Andrews University

School of Education
LEADERSHIP SYNTHESIS PAPER
!Y LEADERSHIP "#URNEY
AN EYE T# THE $UTURE
A Pa%er
Presented in Partial $ulfill&ent
of the Re'uire&ents for the De(ree
Doctor of Philoso%hy
)y
Dean Sher*ai
Dece&+er ,-./
0 1o%yri(ht +y Dean Sher*ai ,-./
All Ri(hts Reserved
$or the co&%lete %ortfolio visit htt%22www3instituteforhealthya(in(3co&2%ortfolio
4Password andrews.,/5
6The a+ility to see the world fro& another set of eyes7 to e8%erience thin(s vicariously7 at
&ulti%le levels7 is trainin( (round for such feats of i&a(ination and reason that allow a Hol&es
to solve al&ost any cri&e7 an Einstein to i&a(ine a reality unli9e any that we:ve e8%erienced
+efore 4in 9ee%in( with laws unli9e any we:ve co&e u% with +efore57 and a Picasso to &a9e art
that differs fro& any %rior conce%tion of what art can +e3;
!aria <onni9ova
Introduction
As &y =ourney throu(h this +eautifully or(ani*ed leadershi% doctorate co&es to a close
and the =ourney &oves forwards7 I have reali*ed the i&%ortance of an educational %ro(ra& that is
focused on stren(ths of a leader and the life =ourney that (oes with it3
This conce%t of learnin(7 teachin(7 and livin( is in %erfect ali(n&ent with what we are
learnin( a+out hu&an +ehavior at the individual7 (rou%7 and %o%ulation levels7 and &ost nota+ly
at the neuro+ehavioral and neuroleadershi% levels3
In this synthesis %a%er7 which is a written odyssey of &e +eco&in( a leader7 I have
atte&%ted to chronicle &y =ourney inward and that with others3 I have reflected on &y vision of
leadershi%7 and how I have learned to ali(n and syner(i*e this vision with an incredi+ly diverse
world of leaders7 +y seein( the world throu(h their eyes and their %ers%ective3 The o+=ect of &y
=ourney has +een e&%owerin( the ra%idly e8%andin( a(in( co&&unities and the co&&unities
that e&+race the&7 +y hel%in( the& see the stren(ths and resources that they %oses3
>hat is &ost re&ar9a+le a+out this %ro(ra& is that it is truly a+out +uildin( leadershi%
fro& inside out3 If a %erson doesn:t develo% the tools to &ana(e their own life how can they +e
ho%ed to lead others3 This %ro(ra& is entirely a+out e&%owerin( each candidate develo% the
.
tools of self?&otivation7 infor&ation &ana(e&ent7 visionin(7 or(ani*in(7 and develo%in( the
coura(e to lead in a challen(in( =ourney of self?discovery3
!y %ersonal =ourney of leadershi% has not +een a %erfectly lucid one7 +ut was at ti&es
o%a'ue and out of focus7 as I have encountered &ultitude of i&%edi&ents +ut what has 9e%t &e
&ovin( forward towards (reater clarity has +een a set of values that &y %arents had inculcated in
&e3 These values include always havin( ho%e in &an:s ca%acity to chan(e and sha%e a +ri(hter
futures@ always %ursuin( 9nowled(e and &a9in( it the +asis of one:s actions@ thou(h co&%assion
is the o+=ective e&%ower&ent &ust +e the tool7 and thou(h chan(e is a constant we can never
ho%e to &ana(e it without coura(e3
In this synthesis %a%er I will +e reflectin( on how &y =ourney has chan(ed &e and how7
with the new insi(ht that I have ac'uired7 I ho%e to e&%ower others3
Loo9in( to the Past to $ind &y Stren(ths
#ver the last ,- years I have en=oyed a &yriad of leadershi% %ositions3 I have had
successes and failures3 I have ins%ired %eo%le and at ti&es have failed as a leader3 In loo9in(
+ac9 at &y years as a leader7 (oin( throu(h the %ersonality analyses7 and &ore i&%ortantly7 the
self?analysis7 and havin( received in%ut fro& friends7 fa&ily7 and cowor9ers7 I started the
%ro(ra& with a clearer vision of who I had +een as a leader3 The first few &onths of the
leadershi% %ro(ra& was the &ost infor&ative %eriod of &y life3 Des%ite &y %sycholo(y7 and
neuro+ehavioral +ac9(round I never too9 the ti&e to do the 9ind of self?reflection that ca&e
fro& this e8ercise3 This %rocess &ade &e &ore aware of &y wea9nesses and &y stren(ths7 and
hel%ed &e reali*e that the way forward would have to +e for(ed around &y stren(ths7 and &ore
i&%ortantly around &y %atients: and their co&&unity:s stren(ths3 #n reviewin( the co&%ilation
of tests we co&%leted and reflectin( on the& in the conte8t of &y life e8%eriences7 the stren(ths
,
that consistently e&er(ed were e8travertedness7 action?oriented7 hi(hly &otivated7 self?driven7
9nowled(e see9in(7 data driven7 and yet &otivational3 #ther characteristics that also stood out
were a need to ta9e on al&ost i&%ossi+le &issions7 and to &arshal resources7 as well as an
a+ility to &otivate others 4&yers +rin(s7 stren(th finders53 Thus &y leadershi% 'ualities can +e
su&&ari*ed as data driven ins%irational leadershi% loo9in( to the future3
Early on in &y career the 'uestion was how to focus &y stren(ths around &y drea& of
+rin(in( a new a%%roach to care of the elderly3 The two (oals I started this %ro(ra& with were to
have a &ore focused and strate(ic a%%roach to the %ro+le& of a(in( throu(h creation of the a(in(
institute7 and to esta+lish an or(ani*ed didactic %ro(ra& that further enhanced &y stren(ths and
filled the (a%s in &y leadershi% ca%acity3
>ith re(ards to enhancin( &y stren(ths7 I created a s%ecific curriculu& to +uild &y
%ersonal %hiloso%hical and ethical theories 4.a7 .+7 .c57 co&&unication 4,a57 conflict resolution
4,+57 social res%onsi+ility 4,d57 9nowled(e of diversity 4,e5 s9ills3 As it %ertained to &y
wea9nesses7 I set sail to create the ri(ht curriculu& to +uild &y data analysis7 'ualitative7 and
research s9ills in (eneral 4Aa?d5 as well as &y &ana(e&ent and leadershi% throu(h or(ani*ational
s9ills 4/a?/e53
The >hy of the #dyssey
It was li9e any other clinic day and I was scheduled to see several new %atients in a row3 I
was e8%ected to (et a history7 do a co&%lete neurolo(ical e8a&7 order so&e la+s7 write &y notes7
while the %atients and their fa&ilies were still in the roo&7 (ive the& the dia(nosis and %lan7 and
(et to the ne8t %atient within the allotted ti&e of half hour3 I saw this %articular fa&ily at the
+e(innin( of &y career in Lo&a Linda 4,--B5 as an attendin( and de&entia s%ecialist3 I was told
that %atient 6"; and her hus+and were in the roo& waitin( for &e3 I was also told that he used to
/
+e a %hysician and had recently fallen on hard ti&es3 As I entered the roo& I saw a cou%le who
were in their &id B-s and I could i&&ediately sense the +urdens and trou+les in their eyes3 After
introducin( &yself7 consistent with usual %rotocol7 I as9ed if I could tal9 to the %atient:s hus+and
se%arately3 The %ur%ose of the se%aration is to allow the care(ivers to s%ea9 freely a+out the
difficulties and chan(es they have witnessed in their %artner3 The %atients are often unaware of or
in denial and an(ry a+out everyone:s concerns re(ardin( the &e&ory and +ehavioral issues3
#nce in the ne8t roo& with Dr3 6P; this very stoic and laconic &an suddenly let down the facade
and started to so+ li9e a child3 This &an who had +een &arried to the love of his life for C, years
and was now seein( this vi+rant7 active7 and %owerful wo&en disa%%ear in s&all &easure in
front of his eyes7 had lost control over his life3 He had no idea how to e&otionally deal with loss
of a life lon( friend7 and the chan(es in %ersonality he was seein(3 This ca%a+le %hysician didn:t
9now how to deal with all the social and &edical needs of an all enco&%assin( disease3 This
%erson who had co&%lete control over his fiscal state recently found out that financial %redators
had (otten to his wife a few &onths earlier and had e&%tied their +an9 account3 )ut &ost
i&%ortantly he had no idea how to &a9e the rest of her =ourney =oyous and di(nified3 So all I was
e8%ected to tell her was that she has Al*hei&er:s de&entia as o%%osed to so&e esoteric disease7
and she is to ta9e a &ar(inally effective &edicine that is not e8%ected to influence the course of
her disease for the ne8t few years7 and that we had no other resources to hel% the&D I could not
acce%t this %redicta+le role7 and I wanted to do &uch &ore3 I wanted to start a &ove&ent to
e&%ower &y %atients and their fa&ilies3
>ith the ra%id rise in the a(in( %o%ulation7 and the (rowin( cost of chronic diseases
associated with a(in(7 the current disease +ased &odel of elderly care will +e ra%idly
overwhel&ed 4<nic9&an7 ,--,53 This (rowin( %o%ulation uses &ore than B-E of the health care
A
dollars7 and a lion share of the cost is due to inefficient service delivery7 lac9 of %reventive care7
and si(nificant a+sence of access3 The very (rou% that re'uires close follow u%7 access to
co&&unity resources7 9nowled(e and availa+ility of +etter nutrition7 and e8ercise %ro(ra&s is
the (rou% that &ost often uses health care only under e&er(ency circu&stances7 which is the
&ost e8%ensive for& of healthcare 4!cFlynn7 ,--/@ #rs*a(7 ,--G@ Schoen7 ,--B53 !ore
i&%ortant than the &onetary cost is the fact that this inefficiency will cost lives and incur &uch
sufferin(3
Havin( dealt with this cynical and destructive a%%roach to care I reali*ed that I had to try
and chan(e the %aradi(& fro& a disease +ased &odel to one of di(nity and care throu(h
e&%ower&ent of those sufferin( fro& chronic diseases of a(in(3 The first ste% was to %in%oint
the needs of the a(in( %o%ulation in &y re(ion7 identify the resources needed to fulfill those
needs7 catalo( what currently e8ists7 and usin( the (reater co&&unity 4acade&ic7 faith?+ased7
+usiness7 %olicy &a9ers7 and the rest of the co&&unity5 atte&%t to create +etter access to
continuous care for the elderly3 I saw this +ur(eonin( a(in( crisis and the chronic diseases that
co&e with it as an o%%ortunity to shift care towards a collective syner(istic and %reventive &odel
that could +e translated to all other co&&unities around the country3 This a%%roach is a %erfect
reflection of &y leadershi% &odel of e&%owerin( leadershi% throu(h stren(th develo%&ent and
syner(y 4Al+recht7 H Andreeta7 ,-..53 This a%%roach of seein( the world throu(h &any eyes7
(ives a &uch richer and co&%rehensive view of the solutions ahead of us3
The I&a(es $ro& the Past That 1reated &y Iiew of Leadershi%
Throu(hout &y life I have +een surrounded +y a&a*in( %eo%le who (ave &e all the
insi(ht I needed with re(ards to life3 !y earliest so?called &entor was &y (rand&other who7 I
+elieve7 was the &ost intelli(ent %erson I have ever 9nown3 Fiven that I have +een in &any of
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the world:s +est acade&ic settin(s7 I:& descri+in( an older wo&en fro& Af(hanistan as the
s&artest %erson I have even 9nown3 She (rew u% at a ti&e and a %lace where wo&en were not
su%%osed to (et educated3 Yet all I can re&e&+er7 fro& very early on7 is her =oy of sittin( on a
co&forta+le chair with a cu% of tea in hand and readin(3 )ut there was &uch &ore to herKshe
was a co&&unity leader and would dedicate at least three days of the wee9 to hel% others3 In fact
she was the one that first lit the li(ht of %assion for 9nowled(e and %eo%le7 throu(h her actions
and how she en=oyed learnin( and hel%in( others3
Since that childhood I have lived a very eventful life7 which saw us &i(rate to United
States when &y native land was devastated +y the Russian confederacy7 then (oin( throu(h
several schools with &ini&al 9nowled(e of the En(lish lan(ua(e7 and then to the halls of the
(reatest research institute in the world 4National Institutes of Health57 wor9in( with (reatest
researchers7 and su+se'uently to Af(hanistan as the de%uty &inister of health7 creatin( the
healthcare syste& of that +elea(uered country3 !any de(rees7 / fellowshi%s7 and thousands of
&iles laterKwhat is hu&+lin( is that &ost of what &a9es &e who I:& today was carved into &y
soleKat the side of an older wo&en drin9in( tea and lau(hin( =oyously at the stories she read to
&e3 >hat I re&e&+er the &ost a+out her is the e8%ressions in her eyes@ the 9ind s&ile when she
hel%ed the children and the downtrodden7 the focus reflective in her +rows and %u%ils when she
was readin( an interestin( story@ and the wisdo& that was reflected in her eyes when she was
teachin( a life lesson3 There are far too &any others that have had (reat influence on &y life7 +ut
the one7 whose eyes a%%eared to e&it rays that o%ened doorways into other worlds7 is the one
that stands out the &ost in &y life3
C
Leadershi% and the Self
6A &an:s felicity consists not in the outward and visi+le +lessin( of fortune7 +ut in the inward
and unseen %erfections and riches of the &ind3;
Tho&as 1arlyle
Althou(h leadershi% is a+out influencin( others the &ost i&%ortant feature of that
relationshi% starts with the self3 This relationshi% is an invest&ent in ti&e and ener(y +y all
%arties3 In order for individuals to invest in the vision of the leader they &ust +elieve and trust
the leader3 Develo%&ent of %ersonality traits7 values7 +ehaviors and %hiloso%hical %ers%ectives
that are consistent7 other focused7 and7 +y e8tension7 trust worthy can only ha%%en when a leader
has had the ca%acity and coura(e to loo9 dee%ly into hi&2herself and has found co&fort in those
+eliefs3 It is that inward eye that is the &ost i&%ortant one to develo% in a leader3 It is this eye
that hel%s the leader 9now the&selves7 develo% the&selves around a consistent set of values and
%hiloso%hies7 identify an ethical fra&ewor97 and a syste& of %er%etual self i&%rove&ent in order
to connect with others fro& a secure center 4self53
It is only with this ty%e of arduous wor9 on oneself throu(h reflection that one can
develo% the character that can en(ender trust and loyalty fro& others3
Philoso%hical $oundations
6Your +eliefs +eco&e your thou(hts7 your thou(hts +eco&e your words7 your words +eco&e
your actions7 your actions +eco&e your ha+its7 your ha+its +eco&e your values7 your values
+eco&e your destiny3;
!ahat&a Fandhi
!y %hiloso%hical fra&ewor9 is a continuu& of servant leadershi% and e&%owerin(
leadershi%3 they are two sides of the sa&e coin7 and are interde%endent 4Send=aya7 ,--,53 The
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central idea +ehind servant leadershi% is to %ut others first3 Thou(h this idea has +een around for
&any years7 it was first coined +y Ro+ert Freenleaf in his essay7 6The Servant as Leader;7 in
.LG- 4Freenleaf7 ,--,53 It was here that he was 'uoted as sayin(@
Servant leadershi% is all a+out e&%ower&ent of the %erson7 and a +elief in the infinite
ca%acity of each %erson7 and a (ood leader:s a+ility to +rin( out the +est out of their followers
4Russell7 ,--,53 E&%owerin( leadershi% can only start with the other in &ind7 +ecause it is only
in this &anner that one can en(ender trust 4Send=aya7 ,-.-53
E&%owerin( leadershi% is an ac9nowled(e&ent of the incredi+ly uni'ue (ifts of each
individual and what they can +rin( to society7 if e&%owered with the ri(ht tools7 at the ri(ht ti&e7
for the ri(ht %ro=ects3 This conce%t +uilds on the idea that7 as leaders7 we can +rin( the full force
of our follower:s +rains 4. 8 .-
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neuronal connections5 to its full creative %otential when we
e&%ower the& with the ri(ht tools and conditions 4Mhan(7 H )artol7 ,-.-53
!y (reatest e8a&%le and e&+odi&ent of this ty%e leadershi% ca&e fro& a servant leader
called Dr3 Fordon Hadly7 a Seventh?day Adventist servant leader7 who was often found in the
&ost i&%ro+a+le %laces in the world3 >here I first learned of this &an and a livin( &odel of this
ty%e of leadershi% was in Af(hanistan durin( the tyrannical rei(n of the Tali+an7 when the only
>esterner hel%in( the %eo%le of this +elea(uered country was Fordon3 It was here that I saw how
(enuine servant leadershi% can serve to chan(e hearts and &inds3
#nly when servant leadershi% +eco&es %art of one:s +elief syste& and is inculcated into
one:s very e8istence will +e ta9en as (enuine and en(ender trust3 This is when the followers
would +e o%en for chan(e and e&%ower&ent3
B
>hen the consistency and selflessness of your +eliefs ta9e away the vail of e8istence and
&a9e you trans%arent is when others can see ri(ht throu(h to your core and see the %urity of your
%ur%ose and follow you anywhere3
Ethics7 Ialues7 and S%irituality
There is a lens of values and ethics throu(h which I see &yself livin( this (ood life3 As I
have (rown older and7 ho%efully7 wiser &y lens has +eco&e &ore tolerant and understandin( of
the life circu&stances that have +rou(ht others to where they are today3 I have also develo%ed a
+roader and universal7 wide an(le7 view of e8istence7 +eyond the e8i(encies of the &o&ent and
one that (ives &e a view of &y e8istence in relation to the universe around &e3 This latter
%ers%ective I consider a s%iritual %ers%ective and one that should always su%ersede the &yo%ic
ethics of the &o&ent3
Ethics7 values7 and s%irituality are central to &y a%%roach to leadershi%3 I would (o as far
as to say that they are central to any leaderNs a%%roach3 These are the conce%ts that fra&e and
(ive oversi(ht to how we see the world around us3 >ithout values and an ethical fra&ewor97 the
leader will +e decidin( on the vision7 &ission7 and (oals solely fra&ed +y the linear land&ar9s of
the %ro=ect3 They will not ta9e into account the +roader i&%lications of the %ro=ect over ti&e7 the
(reater co&&unity7 and hu&anity in (eneral3 Ethics and values si&%ly %lace a historical
%ers%ective of what is ri(ht and wron( for hu&an +ein(s +eyond the &yo%ic li&its of the (iven
%ro=ect3 The s%iritual %ers%ective elevates it to even hi(her vision3 It (ives it conte8t +eyond
oneNs i&&ediate life and &eanin( fro& a &uch hi(her altitudes3 The difference +etween ethics
and values is that ethics is i&%osed fro& outside and values are what is drawn fro& inside
4Stanford7 ,-..53 S%irituality is very difficult to define7 +ut one that resonated with &e was the
relationshi% that each individual has with a %erceived hi(her +ein( and2or hi(her %ur%ose
L
4htt%22u&&3edu2health2&edical2alt&ed2treat&ent2s%irituality53 1entral to &y desire to +e a true
leader is a stron( foundation of values and s%iritual connection3 S%irituality (ives a leader:s
%erceived values or ethics sta+ility +eyond the ca%ricious whi&s of ti&e7 s%ace7 and
circu&stance3 It is only with this inculcated sta+le set of o%eratin( %rinci%les that one can ho%e to
influence others durin( ti&es of chan(e and chaos3 It has +een with &y values and ethical
%aradi(& as well as a s%iritual view of the world around &e that I have ta9en on this %ath less
traveled +y doctors3 This %ath that often ta9es &e +eyond &y co&forts *one and into un9nown
territory of co&&unity e&%ower&ent3 I ho%e that &y (reater s%iritual %ers%ective will continue
to %rovide &e with the coura(e to face difficult challen(es and +rin( a+out chan(e3 Fiven that
the fastest (rowin( se(&ent of our %o%ulation are the elderly7 and today our %olicies re(ardin(
care7 and lon( ter& value of this %o%ulation is nothin( less than dis&issive7 I would li9e to have
influence in chan(in( %olicy towards (reater value and i&%ortance in this %o%ulation3
Learnin( and Hu&an Develo%&ent
>hat I have en=oyed the &ost in life has +een a continually chan(in( and &ore vivid
landsca%e of reality around &e3 Thou(h the central the&e of &y life7 as re%resented +y &y
values and ethics7 &ay not have had seis&ic shifts7 &y view of that landsca%e has +eco&e &uch
richer and fulfillin(3 >hat has contri+uted to this enrich&ent of %ers%ective and vision has +een
a continued 'uest for 9nowled(e3
Leadershi% fosters an understandin( of the %rinci%les of learnin( and is co&&itted to
continuous %ersonal7 inter%ersonal7 (rou%7 and or(ani*ational learnin(3 Learnin( and hu&an
develo%&ent is central to leadershi% today &ore than ever +efore3 Leadershi% in the ,.st century
is a+out a continuous 'uest for 9nowled(e7 and constantly 9ee%in( infor&ed a+out the ever?
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chan(in( infor&ation hori*ons3 !ost i&%ortantly7 leadershi% is a+out leadin( +y e&%owerin(
others throu(h 9nowled(e3
In &y search into this su+=ect &y studies +rou(ht &e to the wor9 of Dr3 )loo& and the
wor9in( (rou% that ca&e u% with the learnin( ta8ono&y in .LJA3 this ta8ono&y was created as a
for&al &ethod of syste&atically and re%roduci+ly educatin( students3
4htt%22en3wi9i%edia3or(2wi9i2)loo&NsOta8ono&y53 The ori(inal idea stratified education alon(
three do&ains co(nitive 49nowled(e H critical thin9in(57 affective 4attitude and e&otions57 and
%sycho&otor 4doin(53 An i&%ortant as%ect of this conce%t is that hi(her levels of learnin( are
de%endent on learnin( and &asterin( the lower levels7 and that the three do&ains are
interde%endent at so&e levels3 Since then there have +een &any iteration and innovations a%%lied
to this sentinel wor9 4htt%22www3celt3iastate3edu2%dfs?
docs2teachin(2Revised)loo&sHandout3%df53 #ne of the first su+ cate(ories of the ta8ono&y is
9nowled(e7 which neurolo(ically can +e &a%%ed to the &ediote&%oral lo+es of the +rain7 which
is the short ter& &e&ory centers7 occi%ito?te&%ero?%arietal association re(ion7 which is the
infor&ation %rocessin( area7 and frontal lo+e7 which functions to hel% us %rocess and
co&%rehend conce%ts 4De&asio7 ,---53 At the sa&e ti&e7 our a+ility to understand words ta9es
%lace in the left %arietal lo+e7 s%ecifically7 >erni9e:s corte87 which has the sole role of
understandin( lan(ua(e 4Ro+son7 ,-./@ Lesser7 .LBC@ Heil&an7 .LGC53 The e&otional as%ects of
co(nition ori(inates in the a&y(dala7 which is %art of the li&+ic e&otional syste&s involvin( the
hi%%oca&%us7 a&y(dala7 foni87 %arahi%%oca&%al (yrus7 cin(ulate (yrus7 and dentate (yrus
4"ose%h7 ,-..53 So&e of the newly reco(ni*ed structures hel%in( in learnin( and teachin(7 which
involve our a+ility to e&%athi*e with others are the &irror neurons as well as the cin(ulate (yrus
4Iaco+oni7 ,--L53 Today we are a+le to not only &a% the functional centers of the +rain across
..
different activities such as learnin(7 +ut to o+serve it as it ta9es %lace usin( such tools as
functional &a(netic resonance i&a(in( 4f!RI5 41hen7 ,-.,53 Havin( (reater 9nowled(e of the
neuroanatony7 as well as a +etter loo9 into the functional as%ects of the +rain throu(h i&a(in(
4f!RI5 we now reco(ni*e the i&%ortance of the affective as%ects of the +rain on the %rocessin(
and &e&ori*in( co&%onent:s accessi+ility to learnin( as well as its resilience as we a(e
4Sher*ai7 ,-..53 The future of learnin( and teachin( is very +ri(ht as we will +e a+le to
&a8i&i*e the tre&endous ca%acity of the a&a*in( +rain7 with its .-- trillion connections7
throu(h individuali*ed7 stren(th +ased7 and technolo(ically +ased tools and %rocesses3
Leadershi% >ith #thers
6!e&+ers of the northern Natal tri+es of South African (reet one another +y sayin( PSawa +ona7:
which literally &eans PI see you3:The res%onse is PSi9hona: which &eans PI a& here3: This
e8chan(e is i&%ortant7 for it denotes that 6until you see &e7 I do not e8ist@ and when you see &e7
you +rin( &e into e8istence3 !e&+ers of these tri+es (o a+out their day with this %ersonal
validation fro& everyone they encounter Q seen for who they are3 This s%ea9s to the (reater
intrinsic hu&an need for validation7 which we all share3;
Dr3 Eli*a+eth Taylor
This is a re&ar9a+le dialo(ue ac9nowled(in( each other:s e8istence and values3 It si&%ly
ac9nowled(es that +y you truly seein( &e you literally +rin( &e into your e8istence7 &eanin(7
and vision3 This is &uch richer than a cursory hi or hello3 It is a validation3 It is lan(ua(e that
creates safety7 and reco(ni*es the other in all their diversity and co&%le8ity3
This view of others: %ers%ective7 stren(ths7 and vision as well as creatin( safety7 and
%rovision of the necessary resources to +rin( a+out a co&&on and (reater vision is at the heart of
what I +elieve leadershi% to +e a+out7 E&%owerin( Leadershi%3
Thou(h there are &any livin( +ein(s7 such as insects7 that have a &ore ordered social
structure7 it is clear that none has a &ore ela+orate and co&%le8 syste& of co&&unication7 or
.,
(reater a+ility to e&%athi*e with others3 In fact7 what has allowed &an to create civili*ations7
&ana(e the lives of +illions7 create &achines at the &icrosco%ic level7 and fly to the stars is our
a+ility to connect e&otionally and intellectually3
1o&&unication
6I $eel Therefore I A&7; Dean Sher*ai
A scholar of co&&unication 1harles 1onrad defines co&&unication as 6the %rocess +y
which %eo%le interactively create7 sustain7 and &ana(e &eanin( 41onrad7 .LLG53 Thus
co&&unication doesn:t only reflect facts7 +ut also sha%es it and creates the consciousness a+out
it in the %erceiver:s &ind3 In other words7 what we co&&unicate and how we co&&unicate it is
the very fa+ric of consciousness 4"aynes7 ,---53 1o&&unication is not si&%ly a co&%onent of
leadershi%7 +ut rather constitute the very +uildin( +loc9s of leadershi%3 It is not si&%ly a
transference of data7 +ut rather a re?creation of e&otional7 &eanin(ful reality that can
synchroni*e %ur%ose3
>e see& to %ri&arily connect with others throu(h e&otion rather than intellect
4Fole&an7 ,--J@ Haidt7 ,-.,53 The e&otional center of the +rain7 the a&y(dala7 is a &a=or relay
station of the +rain3 It connects to the visual7 auditory7 &e&ory7 and co(nitive re(ions of the
+rain3 Des%ite its si*e and %ri&itive nature7 the a&y(dala has a tre&endous ca%acity to influence
even the &ost so%histicated re(ions of the +rain such as the frontal lo+e7 which e8ists to (ive us
reason and direction 4Fole&an7 ,--J53
Since the ince%tion of the field of co&&unication we have &ade tre&endous strides and
it is now one of the &ost %o%ular fields of study in &ost universities 4)erlo7 .LC-@ )arnlund7
,--B@ 1rai(7 ,--C53 Thou(h the different &odels of co&&unication are of tre&endous value7 &y
%ersonal interest lies in the neuroscience +ehind co&&unication7 and our (reater understandin(
./
of the dee%er neurolo(ical di&ensions of co&&unication3 #ne such conce%t is the idea of
intuition7 which is the incredi+le world of understandin( we %osses outside of ver+al lan(ua(e3
This understandin( co&es to us fro& our su+cortical syste&s that7 over the years7 %rovide us
with incredi+le %attern reco(nition ca%acity7 and can +e enhanced 4Fole&an7 ,--J@ Lie+er&an7
,---@ Iol*7 ,--C7 ,--B53 Another uns%o9en for& of co&&unication is our incredi+le a+ility to
e8%erience the &ental state of others3 This a+ility a%%ears to +e lin9ed to our +rain:s s%ecial
neurons called &irror neurons as well as other re(ions such as the insula corte83 The insula
corte8 can sense another %erson:s e&otions +y wor9in( with the frontal lo+e to identify
infor&ation fro& the a&y(dala and the e&otional centers so that our +rain can fully inter%ret and
res%ond to the infor&ation (athered 4to% down vs3 +otto& u% analysis5 4Fole&an7 ,--J53 >arren
)ennis uses the ter& 6first class noticers; for those that are hi(hly tuned to inter%retin(
co&&unicative situations and other %eo%le:s e&otions 4)ennis7 .LLA53 1o&&unication has +een
at the core of hu&an civili*ation7 %ro(ress7 and the stories we tell a+out the futures we foresee7
and it has always +een a co&%licated conce%t to (ras%7 decode7 and then to fully &aster3 >ith the
advent of devices such as functional &a(netic resonance i&a(in( 4f!RI57 and &ulti?lead
electroence%halo(ra&s7 and others so%histicated tools that have (iven us a +etter window into
this +lac9 +o8 we call the +rain we are +e(innin( to understand lan(ua(e7 in all its co&%le8ity7
&uch +etter3 This will only hel% us +etter deci%her the &essa(es that we %erceive fro& other
&inds7 and hel% us &ore o%ti&ally interact3
As we (ain (reater 9nowled(e into the relationshi% of lan(ua(e and its &ultifarious
e8%ressions in the faces and (estures of others it will only hel% to reduce the &isunderstandin(s
and +etter co&&unicate our e8%eriences to each other throu(h our ears7 li%s7 and &ost
i&%ortantly throu(h our eyes3
.A
1onflict Resolution
1onflict resolution is the %rocess of resolvin( a dis%ute or a conflict +y seein( the issue
fro& each other:s %ers%ective and seein( the solution with +oth sides in the story3 <nowin( how
to &ana(e and resolve conflict is essential for havin( a %roductive wor9 life7 and it is i&%ortant
for co&&unity and fa&ily life as well3 In &y own life I have e8%erienced the i&%ortance of
conflict resolution in every as%ects of life@ fro& wor9 in at the National Institutes of Health
where I needed to +e aware of and syste&atically resolve conflicts of e(o and co&%lacency7 to
Af(hanistan where I had to address and resolve overt conflicts of ideolo(y that could influence
others: lives3 Foin( forward I will &a9e conflict resolution an inte(ral %art of &y leadershi%
e8%erience7 and actively a%%roach each interaction as an o%%ortunity to eli&inate any %otential
for conflict3
Thou(h we have +een aware of the conce%t of conflict resolution for centuries7 it +eca&e
a for&al field of study only durin( >orld >ar II3 Hu&ans have7 for (enerations7 +een
conditioned to tacitly +elieve that every interaction is7 %otentially7 a loss for &e and a (ain for the
RotherR 4Loss?>in7 or >in?Loss53 This *ero su& econo&ic &odel has do&inated our %sycholo(y7
and this is the &indset that &ust +e ad=usted3 If one is a+le to convince the %artici%ants that7
throu(h a colla+orative %rocess7 one can increase the si*e of the R%ieR then every interaction
+eco&es a 6win?win; scenario3
Thus conflict resolutionKor as I call it7 o%%ortunityKto create syner(y7 is %resent in
every interaction7 and when a%%roached fro& the %ositive %ers%ective7 can have a revolutionary
effect on every interaction and not =ust when one faces a conflict3
Today we have arrived at &any different &odels that &ay +e a%%lied in different
conte8ts7 and at different levels 4%ersonal7 (rou%7 cultural7 or national5 4!en9el?!eadow7 ,--.53
.J
So&e delineation includes individual characteristics theories7 social %rocess theories7 social
structural theories7 and for&al theories3 If individual characteristics are e&%hasi*ed as the +asis
of social conflict7 then the %ri&ary &eans for conflict resolution is to chan(e the %erson3 If the
a%%roach is a social %rocess a%%roach7 then the solution is in correctin( the %rocess3 If7 on the
other hand7 the conflict is at the social structural level7 then chan(e can co&e a+out only throu(h
refor& or revolution3 The for&al scenario focuses on lo(ical &athe&atical a%%roaches to
conflict3 At the sa&e ti&e there are different s%ecific &ethods of conflict resolution7 such as
coercion7 which uses force in order to achieve an end@ ne(otiation7 which involves a (ive and
ta9e@ ad=udication7 usin( the le(al syste& to +rin( a+out chan(e@ &ediation@ which uses an
inde%endent %arty to +rin( the conflictin( %arties to a &utually a(reea+le outco&e@ and
ar+itration7 where the third %arty actually &a9es the decision for the conflictin( (rou%s2%ersons
after listenin( and analy*in( the data3 A third layer of co&%le8ity7 +eyond the social7 versus the
individual7 and +eyond the &ethods of conflict resolution7 is the individual style differences seen
across a(e7 (ender7 race7 and culture3 Yet there is another as%ect that cannot +e i(nored7 which is
re(ardin( the diversity of individual styles and a%%roaches7 such as@ avoidance conflict style7
yieldin( conflict style7 co&%etitive conflict style7 coo%eration conflict style7 and conciliatory
conflict style 4Holt7 ,--J7 "ar+oe7 .LLC@ Stern+er(7 .LBG53
Des%ite the &ultifarious a%%roach to this very i&%ortant to%ic7 I +elieve7 at its core7
conflict resolution is a+out creatin( an internal co(nitive and e&otional state in the dis%utin(
%arties that is conducive to e8chan(e and e8%erience of +roader %ers%ectives3 It7 thus7 re'uires
%rovision of the necessary tools7 vision7 and sense of security in order for all conflictin( %arties
to see that the %roduct of their wor9 to(ether would +e (reater in the lon( run than what they
would (ive u% in the short ter& 4Frenny7 !c!illan7 Patterson7 H Swit*ler7 ,--,53 It is a+out
.C
creatin( the environ&ent necessary for the conflictin( %arties to see7 e&%athi*e and e8%erience
each other:s ulti&ate intentions and vision3 It is also 'uiet %ri&al7 in that it is ulti&ately a+out
creatin( an environ&ent of safety 4Frenny7 !c!illan7 Patterson7 H Swit*ler7 ,--,53 >hen there
is trust in a (rou% there is a sense of safety and thus %eo%les: %ers%ective e8%and %ast the fear?
+ased syste&s oriented a%%roach to %ro+le&s3 Thus7 %eo%le +eco&e creative and it is in this
settin( where 6out?of?the?+o8 conce%ts can +e created 4Fole&an7 ,--J53 Ste%hen 1ovey s%ea9s
of creatin( the environ&ent for an alternative and creative outco&e +etween two or &ore %arties
41ovey7 ,-..53
Foin( into the future &y =o+ will +e to &a9e the other see the +i((er %icture3
!entor21oach
6A &entor is so&eone who allows you to see the ho%e inside yourself3;
#%rah >infrey
Leadershi% %ro&otes relationshi%s 4&entor2&entee5 that are trust?centered7 %rovidin( the
9ind of e&%ower&ent that results in %ersonal and %erfor&ance i&%rove&ent toward satisfyin(
&utual o+=ectives3 This %osition of &entor or coach is an incredi+ly i&%ortant one and fro& &y
e&%owerin( leadershi% %ers%ective the &ost i&%ortant =o+ title of a leader3 A leader:s =o+7 as a
&entor7 is to follower see the ulti&ate %ri*e7 the clear ste%s that they need to traverse7 and the
tools with which they can achieve the (oal3 It is a+out transferrin( that a+ility to loo9 inward and
into the future to the &entee3
Thou(h &entorin( has +een 9nown to hu&an civili*ations for &illennia7 it was not
ac9nowled(ed as a disci%line unit late ,-
th
century3 There are &any fa&ous historic e8a&%les of
&entorin(7 such as that +etween Socrates and Plato7 and Aristotle and Ale8ander the Freat7 +ut it
.G
is said that no one +eca&e (reat without havin( a (reat &entor
4htt%22www3&entors3ca2&%Ohistory3ht&l53 This relationshi% of &entor2&entee has +een an
infor&al one without structure or theories7 +ut in .LB/ a youn( %ostdoctoral student chan(ed the
field for ever3 <athy <ra&:s dissertation in .LB/7 followed +y her Acade&y of &ana(e&ent
=ournal of .LB/7 is often cited as the +e(innin( of for&al disci%line in &entorshi% 4<ra&7 .LB/53
Later researchers further refined the conce%t to for&al and infor&al &entorin( 41hao7 .LL,53
#ver the years &entorin( theories and literature has +eco&e e8tre&ely ro+ust and diverse3
Research has covered such diverse to%ics as how &entorin( can hel% individual careers 4Allen7
,--A@ Fodshal97 ,--/57 to how &entorin( can +e +est a%%lied at the or(ani*ational level 4Payne7
,--J@ Sin(h7 ,--,53 In all these cases the (reatest e&%hasis has +een %laced on the co&%onent of
trust in these relationshi%s3
!any define &entorshi% as involvin( acce%tance of a(reed (oals and ownershi% of the
%rocess and outco&es +y +oth the &entor and the &entee 4Hessel+ein H Shrader7 ,--B53 I
+elieve7 whether it is a lifelon( relationshi% or an interaction of =ust a few &inutes7 &entorin( is
a+out trust and influence fro& one %erson 4the &entor5 to another 4the &enthe5 towards
i&%rove&ent of certain s9ills3 It is only under these circu&stances that the &enthe would +e
&ost effectively rece%tive to the &entorshi%3 !entorshi% is also a core co&%onent of &y &odel
of leadershi%7 which is e&%owerin( leadershi%3 !entorin( can es%ecially +e a %owerful
co&%onent of e&%ower&ent in the healthcare settin(3 !c<inley 4,--A5 and collea(ues have
fra&ed a very effective e&%ower&ent %ro(ra& for nurses that uses &entorin( as a core
co&%onent3 This &odel achieves +oth the %sycholo(ical needs 4+uildin( the e&otional security7
coura(e to e8%lore5 of the relationshi% as well as the s9ills transfer needed in the e&%ower&ent
%rocess 4S&ith7 ,--.53
.B
It is a+out trust 41ovey7 ,--C53 The &entee &ust +e o%en to learnin(7 and he2she2they can
only +e rece%tive if he2she2they trust4s5 the &entor:s inte(rity and ca%acity3 It is a+out trust
41ovey7 ,--C53 The &entee &ust +e o%en to learnin(7 and he2she2they can only +e rece%tive if
he2she2they trust4s5 the &entor:s inte(rity and ca%acity3
Fiven that e&%owerin( leadershi% is at the core of everythin( I do7 the last few years has
included do*ens of co&&unity tal9s and educations sessions around healthy a(in(7 three
conferences that contained trainin( the trainers at their center7 teachin( and &entorin( residents
throu(hout Lo&a Linda on how to (et involved and %erfor& (reat research3 Foin( forward I see
&y tas9 &ore as a &entor in the clinic7 la+7 and the co&&unity than a %hysician dis%ensin(
&edications3
Social Res%onsi+ility
!y %ers%ective a+out social res%onsi+ility co&es fro& &y %hiloso%hical and s%iritual
outloo9 on life7 which7 in an e&otionally connected world7 sees (reat utility in an e(alitarian
a%%roach to others and society in (eneral3
Leadershi% understands social syste&s7 is accounta+le to others7 and endeavors to see that
fa&ily7 co&&unity7 and environ&ental (oals are &et in local and7 when a%%ro%riate7 in (lo+al
ways3 >hen a %erson has +een (iven the %latfor& of leadershi% +y a (rou% or a society7 their
authentic leadershi% is reflected +y their sense of social res%onsi+ility3 Any for& of leadershi%
that does ori(inate fro& a sense of social res%onsi+ility is no &ore than &ere &ana(e&ent3
There has +een a (reat deal of research re(ardin( the relationshi% +etween such traits as
relia+ility7 loyalty7 de%enda+ility7 and &any others with leadershi%7 and of these the one that has
+een consistently stron(ly correlated has +een that of a sense of social res%onsi+ility 4)ass7
,---53 Yet it wasn:t until the wor9 of >inter and )aren+au& 4.LBJ5 that a set of characteristics
.L
were validated to define the sco%e of social res%onsi+ility3 In their wor9 social res%onsi+ility is
indicated +y a &oral?le(al standard of conduct7 internal o+li(ation7 concern for others7 concern
a+out conse'uences7 and self?=ud(&ent3 As an e8a&%le7 res%onsi+ility co&in( fro& a locus of
internal o+li(ation indicates the de(ree of honesty re(ardin( this relationshi% with others7 and
feels an internal &otive force to do the ri(ht thin(3 This conce%t also has a co&%onent of self
control7 delayed (ratification7 and internal awareness a+out conse'uences of one:s +ehavior
4)lasi7 .LB/53
In the future I will continue to involve &yself in e&%ower&ent %ro=ects as I see an
e&otionally connected world fully functional only when %eo%le o%erate fro& a center of social
res%onsi+ility3
Diversity
6It is ti&e for %arents to teach youn( %eo%le early on that in diversity there is +eauty and there is
stren(th3;
!aya An(elou
To see diversity7 in all its &anifestations7 (ives one a %ers%ective in to the full s%ectru&
of %ossi+ilities3 It is only when one +rin(s diversity in its full sense@ inclusive of race7 (ender as
well as the &ore co&%rehensive definition includin( a(e social +ac9(round7 ty%e of e8%ertise7
and &any others7 into any %ro=ect that one can &anifest the full creative %otential of the (iven
%ro=ect3
It is only in the last few years that we have fully ac9nowled(ed the co&%le8ity of
incor%oratin( diversity into leadershi% and the different theories and %aradi(&s could +e
instituted 4Ay&an H <ora+i97 ,-.-53 Ac9nowled(e&ent of diversity and all its co&%le8ity has
forced us to ta9e another loo9 at trait theories such as the )i( $ive &odel of %ersonality trait and
,-
whether one can e8tra%olate it to other cultures and conte8ts 4"ud(e7 )ono7 Ilies7 H Ferhardt7
,--,53 This re?ins%ection has revealed an unco&forta+le truth that even so&e of our well
esta+lished theories need to +e reassessed and redesi(ned in the conte8t of different races7 and
countries 4Duehr H )ono7 ,--C@ House7 ,--A53 Fiven that the creative &inds of each hu&an can
+rin( uni'ue %ers%ective into a situation7 and individuals and (rou%s fro& diverse e8%eriences
can in=ect tre&endously creative and uni'ue ideas into the %ro+le&7 leadershi% trainin( will have
to ac9nowled(e and actively train the leaders of the future to find co&fort and %ro%a(ate
diversity of wor9force and ideas 4Ea(ly7 ,-.-53
The future of health care has to +e inclusive of the entire creative %otential of a diverse
%o%ulace in order to face the challen(es we will +e facin( with healthcare3 If we are not a+le to
see the challen(es seen +y each diverse %o%ulation we will never +e a+le to &iti(ate and fully
address those challen(es3 !y own e8%eriences tal9in( a+out healthcare and %revention in the
His%anic7 African A&erican7 and Asian churches has +een a livin( testa&ent to this %rinci%le that
e&%ower&ent starts +y includin( the diverse lan(ua(e of the different co&&unities at the onset3
Leadershi% Throu(h #r(ani*ations
6!e&+ers of the northern Natal tri+es of South African (reet one another +y sayin( PSawa +ona7:
which literally &eans PI see you3:The res%onse is PSi9hona: which &eans PI a& here3: This
e8chan(e is i&%ortant7 for it denotes that 6until you see &e7 I do not e8ist@ and when you see &e7
you +rin( &e into e8istence3 !e&+ers of these tri+es (o a+out their day with this %ersonal
validation fro& everyone they encounter Q seen for who they are3 This s%ea9s to the (reater
intrinsic hu&an need for validation7 which we all share3;
Dr3 Eli*a+eth Taylor
This interaction ta9es on a hi(her level of co&%le8ity than that +etween individuals as the
needs and re'uire&ents of or(ani*ations are now su%eri&%osed on those of the individual
,.
interactions3 Anyone wor9in( within an or(ani*ation should +e aware of the dyna&ics that
o%erate at this level7 and how to (ather data and +rin( a+out chan(e in or(ani*ations3
This (rou% of co&%etencies is a+out seein( the &any different %ers%ectives and creatin( a
coherent colla(e that resonates with all &e&+ers of a (rou%3
Resource Develo%&ent Hu&an and $inancial
An a%%ro%riate definition of hu&an and financial develo%&ent7 es%ecially in the conte8t
of leadershi%7 would contain the hu&an co&%onent3 The entire %ur%ose and ai& of a leader is to
e&%ower those around the& throu(h 9nowled(e and resources 4financial and otherwise5 in order
to +eco&e their +est and &ost efficient ally towards the (reater vision3 This version of
leadershi%7 e&%owerin( leadershi%7 is at the core of &y wor9 in the co&&unities3 #ne definition
of e&%owerin( leadershi% is increase in &otivation of the e&%loyees as a result of %ositive
attitude (ained throu(h resources and (reater autono&y towards their wor9 4S%reit*er7 .LLJ53
There have +een &any studies that have de&onstrated &uch (reater efficacy and success
when leaders7 in diverse sectors7 have e&%loyed e&%owerin( leadershi% as their %ri&ary
leadershi% %aradi(& 4Mhan(7 ,-.-53 Thou(h this conce%t had +een a%%lied to +ehavior and
education for decades7 the social entre%reneur and econo&ist !uha&&ad Yunus in )an(ladesh
was a+le to successfully de&onstrate it in a fiscal &odel3 His conce%t e&%owered wo&en at an
incredi+le rate when they were (iven &icro finance loans alon( with +usiness 9nowled(e3 The
wo&en that received the loans7 al&ost universally7 %aid +ac9 the loan and were a+le to raise their
fa&ilies standards a+ove %overty3 Yunus went on to win the No+el Pri*e for this novel
e&%ower&ent %ro=ect 4)ayul(en7 ,--B53 The i&%ortance of leadershi% +ehavior on a tea& and a
co&%any:s %erfor&ance cannot +e underesti&ated 4Drus9at H >heeler7 ,--/53 #ver the last few
decades e&%owerin( leadershi% has (ained si(nificant &o&entu& and the field is studied in
,,
&uch &ore detail@ fro& the &ana(&ent:s %ers%ective of transferrin( %ower7 and inhi+itin( their
intrinsic instincts to control7 as well as the e&%loyee:s %ers%ective of acce%tin( %ower 4<ir9&an
HRosen7 .LLL@ !iller7 ,---53 )oth of these states are often challen(in( and re'uire &uch
ca%acity +uildin(3 The internali*ed sense of safety needed to ta9e the &antle of leadershi% can
actually +e +uilt throu(h reinforce&ent7 tools7 and resources 4>est7 .LLC53 There is yet a hi(her
level of co&%le8ity7 which s%ea9s to our conscious or su+conscious constraints on our a+ility to
ac'uire %ower 4Hardy7 .LLB53 It is only when one understands %ower and conse'uent
e&%ower&ent in its co&%le8ity that it &ay +e %ossi+le to efficiently transfer %ower3
In tryin( to +uild a new &odel of healthcare for the re(ion I 9new that I had to focus on
the hu&an ca%ital and the stren(ths of this re(ion and have involved the co&&unity in all its
co&%le8ity and with all the different lan(ua(es and view %oints in the conversation3 Thou(h at
the +e(innin( it was a caco%hony7 what has co&e forth7 as a result of &uch reflection on all
%arties7 has +een nothin( short of a sy&%hony and a co&%rehensive %icture of what health care
for the elderly in the re(ion &eans@ fro& trans%ortation7 to nutrition in the co&&unity7 to
co&&unity connectedness7 to faith +ased su%%ort7 and finally the least i&%ortant which is the
clinics and the hos%itals3 Foin( forward we would li9e to &ove to a &ore /?di&ensional &odel
of health in the re(ion that is co&%rehensive yet co&&unity driven and self sustainin(3
Syste&s Thin9in(
Syste&s thin9in( is a+out a &indset and an understandin( that any activity is usually not
a+out the individual co&%onents or even a+out the co&%onents that are easily vision or
accessi+le to us7 +ut rather it ha%%ens in a &ore co&%le8 settin(3 >ith health care7 our ina+ility
to loo9 at the %ro+le& as a syste&s %ro+le& has cost us si(nificant ti&e and &illions of lives3
$or the last few decades we have 9nown all that ails the health care syste&3 >e have identified
,/
the diseases that i&%ose the (reatest +urden on our society7 and have7 at (reat e8%ense to us all7
addressed each of these diseases individually3 >e have s%ent +illions of dollars on heart disease7
cancer7 stro9e7 1#PD7 dia+etes7 trau&atic in=ury7 and co(nitive diseases7 +ut we have only seen
an e8%onential increase in &ost of these diseases throu(hout society3 In fact7 so&e of these
diseases were never seen at such nu&+ers a&on( certain se(&ents of society7 yet today we have
an e%ide&ic of ty%e , dia+etes in the in all a(e (rou%s 4Insaf7 ,-.A53
The reason that we have a (rowin( %u+lic health crisis7 as it %ertains to chronic diseases
of a(in(7 is that we have not a%%roached this %ro+le& as a syste&s %ro+le&3 Pu+lic health needs
to +e a%%roached in its co&%le8ity of causal %rocesses across diverse %o%ulations3 >e +elieve
that any co&%rehensive7 valid7 and lon(?lastin( chan(e can co&e a+out only when a%%roached
throu(h syste&s thin9in(3 Recently this a%%roach7 which was cha&%ioned +y Stanford
University7 has +een called the 61ollective I&%act !odel3; 4<ania7 ,-..5
4htt%22www3ssireview3or(2articles2entry2collectiveOi&%act53 It reco(ni*es the i&%ortance of a
co&%rehensive a%%roach to syste&s7 and involve&ent of ele&ents fro& the co&&unity7
university7 +usiness7 and +eyond3
The collective i&%act &odel that we have i&%le&ented here in Inland E&%ire is
indicative of our understandin( of the co&%le8ity of health and our a+ility to see the +i((er
%icture involvin( the acade&ic7 faith +ased7 +usiness7 and health care co&&unity all to(ether
+rin(in( a+out chan(e3
#r(ani*ation )ehavior7 Develo%&ent7 and 1ulture
!y definition of culture is lan(ua(e around a conce%t that +eco&es u+i'uitous in a (rou%
or %o%ulation and ulti&ately +eco&es o%erational3 This culture consists of a set of +ehaviors and
,A
a values +ased +elief syste& and set of +ehaviors that is tacitly understood +y a lar(e %ro%ortion
of the (iven %o%ulation3
Leadershi% understands %ersonal7 (rou%7 and inter?(rou% +ehaviors and how they i&%act
or(ani*ational history7 needs7 and (oals3 Since leadershi% is a+out influencin( others7 a leader has
to understand the +ehavioral as%ects at +oth the individual and (rou% levels3 #nce (rou%s start
o%eratin( around consistent the&es of +ehaviors and +elieves those the&es and +ehaviors7 it can
+e considered a culture3 Schein considers leadershi% and culture to +e inse%ara+le and at the
sa&e ti&e two side of the sa&e coin3 The &ost i&%ortant =o+ of a leader thus +eco&es
understandin( the syner(y +etween culture7 and vision of a co&%any7 and how to +rin( this
interaction to its full reali*ation 4Schein7 ,-.-53 This %roactive a%%roach to creatin( constructive
%ositive or(ani*ational +ehaviors around (rou% stren(ths has +een shown to +e e8tre&ely
e&%owerin( 4Luthans7 ,--,53 In his %resentation on the su+=ect he e&%hasi*ed the %oint that
cultures7 es%ecially %ositive ones7 are created throu(h consistent lan(ua(e that ste&s fro& livin(
value7 not &erely one that is written on a %lacard on a wall and no one reads7 as well as throu(h
reco(nition and rewards 4Tush&an7 ,--,53
In an atte&%t to create a culture of colla+oration and e&%ower&ent we included these
words in every conference7 colla+orative and vision docu&ent7 and &ade sure that it was a
functional and conscious ele&ent of our county and city wide (oals3
Leadin( and I&%le&entin( 1han(e
6!en &a9e history and not the other way around3 In %eriods where there is no leadershi%7 society
stands still3 Pro(ress occurs when coura(eous7 s9illful leaders sei*e the o%%ortunity to chan(e
thin(s for the +etter3;
Harry S3 Tru&an
,J
Identifyin( the ri(ht chan(e and i&%le&entin( chan(e is at the heart of leadershi%3 This is
es%ecially true in the ,.
st
century7 Fraet* 4,---5 states@ 6A(ainst a +ac9dro% of increasin(
(lo+ali*ation7 dere(ulation7 the ra%id %ace of technolo(ical innovation7 a (rowin( 9nowled(e
wor9force7 and shiftin( social and de&o(ra%hic trends7 few would dis%ute that the %ri&ary tas9
of &ana(e&ent today is the leadershi% of or(ani*ational chan(e3;
In a world de&andin( ada%ta+ility7 fle8i+ility7 and innovation7 if we are not leadin( as
chan(e a(ents and identifyin( the 9ind and direction of chan(e7 chan(e will +e i&%osed u%on us3
Sadly this &odel of reaction to chan(e i&%osed7 +oth fro& the health and the %olicy %ros%ective7
is how we lead today as health care %roviders3
>e also have to ada%t institutional structures fro& a centrali*ed hierarchical ones to ones
that rely on hori*ontal e&%owered se(&ents ca%a+le of ada%tin(7 havin( a hand in the diverse
sea of data7 and %ilotin( and i&%le&entin( chan(e &odels in tur+ulent environ&ents 4)ahra&i7
.LL,@ Fraet*7 ,---53 This will re'uire challen(in( the status 'uo7 and is %ro+a+ly the &ost
difficult tas9 of a leader 4<ou*es H Posner7 .LLJ53 )ut this conce%t of chan(e?centered
leadershi% is fairly new and was not central to the leadershi% conversations3 In fact the idea that
chan(e?centered leadershi% is distinct and &eanin(fully different fro& another style was first
enunciated +y Dr3 )urns when he distin(uished transactional fro& a transfor&ational 4chan(e5
leadershi%3 Later )ass added another style7 which he called Laisse*?faire leadershi% 4)ass7 .LL-53
The transactional leaders were &ore concerned with acco&%lish&ent of %re?defined tas9s7 where
as transfor&ational leaders set new (oals and search out and for(e new %aths3 They also ha%%en
to +e &ore charis&atic and feel &ore co&forta+le ada%tin( the or(ani*ation to e8ternal
conditions 4E9val7 .LLA53 Research revealed stron( evidence that a e&%loyee centered leadershi%
style was not as correlated with =o+ satisfaction as a chan(e centered leadershi% style was
,C
4Arvonen7 .LLJ@ Yu9l7 ,-.,53 )ut it was also found that in order to &a9e chan(e centered
leadershi% &ost effective leadershi% should also i&%le&ent an e&%owerin( %ers%ective and
+efore i&%le&entin( the chan(e centered a%%roach %re%are the (rou% +y develo%in( the tea&:s
s9ills and +uild their self confidence 4Fil7 ,--J53
The world around us is chan(in( at an un%recedented rate3 Leadershi% in the future is
(oin( to +e nothin( &ore than %redictin( the a%%ro%riate direction of chan(e and %lacin( one:s
(rou% or or(ani*ation in the %ath that ali(ns with one:s vision as well as the strea& of chan(e3
#ur +rains7 and s%ecifically our su+cortical intuitive centers7 (ive us an uncanny a+ility to
visuali*e that chan(e7 +ut the first ste% is to e&+race the i&%ortance of chan(e centered
leadershi% as well as our a+ility to create intuition 4visuali*ation5 towards that chan(e3
Le(al and Policy Issues
Ulti&ately what we envisioned as the %roduct of all our efforts towards a healthy Inland
E&%ire would +e around two ideas@ 4a5 a culture of health that involved all se(&ents of the
co&&unity7 and 4+5 %olicy chan(es locally7 re(ionally7 and state?wide that would +eco&e a force
for %er&anent chan(e in health care for our a(in( %o%ulation3 This re'uired a very co&%licated
vision and strate(y that would +e sustaina+le and acce%ta+le +y all3 Thus once a(ain our =o+ was
to %aint a %icture to all involved where they all saw the&selves in the co&%onents and in the
final %roduct3
Henry !int*+er( fro& !cFill University defined strate(y as 6a %attern in a strea& of
decisions; to contrast with a view of strate(y as %lannin(7 while !a8 !c<eown 4,-..5 ar(ues
that 6strate(y is a+out sha%in( the future; and is the hu&an atte&%t to (et to 6desira+le ends with
availa+le &eans3; Strate(y is +asically a %lannin( %rocess that can hel% +etter %redict the future
and a%%ro%riate actions toward one or &ore (oals3 Policies7 on the other hand7 involve a%%lyin(
,G
laws and edicts in a co&&unity 4school7 city7 county7 state7 county7 etc35 o +rin( a+out certain
outco&es3 In &any ways7 I +elieve7 the conce%ts of strate(y and %olicy have +een the &ost
i&%ortant +y %roduct of this a&a*in( +rain of ours7 and s%ecifically the frontal lo+e7 which is
uni'uely and dis%ro%ortionately hu&an3 The frontal lo+e serves one very i&%ortant role7 which is
to %lan the course forward and to interact with other forward thin9in( +ein(s to7 colla+oratively7
&a% the course in to the future3 !any state that the rest of the +rain e8ists to do the +iddin( of
the frontal lo+e7 althou(h it is difficult to disre(ard the %ower and value of the li&+ic syste&
4e&otional centers of the +rain53 Hu&an survival was tre&endously i&%roved when the +rain
learned to create strate(y and %olicy toward desired lon(?ter& (oals 4The e8ecutive +rain
$rontal lo+es and the civili*ed &ind3 4Fold+er(7 ,--.53
Such tools as $unctional !RI 4f!RI5 are a+le to reveal which %arts of the +rain utili*e
+lood2o8y(en &ore intensively when challen(ed with e8ecutive and strate(ic %lannin(3 >e now
9now7 that thou(h lar(e %ortions of the +rain are e&%loyed in &ost activities7 the %refrontal
corte8 is uni'uely e&%loyed in strate(ic %lannin( 41oricelli7 ,--L53
Foin( forward one of our first strate(ies is to esta+lish %olicies that will allow seniors to
+e involved &ore in their own care and %lannin(7 which will re'uire (reater access and tools of
access3
Leadershi% in a Sea of Infor&ation
Leadershi% without an a+ility to reco(ni*e valid infor&ation7 &ani%ulate the a%%ro%riate
infor&ation7 and to e8tra%olate the way forward accordin( to relevant infor&ation is +lind
leadershi%3 This is even &ore relevant in the ,.
st
century when our 9nowled(e is dou+lin( at the
s%eed of li(ht7 and if we don:t have a syste&atic &eans +y which to &ana(e infor&ation we are
destined to lose ourselves in this &a*e of data3
,B
The last few years have o%ened &y eyes to7 what I now consider one of the &ost i&%ortant
ele&ent of leadershi%7 which is data and data (uided action3 Thou(h &y star co&%etency has
+een co&&unication I fully reco(ni*e that throu(hout ti&e the &ain %ro+le& facin( leaders has
not +een co&&unicatin( facts7 +ut rather what facts were +ein( co&&unicated and the outco&es
that co&e a+out when o%eratin( fro& false data3
The (reat lea%s in hu&an ca%acity in the ,.
st
century and +eyond will de%end on how
well we do this =o+3 In fact the 'uestion is not whether we will o%ti&i*e this %rocess7 +ut rather
how 'uic9ly we will o%ti&i*e7 and for each of us7 if we will +e %art of this truth findin( and truth
tellin( story3 >hat is central in this reflection is how &y =ourney has chan(ed &e7 and how I
ho%e to add to the story of others around &e3 The four co&%etencies that I have +rou(ht to(ether
are evaluation and assess&ent7 readin( and evaluatin( research7 conductin( research7 and
re%ortin( and i&%le&entin( research3 These four co&%etencies fall alon( a s%ectru& of activities
that deal with identifyin( infor&ation7 analy*in(7 %rocessin( and then %ro&ul(atin( that
infor&ation to the world3 This is7 after all7 what &a9es us uni'uely hu&an7 to trans&it newly
discovered infor&ation to each other and +eyond3
#ur a+ility to visuali*e7 inter%ret7 refor&ulate7 and recreate infor&ation and then trans&it
it7 throu(h sche&atics (ra%hs7 and writin(s to others is the foundations of all our civili*ations3
Evaluation and Assess&ent
Evaluation and assess&ent is a+out &ore accurately understandin( the world around us3
It is a+out ac'uirin( the tools necessary to discern +etween the infinite sea of infor&ation that we
face every day in a infor&ation u+i'uitous connected world3
The hu&an frontal lo+e is desi(ned to do one thin( a+ove all else To evaluate the
environ&ent and assess the way forward usin( the &e&ory +an9s3 >e have a uni'ue a+ility to
,L
evaluate and assess3 #ur a+ility to (ather infor&ation7 analy*e7 and e8tra%olate into the future is
+etter than any other or(anis&7 yet still flawed and su+=ect to errors at each level 4data (atherin(7
%rocessin(7 and e8tra%olatin(53
So7 the first ste% is to validate the infor&ation that co&es to us and identify infor&ation
that is +eyond our individual senses3 Ialidity is defined as the a+ility to truly &easure what it is
intended to &easure3 If the assess&ent is not done correctly or uses an invalid tool the outco&e is
(uaranteed to +e wron(3 Data (atherin( can (o wron( at several levels@ we could +e focusin( on
the wron( o+=ect of &easure&ent7 usin( the wron( tool for &easure&ent7 and finally the analysis
could +e wron(3
#ne of &y (reatest lessons in research7 and for that &atter in life7 ca&e fro& the world of
'ualitative research3 U% until ,--B7 I was always involved in 'uantitative research and dealt with
data that was %roduced +y others3 Althou(h I had %artici%ated in so&e +asic science research
while in &edical school and residency7 it could +e considered no&inal3 The &a=ority of &y wor9
has +een in secondary data analysis3 I have ta9en &any classes that s%o9e a+out not ta9in( data
for (ranted7 and validatin( data7 yet the %rocess was never a%%roached seriously3 In fact7 &ost
researchers too9 it for (ranted that the data was validated7 and if there was validation then it was
accurate3 It was not until I ca&e to Lo&a Linda University and started wor9in( with Dr3 Susanna
!ont(o&ery7 who was the head of co&&unity?+ased %artici%atory research 41)PR5 %ro=ect7 that
I saw a different side of research3 At the ti&e &y %lan was to a%%roach the elderly %o%ulation of
San )ernardino 1ounty with a 'uestionnaire that we had %urchased fro& )oston in order to (et
+etter assess&ent of their %erce%tion of a(in(7 the li&itations that they saw7 and o%%ortunities
that e8isted in order to educate and e&%ower the co&&unity of elderly in the 1ounty3
/-
If we ho%e to lead the %o%ulation of this county towards +etter health we have to listen to
the& first7 we have to ac9nowled(e the validity of their %ersonal stories7 and involve the& at
every ste% of the %rocess3 Listenin( and truly hearin( the %erson7 the (rou%7 or si&%ly the data7 is
at the core of leadershi%3
!y e8%erience with co&&unity?+ased %artici%atory research has de&onstrated to &e that
data evaluation starts with understandin( the data@ whether the data is valid7 co&%lete7 and
useful3 Data can +e invalid +ecause of incorrect &ethod of data collection7 ina%%ro%riate tools for
data collection7 or incorrect analysis of data3 There could +e different &ethods of data collection7
+ut in (eneral7 what &a9es the &i8ed &ethods a%%roach of 1)PR7 in &any ways7 &ore valid is
that even the tools of data collection co&e fro& the co&&unity 4su+=ects57 and are a &ore
accurate re%resentation of the data 4Tasha9uri7 ,--,53
#ne of the &ost i&%ortant ste%s in data?driven decision &a9in( thus +eco&es loo9in( at
the world of infor&ation with a discernin( eye that can differentiate +etween true and false as
well as +etween relevant and irrelevant data3
Readin( and Evaluatin( Research
A uni'ue feature of (reat leadershi% is the %erson:s a+ility to loo9 at data with a
discernin( eye3 History is re%lete with e8a&%les of actions co&in( fro& ina%%ro%riately
analy*ed and evaluated data3 This ty%e of error was co&&on for &illennia when %eo%le would
act u%on incorrectly assessed data in the world around the&3 <in(s havin( soothsayers %redictin(
the future and the re'uired future actions fro& data co&in( to the& u%on readin( the %atterns of
the stars or the entrails of ani&als was a co&&on%lace3 Today the errors can +e as e(re(ious
when we +eco&e co&%lacent with our scientific data and what it re%resents3
/.
Throu(hout the last several years I have learned so&e (reat lessons in how to loo9 at
research and have so&e of the lessons that I have learned have +een around how the %ositive
%u+lication +ias can s9ew our %erce%tion of reality when the %u+lishers refuse to %u+lish
ne(ative results 4Dic9ersin7 .LL-@ Easter+roo97 .LL.@ E((er7 .LLG53 This +ias can have (rave
conse'uences and s%uriously e8a((erate the %ositive results 4Har+ord7 ,--C@ !ontonri7 ,---53
)ein( the director of research and clinical trials for the neurolo(y de%art&ent I also +eca&e
fa&iliar with how certain trail results are e8a((erated +y si&%ly e&%hasi*in( the relative ris9
reduction as o%%osed to a+solute ris9 reduction 4)est7 ,--A53
Thus7 for the last several years I have7 at a cost to &y own %u+lication nu&+ers7 (one out
of &y way to +e e8tre&ely dili(ent in scrutini*in( infor&ation7 data7 and the conclusions that are
drawn +y &y own tea&3 This has &ade &e even &ore discernin( when it co&es to any
%u+lications that clai& (round+rea9in( results3
In the ne8t few years7 as the director of research for the Neurolo(y de%art&ent as well as
the director of research education for all the residents and fellows in Lo&a Linda University7 a
si(nificant %art of &y wor9 will +e to e&%ower the students with the a+ility to %erfor& research3
I +elieve two of the least i&%ortant as%ects of research are data analysis and &anuscri%t writin(3
Iery few clinicians will (o on to do data analysis or write &anuscri%ts7 +ut what is i&%ortant to
all clinicians7 and for that &atter7 to all acade&icians7 is the a+ility to critically loo9 at data with
a discernin( eye in order to do oneNs =o+7 +e it &edicine or +usiness in an efficient &anner3
1onductin( Research
Leadershi% understands the lo(ic and %rocesses of scientific in'uiry7 e8%lains &a=or
research &ethodolo(ies7 for&ulates e&%irically driven research %ro+le&s7 selects a%%ro%riate
research desi(ns7 e8%lains standards for data collection7 and conducts +asic data collection and
/,
analysis3 >hat &a9es the hu&an +rain so uni'ue is its a+ility to discern7 identify %atterns7 and
+ased on the data (athered7 for(e the way into the future3 #ur a+ility to conduct research is a
natural +y%roduct of this tool7 and stretches the li&its of the hu&an +rain to ca%ture relevant7
accurate7 and actiona+le infor&ation +eyond its %hysical and sensory li&its3
#ne of the +est lessons I learned a+out writin( review %a%ers ca&e conse'uent to
su+&ittin( the %roduct of C &onths: wor9 to the %resti(ious =ournal of nutrition3 >hat followed
was a re=ection letter in a &atter of wee9s3 #nce I was a+le to (et %ast the hu&iliation we
reali*ed that they had %rovided us a&a*in( (uideline and resources for how to conduct the
review 4Lichtenstein7 ,--L@ !adhu9ar7 ,--A@ Pai7 ,--A53 This e8%erience hel%ed us %u+lish a
total of three reviews in a %eriod of one year3
>ith &y own tea& I have a syste&atic a%%roach to any research %ro=ect3 The first ste% is
for&ulatin( the research 'uestion3 This is the &ost i&%ortant ste% and also where doin( a
co&%rehensive review can hel% a (reat deal3 The way we for&ulate this 'uestion 4hy%othesis5
will deter&ine all the ste%s that follow3 Fiven the literature review and the data availa+le or
desired one can decide on the desi(n of the study 4retros%ective case control7 cross sectional7
%ros%ective7 or interventional53 #nce one has the data analysis is %erfor&ed de%endin( on the
ty%es of outco&e data 4no&inal7 ordinal7 Interval7 or ratio53 De%endin( on the ty%e of de%endent
varia+le one can %erfor& a linear7 lo(istic7 or &i8ed re(ression7 or an AN#IA7 !AN1#IA7 or
so&e other statistical &odel3 There is &uch &ore to data analysis and research7 and as director of
research education for the residents of Lo&a Linda I atte&%t to (et the students %ast the
inti&idation and into the fun %art of research3
$or the last B years7 educatin( &yself in research theory and &ethodolo(y has +een a
central the&e of &y life3 I finished a fellowshi% in e8%eri&ental thera%eutics and a(in( at
//
National Institutes of Health 4NIH53 Durin( these two years I also received a full scholarshi% in
1linical Research fro& Du9e University3 >hile in U1SD7 ,--C?,--B7 I finished &y &asters in
clinical research and co&%leted a fellowshi% in research and de&entia3 >hile in Lo&a Linda
University I finished the course wor9 for a DrPh in E%ide&iolo(y and co&%leted &ore than ten
%ro=ects in e%ide&iolo(y of de&entia as well as led an entire tea& of researchers in co&&unity
+ased %artici%atory research3 This %eriod solidified &y 9nowled(e re(ardin( 'ualitative7
'uantitative as well as &i8ed &ethods research3
After a lon( =ourney in research what I have ac'uired is an eye for the ri(ht 'uestions and
a discernin( vision for the future of research in a(in(3 Thou(h learnin( and e8%andin( &y
9nowled(e of research will continue for the rest of &y life7 in the ne8t few years I ho%e to
e8%and &y research tea& as well as a%%ly for several co&&unity?+ased (rants that will allow &e
to delve into translational research3
Re%ortin( and I&%le&entin( Research
Leadershi% ade'uately co&&unicates research findin(s and i&%le&ents the findin(s in
the wor9%lace and the (reater %o%ulation3 It is not enou(h =ust to do research for the sole %ur%ose
of doin( research7 +ut it is i&%ortant to use the %roduct of the research to +rin( a+out chan(e in
the world around us3 >hat &a9es us hu&ans very uni'ue is our a+ility to co&&unicate the
lessons learned in life that can +e trans&itted to others and other (enerations throu(h lan(ua(e3
Thus7 co&&unicatin( the %roduct of our in'uisitive discernin( +rain to others in order to
increase their 'uality and 'uantity of life is very hu&an3 The art of re%ortin( research and
i&%le&entin( the learned lesson is one that is critical to leadershi%@ +ecause leaders7 due to their
%osition and %ower7 can &ost effectively co&&unicate the lessons learned and are uni'uely
ca%a+le of i&%le&entin( chan(e accordin( to the lesson3
/A
The +est lesson on co&&unicatin( research infor&ation ca&e to &e when I was
%resentin( infor&ation on influence of lifestyle on chronic disease3 This interest ca&e out of &y
9nowled(e of how dis%arities a&on( the different races led to si(nificantly (reater &ortality and
&or+idity a&on( the &inority %o%ulations3
After several tal9s in faith +ased or(ani*ations it +eca&e evident to &e that there was a
%aucity of older African A&erican &en in the leadershi%3 U%on further investi(ation7 I was sad to
reali*e that &any of the African?A&erican &en had died %re&aturely in their C-s3 !y research
into lar(e national data+ases has confir&ed this fact7 +ut it was now that I ca&e face?to?face with
the facts3 It was ti&e to i&%le&ent chan(e3
The challen(e I had +efore &e was how to +rin( a+out true7 effective7 and sustaina+le
chan(e3 The research that ca&e fro& lar(e data+ases did not %rovide a clue7 +ut our co&&unity?
+ased research had (iven us the data necessary to %ave our way to a%%ro%riate7 effective7 and
a%%lica+le ways of educatin( and e&%owerin( the different %o%ulations3 The lesson here was that
research is not a+out cold facts and nu&+ers7 +ut rather conte8ts and stories3 If we truly want to
%erfor& i&%actful research7 we &ust first see the %ro+le& fro& the (iven co&&unity:s
%ers%ective3 Thus +esides involvin( the co&&unity in the sha%in( and conductin( the research
%ro=ect7 I also always (o +ac9 to the co&&unity and %rovide the& with the results3 This has an
a&a*in( effect of e&%owerin( the&7 hel%in( the& feel a sense of ownershi%7 and res%onsi+ility
when it co&es ti&e to i&%le&ent chan(e in the co&&unity3 Perfor&in( a 1o&&unity )ased
Partici%atory Research %ro=ect has allowed us to see the %ro+le& fro& the co&&unity:s
%ers%ective and for the co&&unity to see the&selves as %art of the solution3
Ever since &y new research revelation I have &ade sure that &y research is ins%ired7
infor&ed7 and driven +y the co&&unity7 and7 &ost i&%ortantly7 that it is also i&%le&ented +ac9
/J
into the very co&&unity3 Every research %ro=ect I have +een involved in has e&anated fro& &y
interest in a(in( and co&&unity e&%ower&ent3 I see9 to re&ain dili(ent with re(ards to
research &ethodolo(y7 and ho%e to re&ain effective in the way I re%ort to the audience 4other
scientists and the co&&unity53
>ho I have )eco&eD
6As we loo9 ahead into the ne8t century7 leaders will +e those who e&%ower others3;
)ill Fates
E&%owerin( leadershi% is our %ath to a +ri(hter future3 $or the first ti&e in hu&an
history we can loo9 at leadershi%7 not &erely as a +lunt +attle of wills7 +ut rather as a science
4neuroscience5 that can +e &easured and syste&atically and effectively i&%le&ented in order to
o%ti&ally influence others3 $or the first ti&e in history we will +e a+le to use this re&ar9a+le
or(an to its full and infinite ca%acity3 $or the first ti&e in history there will +e a 'uantu& lea%
and a %aradi(& shift in the way we a%%roach la+or7 &ana(e&ent7 and leadershi%3 $or &illennia
we have led +y directin( %eo%le to follow a sin(ular vision7 and in doin( so we have used only
their &uscles and %hysical ca%acity3 >e have ne(lected hu&anities (reatest asset7 its intellect7
creativity7 and wisdo&3 Neuroscience has o%ened a window into the &iracle that is the hu&an
+rain3 >e now 9now that hu&ans have over .-- +illion +rain cells7 which &a9e over .-- trillion
connections7 with a %arallel %rocessin( ca%acity that (ives each +rain anywhere +etween . S .-
to ,G to . S .- to .-- %ower for %rocessin(3 In harnessin( the i&&ense infinite and creative
%ower of this en(ine we would +rin( a seis&ic shift in hu&an history3
>e live in a very interestin( ti&e +ecause as we are a+le to si&ultaneously ac'uire
i&&ense 9nowled(e a+out the +rain and hu&an +ehavior we are also e8%eriencin( an a&a*in(
/C
technolo(ical revolution7 which has %ro%elled our a+ility to co&&unicate7 discover7 and create
e8%onentially3 The challen(e of the twenty first century is (oin( to +e in our a+ility to use the
o&ni%resent ca%acity of this ever e8%andin( technolo(y to its full %otential3 To +e a+le to
su%eri&%ose the %ower of technolo(y u%on the new hori*ons that we have o%ened in hu&an
ca%acity is unfatho&a+le3 #ver the last four years &y leadershi% odyssey has7 at ti&es7 +een
&ore challen(in( and rewardin( than any e%ic Freece &yth3 Yet at the sa&e ti&e it has +een
frau(ht with %erils &uch &ore conse'uential than any faced +y #dysseus7 +ecause &y +attle has
+een for the thousands of elderly who suffer fro& disa+lin( chronic diseases and in the conte8t
of ever shrin9in( resources3 I see the conse'uences of failure in this =ourney everyday in &y
clinic3 The sufferin( I see and the %ain I e8%erience in &y %atients and their fa&ilies are (reater
than any cala&ity faced +y those heroes and heroines3 Al*hei&er:s alone has left7 in its wa9e7
&illions of fa&ilies in utter desolation3 It is a +ewilderin( siren that ro+es fa&ilies of their
&e&ories7 and leaves the& as desiccated re&nants of their for&er selves3
As if this 6silver tsuna&i;7 as the ra%idly a(in( society is7 whi&sically7 called7 is not
enou(h to worry us7 we are also facin( a harrowin( econo&ic %ro+le&s7 and an ever?e8%andin(
healthcare +urden that is %ro=ected to overwhel& the US econo&y in the near future3 It is now7
&ore than ever7 i&%erative to have a si(nificant shift in healthcare strate(y3 $or the last A years7 I
have focused on the +i((est sector in healthcare7 a(in(3 1urrently &ore than B-E of healthcare
costs can +e attri+uted to the needs of those over the a(e of JJ3 These nu&+ers are e8%ected to
increase e8%onentially in the future3 Yet we have no %lans in %lace to hel% &iti(ate these
%ro+le&s3 The %ath ahead &ust involve &ore consistent and u+i'uitous surveillance7 screenin(7
and treat&ent3 In the&selves there is nothin( new a+out these conce%ts7 +ut in the %ast we have
not +een a+le to do a (ood =o+ with any of the latter ele&ents7 and have often ac'uiesced to care
/G
at the clinic and &ore often in the e&er(ency roo&3 This is usually the &ost inefficient and
costly %lace to ta9e care of the elderly3 This is ironic in li(ht of the fact that data fro& all studies
echo the sa&e facts that &ore than B-E of the to% chronic and &ost costly diseases are
%reventa+le throu(h diet7 lifestyle7 and surveillance3 Rarely are we a+le to do a (ood =o+ of
surveillance7 screenin(7 and education with re(ards to diet and lifestyle chan(e in the clinic3
#ften the very %o%ulation that re'uires the re(ular follow?u% chec9u%s7 education7 and the
resources to +rin( a+out chan(e are the ones with the least access to the&3 This &eans that they
ulti&ately end u% in the e&er(ency roo& and or face %re&ature &or+idity and &ortality3
!y vision has +een one where7 usin( a new &odel of leadershi% throu(h creation of a
co&&on vision7 e&%athic co&&unication7 a%%ro%riate resource allocation7 creation of syner(y7
and data driven action we are a+le to e&%ower the different co&&unities 4elderly7 clinicians7
researchers7 +usiness7 faith7 and %olicy &a9ers5 in order to reduce the sufferin( of the elderly3
!y Iision of the $uture
In a *ero?su& world7 where ever dwindlin( resources and continually e8%andin( needs
will overwhel& the health care sector7 efficient resource &ana(e&ent7 coalition +uildin(7 and use
of innovative new technolo(ies will +e the answer3 I ai& to +e one of the innovators in health
care delivery +y +ein( the one who devises and i&%le&ents a county wide new %aradi(& shift3
In doin( so we will have orchestrated a &odel that could %otentially +e used throu(hout the
country3 >hat is even &ore rewardin( a+out this %aradi(& is the fact that at its center is not
technolo(y7 +ut rather traditional fa&ily and co&&unity structures that have +een in %lace for
&illennia and draws u%on the intrinsic hu&an characteristics that can never +e &anufactured or
su%%lanted3
/B
!y stren(th has always +een &y a+ility to e&%athi*e7 create coalitions and to
co&&unicate &y vision to those around &e3 !y stren(th has also +een to e&%ower and use the
fullest ca%acity of those around &e3 I +elieve7 these stren(ths are ideal for a %ro=ect that re'uires
inte(ration of diverse co&&unities7 with talents of uni'uely different clinicians and researchers3
Loo9in( to the future I see a new &odel of healthcare leadershi%7 an inte(rative and
innovative one where the locus of health is &oved fro& the clinics and the hos%itals to the
co&&unity and in the hands of the fa&ilies7 co&&unity leaders7 and +usiness %artners3
/L
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