We spend a lot of our time helping health system executives craft and communicate enterprise-level strategy: entering new markets or businesses, developing new services, responding to competitive threats, exploring partnership opportunities. Strategy is about the “what” and “when”—what moves are we going to make, and when is the right time to make them? Answering those questions requires an understanding of industry and market forces, organizational capabilities, and consumer needs. But there’s another important component that often goes missing in the rush to get to the “how” of strategy execution: the “why”.
Yet understanding why we’re pursuing one path and not another is critical for aligning stakeholders: physicians, operators, and (importantly) the board. Joan Didion famously wrote that “we tell ourselves stories in order to live”, and we’d agree; the “why” is about storytelling. What’s the strategic narrative, or story, that frames our intended actions? Making sure that everyone involved—including our patients and consumers—has a clear understanding of why we’re opening a new facility, or launching a new service, or entering into a new partnership, is a key to success.
It’s about sharing the vision of our desired role as a system, and the part we see ourselves playing in improving healthcare. We’re sometimes criticized for spending so much time on “framing” and drawing “pretty graphics”, but we’ve come to believe that the ability to succinctly and compellingly describe the “why” of strategy is as important as coming up with the vision in the first place. And then, of course, delivering on the “why”—a job made easier if all involved are clear on just what it is.
IN THE New York Times, Stephen I. Sadove, chairman and chief executive of Saks Inc., explains that it is culture that drives results:
It starts with leadership at the top, which drives a culture. Culture drives innovation and whatever else you’re trying to drive within a company — innovation, execution, whatever it’s going to be. And that then drives results.
When I talk to Wall Street, people really want to know your results, what are your strategies, what are the issues, what it is that you’re doing to drive your business. They’re focused on the bottom line. Never do you get people asking about the culture, about leadership, about the people in the organization. Yet, it’s the reverse, because it’s the people, the leadership, the culture and the ideas that are ultimately driving the numbers and the results.
While we know that our most important resource is our people, it’s not so easy to get people “all in”—convincing people to “truly buy into their ideas and the strategy they’ve put forward, to give that extra push that leads to outstanding results.”
All In by Adrian Gostick and Chester Elton explains why some managers are able to get their employees to commit wholeheartedly to their culture and give that extra push that leads to outstanding results and how managers at any level, can build and sustain a profitable, vibrant work-group culture of their own. All In takes the principles found in their previous books—The Orange Revolution and The Carrot Principle—and expands on them and places them in a wider context.
They begin by explaining that it all rests on the “belief factor.” People want to believe, but given the fact that “failure could cost them their future security why shouldn’t they be at least a little dubious about your initiatives?” But belief is key. “As leaders we must first allow people on our teams to feel like valuable individuals, respecting their views and opening up to their ideas and inputs, even while sharing a better way forward. It’s a balancing act that requires some wisdom.”
To have a culture of belief employees must feel not only engaged, but enabled and energized. What’s more, “each element of E+E+E can be held hostage by an imbalance in the other two.”
The authors have created a 7 step guide to develop a culture where people buy-in:
Define your burning platform. “Your ability to identify and define the key “burning” issue you face and separate it from the routine challenges of the day is the first step in galvanizing your employees to believe in you and in your vision and strategy.”
Create a customer focus. “Your organization must evolve into one that not only rewards employees who spot customer trends or problems, but one that finds such challenges invigorating, one that empowers people at all levels to respond with alacrity and creativity.”
Develop agility. “Employees are more insistent than ever that their managers see into the future and do a decent job of addressing the coming challenges and capitalizing on new opportunities.”
Share everything. “When we aren’t sure what’s happening around us, we become distrustful….In a dark work environment, where information is withheld or not communicated properly, employees tend to suspect the worst and rumors take the place of facts. It is openness that drives out the gray and helps employees regain trust in culture.”
Partner with your talent. “Your people have more energy and creativity to give. There are employees now in your organization walking around with brilliant ideas in their pocket. Some will never share them because they don’t have the platform to launch those ideas on their own. Most, however, will never reveal them because they don’t feel like a partner in the organization.”
Root for each other. “Our research shows incontrovertible evidence that employees respond best when they are recognized for things they are good at and for those actions where they had to stretch. It is this reinforcement that makes people want to grow to their full shape and stature.”
Establish clear accountability. “To grow a great culture, you need to cultivate a place where people have to do more than show up and fog a mirror; they have to fulfill promises—not only collectively but individually.” And this has to be a positive idea.
Gostick and Elton explain that the “modern leader provides the why, keeps an ear close to those they serve, is agile and open, treats their people with deference, and creates a place where every step forward is noted and applauded.”
The authors skillfully examine high-performing cultures and present the elements that produce them. A leader at any level can implement these ideas to drive results. A great learning tool.
Just days after a landslide election victory for the Conservative Party, Britain’s Prime Minister Boris Johnson just made a massive and bold announcement: He’ll get laws passed to guarantee plenty of cash for the state-run healthcare system.
The official announcement will likely come Thursday when the Queen, who is the official head of state, will reopen Parliament and outline the coming legislative agenda. Tucked within her speech will be a call for £34 billion ($45 billion) in annual taxpayer money for the National Health Service (NHS).
While other countries embrace their private health systems, the British love their publicly funded NHS, an employer of 1.5 million people, which services the population of 66 million. In general, the people are concerned about the quality of care provided by the NHS and look to the government for solutions, says Mary Macleod, a senior client partner for Korn Ferry’s Board and CEO Services practice and a former Conservative Party MP. “The NHS does become a bit of a political football,” she says. “And to a large extent, everyone in the UK feels that they are stakeholders in it.”
The pledge to secure NHS money will likely bolster Johnson’s political leadership versus the opposition Labour Party. And the move also neutralizes critics that have barraged the Conservative Party with allegations that it would sell parts of the NHS to foreign investors. In other words, pushing a new funding law through Parliament could partially neutralize political opponents.
But the politics of the matter is only part of the announcement’s strength, Macleod says. Promising the NHS years of generous financing will allow the organization to develop a strategy for how it will care for the country’s population for years into the future. In short, Macleod says, it sends a message to the NHS leadership: You can get busy now. “If you now know you are getting the funding, you can plan ahead,” she says.
Johnson’s lack of specifics about how the NHS should spend the money could be a strength. In a sense, he has empowered the organization’s leadership to make the decisions that they deem suitable. “What the prime minister is not doing is defining the solutions,” Macleod says. But she also notes that he will want results in the form of improved service from the organization. “He will hold them accountable,” she says.
While there are benefits when leaders take bold steps, there are also risks, says Christina Harrington, Korn Ferry’s head of advisory services in Stockholm, Sweden. She says it is good for leaders to act quickly and with conviction, as the public expects that of its leaders. But that alone isn’t enough. She says the problem comes when there’s too much ego involved. “You need an egoless conviction to drive a decision making the greater good,” she says.
Ideally, the driver of proposed changes needs to have a long-term vision of something better than the current situation. If that vision is lacking, then the leader may lack the required stamina to get the job done. Indeed, if headline-grabbing is all that the boss wants, then he or she might wind up doing a U-turn. “If there isn’t a long-term vision, then another fast decision may come in the other direction,” Harrington says. “And that’s what we see a lot of.”
On his first day as CEO of the Carlsberg Group, a global brewery and beverage company, Cees ‘t Hart was given a key card by his assistant. The card locked out all the other floors for the elevator so that he could go directly to his corner office on the 20th floor. And with its picture windows, his office offered a stunning view of Copenhagen. These were the perks of his new position, ones that spoke to his power and importance within the company.
Cees spent the next two months acclimating to his new responsibilities. But during those two months, he noticed that he saw very few people throughout the day. Since the elevator didn’t stop at other floors and only a select group of executives worked on the 20th floor, he rarely interacted with other Carlsberg employees. Cees decided to switch from his corner office on the 20th floor to an empty desk in an open-floor plan on a lower floor.
When asked about the changes, Cees explained, “If I don’t meet people, I won’t get to know what they think. And if I don’t have a finger on the pulse of the organization, I can’t lead effectively.”
This story is a good example of how one leader actively worked to avoid the risk of insularity that comes with holding senior positions. And this risk is a real problem for senior leaders. In short, the higher leaders rise in the ranks, the more they are at risk of getting an inflated ego. And the bigger their ego grows, the more they are at risk of ending up in an insulated bubble, losing touch with their colleagues, the culture, and ultimately their clients. Let’s analyze this dynamic step by step.
As we rise in the ranks, we acquire more power. And with that, people are more likely to want to please us by listening more attentively, agreeing more, and laughing at our jokes. All of these tickle the ego. And when the ego is tickled, it grows. David Owen, the former British Foreign Secretary and a neurologist, and Jonathan Davidson, a professor of psychiatry and behavioral sciences at Duke University, call this the “hubris syndrome,” which they define as a “disorder of the possession of power, particularly power which has been associated with overwhelming success, held for a period of years.”
An unchecked ego can warp our perspective or twist our values. In the words of Jennifer Woo, CEO and chair of The Lane Crawford Joyce Group, Asia’s largest luxury retailer, “Managing our ego’s craving for fortune, fame, and influence is the prime responsibility of any leader.” When we’re caught in the grip of the ego’s craving for more power, we lose control. Ego makes us susceptible to manipulation; it narrows our field of vision; and it corrupts our behavior, often causing us to act against our values.
Our ego is like a target we carry with us. And like any target, the bigger it is, the more vulnerable it is to being hit. In this way, an inflated ego makes it easier for others to take advantage of us. Because our ego craves positive attention, it can make us susceptible to manipulation. It makes us predictable. When people know this, they can play to our ego. When we’re a victim of our own need to be seen as great, we end up being led into making decisions that may be detrimental to ourselves, our people, and our organization.
An inflated ego also corrupts our behavior. When we believe we’re the sole architects of our success, we tend to be ruder, more selfish, and more likely to interrupt others. This is especially true in the face of setbacks and criticism. In this way, an inflated ego prevents us from learning from our mistakes and creates a defensive wall that makes it difficult to appreciate the rich lessons we glean from failure.
Finally, an inflated ego narrows our vision. The ego always looks for information that confirms what it wants to believe. Basically, a big ego makes us have a strong confirmation bias. Because of this, we lose perspective and end up in a leadership bubble where we only see and hear what we want to. As a result, we lose touch with the people we lead, the culture we are a part of, and ultimately our clients and stakeholders.
Breaking free of an overly protective or inflated ego and avoiding the leadership bubble is an important and challenging job. It requires selflessness, reflection, and courage. Here are a few tips that will help you:
- Consider the perks and privileges you are being offered in your role. Some of them enable you to do your job effectively. That’s great. But some of them are simply perks to promote your status and power and ultimately ego. Consider which of your privileges you can let go of. It could be the reserved parking spot or, like in Cees ‘t Hart’s case, a special pass for the elevator.
- Support, develop, and work with people who won’t feed your ego. Hire smart people with the confidence to speak up. Humility and gratitude are cornerstones of selflessness. Make a habit of taking a moment at the end of each day to reflect on all the people that were part of making you successful on that day. This helps you develop a natural sense of humility, by seeing how you are not the only cause of your success. And end the reflection by actively sending a message of gratitude to those people.
- The inflated ego that comes with success — the bigger salary, the nicer office, the easy laughs — often makes us feel as if we’ve found the eternal answer to being a leader. But the reality is, we haven’t. Leadership is about people, and people change every day. If we believe we’ve found the universal key to leading people, we’ve just lost it. If we let our ego determine what we see, what we hear, and what we believe, we’ve let our past success damage our future success.
In a presentation to investors this week, retail pharmacy giant CVS Health announced plans to expand its “HealthHUB” store concept, first launched at three store locations in Houston, to 1,500 stores in the next three years.
The new store concept, built to take advantage of CVS’s 2018 acquisition of health insurer Aetna, is centered around providing more extensive care management and wellness services than traditionally available at the chain’s Minute Clinics. In addition to Houston, the company is targeting Atlanta, Philadelphia, and Tampa, all in states where Aetna’s existing insurance footprint and the new care offerings can be combined to create new benefit designs and consumer engagement approaches.
In a wide-ranging discussion of the company’s future strategies, CVS executives also outlined plans for delivering home-based dialysis, expanded in-store primary care services, and further expansion of virtual care. In sum, CVS is banking on its ability to lower care costs for health plan enrollees and increase use of its clinic services to grow incremental revenue by $850M in the next three years, and $2.5B longer term.
We continue to view CVS as an entirely new kind of healthcare delivery company, bringing together convenient, lower-acuity care services and a risk model that will allow it to prosper by reducing the cost of care and building consumer loyalty. The speed of CVS’s rollout of this new value proposition should be a wake-up call to traditional healthcare providers everywhere.