The counterforce isn’t just a theory. It’s here. It’s alive in those embracing new capabilities—collaboration, humility, and the courage to lead across boundaries toward what really matters.

This is what collective leadership looks like in action. And it’s how we move from talk to traction—through collective action that aligns across organizations, sectors, and lived experiences. At its heart, integrated care is a collaborative act—and without collective leadership and action, it remains a concept rather than a lived reality. But when we commit to a process to lead together—with curiosity, with courage, and with care—we create the conditions for transformation to truly take root.

Over the past decade, I’ve seen this possibility begin to bloom in communities across Canada and beyond. And I’ve also seen the forces that hold us back.There’s a tension we encounter in almost every system change effort: the quiet, persistent pull of the status quo.

The status quo tells us that if we just restructure, launch another pilot, or tweak policy on the margins, we’ll make progress. But we know better. We’ve been in spaces and experiences where everything is “changing”—yet nothing is truly different.

Enter the counterforce.

The counterforce disrupts this cycle. It dares to challenge and reimagine. It pushes us to focus on what truly enables transformation: a commitment to trust building, co-creation, and radical collaboration. It lives in our sense of shared purpose—and in the relationships we build with each other along the way.

We seethis tension play out in boardrooms, at policy tables, among leadership, and onfront lines. But today’s challenges demand something different:
– A shift from egocentric to eco-centric leadership
– A movement from fragmented efforts to authentic convergence
– A transformation from isolated pilots to shared, scalable impact

Imagine if…

  • Our standard operating model emphasized capability-building, collaboration, and collective foresight
  • National initiatives and assets didn’t just coexist, but converged—maximizing their potential for sustained impact
  • We stopped reinventing the wheel and instead built momentum for learning across the system
  • Every health and social care organization in a community aligned on a shared strategic priority—embedded in each     plan—enabling bold leadership both inside organizations and across the larger system

“The counterforce challenges the status quo – it questions, disrupts and reimagines.It champions enabling the conditions and capability we need for transformation, reinforcing the power of social capital: trust, relationships and belonging.”
— Leslee J Thompson & Jodeme Goldhar

That’s the vision Leslee Thompson and I explored in our recent article:
Health Quality 5.0: The Counterforce in Advancing Integrated Care – OurPath to Transformation

Under Leslee’s leadership, Health Standards Organization (HSO) has developed the first maturity model for integrated care—a groundbreaking framework co-designed with people with lived experience alongside those working in health and social care. This model provides organizations and systems with a clear and practical roadmap. It can be leveraged in multiple ways: to inform a possible path forward, to assess progress over time, and to outline a concrete process for committing to and advancing integrated care. It offers a common language and structure that supports alignment, accountability, and shared learning across diverse settings—turning aspiration into action.

Alongsidethis important work, NACIC—The North American Centre for Integrated Care is helping to activate the counterforce acrossCanadian communities by building the leadership, capabilities, and connections needed to advance integrated care at scale. Through shared learning networks, coaching, and convening, NACIC is cultivating the collective leadership Canada needs to accelerate meaningful and measurable system transformation.

At 4CImpact, we partner with leaders, organizations, and communities to turnambition into aligned, sustained action. Our work focuses on building theenabling conditions that allow transformation to take hold—trust, sharedpurpose, system alignment, and collaborative leadership. We support those whoare ready to step into the counterforce and lead forward—not alone, buttogether. Whether facilitating strategic retreats, guiding multi-partner collaborations, or coaching leaders at all levels, 4C Impact is committed to strengthening the human infrastructure that makes transformation possible.

Thank you to Longwoods Publishing for championing conversations that matter.

As Co-Director of NACIC, IFIC Canada, NICE, and McMaster University’s Health Leadership Academy National Health Fellows  and Collaborative Health Governance Programs and Managing Director of 4C Impact, I’ve seen how powerful it can be when people come together—across roles, across sectors, across lived experience—to lead differently.

Together, we can:

  • Create the enabling conditions for transformation
  • Build the relational infrastructure that sustains change
  • Unlock the collective potential of our systems and communities

Read the article here: Health Quality 5.0: The Counterforce in Advancing Integrated Care – OurPath to Transformation

We hope it sparks reflection—and conversation. Because transformation doesn’t belong to a single leader or organization. It belongs to all of us.

And the counterforce?
It begins with how we choose to show up.

‍

Jodeme Goldhar