Peril of Forgetting Step Two



       I have written previously about the
day-long communications seminar I attended with John and Anne Mendelsohn many
years ago. There were many critical lessons presented and some were actually
learned that Saturday. The most critical of these occurred during the
discussion of internal communication. It focused on what you need to say to an
organization or group that you have just been tapped to lead.

1.  I have a
vision for the organization

2.  I have a
plan to get us there

3.  It won’t
be easy

4.  It will
be worth it when we get there

Let’s discuss step 2, for it is
my belief that this is the step that is so often forgotten when leaders try to
lead and run into the brick walls they so often do.

Admittedly, these are very
biased examples, but the best that I have ever seen this done is by two Coach

The first, of course, is Mike
Krzyzewski, the head basketball coach at Duke who is now the winningest coach
in men’s college basketball history. His book, Leading With the Heart, is as
good a leadership text as one would ever want to read. He builds his teams
around five principles: communication, trust, collective responsibility, caring
and pride. These are the 5 fingers of the fist that is the power of the Duke
team. This is a plan. The vision is the National Championship which has been
won four times by Coach K #1, but the plan is the same. The details change
according to the players, but the team plan, the one that has led to so much
success, remains. Whether Duke wins or loses, it is never easy. But because of
the coaching and the plan, the experience is always worth it to the players,
even the ones that never get a ring. Oh yes, we fans like it a lot as well.

The second Coach K is a bit
closer to home. My home.

Coach Kleinerman has led the
Division of Pediatrics since 2001 when she took over a rather small and undistinguished
group of faculty and staff. That first day (I was there) she recited the four
part mantra. Then she did it. Pediatric intensive care was first with the
hiring of Alan Fields and then an entire team. 4 Kids 2 was about more than
cancer care. It meant caring for children with cancer with the best of modern
technology as uniquely applied to pediatrics. MD Anderson, from then on, was
for children as well. Believe it or not, in 2001, there were many in Houston
who had no idea MD Anderson even cared for kids. No more.

Then came great and externally-funded
laboratory based scientists, including physician-scientists. Then Coach K #2
had the idea for the Children’s Cancer Hospital at MD Anderson. Last year the
newly redesigned floors in that hospital opened to care for those kids. Just
like the Duke Coach K #1, Duke Coach K #2 had both a vision and a plan and now
it is reality. That does not mean the work is over. It takes constant oversight
and effort, for organizations behave according to the second law of
thermodynamics. They will break apart into chaos without the leadership pumping
in free energy. No sitting on their laurels for either Coach K. But the goal of
creating an elegant, world-class albeit small Division of Pediatrics at
Anderson is a reality. Like I said. I am biased.

Since most visions are never
realized, what happens to them?

It is my hypothesis that step 2
is omitted or the leaders think their work is done with the pronouncement of
their vision, a misstep the Coaches K never got confused.

Exhibit one on the negative side
of the ledger is President Obama. Dr. Kripke always said hope is not a strategy
and neither is “hope and change”. Mr. Obama assumed the American Presidency in
the midst of the worst financial crisis in over 75 years and had no plan. (The
stimulus was either too small or too large and certainly was poorly applied
over too brief a time). He then took to remaking one-sixth of the American
economy by trying and succeeding in passing the ACA which is looking every day
like a bigger and bigger error and of less and less consequence. With the ACA,
not only did he have no plan, he let Congress plan it. Thus his plan was to
turn over the planning to the most dysfunctional group of people since the 1961
Mets played at the Polo Grounds. (I was present on Capitol Hill in 2009 and the
Polo Grounds in 1961. Not sure I saw the difference).

Then there is Dr. DePinho. You
cannot fault him for not having a vision. He wants to cure cancer. Me, too. His
plan is the Moon Shots. This name for his plan alone displays his complete
misunderstanding of the history of Cold War politics as well as biological
sciences. In their execution the Moon Shots are still pretty vague. Where’s the
real plan? Just as “hope and change” are not a plan neither is spending the
institution into oblivion to convert it into a drug company.


The lesson I take away from all
of this is that a leader cannot simply articulate his or her vision and then
walk away leaving the planning to others. Plans need constant caring and
feeding and often require amending in the heat of battle.

I do know one thing though.
Without the plan, everyone in the system is confused and gradually either goes
comatose or leaves.

At Duke, no one in the
basketball (or now football!) program goes comatose and the ones that leave go
to the NBA. That’s just fine.

At the Children’s Cancer
Hospital, the faculty and staff are exemplary and the ones who leave, should
have either to advance their careers or because Coach K #2’s vision was not
theirs, thus they could not buy into her plan.

The Obama Presidency will come
to an end in 2017, but functionally it may already be over as the policies and
plans put forward have met with national rejection, an emboldened GOP with
members scrambling for position to run for the White House regardless of who
the Dems put up, and a feeling of, dare I say it, malaise in the nation. Most Americans
think we are going in the wrong direction. That’s because the guy in charge of
planning the trip has checked out, if he ever checked in. He talked the talk,
but forgot to walk the walk or even plan the walk.

At Anderson, I left and I should
have. There was nothing for me to do nor was I to be permitted to do anything.
Besides my tenure renewal was rejected (as it should have been given my
non-research activities and lack of research productivity). My leaving is no
loss for Anderson and certainly not for me. However, the other key faculty who
have left, many in clinical divisions, are not so easy to replace especially
given the obvious need for clinical income to stoke the fires of IACS.

On a personal note, some of
those folks were among my closest friends who shared with me a love for MD
Anderson and left rather reluctantly. This really makes me sad.

Perhaps had there been a plan…..

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