, the people around us. Everybody’s very caring for each other, and so that feels good. And now it’s good to see how, with 950 teams all over the country, how we can communicate in a way that the teams, the nurses feel that they are supported, that they get new inspiration. So connecting, staying connected with everybody. So this is what’s happening at the moment.

Lisa: Yeah, that sounds like a really tough moment, and it sounds like you’re handling it with a lot of humanity and compassion. I’m curious because it was one of the questions that some of the listeners asked about actually—how Buurtzorg dealt with the pandemic and in what ways you think that how you’re kind of set up and your culture helped you navigate that, especially given the kind of battle almost with the system and different things going on in the government. So what have been some of the main lessons and things that you’re proud of in terms of how you responded?

Jos: Well, I think what we saw when it started—we learned very fast from the first teams who had to deal with COVID. So it started in Holland in the south, and we created a kind of what we call the “crisis team” with different people, different nurses. We also had an epidemiologist in the house—we didn’t know that, but she became part of the crisis team. So we studied what happened in different other countries.

But we said there are a few things which are very important: creating safety for the patients and keeping our nurses safe. And that was a kind of different approach than what our government did because in the beginning they even said that we should not wear masks, for example. So we said, but it’s an infectious disease—you should stay safe. So there was a scarcity of masks, and then we said no, we can get them from different places, and otherwise we will make them ourselves.

But we saw there was a lot of resilience. And if you look at the way teams dealt with it, it was very flexible. So what we saw was that the teams were immediately in action when there was Corona in this village or in this neighborhood where they were working. And we heard it also from others that where other organizations were starting kind of command and control strategy—so top-down, “it’s crisis, now we have to put clear protocols” and everything—and we said no, we should ask the teams what they need in their daily work, how they deal with it, and then we can translate it into guidelines also for the other teams.

So there was continuous communication. Every day the crisis team was 24 hours a day available. So we said okay, everybody should be able to come with questions about “This is what I see now, I don’t know, should I go in quarantine or should I do this?” And this ongoing process felt what was, I think, felt by the nurses that they were supported in any way.

And I think that by doing it this way, they were still very flexible. So we also saw that for the patients, it’s the same—the communication with the patients is very important, that you say: “Okay, there is Corona, how can we keep you safe? How can we perhaps reduce the amount of visits, but in a way that it’s aligned?” Not that it’s a command from Buurtzorg to say “Okay, now we have to reduce.” No, that’s in dialogue. And this made, I found, a lot of different solutions which I think you can’t protocolize. So you should ask the nurses, “Okay, you are the owner of your own daily work, try to find ways to deal with it in the best possible way.”

And that’s what I heard from the environment, that people said your teams and your nurses responded differently than all the other organizations. So they were seen as strong, capable, responsible people who took care for all the consequences. And I think it was a very important thing throughout the whole epidemic. It’s still is.

So I see that the sickness rate now in some organizations is also higher in Buurtzorg, but with some other organizations it’s exploding—almost 12, 13, 14%. And in Buurtzorg now it’s 8%, which is also higher than normal, but I think we’re very happy that we say okay, this is a collective responsibility. Let’s go with what we learn from day to day in this pandemic and let’s see that these principles of keeping people as safe as possible, supporting them when it’s needed, being there when it’s needed—and then okay, let’s move forward and let’s learn from it.

Lisa: Yeah, this learning piece feels so strong for me whenever I’ve heard you talk, and when I’ve read things about Buurtzorg. That you have this amazing ability to, as you say, not protocolize things. I think it’s also the same when different teams have developed new products or services—that it’s very much “share the ideas and see where they spread” and allow the teams to choose which ones they take on. How do you do that, and how has that… because I know a lot of organizations really struggle with that, and now you’re like 950 teams. So how do you create that learning culture?

Jos: I think it starts with not wanting to create a culture. So I think that my idea was when you create an environment where it can grow—so the conditions where you’re working—it’s like home. If you have safety, if you have a nice relationship with the people around you, if you feel ownership, if you can be responsible for what you’re doing, all these elements, they’re more or less, I think, like sociological or psychological principles. If they are there, then you feel well and you will grow and you will share your ideas with your environment, with your colleagues. So then it’s just happening.

You see things in your daily work—this was my own experience when I worked as a nurse. So you see a lot of things, practical things, where you say okay, if you do it this way perhaps it’s a bit smarter, or if we add this to it then perhaps we can reduce the inconvenient parts, or we can find new ways. Most people are very creative in my opinion. So nurses, especially nurses who are working in the community, need to be creative because the circumstances are changing all the time.

So just letting people find out what they can do, what new insights they can have, and sharing it with each other creates a lot of innovation. This is kind of an assumption.

I’ve been Director of Innovations in my former job, and then my board asked me, “Oh yes, we want to have these kinds of innovations.” And then I said, “But these are not really innovations that are bringing good things for patients.” They said, “No, but we have to show that we are an innovative organization so that when it comes in the books or people are writing about it…” So the image was more important than what was really happening.

So I said it has to be the other way around. We have to understand that when we are developing new ideas which is helping, for example, 30 of our patients, then it’s a big innovation. But it has to come from the daily practice. So my idea was that okay, when we create this, when we have these environments, when we have these teams who enjoy working together, who feel confident about what they’re doing because they are the owners of their daily work, they will feel the space to explore and to experiment. Then all these things will happen.

Lisa: Yeah, it’s making me think about this question that I have often with colleagues in this space, which is, you know, if you create the environment does everything else follow? Or is there also something else about how people are being, especially people who have power or have had power in the past? Because I find that that can so easily sabotage even the most beautifully set up environment of autonomous teams and things like that. So do you think it’s enough to create the environment, or do you think there’s also something else needed for people to really… because it’s kind of shifting a paradigm really.

Jos: Yeah, I think it depends on what you consider as the environment. And so for me, it’s also the reflection. So you have to be aware that there is always a dynamic in these teams, in Buurtzorg as a whole, that when there is pressure like we have now with COVID, we should argue, we should discuss what does it do with us. Does it influence our behavior in a way that, for example, if we have this discussion about people who are not vaccinated, then you see that in society, in many countries, you see a kind of polarization—that you are against it or you are vaccinated.

We don’t want to have these kinds of things. And then in my blogs I write, “Let’s talk about tolerance, let’s talk about compassion, let’s talk about how we can support each other and respect all choices.” So in these moments when it’s difficult, then it’s more important than ever. And this, in society as a whole, polarization is going on between people who always lived in Holland, for example, and then immigrants.

I think we should go back to what’s human, what’s a human approach to everything. So we should, you know, when I was this morning when I was driving in my car and I was listening to the news, and there was news about Poland. In between Belarus and Poland there are a lot of refugees. And there was this one mayor of this village who said, “I’m going to do things differently than anybody else. We have to take care of these refugees. There are little children, there are even babies, and who are we to send them back into the forests and say that they’re not welcome and that they are people who are making kind of profit of us?”

My idea is that these values—how do we take care of people, how do we take care of each other, how do we focus on tolerance and compassion—that’s in my opinion very human and also brings you a lot if you do that. So in this, if you talk about culture, if you say we want the people who are taking care of patients, then we also say we want the people, our colleagues, are taking care of themselves and for each other, but also for vulnerable people in the society.

So for example, when it comes to big cities where we have people who are homeless, then we say okay, even if they don’t have a health insurance, we will help them. It’s no problem. Let’s create possibilities that we can help them and that we can advise them, and that we can contribute so their lives can become better. Our nurses have these networks.

So in Amsterdam, some of the teams are in buildings where they also take care of homeless people, and we do it together. So for me it’s very important that we say okay, healthcare is not only about health and taking care of people with health problems. It’s also taking care of people in society who are vulnerable and who need support. So I think when you talk about it, when you share it, I think people will feel that it’s okay. So it’s good that we just spend time on this. It’s not productive, it’s not bringing money, but it’s important. It’s an important thing.

Lisa: Yeah, and it sounds like when you write blogs or when you pose these questions about reflection, for example, that seems like a very important part of your role in sort of keeping alive this culture.

Jos: Yeah, but I think it’s important that everybody’s feeling that they can do it also. So it’s not my opinion is not more important than the opinion of others. But of course, because of the continuity and the way we share ideas or share values, I think you see that a lot of people feel trust in it or feel that okay, it’s also my idea. So it’s what I try to write about, but I think that most of the nurses feel.

So it’s this collective, and of course there are all kinds of different opinions on anything, but there is a kind of general development throughout the years that everybody feels, “Okay, I’m happy that I’m part of this, and that I can share when I’m at a party, for example, or we have an event.” Then it’s nice to see that people feel good just by saying, “Okay, I’ve chosen to work this way as we do within Buurtzorg, but I also feel that there is more than that—that I’m trusted in what I’m doing, that I’m rewarded for what I’m doing, that I can develop myself, and that I can contribute with all my ideas and who I am.”

So this idea of wholeness, that Laloux wrote about—I think it’s very good that he used these kind of words. They say, “Okay, how can you be yourself at a place where you’re working?” It’s so important that you don’t wear a mask or you don’t—you’re not somebody else who’s doing all kind of protocolized activities. No, you have your concerns about the people you’re dealing with, you have your qualities, your skills, your education, and you’re doing it the best way you can do it. But it can be different than another one.

So all these things, I think it’s creating and continuously kind of reflecting on what you’re doing. And then I think it’s also very connected with the environment where you’re working. So these nurses you met in Houghton, they are very connected with this neighborhood. They know everything, you know. They live there for many years, they’ve worked there for many years. They’re smart, very smart nurses, and they know what to do when this or that is happening.

So if you would protocolize them or say, “Okay, these are the tasks you do”—it would be damaging them. And in fact, I think that a lot of organizations are creating damage for a lot of people by all the restrictions, by all the protocols, by all the top-down—I call it directions. So I see Buurtzorg as a kind of a living organism, but everybody is organically connected.

Lisa: Yeah, and that very much came across when I met Marion and Sheila and Yolanda in Houghton. That they talked about the trust and they talked about really like that it’s a steep learning curve at the beginning because it was really like they owned their own business and they had to do everything. Yeah, and they talked about their coach also as being so important and being a real… and also as you describe this thing about being human and being yourself, that when they had tough times, the coach really cared about them and that they could really rely on each other and care about each other when one of them was struggling with burnout, you know, that they would really step in. So that very much came across to me also.

I’m wanting to ask you these tough questions because I think so many people are inspired by Buurtzorg, and I’ve had so many guests on the podcast who have created almost versions of their own, you know, taking inspiration from Buurtzorg. And at the same time, I speak to a lot of people who really struggle, particularly for example in the Health and Social Care sector, many people in the UK for example who are within the NHS, this kind of huge system, and really passionate and committed about changing things and making it more human, you know, for patients and for colleagues, but really struggling against the system.

And many people say to me that well, in Buurtzorg’s case, you created something from scratch, and that has its advantages of course. But I’m wondering what your thoughts are for people who are transforming from a sort of traditional organization, and they’re trying to implement… So I talk to a lot of organizations in that sector who are creating autonomous teams, they’re bringing in coaches to support them, but they come across challenges like for example managers feeling really threatened by it and saying, “Oh, so now I’m no longer a manager, I’m a coach?” or “Does that mean that I’m not valued anymore?” or “Is that because you want to pay me less?”

And people at the other end of the spectrum feel sort of scared to step in and are so used to having the structure of a manager telling them what to do or appraisals or whatever, that it also feels quite challenging and intimidating. So you hear leaders saying, you know, “We’ve created a self-managing system—why is no one stepping in?” So there are all sorts of pain points for organizations that are transforming. And I imagine you’ve talked to many people in these organizations yourself as well. So what are your thoughts and what have you learned in trying to support these people?

Jos: Yeah, but you just said about when leaders say, “We created a self-organized organization” or something like that, and people are not stepping in, then you can ask yourself what was the starting point. Because I think if you’re not creating alignment and commitment from the start with everybody, it will not succeed. So you can’t—an organization is not a thing. It’s the people who are in it.

And of course, I think the starting point, in my opinion, should be: how is it influencing the daily work of a lot of people? And how is it influencing the services or the products they’re making, or the services that they’re delivering? And it’s not only in healthcare, it’s also in other industries. What’s your service? What’s your product? How is it made by people? What do they think about that process of making it or delivering it? And what do they see? In what way it could be improved or changed that it has a lot of impact on the people who buy it or use it, and the people who make it?

So that process you can say the primary process—and what is the difference between delivering activities by the minute or creating solutions? So for a lot of people in healthcare, there is a big difference. But also you can see it in banks—are you selling financial products, or are you creating value for the people who are your clients? And so that’s the starting point.

What kind of organization do we want to be in five to ten years? How do we want to develop ourselves in a way that we have a strategic advantage? If you just talk about any kind of business language, then you can say, “Okay, we want to have an organization where the workers feel well, the products and the services are the best we can imagine, and there is a reasonable profit. And by doing this, we can survive the coming 10 to 15 to 20 years.”

So the strategy, the vision, and the way you operate should be consistent. So it should not be something just taught by some people who said, “Okay, and we have an idea, we structured it in another way, we make autonomous teams.” And then now it’s about dialogue, it’s about reflection about how do you see your work, how do you see these different roles in an organization. And if you do that in a positive, consistent way that it shows—also you have to show what it means also in behavior.

So the leaders have to use the language that fits this. So it’s not—if you say it’s another paradigm, because I think it is—you want to create something which is based on another paradigm. Then—and that’s sometimes very difficult—then the leaders have to show new behavior. So instead of telling people what a vision and the strategy is, you have to have a dialogue about it. So how do you look at the world? How do you see your daily work? Do I really understand what you’re doing and the way I understand what it brings you?

All these mechanisms of 15, 20, sometimes even longer, 30 years are inside of all these people. So and it’s not so easy to say from one month to another day, “Oh, it’s not there anymore.” No, you did the MBA education, so you have all this presence in your head. So and you don’t know yet what the new pattern will be. So so there is a transformation on a personal level, there is a transformation on an organizational level, and perhaps—and I think that’s going on—there is a transformation on the societal level.

So and then you get all these complications throughout the process. Okay, because then it affects these management positions—how do we deal with that? But if it’s built on something you want to achieve together, then people will also say, “Okay, how can I contribute?” That should be the kind of question instead of “Am I losing my position?”

And this process is not very easy, but I’ve seen in the organizations I support or we supported with some colleagues, that the organizations which were led by women achieved it in a better way than the organizations which were led by men. So it’s more about feeling, intuition, it’s communication, it’s continuity. So it’s seeing things for a longer period, building on relationships. And it’s easier in general—I think it’s easier for people with feminine elements and characteristics. And also, of course, there are also men with feminine characteristics.

So but yeah, this process, I think, because I’ve met many, many people from different organizations, and yeah, it always starts with how do you reflect on yourself, how do you see yourself in this process. And then you can you see there are beautiful things happening all over the world in all kinds of industries. So there are more and more examples, very successful examples.

And what I see is part of social change is—if you connect the climate discussion and the energy problems and all the big problems in the world today to this process—so we need to deal in a different way with our environment. We can’t go on like this. We are destroying the environment by the economical view on everything. It starts with the economics. No, it starts with humans. So it starts with human behavior, it starts with how do we deal with each other, how do we take care of each other, and then of course, how do we do this in a way that it’s also financially healthy.

But in my opinion, it should be another way of priorities, of looking at priorities. So if you take care of people in a good way, if people can be themselves in the workplace, it will also be good for the company, it’s for the place where you’re working.

These are some reflections on how I see it. And sometimes I see that people, organizations are doing a project on self-organization. They have a steering group, a project group, they start to work, and then they are going to tell the people what it means. But that’s not the right way, I think.

Lisa: So what I’m hearing in what you’re saying, some themes are that the way that you start… I really like this thing you say about it’s all about dialogue, starting dialogues about and listening also, really understanding how people who are on the front lines, so to speak, how they see things, what gets in the way, how they would like things to be, and so on—to really involve them and enroll them in that process instead of, as you say, kind of revealing some grand plan.

And I’m also—I’m glad you said the thing about leaders, because I can really see that it’s painful for them in a lot of ways, that this paradigm up till now, you know, these people who’ve done MBAs and have built their career on certain characteristics are now being told, “Oh, the game’s changing now, and now we need you to be in a completely other way.” And there are advantages and great rewards in that, I think, once people are able to get there. But it’s that transformation, as you say, is a big one. And I’m wondering what you’ve learned or what your reflections are in terms of what helps leaders in that transformation—what helps?

Jos: I think they’re very basic things. Just start talking with people instead of telling them things. You know, these expectations—and that’s also the difficulty—these expectations from managers and leaders in the positions they have are creating a behavior that people are easily giving their opinions on everything. So because you are a manager in this position, it’s not so easy to just walk to some people and say, “How do you think about this?” Because in some organizations, people are expecting that you know this.

But I always said what’s most effective is that you act like—and then I hope I’m right—that you act like you’re at home. The way you talk with your family, you should also use that in your work. And then I expect that it’s positive. So the way you treat your dear ones and you talk about all kinds of things in your family, you should also—that can be helpful.

Another thing is that you ask for coaching. Sometimes, you know, you also have your blind spots. Sometimes we don’t even know—people say, “I believe I’m not easily angry, almost never.” But then people say to me, “But when you’re silent and you’re not saying anything, you will have a certain expression, and then people believe that there is something behind it.”

So you have to sometimes communicate how you feel. “Oh, that’s okay. Just let me know when this is happening because I don’t want…” You know, for example, I have, I’ve had depressions sometimes. I have moods that are not very, very nice. And I’m still, I’m just working, but then of course, the things I’m saying will have another effect than when I’m laughing and enjoying. But it’s good to know this from yourself and then think about how can it influence the communication I’m having.

So I’m also a bit, if I’m talking a lot with health insurers or with the ministry, then sometimes I think, “Okay, do I have the good, the right feeling? You know, do I feel what’s really happening?” So these things, but you can learn. You can learn to reflect on yourself.

But I always advise people not to go in a kind of—I call that a peer group, because then you all have the same language and you’re all supporting the wrong thing. So talk with people who you’re feeling less comfortable with. So for example, I think if you have a kind of a managerial role or a leader role, I think talking with nurses would be very healthy. You know, as a nurse—I’m a nurse—you’ve been talking to everybody, with every kind of background. So you have to attune to everybody. So in general, if there is not a hierarchical position, then nurses will tell you what they see. And in that sense, nurses are very important for society. In the home, but that’s so that can heal the system.

So these are some reflections. So I don’t believe in all these leadership courses. I think it’s bringing more negative things than positive. So it’s all the same all talking about leadership and how important is leadership. And now it’s, I called it being humble—how can you put yourself in a role that people show, that people see who you really are as a person, not as a leader, but as a person.

So it’s too much about techniques and not too much about the things you should learn. I think you should unlearn a lot of things. So you should go back to: okay, what’s the core of you? How can you show that you are the caring person in your family and that you also can be the caring person in your personal life and your work?

I think a lot of people will appreciate if you share your feelings with them. All these patterns, all these things you’ve learned, and the way you had to deal with all those dilemmas in your daily work—I have put a focus on your more or less—I call it soft—characteristics. So if you say the soft side of you, the soft side of people… And I believe that the soft side of people who have been managers and leaders for a long time has been underdeveloped. So for example, just showing your emotions, crying when you should cry, talking about your doubts, your fears, these kind of things.

No, you have to be as a leader—the wrong leaders—confident about everything. But you can’t be confident about everything. There’s a lot of fear, and all these things you have to—so let’s just say it’s there. So how can we deal with it? Building trust—you can only build trust when you talk about the basic things. Then people can see what trust means for you.

So these are—it’s not a program, but it’s I think it’s just different elements. So being aware what the transformation is about, dialogue as you said is a very important thing, reflection, understanding how your personality developed in time, and trying to find out how you can make it work in a new paradigm. It’s all a part of a process you’re going through. But it’s a lot of fun too, because you can be yourself too in this process. So you don’t have to behave like…

So the first thing I would advise is take out your suit and your tie and wear something different, like when you feel comfortable when you come home and then your wife or your husband says, “Ah, shall I… I bought you some new… it’s better but funny colors. Perhaps you should wear it at your work.” It’s all just thoughts.

Lisa: I want to add a reflection on what you said about not believing in leadership training, or what I hear you to mean kind of traditional leadership training in the sense of like, “This is what leadership is” and theory and blah blah blah. But what in my experience, what I find does help is creating some spaces where people can experience and share and be vulnerable, outside of the sort of day-to-day work as well as kind of integrating it into their day-to-day work, because as you said, I see that a lot of people have blind spots of not being aware of…

And I’m biased of course because I lead trainings, and I’m not saying that trainings are the only answer. I think it’s different things for different people. But I see that there’s a value in helping people to see, because it’s a lot of it is coaching, helping people to see when, you know, like the feedback that you got about “Ah, sometimes when you become a bit silent, I wonder this or that.” So that you can get help with your awareness and perhaps practice things—you know, tough conversations or vulnerable conversations, things that you don’t normally do, in a safe space where you can get feedback and input and coaching and support.

I do find that that’s really valuable for people, especially in organizations maybe slightly different to Buurtzorg, where there’s lots of cross-functional teams and complexity and a mix of managers and so on. It’s, I think, where in an organization where there’s very competent nurses, they’re really kind of driving most of the organization supported by coaches and a support services team and so on—it’s perhaps less needed because they know what they’re doing and you just need to get out of the way and support them. But it seems to me like in other organizations where, as I said, there are lots of different cross-functional teams and lots of other layers of complexity, that it’s even more challenging, and you need to have even stronger levels of kind of communication skills, building trust, listening, being able to really have those dialogues, that that’s perhaps not going to happen by just sort of asking people to reflect more or try this, you know, because they have no concept of what that is. They haven’t done it before.

Jos: Yeah, but I’m very practical. So I said there are some things you can do in general, but at the same time you have to build something which is based on very practical things. So the daily routines, for example—so what I did before I started with Buurtzorg, I wrote a lot about my expectations in how it can work in a team and what these principles and routines were, in my opinion, which could lead to the results we wanted. So that was the design, more or less, of the new world. So you have the old world, and I think you have to think about the design of the new thing.

The routines—what kind of routines, what kind of principles, what kind of expectations, guidelines, and also on the back office, for example. So you have, if you say we don’t have a management structure, what will be the supportive system? What kind of support do we need and do we want? So this, the strategy on building should be should be very clear. And I totally agree with you that on some of these topics, trainings are very useful.

But what I was referring to was that what I see most of the time is that leaders are talking with leaders. And I believe that this language is a very important thing. The language you use, the words you use, should be connected with what you’re doing and the people who are doing it. So I had a discussion with a researcher who said not so long ago, he said nurses should use more of the language of their leaders because otherwise they can’t explain what they need. And I said, “But that’s the other way around. I think leaders should try to understand at least what the people are—how they feel about their daily work.” That’s the beginning.

So and you know, language—for me, when I did the MBA education, it helped me to understand how our leadership managed to think. But on the other hand, it’s strange that when they’re all using the same language, that there is not any space anymore for something different. So that’s, I made a difference between managing or management and organizing.

So for me, and of course you can have all kind of mixes, but I think if you say, “Okay, I want to use all the intelligence and all the capacity in how people can organize, and I want them to feel ownership about what they’re doing,” then you should focus more on organizing than on management. And you can use all kind of management elements in this process, but it’s a quite a big change in my opinion.

And then language comes very close because I hear a lot when our nurses are in a meeting when there are a lot of managers or leaders, that they say, “We really don’t understand what they’re talking about.” And when you ask the managers what they are really talking about, I think that a lot of them even don’t know exactly what they’re talking about. So that’s my perception.

I’ve been in a lot of management teams, and I talked a lot with CEOs from all kind of companies. And when I see this language, then I see uncertainty. I see that people don’t really know, and then they use words that they can… It’s kind of a masquerade. They have to say in a very concrete way what they exactly mean. There is this Danish philosopher who wrote a book about it. He called it “plastic language.” So it’s using a lot of words, but you’re saying nothing.

Policy language and management language has a lot of these kinds of things in it. So you use “HR,” “management,” usually also have these kind of elements. But also if you hear people who are talking about information management and logistics and all kind of words—but if you listen, you say, “Oh, what’s this about?”—but I think it should be based on, “I don’t understand it. It’s a higher level of understanding.” And then there’s a misunderstanding, in my opinion.

Lisa: Well, we were reflecting on training and when it can be good and when it’s not so helpful.

Jos: Yeah, but in general, I think, don’t you think—I believe that if the starting point is you, and you say, “Okay, I want to learn these skills, I want to understand this or that,” that the results are much better than when there is a kind of a standard program on a certain theme.

So I’m working a lot with Sharda Nandram, and Sharda is a professor and wrote a wonderful book about Buurtzorg. It’s called “Organizational Innovation by Integrating Simplification” developed the integrating simplification theory—so simplifying processes is more important than creating complexity. But we talked a lot about integrating different kinds of intelligence. So integrative intelligence. So we’re doing research on that. So if you have different reflections from different perspectives together, it creates new insights.

And one of my observations is that if you look at management trainings and also this leadership training from a management perspective, they create a kind of a monoculture. So it’s also using the same patterns, using the same words all over the world. So it feels comfortable because you think, “I understand this world.” So that’s too easy. You have to go to worlds you don’t understand. So this reflection from different people around you, I think, is very important that you understand, “Okay, it’s not my language, my behavior, the way I do things has a certain impact on my environment, and I have to understand this before I can do it in a different way.” But that’s my view, and there are many other views.

Lisa: Sad to say that we’re starting to wrap up now because I know you have many other things to go on to. But is there anything else that you would really like to share with listeners, people who are exploring new ways of working, more human ways of working themselves?

Jos: Yeah, I think it’s important to connect the ideas with a very practical design where you say, “Okay, this is what we going to do, this is the way we are doing it,” and that you can say creating conditions and “this is what we want to get out of it.”

So what I see is that I see sometimes people who are very eager to start something, but they don’t have a good business model. So and that’s also—I see sometimes with Buurtzorg that they say, “Okay, this working in teams and taking care of people, wonderful. We also want to do it.” But you need—and I have these discussions a lot within the NHS—you need to have a clear business model. So and it’s very simple—what if you work this way, what’s the financial structure, what money is coming in, and what’s coming out? Simple like that. And there you have, you need to have a model. And I always use different scenarios. So I said I have a good—when it’s working good—or I call that medium, and when it’s not going well…

Thinking in scenarios, thinking in the design, and being flexible, agile in the process you are working—so these elements, but don’t think it will happen just by accident. You have to think through these things. But it asks—and then I think, “Just do it.” That’s another thing. Another thing is that people keep on talking about it for a long time, and there are not—there should be more people who are acting, just doing, starting. And sometimes you fail, and sometimes it goes well. But when it’s built on a good idea and a good design, and you have the skills to deal with all these different elements, things will work out.

So and even with my sometimes depressive moods, we built something beautiful together with all these wonderful nurses. And three of them you met in Houghton, and they are the examples. They’re all like that, wonderful people, and it’s a privilege to work with so many great people.

Lisa: Thank you.