None of us can envisage how the complex adaptive system of planet Earth and its ecosystems will develop over time, but one thing is certain – that our planet, and the human societies, animals and plants which inhabit it – will change in ways which are unknown and unknowable. The dominant cultural paradigms which have defined modern healthcare and healthcare leadership are being replaced by a new paradigm which is increasingly referred to as ‘metamodernism’. In these two linked blogs, Dr Fiona Day describes this emerging cultural pandemic, and discusses how medical leaders will need to attend to their own development, to be effective in this new paradigm.
Human beings have lived in societies communicating with each other, and have created culture for at least 40,000 years. Cultural ‘memes’ (non-biological units of cultural transmission) are spread between human beings by communication: similar to a virus, some memes take off and ‘go viral’, causing local epidemics. Others become dominant and go on to define global culture – causing a cultural pandemic. The cultural paradigm of ‘modernism/scientific rationality’ has dominated Western healthcare for the last few hundred years, alongside the more recent cultural paradigm of ‘postmodernism’.
These paradigms have brought significant improvements to the health and wellbeing of people and the planet. However even the most well-intentioned interventions often bring unintended negative consequences of their own: we are currently experiencing serious local and global issues relating to inequality, alienation and ecological collapse.
There is evidence, especially in Nordic countries, of an emerging new cultural paradigm which medical leaders may wish to consciously pay attention to, increasingly referred to as ‘metamodernism’. Will this metamodernism meme take off and become a new global cultural pandemic? At this point in time, we don’t know. However, there is a window of opportunity for medical leaders to shape its direction, to enhance the benefits and to mitigate the unintended, inevitable, negative consequences.
Metamodernism is a perspective which transcends and includes many aspects of previous paradigms, and is based on complexity, emergence, and dialectical thinking. Individuals are seen in the context of transpersonal networks integrated with the planetary ecosystem, ie both autonomous and indivisible from others and the whole. Descriptions of a possible metamodern society are based on ideas of cultivating new forms of social welfare – building societies where people feel heard and valued, with a focus on adult development and psychological wellbeing. Metamodern politics focuses primarily on process, in order to ensure that all people can flourish and thrive – and all of this in a way which is open, democratic and without ‘being controlled’. As medical leaders, we know that this must be underpinned by the essential needs of food, security, income, and other key determinants of health: and yet there is also increasing evidence that people with, for example, poor mental health can also experience high levels of wellbeing, and vice versa.
Medical professionals and medical leaders have always worked at the forefront of new ideas and new paradigms, and are increasingly working across systems, organisations and communities in service of their populations. In order to lead in the context of new, post-postmodern cultural paradigms, medical leaders will need to grow their own forms of mind through adult development to embrace the metanarratives of metamodernism.
Dr Fiona Day
Dr Fiona Day is a former Consultant in Public Health Medicine, now working as an Executive Coach offering world-class coaching for senior doctors, medical and public health leaders in the UK and internationally. She specialises in using adult development theory in the context of complexity to enable leadership development.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: I am the sole Director of Fiona Day Consulting LTD and provide executive coaching and mentoring services for doctors and public health leaders.