The False Dichotomy that Sinks Mergers and Acquisitions


My firm was called in to integrate two large regional healthcare companies merging into one.

As part of the integration, the acquired company would adopt the EMR (electronic medical records) system of the acquirer. EMR systems are basically the computerized version of paper medical records that clinicians use when working with patients.

The integration team got wind of some annoyance and resistance around the adoption of this records system.

This perplexed them. Yes, there might be a learning curve associated with the adoption of a new records system—but it just didn’t seem like the biggest deal.

At a loss, they took the only step they saw to take: they shared more information. Here’s how you use the system. Here are some troubleshooting tips. Here are some best practices. They even sent out corporate training teams to local offices to ensure the technical aspects of the EMR were understood.

But more information did not alleviate the grumpiness. In fact, nothing changed.


It turns out, the integration team fell into one of the most common pitfalls I see in M&A situations:  the compartmentalization of the technical and human considerations.

On the one hand, the technical aspects of a merger are well understood. Integration teams must consolidate a dizzying array of processes, procedures, and platforms in a variety of domains, from information technology to supply chain management, marketing to accounting, production to human resources. A new EMR system would presumably fit into this category.

Then, separate from those technical points, conversations can be had in the human domain. Questions of identity and values, moods and feelings, relationships and culture.

But in my experience, this ostensibly neat divide between human and technical isn’t a real one. In fact, I often find that the important “human” conversations to be had are lurking within the seemingly “technical” conversations—and those conversations can be left unsurfaced if the human and technical are too rigidly separated.

Back to our example…

We worked with the leadership team to take a different approach altogether, one that began with getting curious about what else was going on when it came to this records system. We got them to probe the annoyance. To ask more questions, such as, “Why does this matter to you? What’s at stake here?” In other words, we get them to go past the technical implications of the change and get to human implications.

And they were quite surprised by what they found.

First, they got more detail as to the nature of the clinicians’ concerns with the EMR system, beyond a general annoyance. They heard stuff like:

“You are micromanaging us through this system. We can’t do our job well with those kinds of constraints.”

“I’m a professional. I don’t need to be handled this way. You don’t trust me to do my job.

“I won’t be able to give the patients what they need. This new system only lets me do a standard procedure. What if they need something else?”

“Everything is going to take so much longer. We’re going to encounter bottlenecks left and right and spend half of our time waiting on approvals to make their way through the system.”

Rather than being defensive, they probed further…they asked the question, “what do you really care about that seems to be at risk here?”

What they heard amazed them. It turns out, what they really cared about was:

Autonomy – “I am given the runway to do what I do best.”

Respect – “I am respected as a professional who knows what they are doing and needn’t be micro-managed.”

Integrity of the care – “I must provide quality care to my patients, and not allow technicalities to get in the way of that.”

Succeeding at my job – “Succeeding at my job is important to me, and I would like to be set up for success.”

From this place, the integration team was able to lead much more powerful conversations with their colleagues. It wasn’t just about the technology—they needed to see how their fundamental cares were being addressed in this technological change.

Were they still able to have the autonomy they needed to do the job well? Could they learn how to use the technology fast enough to be successful at their job and at patient care? And were they seen as critical, discerning, autonomous professionals, rather than robots?

By listening to the fundamental cares, the integration team could acknowledge and validate the concerns around the EMR change and engage in entirely different conversations than simply adding more training and best practices. These were very human conversations, and by connecting from one human to another, many concerns simply fell away. There was nothing to fix—just dots to connect. These conversations freed up their clinician colleagues to do their work with confidence.

It’s no secret that success in mergers and acquisitions is anything but guaranteed. (Harvard Business Review famously puts that success rate at only around 30%.)

It follows, then, that executives that preside over these deals must look to expose any possible blind spots that could put the endeavor at risk. And in our work, the biggest blind spots we see are the human aspects of change that do not easily fit into a given workstream. Or, worse, thinking the human aspects are simply a workstream to be managed. Each technical change could benefit from looking through the lens of the possible fundamental cares (or concerns) that could be threatened through that change.

So ask yourself: are you setting up a false dichotomy between the technical and human aspects of change that are arising in your deal? And do your leaders—the ones interfacing with those most impacted by the change—know how to scratch the surface of seemingly technical changes to explore the fundamental cares and concerns hiding within?