Mastery of Systems Leadership: Where Complexity Moves from Head to Body

In 2025, Danielle Ko joined the inaugural cohort of the Mastery of Systems Leadership: a year-long, immersive journey co-created by Small Giants Academy and Be The Earth Foundation for leaders ready to navigate complexity and drive transformation.

Danielle is the Palliative Care Specialist & Clinical Ethicist at Austin Health, Melbourne — soon to be Medical Director at Olivia Newton John Wellness.

We invited Danielle to reflect on her learning journey so far.

Since embarking on the Mastery of Systems Leadership, what feels different in how you sense the world — its complexity, its tensions, and your place within it?

What feels most different is that complexity now sits in my body rather than only in my head. 

My training in law, medicine, ethics and palliative care has always pushed me to think broadly about causes and consequences, favouring the more rational thinking part of me, but through the MSL program, I have been encouraged to lean and proudly own my instinctive side, which has made things feel less effortful.

I am also more conscious of my own role in the system. Rather than trying to stand outside it as the fixer — something I have often been drawn to in establishing services like the hospital’s Voluntary Assisted Dying Service or the Clinical Ethics Unit, I am more aware of how I shape outcomes through presence, language, timing and trying to choose more carefully what I elevate or leave unspoken. That has made me more deliberate about creating space for complexity to surface rather than smoothing it over too quickly.

Can you share a moment where you noticed yourself responding differently than you would have before this journey?

Across my career I have been quick to challenge inequity or poor process — whether in end-of-life care, access to services, or organisational decision-making. What has shifted is where I now locate the problem.

Over the last 12 months, much of my mental space has been occupied with how the Olivia Newton John Cancer Wellness Centre and programs at my hospital can more effectively contribute to a patient’s overall wellbeing as they receive treatments for cancer.

In the ONJ Wellness work, tensions around access, philanthropy, clinical priorities and constrained public funding collide. Previously, I might have focused my energy on correcting a particular decision or advocating strongly against a specific outcome.

Now, I find myself stepping back first and asking what system conditions are producing this pattern, what narratives about value, risk or scarcity are being reinforced, and what structures or conditions make certain choices feel inevitable.

That same shift has shown up in my other roles, as a senior palliative care specialist or as the Head of our Clinical Ethics Service. I am definitely more curious about what the organisation has made easy, hard, rewarded or ignored.

It has also changed how I respond at home. When family dynamics feel stuck, I am less interested in allocating blame and more curious about what environment we have collectively created and the contributing often hidden factors. 

With my husband and two adolescent boys, I am definitely trying to slow down and ask what else might be shaping this moment: what pressures are invisible, and what incentives or fears are driving behaviour, resulting in less urgency to fix the problem.

How has your relationship to power, agency or responsibility shifted — especially when outcomes are uncertain?

Perhaps the biggest shift has been loosening my grip on the idea that I must personally carry complex problems to resolution.

In my previous senior roles as the former Divisional Medical Director of Cancer Services, or the senior clinician establishing the Voluntary Assisted Dying service back in 2019, I often felt a heavy sense of responsibility when changes or projects did not result in any positive change.  Over the years, this sense of responsibility has been a burden and has negatively impacted my own wellbeing and my ability to be fully present and joyful outside work.

Through this course, I have a better understanding that systems change is something we hold collectively. That in turn has altered how I think about power.

I am now practicing to be less focused on control and more on contribution in terms of what I can convene, name, protect or test, even when the outcome is unclear. I am more open to the idea of experimentation and already notice that I am less destabilised when initiatives or plans falter.

I have also shifted my sense of time. Much of hospital life is driven by urgency and crisis. MSL has helped me hold a longer view of change, with a lighter view on timeframes.

As some of our guest speakers have so eloquently conveyed and embodied, we may not see the change we want in our lifetime, and that is ok. Trying to shift the dial closer to that system even just one degree is still worthwhile and matters. That perspective has been liberating. It has made me more patient, steadier in uncertainty, and clearer about where my responsibility genuinely sits.

If the MSL learning shapes not just what you do, but how you are in the world, what kind of leader or human are you becoming?

I can already feel this learning reshaping me alongside everything else that forms my identity as a doctor, a systems leader, a mother, a partner and a human.

While I have spent much of this reflection talking about systems thinking and organisational change, the biggest impact has actually come through the conversations and extraordinary connections with my fellow MSL participants and facilitators, who are, quite simply, remarkable humans. 

Those interactions have become the thing I hold dearest from this experience. Week after week, when I have arrived carrying frustration from work, or the weight of witnessing world events, those spaces have grounded me, steadied me and reminded me why this work matters. I am deeply grateful to be part of that community.

I am not entirely sure who I am becoming, and I feel that is about right. What I hope is that I can be more in the moment, and someone who notices, cares, and has the courage to act even when the path forward is incomplete.

I would like to be more comfortable being in the unknown, more anchored in the intention to leave things better where I have influence.

👉 Learn more & join the Mastery of Systems Leadership: www.smallgiants.com.au/msl