Remarkably, the issues plaguing the US, Canada and UK, have common themes, despite their differing approaches to healthcare and distinctly varied philosophies and values: 2011 finds Healthcare in the throes of transformational change, locally and globally. In some Canadian provinces, such as Prince Edward Island, change has been as gradual as tectonic plates forming the earth's crust but, Alberta, has known the volcanic eruption of change, destroying what was created before, while organizations and people struggle to survive the onslaught and the aftermath.

• Emergency room overcrowding
• Poor access to care
• Disjointed silos of care
• Escalating costs
• Aging populations
• Dissatisfaction with pharmacologically based algorithmic care
• Separation of mind, body & spirit in the application of the medical model
• Impact of ignoring social determinants of health
• Caregiver & provider burnout
• Challenges, risks & benefits linked with the use of the Internet and medical technology.

But 2011 finds me working as a doctor, healer, teacher and guide within a renewed context of self managed health and wellness. What transformed me and my practice in the last two decades?

The first influence was working collaboratively with patients, families and an inter-disciplinary mix of physician & non-physician providers. The second influence relates to the development of a robust electronic interface within my practice. Lastly, the freeing exchange of knowledge, enabled by the Internet, has broken down walls that once separated doctors, patients and other providers of care.

Many people working in interdisciplinary teams believe they are working collaboratively. I would like to challenge this view using the perspective gained from observing Canada Geese. "Lessons fromGeese" has found worldwide circulation since it was written in 1972 by Dr. Robert McNeish, a biology teacher and student of nature from Baltimore. A combination of aerodynamic benefits and enhanced ability to communicate are thought to be reasons why geese fly in V- formation. They also fly in columns and clusters and V-formation flying occurs less than 25% of the time. Below are a few Facts, Lessons and Reflections comparing the collaborative nature of Geese to that of healthcare providers.

"It pays to take turns doing the hard tasks and sharing leadership. As with geese, people are interdependent on each other's skills, capabilities, and unique arrangements of gifts, talents, and resources"

Fact: As each goose flaps its wings it creates an "uplift" for the birds that follow. By flying in a V-formation, the whole flock adds 72% greater flying range than if each bird flew alone.

Lesson: People who share a common direction and sense of community can get where they are going quicker and easier because they are traveling on the thrust of another.

Reflections: How often do you work as part of a team with others? Do you consider "patients" and "family members" as members of your team?

Fact: When a goose falls out of formation, it suddenly feels the drag and resistance of flying alone. It quickly moves back into formation to take advantage of the lifting power of the bird immediately in front of it.

Lesson: If we have as much sense as a goose we stay in formation with those headed where we want to go. We are willing to accept their help and give our help to others.

Reflections: Do you lift others with your energy? Do you allow yourself to be lifted by another's energy?

Fact: When the lead goose tires, it rotates back into the formation and another goose flies to the point position.

Lesson: It pays to take turns doing the hard tasks and sharing leadership. As with geese, people are interdependent on each other's skills, capabilities, and unique arrangements of gifts, talents, and resources.

Reflections: Does your ego get in the way of recognizing what you need to learn from the experiences of others? Can you balance the needs of the flock and your personal ambitions?

Fact: The geese flying formation honk to encourage those up front to keep up their speed. Lesson: We need to make sure our honking is encouraging. In groups where there is encouragement, the production is greater. The power of encouragement (to stand by one's heart or core values and encourage the heart and core of others) is the quality of honking we seek.

Reflection: Do you recognize when you seek to compete rather than collaborate? Are you secure enough, empowered enough, to give another what they need from you?

Fact: When a goose gets sick or wounded, two geese drop out of formation and follow it down to help and protect it. They stay with it until it dies or is able to fly again, then join another formation or catch up with the flock.

Lesson: If we emulated geese, we would stand by each other in difficult times as well as when we are strong.

Reflections: How much can you give up for another? Today? Tomorrow? In a lifetime? Is the path to your goal linear and rigid? How much change can you tolerate and how flexible are you?

Fact: Geese fly south for the winter in the Northern Hemisphere.

Lesson: It is a reminder to take a break from the cold of winter and take a vacation to some place warm & sunny to rejuvenate ourselves.

Reflections: How well are you? How happy? How content? Are you alive? Are you engaged in your life? When did you last replenish your reservoir?

Fact: The larger flocks of geese usually inhabit areas where eating geese is more popular whereas when there are smaller flocks of geese flying, there is usually smaller demand for geese, to be consumed as food.

Lesson: Larger groups of humans may not always be as effective as smaller groups that can maneuver quickly in life and business without being eaten up by the competition.

Reflections: Is your "team" effective in affecting change that is meaningful? Is your team in "touch" with the real world? How responsive is your team?

These points of reflection are intended to evoke an inner dialogue about "collaborating" with others; physicians, non-physicians, patients, clients, families, caregivers, politicians, policy makers, administrators, students, and those in institutions that are linked with "health care". As the winds of change blow and the currents of transformation threaten us, V-forming our disciplines through true collaboration appears to be the path of least resistance and best direction. Honk, if you agree!