That got me interested in health care in general because I was in the hospital for several weeks. The first part wasn’t so fun because I was isolated. But then I got into a children’s ward, and the camaraderie was really fun. You would see the senior physician and the entourage of nurses and there was a social/team aspect to it that was attractive. Yeah, I fulfilled the 6th-grade me’s dream, and I was always pretty focused on being a physician from that point on.
I would say it’s a constant learning experience. Every position I’ve had, I’ve learned something. The scale of leadership is very different, and you learn that as you go to different places. Being in charge of something like a research lab where you manage 30 people is very different than being in charge of something that has a couple hundred people—and that’s different than running a medical center with 10,000 people. You learn to relate in different scales and different ways.
Try to position yourself so whatever it is you’re doing feels meaningful to you. It doesn’t matter if it’s medicine or art or whatever. You need to find some meaning in your work. Part of the test is: Do you enjoy what you’re doing? Do you enjoy the people you’re with? Positions don’t work as well if you don’t like the environment and you don’t enjoy your colleagues. Life’s too short for anything less.
Once we get over the technical expertise that we’re looking for, it comes down to the person. Every place has a specific culture. Is this a person that will fit into your culture? Or are you trying to shift your culture and this person exemplifies that shift? When I was dean of a medical school and we were hiring a department chair, one critical part of the interview was to allow that person time to speak with my assistant. I would then talk to my assistant to see what that interaction was like. Was my experience with the interviewee tainted because of the power differential? When it was flipped, and, say, a senior person from Stanford was talking to my assistant, did she have the feeling that the interaction was respectful and interesting? It’s really about getting a sense of what the person is like. Does the person seem authentic? Do they relate in ways that seem natural?
At every stage of my career, I’ve had a different role model. There is one in particular I remember who taught me that you should expect excellence around you but have everyone’s back. Your job is to make everyone else as successful as you possibly can. If the people around you, including the people who report to you, aren’t successful, you’re not successful.
Another thing I’ve learned is that it’s good to set up some rules of the road that fit you personally and serve as guardrails for behaviors. One rule for me is: take the high road. Another rule: don’t be afraid of being caught in the truth. Everyone does things that are bone-headed. It’s better to just admit when you’ve made such a mistake than to try to make excuses or place blame. Another one is: don’t mistake someone who drops the ball for a conspiracy. Often something happens in your environment that doesn’t seem right, and you think, “Oh my goodness, did that person do that to undercut my organization, or me?” It turns out that humans aren’t very good at conspiracies. Typically, someone just dropped the ball, and that’s all there is. Principles should serve as guardrails and help you make decisions.
One of the things I’ve really enjoyed in all of my positions is developing and grooming the next generation of health care professionals. As you get older, you begin to realize that someone’s legacy is not the work that they do, but rather the work that people who were mentored by them do. That’s the only thing that has lasting power.
In the scientific area, I had a very active and productive lab. We were at the forefront of our field. I closed a lab when I went to the University of Chicago. When I look back on it, I feel, in a way, like I still lead the field. Not from work that I do, but from the work that the people do who were trained in my lab.
Our mission statement is to promote the art and science of medicine and the betterment of public health. You think of the opportunity not only to work with 850,000 physicians and federal government employees, but to answer the question, “How can 850,000 physicians, with $3 trillion to spend and 5,000 hospitals to use, deliver the best health outcomes for 320 million Americans?” That’s very motivating.
Medicine changes a little bit each day. You start looking at long periods of time, and you see how profoundly medicine changes. Think about how many children were delivered successfully in 1900—the death rate of that group at the age of 1 was 16 percent. In the year 2000, we went from a death rate of 16 percent at one year to 16 percent of over 60 years. It’s astonishing. To have a role to play in that progress is very motivating.