WEBVTT 00:00:00.000 --> 00:00:02.620 Welcome to the deep dive. This is where we take 00:00:02.620 --> 00:00:05.519 complex ideas, unpack them, and really try to 00:00:05.519 --> 00:00:07.320 distill the knowledge you need to stay ahead, 00:00:07.639 --> 00:00:10.119 well -informed, and, well, often quite surprised. 00:00:10.599 --> 00:00:12.720 Today we're grappling with a really fundamental 00:00:12.720 --> 00:00:15.519 question. It's one that echoes everywhere, boardrooms, 00:00:15.859 --> 00:00:18.350 classrooms, and absolutely... across the demanding 00:00:18.350 --> 00:00:20.730 world of healthcare. How does an organization 00:00:20.730 --> 00:00:22.910 or maybe a team, perhaps even your own career, 00:00:23.190 --> 00:00:25.530 move beyond just being good? How do you get to 00:00:25.530 --> 00:00:28.149 something truly consistently exceptional? It's 00:00:28.149 --> 00:00:30.589 a leap many aim for, right, but actually very 00:00:30.589 --> 00:00:33.409 few make it. So our mission for this deep dive 00:00:33.409 --> 00:00:36.509 is to unlock a framework, a really rigorous one, 00:00:36.770 --> 00:00:38.729 painstakingly pulled together from looking at 00:00:38.729 --> 00:00:40.670 companies that actually made this exact jump. 00:00:40.710 --> 00:00:43.070 We won't just describe it. We want to unpack 00:00:43.070 --> 00:00:45.409 what it really means for you, our dedicated medical 00:00:45.409 --> 00:00:47.259 audience. How can these These principles maybe 00:00:47.259 --> 00:00:50.179 transform a busy hospital department or say a 00:00:50.179 --> 00:00:52.359 groundbreaking research project. And to help 00:00:52.359 --> 00:00:54.659 us navigate this fascinating terrain, I'm genuinely 00:00:54.659 --> 00:00:57.200 thrilled to be joined by Professor Mo Imam. Your 00:00:57.200 --> 00:01:00.179 ability to synthesize these complex ideas and 00:01:00.179 --> 00:01:02.439 connect them to real world impact, especially 00:01:02.439 --> 00:01:05.040 a medical context is, well, it's fantastic. Welcome. 00:01:05.299 --> 00:01:08.379 It's a real pleasure to be here. And yes, that 00:01:08.379 --> 00:01:12.019 question, how to get from good to great. It's 00:01:12.019 --> 00:01:14.810 a powerful one. And from the inside, it often 00:01:14.810 --> 00:01:18.069 feels like this constant, maybe elusive struggle. 00:01:18.650 --> 00:01:19.829 We should probably start with an insight that 00:01:19.829 --> 00:01:22.769 might feel a bit, well, counterintuitive at first, 00:01:22.969 --> 00:01:25.129 maybe even a little blunt. Good is often the 00:01:25.129 --> 00:01:27.230 enemy of great. Right. Good gets in the way of 00:01:27.230 --> 00:01:30.049 great. Exactly. Think about it. So many places, 00:01:30.709 --> 00:01:33.450 large corporations, small clinics, even individual 00:01:33.450 --> 00:01:35.829 practitioners, they tend to settle for being 00:01:35.829 --> 00:01:38.049 good. And the reason, well, it's pretty simple, 00:01:38.129 --> 00:01:40.189 really. Being good is comfortable. It's safe. 00:01:40.250 --> 00:01:43.269 It's safe, yes. It doesn't demand those often 00:01:43.269 --> 00:01:46.629 radical, sometimes uncomfortable changes or the 00:01:46.629 --> 00:01:48.890 fierce unwavering discipline you need to push 00:01:48.890 --> 00:01:52.069 further to achieve something genuinely exceptional 00:01:52.069 --> 00:01:56.030 and crucially sustained. So this comfort, this 00:01:56.030 --> 00:01:57.890 sort of gravitational pull towards just being 00:01:57.890 --> 00:02:00.569 good enough, it becomes the very barrier. It 00:02:00.569 --> 00:02:03.500 stops the leap to enduring greatness. Now, Our 00:02:03.500 --> 00:02:05.299 understanding of this, it comes from a pretty 00:02:05.299 --> 00:02:08.379 comprehensive five -year research effort, meticulously 00:02:08.379 --> 00:02:10.780 designed really to crack the code of this good 00:02:10.780 --> 00:02:13.240 -to -create jump. The methodology was incredibly 00:02:13.240 --> 00:02:15.439 rigorous. We started by finding a select group 00:02:15.439 --> 00:02:17.180 of companies, companies that had demonstrably 00:02:17.180 --> 00:02:20.120 made that leap from just good results to truly 00:02:20.120 --> 00:02:22.659 great results. And this is key, they sustained 00:02:22.659 --> 00:02:25.639 those great results for at least 15 years. 15 00:02:25.639 --> 00:02:28.060 years is a long time to sustain that level of 00:02:28.060 --> 00:02:30.620 performance. It really is. And to make sure our 00:02:30.620 --> 00:02:33.560 findings were truly distinct, We then rigorously 00:02:33.560 --> 00:02:36.240 compared these good -to -great companies to a 00:02:36.240 --> 00:02:38.620 carefully selected control group. These were 00:02:38.620 --> 00:02:41.860 comparison companies that either failed to make 00:02:41.860 --> 00:02:43.879 the leap, or maybe they made it for a short time 00:02:43.879 --> 00:02:46.819 but couldn't sustain it. The whole aim was to 00:02:46.819 --> 00:02:49.280 uncover the precise, distinguishing factors. 00:02:49.819 --> 00:02:52.500 What exactly separated those who achieved lasting 00:02:52.500 --> 00:02:55.319 greatness from those who just stayed good or 00:02:55.319 --> 00:02:58.259 eventually faltered? And their results, frankly, 00:02:58.580 --> 00:03:00.580 they were quite striking. The good -to -great 00:03:00.580 --> 00:03:02.900 companies, on average, achieved cumulative stock 00:03:02.900 --> 00:03:06.280 returns 6 .9 times the general market in the 00:03:06.280 --> 00:03:10.000 15 years after their transition point. 6 .9 times? 00:03:10.039 --> 00:03:12.939 That's huge. It is. Just to give you some perspective, 00:03:13.080 --> 00:03:15.740 think about GE, General Electric, often held 00:03:15.740 --> 00:03:17.639 up as one of the best -led companies of the late 00:03:17.639 --> 00:03:20.599 20th century. Absolutely. Well, GE outperformed 00:03:20.599 --> 00:03:23.460 the market by 2 .8 times over a similar 15 -year 00:03:23.460 --> 00:03:26.400 period. OK, so 6 .9 versus 2 .8, that really 00:03:26.400 --> 00:03:28.300 puts it in context. It does. We're talking about 00:03:28.300 --> 00:03:31.099 a significant, empirically verifiable, almost 00:03:31.099 --> 00:03:33.400 staggering leap in performance, and one that 00:03:33.400 --> 00:03:35.879 wasn't just a flash in the pan. What I find so 00:03:35.879 --> 00:03:38.360 compelling about this, actually, beyond those 00:03:38.360 --> 00:03:41.120 undeniable numbers, is just how universal the 00:03:41.120 --> 00:03:43.159 findings seem to be. It's not just tech, is it? 00:03:43.259 --> 00:03:46.139 or manufacturing. Not at all. These core principles, 00:03:46.379 --> 00:03:48.719 you called it the fundamental physics of going 00:03:48.719 --> 00:03:51.900 from good to great, they seem to apply everywhere. 00:03:52.180 --> 00:03:53.819 Whether you're running a school, a government 00:03:53.819 --> 00:03:56.300 agency, or as we're really focusing on today, 00:03:56.599 --> 00:03:59.719 navigating the incredibly intricate, vital world 00:03:59.719 --> 00:04:02.979 of healthcare. Yes. Be it a major hospital, a 00:04:02.979 --> 00:04:05.560 clinical department, maybe even a cutting edge 00:04:05.560 --> 00:04:08.840 research lab. These insights hold true. That's 00:04:08.840 --> 00:04:11.419 exactly right. The mechanisms aren't tied to 00:04:11.419 --> 00:04:14.000 specific industries. They're rooted in deep -seated 00:04:14.000 --> 00:04:17.079 human behavior, organizational design. It's fundamental. 00:04:17.269 --> 00:04:19.230 And that actually leads to another surprising 00:04:19.230 --> 00:04:21.509 aspect of what we found, the great companies 00:04:21.509 --> 00:04:23.649 we identified. They weren't necessarily the ones 00:04:23.649 --> 00:04:26.089 constantly grabbing headlines or basking in public 00:04:26.089 --> 00:04:27.889 adoration. All right, not the usual suspects. 00:04:28.129 --> 00:04:30.610 Not always, no. In fact, they were often, shall 00:04:30.610 --> 00:04:33.230 we say, rather doubtier groups, companies you 00:04:33.230 --> 00:04:35.329 might not have immediately thought of as star 00:04:35.329 --> 00:04:38.350 performers, like Walgreens, for instance, or 00:04:38.350 --> 00:04:41.759 Fannie Mae. Consider this. In the period from 00:04:41.759 --> 00:04:45.459 1975 to 2000, a single pound invested in Walgreens 00:04:45.459 --> 00:04:47.860 actually outperformed a pound invested in the 00:04:47.860 --> 00:04:50.959 tech superstar Intel. Really? Walgreens beat 00:04:50.959 --> 00:04:54.439 Intel. By nearly two times. It outperformed General 00:04:54.439 --> 00:04:56.860 Electric by almost five times. And the general 00:04:56.860 --> 00:05:00.579 stock market by over 15 times. Wow. That's incredible. 00:05:00.759 --> 00:05:02.660 It really highlights that greatness isn't just 00:05:02.660 --> 00:05:04.639 reserved for the flashy high -growth sectors 00:05:04.639 --> 00:05:07.579 or those getting all the media buzz. It is, in 00:05:07.579 --> 00:05:10.420 fact, possible to turn good into great in the 00:05:10.420 --> 00:05:12.800 most unlikely, seemingly ordinary situations. 00:05:12.920 --> 00:05:14.939 Mm. Provided, of course, these distinct principles 00:05:14.939 --> 00:05:17.480 are applied. That's truly fascinating. OK, so 00:05:17.480 --> 00:05:19.300 let's dive into these principles, then. Let's 00:05:19.300 --> 00:05:21.399 get stuck in. You start with something quite 00:05:21.399 --> 00:05:24.379 fundamental, leadership. But when we talk about 00:05:24.379 --> 00:05:26.420 the kind of leadership that really drives an 00:05:26.420 --> 00:05:29.480 organization from good to great. Your research 00:05:29.480 --> 00:05:32.759 uncovered a profile that was, well, frankly surprising, 00:05:32.959 --> 00:05:35.120 maybe even a little shocking, considering how 00:05:35.120 --> 00:05:37.740 we often define great leaders today. What did 00:05:37.740 --> 00:05:40.379 you discover about these exceptional individuals? 00:05:40.800 --> 00:05:43.079 It was, without a doubt, one of the most provocative 00:05:43.079 --> 00:05:45.660 findings. We absolutely expected to find these 00:05:45.660 --> 00:05:47.819 charismatic, larger -than -life figures. You 00:05:47.819 --> 00:05:50.439 know the type. The celebrity CEO. Exactly. The 00:05:50.439 --> 00:05:52.279 ones who dominate headlines command attention. 00:05:52.649 --> 00:05:55.670 What we discovered instead were what we termed 00:05:55.670 --> 00:05:58.290 level five leaders. These are individuals who 00:05:58.290 --> 00:06:01.629 embody a really powerful paradox. They blend 00:06:01.629 --> 00:06:04.569 extreme personal humility with intense professional 00:06:04.569 --> 00:06:07.050 will. Humility and will, interesting combination. 00:06:07.529 --> 00:06:10.290 Very much so. They're often self -effacing, quiet, 00:06:10.709 --> 00:06:13.589 reserved, sometimes even shy. Yet underneath 00:06:13.589 --> 00:06:17.430 that, they possess this almost fierce, unshakable 00:06:17.430 --> 00:06:20.569 resolve. and an unwavering ambition, crucially, 00:06:20.850 --> 00:06:22.910 for the organization's success, rather than for 00:06:22.910 --> 00:06:25.290 their own personal glory. Take Darwin Smith. 00:06:25.350 --> 00:06:27.970 He became CEO of Kimberly Clark, a very mild 00:06:27.970 --> 00:06:30.670 -mannered, quiet, in -house lawyer. Apparently, 00:06:30.750 --> 00:06:32.470 he wasn't even sure the board had made the right 00:06:32.470 --> 00:06:34.910 choice picking him. Ah, okay. But he stayed CEO 00:06:34.910 --> 00:06:37.310 for 20 years. And in that time, he orchestrated 00:06:37.310 --> 00:06:39.649 this stunning transformation, turned Kimberly 00:06:39.649 --> 00:06:41.850 -Clark into the world's leading paper -based 00:06:41.850 --> 00:06:44.490 consumer products company. Their cumulative stock 00:06:44.490 --> 00:06:47.930 returns 4 .1 times the general market, handily 00:06:47.930 --> 00:06:49.970 beating rivals like Proctor and Gamble, even 00:06:49.970 --> 00:06:52.129 outperforming huge names like Coca -Cola and 00:06:52.129 --> 00:06:54.569 GE. And what was his big move? His most gutsy 00:06:54.569 --> 00:06:56.730 decision, probably, was selling off the company's 00:06:56.730 --> 00:06:58.889 traditional core business, its coated paper mills, 00:06:59.149 --> 00:07:02.129 a huge move to focus entirely on consumer products 00:07:02.129 --> 00:07:04.410 like Huggies. Wow. That must have caused ripples. 00:07:04.750 --> 00:07:07.819 Oh, it was met with media derision, stock downgrades. 00:07:08.699 --> 00:07:12.480 The lot. But Smith never wavered. His drive was 00:07:12.480 --> 00:07:15.300 entirely for Kimberly Clark. Personal ego. Just 00:07:15.300 --> 00:07:17.959 wasn't there. Apparently in retirement, he simply 00:07:17.959 --> 00:07:20.420 reflected, I never stopped trying to become qualified 00:07:20.420 --> 00:07:22.899 for the job. That says a lot. Humility right 00:07:22.899 --> 00:07:26.040 there. Indeed. Another great example, Coleman 00:07:26.040 --> 00:07:29.360 Mockler at Gillette. Again, a quiet, reserved 00:07:29.360 --> 00:07:32.769 man. Very courteous, almost patrician. Yet he 00:07:32.769 --> 00:07:35.110 fiercely battled no fewer than three hostile 00:07:35.110 --> 00:07:37.970 takeover bids to preserve Gillette's future greatness. 00:07:38.089 --> 00:07:40.730 Three bids. Yes. And these bids would have meant 00:07:40.730 --> 00:07:43.329 significant personal financial gain for him and 00:07:43.329 --> 00:07:46.560 other shareholders in the short term. But Machler 00:07:46.560 --> 00:07:48.759 refused to capitulate. He chose to fight for 00:07:48.759 --> 00:07:50.920 the company's long -term viability, its excellence. 00:07:51.500 --> 00:07:53.620 His dedication was profound, this drive to make 00:07:53.620 --> 00:07:55.600 anything he touched the best it could possibly 00:07:55.600 --> 00:07:58.480 be. Very sadly, he died of a massive heart attack 00:07:58.480 --> 00:08:00.660 just minutes after seeing a Forbes cover story 00:08:00.660 --> 00:08:03.720 celebrating his 16 years of struggle. A real 00:08:03.720 --> 00:08:06.339 testament to his quiet intensity. His ambition 00:08:06.339 --> 00:08:08.480 was purely for Gillette. That's quite a story. 00:08:08.959 --> 00:08:12.680 And one more. David Maxwell at Fannie Mae took 00:08:12.680 --> 00:08:16.170 over in 81. The company was hemorrhaging a million 00:08:16.170 --> 00:08:20.709 dollars every single business day. A million 00:08:20.709 --> 00:08:23.990 a day. Wow. Over nine years, he transformed Fannie 00:08:23.990 --> 00:08:26.750 Mae, built a high performance culture, rivaling 00:08:26.750 --> 00:08:29.389 the best on Wall Street. He retired at his peak, 00:08:29.709 --> 00:08:31.370 believing the company would be ill served if 00:08:31.370 --> 00:08:34.009 he stayed too long, handed the reins to a highly 00:08:34.009 --> 00:08:37.450 capable successor. But what really showed his 00:08:37.450 --> 00:08:40.720 level five leadership. His $20 million retirement 00:08:40.720 --> 00:08:43.820 package became controversial in Congress. I can 00:08:43.820 --> 00:08:46.659 imagine. Maxwell voluntarily gave up $5 .5 million 00:08:46.659 --> 00:08:49.299 of it. Why? Because he felt the controversy could 00:08:49.299 --> 00:08:52.159 jeopardize the company's future. His ambition, 00:08:52.399 --> 00:08:54.500 again, purely for fan to me. It's such a striking 00:08:54.500 --> 00:08:56.700 contrast, isn't it? To the narrative we so often 00:08:56.700 --> 00:08:58.679 hear about leadership. I mean, many of the comparison 00:08:58.679 --> 00:09:00.720 companies in your study had leaders who were 00:09:00.720 --> 00:09:03.659 incredibly charismatic, often undeniably egocentric, 00:09:04.080 --> 00:09:06.139 focus much more on their personal brand, their 00:09:06.139 --> 00:09:07.960 glory. That's right. I remember reading about 00:09:07.960 --> 00:09:10.519 Stanley Galt at Rubbermaid, famously quoted saying, 00:09:10.820 --> 00:09:13.340 yes, but I'm a sincere tyrant. Or Al Dunlap at 00:09:13.340 --> 00:09:16.409 Scott Paper. Chainsaw, Al. Exactly. He got 100 00:09:16.409 --> 00:09:19.149 million for just 603 days work, boasting about 00:09:19.149 --> 00:09:21.850 his Rambo in pinstripes nickname after slashing 00:09:21.850 --> 00:09:25.309 jobs in R &D. Yes. And Lee Iacocca at Kreisler, 00:09:25.529 --> 00:09:27.970 a rock star, basically, starring in commercials, 00:09:28.090 --> 00:09:30.909 even thinking about running for president. Yet 00:09:30.909 --> 00:09:33.330 these larger than life figures often left behind, 00:09:33.389 --> 00:09:35.929 well, weak succession planning or performance 00:09:35.929 --> 00:09:38.029 that just wasn't sustainable once they left. 00:09:38.730 --> 00:09:41.210 It almost feels backwards that the quieter, humble 00:09:41.210 --> 00:09:44.190 leaders built lasting greatness. It does, doesn't 00:09:44.190 --> 00:09:47.080 it? And a key distinguishing trait of level five 00:09:47.080 --> 00:09:50.159 leaders is precisely that, their ambition for 00:09:50.159 --> 00:09:52.940 the company. Unlike many comparison leaders who 00:09:52.940 --> 00:09:55.059 seem to have this biggest dog syndrome, wanting 00:09:55.059 --> 00:09:57.620 to be the dominant figure, creating the organization 00:09:57.620 --> 00:10:00.679 in their image, level five leaders consciously, 00:10:01.179 --> 00:10:03.360 systematically set up their successors for success. 00:10:03.549 --> 00:10:05.889 Not failure. This wasn't about building a personal 00:10:05.889 --> 00:10:08.889 empire. It was about ensuring the enduring greatness 00:10:08.889 --> 00:10:11.230 of the institution itself long after they'd gone. 00:10:11.830 --> 00:10:14.009 They were almost fanatical about seeing the organization 00:10:14.009 --> 00:10:16.049 flourish. And it's really crucial to understand 00:10:16.049 --> 00:10:18.090 that this level five finding, it was empirical. 00:10:18.250 --> 00:10:20.169 It wasn't some ideology we went looking for. 00:10:20.409 --> 00:10:22.929 Just what the data showed. Exactly. It was consistently 00:10:22.929 --> 00:10:24.909 present in all the good and great companies at 00:10:24.909 --> 00:10:27.570 their transition point. And it cuts squarely 00:10:27.570 --> 00:10:29.590 against that conventional wisdom that you need 00:10:29.590 --> 00:10:32.690 these big charismatic personalities for transformation. 00:10:32.840 --> 00:10:35.940 It points to something deeper, this deep -seated 00:10:35.940 --> 00:10:38.399 resolve, this institutional ambition that put 00:10:38.399 --> 00:10:40.340 the collective way above the individual. They 00:10:40.340 --> 00:10:43.000 were essentially ordinary people quietly producing 00:10:43.000 --> 00:10:45.799 extraordinary sustained results because they 00:10:45.799 --> 00:10:48.419 put the enterprise first. So let's translate 00:10:48.419 --> 00:10:51.399 this, this profound insight into the medical 00:10:51.399 --> 00:10:54.840 world. What might this unique blend of personal 00:10:54.840 --> 00:10:57.220 humility and professional will actually look 00:10:57.220 --> 00:10:59.860 like in practice, say, for a chief of surgery 00:10:59.860 --> 00:11:02.639 or a head of research or a clinic director? I 00:11:02.639 --> 00:11:04.539 mean, I can imagine a chief of surgery, for instance, 00:11:04.700 --> 00:11:07.340 has to project authority, confidence in really 00:11:07.340 --> 00:11:09.679 critical moments. How do you square that with 00:11:09.679 --> 00:11:12.220 genuine humility? That's a really incisive question 00:11:12.220 --> 00:11:14.500 because you're right. The perception of leadership 00:11:14.500 --> 00:11:17.360 in health care often leans towards that confident, 00:11:17.580 --> 00:11:21.639 decisive figure. almost needs to, perhaps. But 00:11:21.639 --> 00:11:24.000 for a medical professional, level five leadership 00:11:24.000 --> 00:11:26.860 means focusing relentlessly on exceptional patient 00:11:26.860 --> 00:11:30.159 outcomes, on pioneering research breakthroughs, 00:11:30.440 --> 00:11:32.480 on the institutional excellence of the hospital 00:11:32.480 --> 00:11:35.539 department, putting that above any personal acclaim 00:11:35.539 --> 00:11:38.100 or, you know, hierarchical power struggles. Okay. 00:11:38.600 --> 00:11:41.000 The Level 5 doctor, for instance, might dedicate 00:11:41.000 --> 00:11:43.679 themselves to establishing really robust evidence 00:11:43.679 --> 00:11:46.500 -based protocols, things that truly lift the 00:11:46.500 --> 00:11:49.059 standard of care for the entire department, benefiting 00:11:49.059 --> 00:11:52.000 future patients. Even if it means less personal 00:11:52.000 --> 00:11:54.500 glory, less time in the limelight, they might 00:11:54.500 --> 00:11:57.000 prioritize teaching, mentoring the next generation 00:11:57.000 --> 00:11:59.200 of clinicians or researchers, ensuring their 00:11:59.200 --> 00:12:01.399 successors aren't just competent but exceptional, 00:12:01.860 --> 00:12:03.799 capable of pushing boundaries further than they 00:12:03.799 --> 00:12:06.139 themselves could. Building that future capacity. 00:12:06.580 --> 00:12:09.019 Exactly. It means taking responsibility for mistakes 00:12:09.019 --> 00:12:11.679 without blame, giving credit freely, generously 00:12:11.679 --> 00:12:14.500 to the team, understanding that true achievement 00:12:14.500 --> 00:12:17.419 is collective. It's about building a legacy of 00:12:17.419 --> 00:12:19.539 excellence for the institution, for the patients, 00:12:19.960 --> 00:12:23.059 not building a monument to yourself. The authority 00:12:23.059 --> 00:12:25.720 comes from competence, from genuine care for 00:12:25.720 --> 00:12:28.840 the mission, not from ego. That is a powerful 00:12:28.840 --> 00:12:31.519 distinction, and it leads us perfectly, actually, 00:12:31.639 --> 00:12:34.580 into the second principle. First who, then what? 00:12:37.079 --> 00:12:40.019 This really challenges a deeply ingrained assumption, 00:12:40.200 --> 00:12:42.299 doesn't it? Do great leaders start by charting 00:12:42.299 --> 00:12:44.620 a grand new vision, or do they focus on something 00:12:44.620 --> 00:12:47.320 else entirely first? Our research reviewed they 00:12:47.320 --> 00:12:49.740 operated with a, well, a counterintuitive sequence, 00:12:49.759 --> 00:12:51.580 one that really flips conventional wisdom on 00:12:51.580 --> 00:12:54.120 its head. They first focused on getting the right 00:12:54.120 --> 00:12:55.779 people on the bus, the wrong people off the bus, 00:12:55.779 --> 00:12:57.679 and the right people in the right seats. And 00:12:57.679 --> 00:12:59.519 then they figured out where to drive it. So people 00:12:59.519 --> 00:13:02.899 first, direction second. Precisely. This means 00:13:02.899 --> 00:13:04.940 your people are not your most important asset. 00:13:05.340 --> 00:13:08.470 The right people are. And this principle is fundamental 00:13:08.470 --> 00:13:10.809 because the most brilliant strategy in the world 00:13:10.809 --> 00:13:13.649 is, well, useless if you don't have the intrinsically 00:13:13.649 --> 00:13:15.850 motivated, disciplined, passionate individuals 00:13:15.850 --> 00:13:18.470 to actually execute it. Think of David Maxwell 00:13:18.470 --> 00:13:21.570 at Fannie Mae again. Remember, losing a million 00:13:21.570 --> 00:13:24.450 dollars a day, immense pressure to act immediately. 00:13:25.149 --> 00:13:27.990 His very first act, not launching a new strategy, 00:13:28.269 --> 00:13:31.210 not implementing a new financial plan. Instead, 00:13:31.330 --> 00:13:33.669 he systematically interviewed all the officers, 00:13:34.250 --> 00:13:37.019 made it absolutely clear how demanding the challenge 00:13:37.019 --> 00:13:39.440 would be, and gave those not aligned with his 00:13:39.440 --> 00:13:42.360 vision the chance to leave. No prejudice. He 00:13:42.360 --> 00:13:44.679 focused on building that high -caliber, committed 00:13:44.679 --> 00:13:47.080 team before setting a new direction. That takes 00:13:47.080 --> 00:13:48.879 nerve when you're bleeding cash like that. It 00:13:48.879 --> 00:13:51.059 does. And this approach is fundamentally about 00:13:51.059 --> 00:13:54.139 being rigorous, not ruthless. Okay, explain that 00:13:54.139 --> 00:13:56.519 difference. Rigorous versus ruthless. Ruthless 00:13:56.519 --> 00:13:59.700 implies cutting indiscriminately, or firing, 00:14:00.100 --> 00:14:02.799 without really thoughtful consideration, often 00:14:02.799 --> 00:14:06.419 driven by short -term panic. Rigorous means consistently 00:14:06.419 --> 00:14:08.899 applying exacting standards, at all times, at 00:14:08.899 --> 00:14:10.559 all levels, particularly in upper management. 00:14:11.159 --> 00:14:13.120 It's about ensuring your best people can focus 00:14:13.120 --> 00:14:16.039 fully on their highest value work, rather than 00:14:16.039 --> 00:14:18.139 being burdened, compensating for shortcomings 00:14:18.139 --> 00:14:20.659 of underperformers. or carrying dead weight. 00:14:20.820 --> 00:14:23.059 Making space for the best to perform. Exactly. 00:14:23.379 --> 00:14:25.500 Consider Wells Fargo's acquisition of Crocker 00:14:25.500 --> 00:14:28.340 Bank back in 1986. They took the seemingly drastic 00:14:28.340 --> 00:14:31.019 step of terminating 1 ,600 Crocker managers on 00:14:31.019 --> 00:14:33.519 day one. And surprisingly, even some of their 00:14:33.519 --> 00:14:35.559 own managers, if the Crocker manager was judged 00:14:35.559 --> 00:14:38.399 better qualified. Wow, that's bold. It wasn't 00:14:38.399 --> 00:14:41.039 about being cruel. It was about rapid clarity, 00:14:41.720 --> 00:14:44.240 preserving a high -performance culture. One executive 00:14:44.240 --> 00:14:46.419 explained, we were not going to subject our culture 00:14:46.419 --> 00:14:49.389 to a death by a thousand cuts. They acted quickly 00:14:49.389 --> 00:14:51.429 so people could move on, find roles where they 00:14:51.429 --> 00:14:53.970 could flourish, rather than languishing in uncertainty 00:14:53.970 --> 00:14:57.690 which just drains morale. Another powerful illustration, 00:14:58.230 --> 00:15:01.230 New Core, the steel company. They built their 00:15:01.230 --> 00:15:04.070 entire system on a premise. You can teach farmers 00:15:04.070 --> 00:15:06.870 how to make steel. Okay. But you can't teach 00:15:06.870 --> 00:15:08.690 a farmer's work ethic to people who don't have 00:15:08.690 --> 00:15:11.009 it. Oh, I see. Focus on the inherent drive. Right. 00:15:11.110 --> 00:15:13.070 So they located their plants in rural areas, 00:15:13.610 --> 00:15:15.710 created an environment where hard -working people 00:15:15.710 --> 00:15:19.080 thrived, their compensation system, heavily tied 00:15:19.080 --> 00:15:22.279 to team productivity. Over half of workers' pay 00:15:22.279 --> 00:15:24.399 depended on their team's output. They literally 00:15:24.399 --> 00:15:26.740 hired five, worked them like ten, and paid them 00:15:26.740 --> 00:15:29.929 like eight. Intense. And lazy workers. quite 00:15:29.929 --> 00:15:31.490 directly, they were thrown right off the bus. 00:15:32.029 --> 00:15:34.190 Sometimes even physically chased out by teammates 00:15:34.190 --> 00:15:35.950 because they were hitting the collective bonus. 00:15:36.269 --> 00:15:38.269 You know, one of the most surprising findings 00:15:38.269 --> 00:15:40.850 from the study, at least it was for me, was about 00:15:40.850 --> 00:15:43.370 executive compensation. It seems really counterintuitive 00:15:43.370 --> 00:15:46.210 that there wasn't a strong systematic link between 00:15:46.210 --> 00:15:49.289 specific pay structures and making that leap 00:15:49.289 --> 00:15:52.309 from good to great. For many, incentives are 00:15:52.309 --> 00:15:55.000 the be all and end all, right? for driving performance. 00:15:55.879 --> 00:15:57.980 Are you suggesting that traditional bonuses, 00:15:57.980 --> 00:16:01.039 for instance, have no role or is it just not 00:16:01.039 --> 00:16:03.440 the primary driver? That's an excellent question. 00:16:03.720 --> 00:16:05.460 And it really did challenge our preconceived 00:16:05.460 --> 00:16:08.340 notions. We spent weeks digging into compensation 00:16:08.340 --> 00:16:10.759 data, looking for correlations, stock options, 00:16:10.919 --> 00:16:13.159 bonuses, high salaries, linking them to great 00:16:13.159 --> 00:16:16.960 performance. And we found no systematic differences. 00:16:17.659 --> 00:16:20.860 In fact, the good -to -great executives actually 00:16:20.860 --> 00:16:23.379 received slightly less total cash compensation 00:16:23.379 --> 00:16:26.000 10 years after the transition than their counterparts 00:16:26.000 --> 00:16:28.460 at the still mediocre comparison companies. Less. 00:16:28.820 --> 00:16:31.399 Okay, that is surprising. Why? Well, the explanation, 00:16:31.559 --> 00:16:33.840 we concluded, lies right back in that first two 00:16:33.840 --> 00:16:36.620 principle. It's not how you compensate your executives, 00:16:36.940 --> 00:16:38.700 it's which executives you have to compensate 00:16:38.700 --> 00:16:41.220 in the first place. Ah, it's about the person, 00:16:41.419 --> 00:16:43.799 not the package. Precisely. If you have the right 00:16:43.799 --> 00:16:47.379 people on the bus, those level five leaders... 00:16:47.129 --> 00:16:49.690 Those individuals with that intrinsic motivation, 00:16:50.129 --> 00:16:52.429 they aren't primarily driven by what they'll 00:16:52.429 --> 00:16:54.629 get for it. They will do everything in their 00:16:54.629 --> 00:16:56.850 power to build a great company. Not because of 00:16:56.850 --> 00:16:59.429 the next bonus, but because they simply cannot 00:16:59.429 --> 00:17:02.309 imagine settling for anything less. It's their 00:17:02.309 --> 00:17:04.490 internal moral code, their professional will. 00:17:05.009 --> 00:17:07.829 It requires building excellence for its own sake. 00:17:08.109 --> 00:17:11.170 So the motivation is internal? Largely, yes. 00:17:11.349 --> 00:17:13.809 Now, compensation needs to be rational, fair, 00:17:13.930 --> 00:17:16.750 of course, but it's about who you compensate 00:17:16.750 --> 00:17:20.009 attracting and retaining those intrinsically 00:17:20.009 --> 00:17:22.450 driven people, not the elaborate structure of 00:17:22.450 --> 00:17:25.269 the compensation itself, the right people. They 00:17:25.269 --> 00:17:27.349 don't need to be tightly managed, nor do they 00:17:27.349 --> 00:17:29.710 need complicated compensation schemes to be motivated. 00:17:30.089 --> 00:17:32.269 They are self -motivated by that desire to build 00:17:32.269 --> 00:17:34.549 something great. And this leads to a crucial 00:17:34.549 --> 00:17:36.650 practical discipline that just naturally flows 00:17:36.650 --> 00:17:39.069 from first two. Put your best people on your 00:17:39.069 --> 00:17:40.930 biggest opportunities, not your biggest problems. 00:17:41.329 --> 00:17:43.769 Opportunities, not problems. Okay. Managing problems 00:17:43.769 --> 00:17:46.829 can, at best, make you good. It keeps you afloat, 00:17:47.009 --> 00:17:49.170 keeps things ticking over, but it doesn't create 00:17:49.170 --> 00:17:52.009 breakthroughs. Building on opportunities, however, 00:17:52.410 --> 00:17:55.130 that's the only way to become truly great. Philip 00:17:55.130 --> 00:17:57.490 Morris, for example, put his best talent on the 00:17:57.490 --> 00:18:00.009 international expansion for Marlboro, rather 00:18:00.009 --> 00:18:02.910 than trying to endlessly fix its declining domestic 00:18:02.910 --> 00:18:05.690 market share. Focus on the growth area. Yes. 00:18:06.259 --> 00:18:09.180 Similarly, Kimberly Clark's Dick Apert shifted 00:18:09.180 --> 00:18:12.140 his top talent away from the failing paper business 00:18:12.140 --> 00:18:14.700 towards the emerging, high -potential consumer 00:18:14.700 --> 00:18:17.099 business. The right people want to be part of 00:18:17.099 --> 00:18:18.920 building something great, and they're willing 00:18:18.920 --> 00:18:21.559 to move resources, move talent to where the greatest 00:18:21.559 --> 00:18:23.970 impact and growth can actually be made. So if 00:18:23.970 --> 00:18:25.509 we bring this back to healthcare again, you're 00:18:25.509 --> 00:18:27.430 often dealing with highly specialized talent, 00:18:27.529 --> 00:18:30.670 almost irreplaceable sometimes, and intense immediate 00:18:30.670 --> 00:18:33.349 patient pressures. How does a hospital leader 00:18:33.349 --> 00:18:35.490 realistically implement this right people on 00:18:35.490 --> 00:18:38.430 the busses idea without causing chaos? What are 00:18:38.430 --> 00:18:40.910 the actual levers they have to identify the right 00:18:40.910 --> 00:18:43.329 people for challenging clinical roles or groundbreaking 00:18:43.329 --> 00:18:45.869 research initiatives beyond just looking at an 00:18:45.869 --> 00:18:48.210 impressive CV? That's a critical practical challenge 00:18:48.210 --> 00:18:50.750 in healthcare, absolutely. A hospital leader 00:18:50.750 --> 00:18:54.579 needs to adopt that rigor not ruthless approach 00:18:54.579 --> 00:18:58.460 to talent. Which means looking beyond just technical 00:18:58.460 --> 00:19:01.559 skill or years of experience, you evaluate people 00:19:01.559 --> 00:19:03.519 not just on their current performance, but on 00:19:03.519 --> 00:19:06.000 their intrinsic motivation, their capacity for 00:19:06.000 --> 00:19:08.380 continuous growth, their deep alignment with 00:19:08.380 --> 00:19:10.980 the institution's core purpose. So character 00:19:10.980 --> 00:19:14.019 and potential, not just qualifications. Exactly. 00:19:14.420 --> 00:19:16.660 You ask yourself things like, if I were hiring 00:19:16.660 --> 00:19:18.759 this person today, knowing what I know now, would 00:19:18.759 --> 00:19:21.609 I enthusiastically rehire them? Or perhaps more 00:19:21.609 --> 00:19:24.109 tellingly, if this person left for another opportunity, 00:19:24.470 --> 00:19:27.150 would I be secretly relieved? Or would I be truly 00:19:27.150 --> 00:19:29.230 disappointed, worried about the void they'd leave? 00:19:29.349 --> 00:19:31.309 Those are tough questions. They cut to the heart 00:19:31.309 --> 00:19:33.849 of whether someone is truly the right person. 00:19:34.430 --> 00:19:36.369 For clinical roles, it might mean looking for 00:19:36.369 --> 00:19:38.670 individuals who demonstrate profound empathy, 00:19:39.309 --> 00:19:41.609 a relentless commitment to patient well -being, 00:19:42.190 --> 00:19:44.589 a collaborative spirit that genuinely lists the 00:19:44.589 --> 00:19:47.789 whole team, not just their own practice. For 00:19:47.789 --> 00:19:49.769 research, it means identifying those with that 00:19:49.769 --> 00:19:52.769 insatiable curiosity, exceptional intellectual 00:19:52.769 --> 00:19:56.029 rigor, and the sheer tenacity to pursue difficult 00:19:56.029 --> 00:19:58.750 questions even when facing repeated setbacks 00:19:58.750 --> 00:20:01.950 or failed experiments. That resilience! Absolutely. 00:20:02.569 --> 00:20:04.369 And once you have these right people, the next 00:20:04.369 --> 00:20:06.430 crucial step is recognizing you don't just assign 00:20:06.430 --> 00:20:08.430 them to the most immediate crises, the biggest 00:20:08.430 --> 00:20:11.829 fires. Instead, you strategically deploy your 00:20:11.829 --> 00:20:14.589 brightest minds, your most dedicated professionals, 00:20:15.230 --> 00:20:17.009 to the areas with the greatest potential for 00:20:17.009 --> 00:20:19.380 breakthrough. Back to opportunities over problems. 00:20:19.980 --> 00:20:22.359 Yes. Whether that's developing a new, more effective 00:20:22.359 --> 00:20:24.660 surgical technique, exploring novel treatment 00:20:24.660 --> 00:20:26.980 modalities, or pursuing a high -impact research 00:20:26.980 --> 00:20:29.420 hypothesis that could fundamentally change patient 00:20:29.420 --> 00:20:32.039 care, it's about being proactive in building 00:20:32.039 --> 00:20:34.539 greatness, rather than just reactive and maintaining 00:20:34.539 --> 00:20:37.079 goodness. That's a powerful shift in perspective. 00:20:37.660 --> 00:20:40.079 Moving on, the third principle gets into a really 00:20:40.079 --> 00:20:43.000 profound psychological duality. One essential 00:20:43.000 --> 00:20:45.960 for greatness. Confront the brutal facts, yet 00:20:45.960 --> 00:20:49.369 never lose faith. What is this duality, and why 00:20:49.369 --> 00:20:51.250 is it so crucial? It almost sounds contradictory. 00:20:51.329 --> 00:20:53.430 It does, doesn't it? And that's precisely the 00:20:53.430 --> 00:20:55.670 paradox. This principle is encapsulated in what 00:20:55.670 --> 00:20:58.250 we call the Stockdale paradox. It states that 00:20:58.250 --> 00:21:01.049 you must maintain unwavering faith, faith that 00:21:01.049 --> 00:21:03.549 you can and will prevail in the end, regardless 00:21:03.549 --> 00:21:06.210 of the difficulties. And D, at the same time, 00:21:06.490 --> 00:21:08.630 have the discipline to confront the most brutal 00:21:08.630 --> 00:21:10.849 facts of your current reality, whatever they 00:21:10.849 --> 00:21:13.450 might be. holding those two together, faith and 00:21:13.450 --> 00:21:15.950 harsh reality. Exactly. Holding two seemingly 00:21:15.950 --> 00:21:18.809 opposing forces in tension. The name comes from 00:21:18.809 --> 00:21:21.369 Admiral Jim Stockdale. He was the highest ranking 00:21:21.369 --> 00:21:23.849 U .S. military officer held captive in the Hanoi 00:21:23.849 --> 00:21:26.809 Hilton during the Vietnam War. Ah, yes, the POW. 00:21:27.029 --> 00:21:30.609 He endured years of brutal torture, 1965 to 1973. 00:21:31.289 --> 00:21:33.730 No prisoners' rights, no certainty of release, 00:21:34.190 --> 00:21:37.930 no clear end in sight. Just grim reality. When 00:21:37.930 --> 00:21:39.990 asked Years later, who didn't make it out of 00:21:39.990 --> 00:21:42.730 the POW camps, Stockdale famously replied, oh, 00:21:42.730 --> 00:21:45.450 that's easy, the optimists. The optimists didn't 00:21:45.450 --> 00:21:48.069 make it? That seems odd. He explained the optimists 00:21:48.069 --> 00:21:49.509 were the ones who kept saying, we're going to 00:21:49.509 --> 00:21:51.309 be out by Christmas. Then Christmas would come 00:21:51.309 --> 00:21:53.349 and go. OK, we'll be out by Easter. Easter would 00:21:53.349 --> 00:21:55.589 come and go. And eventually, they died of broken 00:21:55.589 --> 00:21:58.670 hearts. Their spirits shattered by repeated disappointment. 00:21:58.950 --> 00:22:00.930 Because their hope wasn't grounded in reality. 00:22:01.650 --> 00:22:05.029 Precisely. Stockdale, by contrast, faced the 00:22:05.029 --> 00:22:07.839 grim reality of his situation head on. never 00:22:07.839 --> 00:22:10.079 deluded himself about how severe it was or how 00:22:10.079 --> 00:22:12.880 long it might last. Yet, and this is the paradox, 00:22:13.200 --> 00:22:15.819 he never lost faith in his ultimate triumph, 00:22:16.440 --> 00:22:18.960 in turning the experience into a defining event 00:22:18.960 --> 00:22:22.359 of his life. This duality, acknowledging reality 00:22:22.359 --> 00:22:24.920 without losing hope, was absolutely critical 00:22:24.920 --> 00:22:27.839 to his survival and his eventual triumph. That's 00:22:27.839 --> 00:22:30.619 a powerful lesson. It contrasts sharply with 00:22:30.619 --> 00:22:33.420 companies that failed to confront reality. Take 00:22:33.420 --> 00:22:36.900 A &P, the old grocery chain. Despite clear market 00:22:36.900 --> 00:22:39.559 changes, the rise of super stores, A &P just 00:22:39.559 --> 00:22:41.900 stuck its head in the sand. They even opened 00:22:41.900 --> 00:22:44.400 experimental stores, the Golden Key, to learn 00:22:44.400 --> 00:22:46.619 what customers wanted. Customers loved them. 00:22:46.680 --> 00:22:49.980 So they got the answer. Yes. But astonishingly, 00:22:50.140 --> 00:22:53.039 A &P closed them because, and I quote, they didn't 00:22:53.039 --> 00:22:55.920 like the answers. You're kidding. No. They then 00:22:55.920 --> 00:22:59.019 lurched from one fad to another. Radical price 00:22:59.019 --> 00:23:00.980 cutting, but without addressing the fundamental 00:23:00.980 --> 00:23:03.740 shift in customer needs, led straight to their 00:23:03.740 --> 00:23:07.759 decline. Meanwhile, Kroger, a competitor, methodically 00:23:07.759 --> 00:23:09.680 confronted the brutal truth about the changing 00:23:09.680 --> 00:23:12.920 market, systematically converted its entire system 00:23:12.920 --> 00:23:15.960 to the Superstore model, achieved sustained greatness, 00:23:16.460 --> 00:23:19.619 another example, Addressograph, under a charismatic 00:23:19.619 --> 00:23:23.599 CEO, Roy Ash, pursued this ambitious office automation 00:23:23.599 --> 00:23:26.000 plan, but Ash refused to acknowledge mounting 00:23:26.000 --> 00:23:28.410 evidence that his plan was failing. kept milking 00:23:28.410 --> 00:23:30.869 cash from profitable areas to fund this doomed 00:23:30.869 --> 00:23:33.089 venture. Willful blindness. Essentially, yes. 00:23:33.450 --> 00:23:35.130 The truth just went unheard until it was far 00:23:35.130 --> 00:23:37.450 too late. Many key people simply bailed out, 00:23:37.549 --> 00:23:39.990 disheartened by the delusion. Okay, let's unpack 00:23:39.990 --> 00:23:43.690 this for our medical listeners. Healthcare. Inherent 00:23:43.690 --> 00:23:47.059 complexities. Ethical dilemmas, immense pressures. 00:23:47.619 --> 00:23:49.700 It can often be hard to confront uncomfortable 00:23:49.700 --> 00:23:51.920 truths, whether it's about patient outcomes, 00:23:52.319 --> 00:23:54.259 resource allocation, treatment effectiveness, 00:23:54.720 --> 00:23:57.680 maybe even internal team dynamics. How do you, 00:23:57.920 --> 00:24:00.099 as a leader in this environment, actually cultivate 00:24:00.099 --> 00:24:02.180 a climate where the truth is not just heard but 00:24:02.180 --> 00:24:04.920 actively sought out, even when it's deeply uncomfortable? 00:24:05.180 --> 00:24:07.619 This is absolutely vital, because the moment 00:24:07.619 --> 00:24:10.140 a leader becomes the primary reality, people 00:24:10.140 --> 00:24:11.579 worry about. Meaning they're afraid to bring 00:24:11.579 --> 00:24:14.220 bad news. Exactly. Afraid to deliver bad news, 00:24:14.339 --> 00:24:16.559 challenge assumptions, worried more about the 00:24:16.559 --> 00:24:18.799 leader's reaction than reality itself. That's 00:24:18.799 --> 00:24:21.640 a recipe for mediocrity. Or worse, for crisis. 00:24:22.160 --> 00:24:23.980 We identified several methods for cultivating 00:24:23.980 --> 00:24:26.700 a climate where the truth is heard. First, leadership 00:24:26.700 --> 00:24:29.019 with questions, not answers. Great leaders, like 00:24:29.019 --> 00:24:31.000 Alan Wurzel of Circuit City, they resisted the 00:24:31.000 --> 00:24:32.759 urge to walk in with all the solutions ready. 00:24:32.900 --> 00:24:36.039 Instead, they started by asking, why? Why? Why? 00:24:36.160 --> 00:24:38.420 Constantly pushing, probing with questions to 00:24:38.420 --> 00:24:41.240 get a clear picture of reality and its implications. 00:24:41.380 --> 00:24:44.480 Like a Socratic approach. Very much so. It encourages 00:24:44.480 --> 00:24:46.720 deep understanding and ownership from the team, 00:24:47.099 --> 00:24:49.420 rather than just passive compliance. Second, 00:24:50.240 --> 00:24:53.240 engage in dialogue and debate, not coercion. 00:24:53.950 --> 00:24:56.710 Good to great teams spent significant time in 00:24:56.710 --> 00:24:59.490 robust debates. The executives at Philip Morris, 00:24:59.490 --> 00:25:01.609 for example, were renowned for arguing about 00:25:01.609 --> 00:25:03.930 everything, but it was always in search of the 00:25:03.930 --> 00:25:06.609 best answer for the common good, not about personal 00:25:06.609 --> 00:25:09.089 agendas or turf wars. What the conflict. Exactly. 00:25:09.569 --> 00:25:11.490 And when a decision was finally made after that 00:25:11.490 --> 00:25:14.509 rigorous debate, everyone stood behind it because 00:25:14.509 --> 00:25:16.569 they felt their voice had been heard in the pursuit 00:25:16.569 --> 00:25:20.549 of truth. Third, conduct autopsies without blame. 00:25:20.750 --> 00:25:23.690 When mistakes happen, like Philip Morris's disastrous 00:25:23.690 --> 00:25:25.910 acquisition of seven -up leaders like Joe Coleman, 00:25:26.470 --> 00:25:29.029 openly dissected the failures, Coleman took personal 00:25:29.029 --> 00:25:31.569 responsibility, identified lessons learned, even 00:25:31.569 --> 00:25:33.390 gave credit to those who had challenged his idea 00:25:33.390 --> 00:25:35.609 originally, rather than trying to protect his 00:25:35.609 --> 00:25:37.789 own image. That fosters psychological safety? 00:25:38.250 --> 00:25:40.650 Absolutely. It fosters a culture where learning 00:25:40.650 --> 00:25:43.650 from failure is prioritized over finger -pointing, 00:25:43.990 --> 00:25:46.930 makes people feel safe to raise issues. And finally, 00:25:47.319 --> 00:25:50.059 Build red flag mechanisms. These are specific 00:25:50.059 --> 00:25:53.160 devices, systems that turn information into something 00:25:53.160 --> 00:25:56.160 that simply cannot be ignored. A vivid example 00:25:56.160 --> 00:25:59.160 is Granite Rock's short pay system. Customers 00:25:59.160 --> 00:26:01.559 could unilaterally deduct payment for unsatisfactory 00:26:01.559 --> 00:26:03.940 service right from the invoice. Didn't even have 00:26:03.940 --> 00:26:05.740 to call the company. Wow, that forces you to 00:26:05.740 --> 00:26:07.880 pay attention. Instantly. It forced immediate 00:26:07.880 --> 00:26:10.339 attention to problems. Acted as an early warning 00:26:10.339 --> 00:26:13.099 system. In a medical context, this might translate 00:26:13.099 --> 00:26:16.240 to structured, no -blame incident reporting systems. 00:26:16.509 --> 00:26:19.349 where staff feel absolutely safe reporting errors 00:26:19.349 --> 00:26:22.309 or near misses without fear of reprisal, knowing 00:26:22.309 --> 00:26:24.069 it will lead to systemic improvement. Making 00:26:24.069 --> 00:26:27.269 it safe to speak up. Yes. Or it could be patient 00:26:27.269 --> 00:26:29.430 feedback loops that aren't just collected, but 00:26:29.430 --> 00:26:32.109 actually force an immediate, visible organizational 00:26:32.109 --> 00:26:35.910 response to address systemic issues, making inconvenient 00:26:35.910 --> 00:26:39.779 truths unavoidable and actionable. That's a critical 00:26:39.779 --> 00:26:42.920 point because fear of blame or even just confirmation 00:26:42.920 --> 00:26:46.819 bias can be incredibly strong, especially when 00:26:46.819 --> 00:26:49.579 dealing with complex patient data or the results 00:26:49.579 --> 00:26:51.660 of a long research study where careers might 00:26:51.660 --> 00:26:54.779 be on the line. So how can a medical leader, 00:26:54.880 --> 00:26:56.779 maybe in a research setting, ensure they are 00:26:56.779 --> 00:26:59.339 truly confronting uncomfortable data or failed 00:26:59.339 --> 00:27:02.380 hypotheses rather than succumbing to that confirmation 00:27:02.380 --> 00:27:05.920 bias or the inherent desire for a positive outcome? 00:27:06.279 --> 00:27:08.279 That feels like a real challenge. It is a profound 00:27:08.279 --> 00:27:10.640 challenge. And it requires a deliberate, almost 00:27:10.640 --> 00:27:13.279 radical commitment to intellectual honesty. In 00:27:13.279 --> 00:27:15.900 a research setting, this means fostering an environment 00:27:15.900 --> 00:27:18.500 where challenging assumptions isn't just tolerated, 00:27:18.799 --> 00:27:20.980 it's actively encouraged, maybe even rewarded. 00:27:21.759 --> 00:27:23.940 A leader needs to model the speedings of themselves 00:27:23.940 --> 00:27:26.859 by openly acknowledging when their own hypotheses 00:27:26.859 --> 00:27:29.299 have been disproven by the data, by demonstrating 00:27:29.299 --> 00:27:31.539 genuine curiosity about why the results went 00:27:31.539 --> 00:27:34.650 a different way. Leading by example. Yes. It 00:27:34.650 --> 00:27:37.009 involves creating formal mechanisms for critical 00:27:37.009 --> 00:27:39.750 peer review that go beyond just superficial checks. 00:27:40.589 --> 00:27:42.670 Perhaps having rotating devil's advocate roles 00:27:42.670 --> 00:27:45.769 in team meetings, specifically tasked with dissecting 00:27:45.769 --> 00:27:47.910 potential flaws in methodology interpretation, 00:27:48.589 --> 00:27:50.849 even the underlying premises of a study, implementing 00:27:50.849 --> 00:27:53.410 robust red flag mechanisms would be vital here 00:27:53.410 --> 00:27:56.049 too. This could be a clear protocol for immediately 00:27:56.049 --> 00:27:58.470 escalating any unexpected or adverse research 00:27:58.470 --> 00:28:01.309 findings, ensuring they aren't buried or rationalized 00:28:01.309 --> 00:28:03.109 away because someone wants a neat narrative. 00:28:03.630 --> 00:28:06.150 So, systems to surface the awkward results. Right. 00:28:06.349 --> 00:28:08.369 For instance, rather than just reviewing aggregate 00:28:08.369 --> 00:28:11.529 data, a research lead might insist on directly 00:28:11.529 --> 00:28:14.670 examining individual patient outcomes that deviate 00:28:14.670 --> 00:28:16.769 from the expected results, no matter how small 00:28:16.769 --> 00:28:19.049 the number might seem. It's about instilling 00:28:19.049 --> 00:28:21.750 this pervasive sense that the integrity of the 00:28:21.750 --> 00:28:24.210 data, the truth of the findings, however uncomfortable, 00:28:24.690 --> 00:28:27.470 always takes precedence. Over personal prestige, 00:28:27.849 --> 00:28:30.529 over a predetermined story, over the desire for 00:28:30.529 --> 00:28:33.329 a particular outcome, the unwavering faith isn't 00:28:33.329 --> 00:28:35.930 in a specific hypothesis, it's in the ultimate 00:28:35.930 --> 00:28:38.450 success of the scientific method itself, and 00:28:38.450 --> 00:28:40.940 its contribution to human knowledge. even if 00:28:40.940 --> 00:28:42.839 that means disproving your own work along the 00:28:42.839 --> 00:28:45.099 way. Okay, so once you have the right people 00:28:45.099 --> 00:28:47.039 and a climate where truth can be heard, how do 00:28:47.039 --> 00:28:49.140 you focus all that energy? This brings us to 00:28:49.140 --> 00:28:51.799 the hedgehog concept, which you draw from that 00:28:51.799 --> 00:28:54.039 ancient Greek parable, the fox and the hedgehog. 00:28:54.619 --> 00:28:56.579 The fox knows many things, but the hedgehog knows 00:28:56.579 --> 00:28:58.799 one big thing. How does this seemingly simple 00:28:58.799 --> 00:29:01.319 idea apply to organizational focus, and how does 00:29:01.319 --> 00:29:04.259 it drive greatness? The hedgehog concept is, 00:29:04.400 --> 00:29:07.539 at its heart, about profound simplicity. It's 00:29:07.539 --> 00:29:09.920 not about being clever or complicated like the 00:29:09.920 --> 00:29:12.799 fox, darting about knowing many things. It's 00:29:12.799 --> 00:29:15.799 about being like the hedgehog. knowing one big 00:29:15.799 --> 00:29:18.960 thing, one simple crystalline idea that provides 00:29:18.960 --> 00:29:21.299 a fundamental frame of reference for all decisions. 00:29:22.039 --> 00:29:24.420 This concept sits right at the intersection of 00:29:24.420 --> 00:29:27.200 three fundamental circles, three crucial questions. 00:29:27.779 --> 00:29:30.059 Firstly, what can you be the best in the world 00:29:30.059 --> 00:29:33.059 at? Not just good at, but best. Exactly. This 00:29:33.059 --> 00:29:34.619 isn't just about what you're currently good at, 00:29:34.640 --> 00:29:36.900 or even what your core business has been for 00:29:36.900 --> 00:29:39.380 years. It's about what you have the potential 00:29:39.380 --> 00:29:42.259 to be truly excellent at, globally. If you cannot 00:29:42.259 --> 00:29:44.200 honestly say you can be the best in the world 00:29:44.200 --> 00:29:46.420 at your core business, then that business cannot 00:29:46.420 --> 00:29:48.920 form the basis of a truly great company. It has 00:29:48.920 --> 00:29:51.869 to be replaced, or radically redefined. It demands 00:29:51.869 --> 00:29:54.109 brutal honesty about competence and potential. 00:29:54.410 --> 00:29:57.269 Secondly, what drives your economic engine? Great 00:29:57.269 --> 00:29:59.509 companies identify the single profit -per -ex 00:29:59.509 --> 00:30:02.170 denominator or maybe cash flow -per -ex in the 00:30:02.170 --> 00:30:04.470 social sector that has the greatest, most sustainable 00:30:04.470 --> 00:30:06.589 impact on their viability and growth. Finding 00:30:06.589 --> 00:30:09.690 that key metric. Yes. It's not always obvious. 00:30:09.750 --> 00:30:12.089 It requires deep insight into your fundamental 00:30:12.089 --> 00:30:16.130 economics. A single metric that, when improved, 00:30:16.869 --> 00:30:19.849 disproportionately impacts your mission. And 00:30:19.849 --> 00:30:23.109 thirdly, What are you deeply passionate about? 00:30:23.269 --> 00:30:25.730 This is about activities that genuinely ignite 00:30:25.730 --> 00:30:28.930 passion within the organization. Not manufactured 00:30:28.930 --> 00:30:31.029 enthusiasm. You're trying to motivate people 00:30:31.029 --> 00:30:33.930 from the top down. Real intrinsic passion. Yes. 00:30:34.269 --> 00:30:36.650 Discovering the passion that already exists and 00:30:36.650 --> 00:30:39.589 harnessing it. What do the people in your organization 00:30:39.589 --> 00:30:42.170 truly deeply care about? So best in the world, 00:30:42.390 --> 00:30:44.750 economic driver, and passion. All three needed. 00:30:44.890 --> 00:30:47.210 All three are absolutely essential for a fully 00:30:47.210 --> 00:30:49.670 developed hedgehog concept. If you only make 00:30:49.670 --> 00:30:51.569 money doing things you're good at but can't be 00:30:51.569 --> 00:30:53.789 the best at, you'll be successful, sure, but 00:30:53.789 --> 00:30:56.849 not truly great or enduring. If you become the 00:30:56.849 --> 00:30:59.250 best at something but lack that intrinsic passion, 00:30:59.710 --> 00:31:01.529 you won't sustain it through the tough times. 00:31:01.750 --> 00:31:03.410 And if you're passionate but can't realistically 00:31:03.410 --> 00:31:05.690 be the best or make economic sense, well, you'll 00:31:05.690 --> 00:31:07.329 have fun, but you won't produce great results 00:31:07.329 --> 00:31:10.049 or have lasting impact. Take Walgreens again. 00:31:10.410 --> 00:31:12.890 Remember, outperform the market 15 times over. 00:31:13.130 --> 00:31:15.390 Their hedgehog concept was beautifully simple. 00:31:16.029 --> 00:31:19.380 Be the best at convenient drugstores. Steadily 00:31:19.380 --> 00:31:21.619 increasing profit per customer visits. Simple 00:31:21.619 --> 00:31:24.519 and clear. Exactly. They were a hedgehog with 00:31:24.519 --> 00:31:27.740 this incredibly simple idea. Systematically seeking 00:31:27.740 --> 00:31:30.599 the best sites, clustering stores, pioneering 00:31:30.599 --> 00:31:32.839 drive -through pharmacies, all reinforcing that 00:31:32.839 --> 00:31:36.099 concept. Contrast that with Eckerd, a competitor. 00:31:36.700 --> 00:31:39.559 They pursued growth in a real hodgepodge fashion, 00:31:40.079 --> 00:31:42.500 acquiring clumps of stores with no unifying theme. 00:31:42.589 --> 00:31:46.089 even dabbled in home video rentals, led to fragmented 00:31:46.089 --> 00:31:48.829 efforts, mediocrity. The Fox trying too many 00:31:48.829 --> 00:31:50.710 things? Correctly. Well, Fargo is another prime 00:31:50.710 --> 00:31:52.509 example. They realized they couldn't realistically 00:31:52.509 --> 00:31:55.009 be the best global bank like Citicorp. Their 00:31:55.009 --> 00:31:57.710 hedgehog concept became the best at running a 00:31:57.710 --> 00:31:59.970 bank like a business, with a focus on the Western 00:31:59.970 --> 00:32:02.930 United States, using profit per employee as their 00:32:02.930 --> 00:32:06.049 economic driver. That focus became a mantra guiding 00:32:06.049 --> 00:32:08.049 every decision. And you mentioned a health care 00:32:08.049 --> 00:32:10.609 example, Abbott Labs. Yes, a really relevant 00:32:10.609 --> 00:32:13.759 one. For years Abbott was a pharmaceutical company 00:32:13.759 --> 00:32:16.920 mainly in antibiotics. But they lag behind giants 00:32:16.920 --> 00:32:19.579 like Merck and Pfizer. They confronted the brutal 00:32:19.579 --> 00:32:22.240 fact. They couldn't realistically become the 00:32:22.240 --> 00:32:24.480 best pharmaceutical company in the world. So 00:32:24.480 --> 00:32:27.299 guided by level five leadership that Stockdale 00:32:27.299 --> 00:32:30.039 Paradox Faith, their hedgehog concept evolved. 00:32:30.480 --> 00:32:33.059 It became creating products that contribute to 00:32:33.059 --> 00:32:35.000 cost effective health care. This shift in focus. 00:32:35.200 --> 00:32:37.599 A significant shift. They strategically moved 00:32:37.599 --> 00:32:39.819 toward hospital nutritionals and diagnostic devices 00:32:39.819 --> 00:32:41.579 areas where they could be the best in the world. 00:32:42.380 --> 00:32:45.119 Abbott became number one in both, radically improved 00:32:45.119 --> 00:32:47.480 their performance, their impact. This wasn't 00:32:47.480 --> 00:32:49.400 about abandoning their field, but finding their 00:32:49.400 --> 00:32:52.039 unique excellence within it. Philip Morris, too, 00:32:52.079 --> 00:32:54.920 had a clear hedgehog. Best in the world at building 00:32:54.920 --> 00:32:57.380 brand loyalty in cigarettes and later other consumer 00:32:57.380 --> 00:33:00.259 products. Profit per global brand category was 00:33:00.259 --> 00:33:03.099 the driver, fueled by a deep, almost religious 00:33:03.099 --> 00:33:05.759 passion for their brands. It's about singular 00:33:05.759 --> 00:33:08.480 focus. What's striking to me is how this applies 00:33:08.480 --> 00:33:10.880 down at the level of a medical practice or a 00:33:10.880 --> 00:33:13.619 research department. It's about deep self -understanding, 00:33:13.759 --> 00:33:16.880 isn't it? Not just bravado or ambition. How can 00:33:16.880 --> 00:33:19.799 a clinical team, for example, realistically identify 00:33:19.799 --> 00:33:22.920 its hedgehog concept? What unique contribution 00:33:22.920 --> 00:33:26.160 can it truly make? What drives its economic engine? 00:33:26.279 --> 00:33:28.559 Maybe patient recovery rates or research grant 00:33:28.559 --> 00:33:32.599 acquisition. And what genuinely ignites its collective 00:33:32.599 --> 00:33:35.220 passion? This seems like a really difficult, 00:33:35.299 --> 00:33:37.500 maybe awkward conversation to have internally. 00:33:37.740 --> 00:33:40.900 It is difficult, yes, yet profoundly necessary. 00:33:41.380 --> 00:33:43.380 For a clinical team or research department, finding 00:33:43.380 --> 00:33:46.259 the hedgehog concept is often an iterative process. 00:33:46.519 --> 00:33:48.339 It's not usually a single brainstorming session 00:33:48.339 --> 00:33:50.660 that just spits out the neat answer. It starts, 00:33:50.700 --> 00:33:52.559 as you say, with confronting those brutal facts 00:33:52.559 --> 00:33:54.660 about your current capabilities and, crucially, 00:33:54.799 --> 00:33:57.480 your limitations. You need to ask, what treatments 00:33:57.480 --> 00:33:59.680 or conditions do we truly excel at compared to 00:33:59.680 --> 00:34:02.740 others nationally? even globally. Where is our 00:34:02.740 --> 00:34:05.039 team's unique clinical or research expertise 00:34:05.039 --> 00:34:06.920 genuinely world class, or where does it have 00:34:06.920 --> 00:34:09.559 the potential to be? This often needs looking 00:34:09.559 --> 00:34:12.480 beyond internal perceptions to external benchmarks. 00:34:12.900 --> 00:34:14.739 An honest look in the mirror. Absolutely. For 00:34:14.739 --> 00:34:16.679 the economic engine in health care, you're right. 00:34:16.820 --> 00:34:19.039 It's not usually financial profit in the traditional 00:34:19.039 --> 00:34:21.679 sense. It's about the most impactful, measurable 00:34:21.679 --> 00:34:24.219 output that sustains and grows your mission. 00:34:24.500 --> 00:34:28.210 It could be patient recovery rate per specialized 00:34:28.210 --> 00:34:31.670 surgical procedure, or research grants acquired 00:34:31.670 --> 00:34:33.989 per lead investigator for a specific disease, 00:34:34.389 --> 00:34:38.429 or maybe successful patient outcomes per integrated 00:34:38.429 --> 00:34:40.849 care pathway for complex chronic conditions. 00:34:41.570 --> 00:34:43.809 Identifying that single most powerful denominator 00:34:43.809 --> 00:34:46.989 forces immense clarity and prioritization. And 00:34:46.989 --> 00:34:49.730 the passion part. For passion, it's about what 00:34:49.730 --> 00:34:52.750 genuinely ignites the team, what truly gives 00:34:52.750 --> 00:34:55.780 them meaning. Is it pioneering new surgical techniques? 00:34:56.199 --> 00:34:58.639 Developing compassionate care models for chronic 00:34:58.639 --> 00:35:01.579 conditions? Leading the charge in specific disease 00:35:01.579 --> 00:35:04.320 eradication? It's not about trying to be passionate 00:35:04.320 --> 00:35:07.139 or faking enthusiasm. It's discovering where 00:35:07.139 --> 00:35:09.840 that deep intrinsic drive already resides among 00:35:09.840 --> 00:35:12.880 your most dedicated people. When a team truly 00:35:12.880 --> 00:35:15.400 nails its hedgehog concept, there's often this 00:35:15.400 --> 00:35:18.420 distinctive, quiet ping of truth. A profound 00:35:18.420 --> 00:35:20.710 sense of clarity, alignment. It's very different 00:35:20.710 --> 00:35:22.650 from the mindless bravado we saw in comparison 00:35:22.650 --> 00:35:24.809 companies, obsessed with growth for growth's 00:35:24.809 --> 00:35:28.170 sake or diversifying endlessly. Greatness paradoxically 00:35:28.170 --> 00:35:30.449 often involves having the discipline to say a 00:35:30.449 --> 00:35:33.010 resolute no to opportunities, even seemingly 00:35:33.010 --> 00:35:35.250 attractive ones if they fall outside those three 00:35:35.250 --> 00:35:37.130 intersecting circles. That discipline to say 00:35:37.130 --> 00:35:40.550 no. Yes. It's about extreme focus and the quiet, 00:35:40.789 --> 00:35:42.289 unwavering confidence that comes from knowing 00:35:42.289 --> 00:35:44.630 exactly where your unique contribution and greatest 00:35:44.630 --> 00:35:47.630 impact really lie. That discipline you just mentioned 00:35:47.630 --> 00:35:50.679 brings us neatly to the fifth principle. a culture 00:35:50.679 --> 00:35:54.900 of discipline, freedom within a framework. Discipline 00:35:54.900 --> 00:35:57.500 is clearly crucial, but what kind of discipline 00:35:57.500 --> 00:35:59.980 are we really talking about here? And how do 00:35:59.980 --> 00:36:02.639 you balance that with creativity, entrepreneurship, 00:36:03.340 --> 00:36:05.000 especially in an environment like healthcare 00:36:05.000 --> 00:36:08.659 that thrives on innovation and often rapid problem 00:36:08.659 --> 00:36:10.980 solving? It's vital to understand it's not about 00:36:10.980 --> 00:36:13.780 being a tyrant. We saw leaders like Lea Kaka 00:36:13.780 --> 00:36:17.260 at Chrysler who initially force discipline through 00:36:17.260 --> 00:36:19.559 sheer force of personality. Right, the sincere, 00:36:19.840 --> 00:36:22.800 tyrant idea again. But later he lost focus. The 00:36:22.800 --> 00:36:25.239 company declined because the discipline was linked 00:36:25.239 --> 00:36:27.800 to his presence, not embedded in the underlying 00:36:27.800 --> 00:36:30.659 culture. Instead, good to great companies built 00:36:30.659 --> 00:36:33.159 a self -sustaining culture of discipline. This 00:36:33.159 --> 00:36:35.880 means disciplined people who engage in disciplined 00:36:35.880 --> 00:36:37.780 thought and who then take disciplined action. 00:36:38.099 --> 00:36:41.219 People, thought, action, all disciplined. Exactly. 00:36:41.460 --> 00:36:43.239 When you have disciplined people, you don't necessarily 00:36:43.239 --> 00:36:45.880 need extensive hierarchy. When you have discipline 00:36:45.880 --> 00:36:48.139 thought, you don't need stifling bureaucracy. 00:36:48.960 --> 00:36:51.059 And when you combine this discipline culture 00:36:51.059 --> 00:36:54.039 with an ethic of entrepreneurship, you get that 00:36:54.039 --> 00:36:56.800 magical alchemy. Truly great performance. Take 00:36:56.800 --> 00:37:00.460 Abbott Laboratories again. Under George Rathmann's 00:37:00.460 --> 00:37:03.820 influence, they created a system. Every manager 00:37:03.820 --> 00:37:06.079 was responsible for their return on investment. 00:37:06.230 --> 00:37:10.090 instilled deep financial discipline. Okay. But 00:37:10.090 --> 00:37:13.110 here's the key. This discipline didn't stifle 00:37:13.110 --> 00:37:16.050 creativity. It actually enabled it. By having 00:37:16.050 --> 00:37:18.670 tight financial controls, Abbott reduced its 00:37:18.670 --> 00:37:21.210 administrative costs to the lowest in its industry. 00:37:21.480 --> 00:37:24.019 which freed up substantial resource to fund new 00:37:24.019 --> 00:37:26.519 product innovations. Precisely. They derived 00:37:26.519 --> 00:37:28.860 up to 65 % of their revenues from new products 00:37:28.860 --> 00:37:31.559 introduced in just the previous four years. This 00:37:31.559 --> 00:37:33.699 is freedom and responsibility operating within 00:37:33.699 --> 00:37:35.639 a highly developed system. Take an airline pilot. 00:37:35.659 --> 00:37:37.539 They operate with tremendous freedom, autonomy, 00:37:37.699 --> 00:37:39.969 but within very strict disciplined rules. Your 00:37:39.969 --> 00:37:42.889 traffic control checklists. Exactly. The discipline 00:37:42.889 --> 00:37:45.630 provides the safety, the structure, that allows 00:37:45.630 --> 00:37:48.369 bold creative action to flourish rather than 00:37:48.369 --> 00:37:51.489 being crushed. And we distinguish this from being 00:37:51.489 --> 00:37:54.250 ruthless. Ruthless means hacking and cutting 00:37:54.250 --> 00:37:56.710 indiscriminately, often for short -term gain. 00:37:57.369 --> 00:37:59.809 Rigorous means consistently applying exacting 00:37:59.809 --> 00:38:02.469 standards at all levels, especially upper management. 00:38:02.949 --> 00:38:04.849 Ensuring the best people can thrive without being 00:38:04.849 --> 00:38:07.050 burdened or pulled down by underperformers. Clearing 00:38:07.050 --> 00:38:09.829 the way for talent. Yes, and a key manifestation 00:38:09.829 --> 00:38:12.250 of this culture of discipline is the stop doing 00:38:12.250 --> 00:38:14.710 list. Stop doing list? I like that. Most of us 00:38:14.710 --> 00:38:17.409 just have to -do lists. We do. Always trying 00:38:17.409 --> 00:38:19.690 to do more, add more. But good to great companies 00:38:19.690 --> 00:38:21.909 displayed remarkable discipline in unplugging 00:38:21.909 --> 00:38:24.610 extraneous activities. Things that just didn't 00:38:24.610 --> 00:38:28.409 fit their hedgehog concept. Darwin Smith at Kimberly 00:38:28.409 --> 00:38:31.570 Clark. He stopped annual Wall Street forecasts, 00:38:32.130 --> 00:38:34.210 unplugged titles to reduce class consciousness, 00:38:34.710 --> 00:38:36.670 dismantled layers of management by requiring 00:38:36.670 --> 00:38:39.050 managers to justify having at least 15 direct 00:38:39.050 --> 00:38:42.230 reports, forcing efficiency. Cork Walgreens even 00:38:42.230 --> 00:38:44.369 exited the profitable food service business at 00:38:44.369 --> 00:38:46.730 Walgreens. Despite it being a long -standing 00:38:46.730 --> 00:38:48.469 family tradition, some restaurants were even 00:38:48.469 --> 00:38:51.510 named Corkies. Really? Why? Because it didn't 00:38:51.510 --> 00:38:53.650 align with their hedgehog concept of convenient 00:38:53.650 --> 00:38:56.320 drugstores. This deliberate, often difficult 00:38:56.320 --> 00:38:58.679 elimination of non -core activities frees up 00:38:58.679 --> 00:39:01.519 invaluable resources and focus. This principle 00:39:01.519 --> 00:39:04.039 feels particularly challenging, though, in highly 00:39:04.039 --> 00:39:06.579 regulated, complex environments like healthcare, 00:39:07.099 --> 00:39:09.320 where every task often feels critical, deeply 00:39:09.320 --> 00:39:11.940 interconnected. How do you cultivate a culture 00:39:11.940 --> 00:39:13.940 of discipline within a medical practice or a 00:39:13.940 --> 00:39:16.559 research facility without just stifling crucial 00:39:16.559 --> 00:39:19.710 innovation? or maybe overburdening staff with 00:39:19.710 --> 00:39:22.329 endless protocols? And how can you realistically 00:39:22.329 --> 00:39:25.150 apply the stop -doing principle in a field where, 00:39:25.150 --> 00:39:27.750 well, everything seems critical for patient safety 00:39:27.750 --> 00:39:30.449 or research integrity? That's a very perceptive 00:39:30.449 --> 00:39:33.050 observation. In healthcare, cultivating a culture 00:39:33.050 --> 00:39:35.550 of discipline isn't about imposing rigid bureaucracy 00:39:35.550 --> 00:39:38.010 or stifling innovation with excessive rules. 00:39:38.329 --> 00:39:40.730 It's more about standardizing the essential, 00:39:41.010 --> 00:39:43.809 repeatable processes. Doing that frees up cognitive 00:39:43.809 --> 00:39:46.710 load, frees up precious resources for true innovation. 00:39:46.960 --> 00:39:49.500 for complex problem solving. So discipline in 00:39:49.500 --> 00:39:51.719 the routine frees up creativity for the complex. 00:39:52.119 --> 00:39:55.199 That's the idea. Think of creating highly disciplined 00:39:55.199 --> 00:39:57.780 systems for routine care, for data collection, 00:39:58.099 --> 00:40:00.579 for patient flow, which then enables clinicians 00:40:00.579 --> 00:40:02.960 and researchers to apply their creativity, their 00:40:02.960 --> 00:40:05.079 expertise, their entrepreneurial spirit to the 00:40:05.079 --> 00:40:08.239 most challenging, nuanced cases or groundbreaking 00:40:08.239 --> 00:40:11.559 research. The discipline provides the foundation 00:40:11.559 --> 00:40:14.769 upon which innovation can safely stand. Now, 00:40:14.809 --> 00:40:16.869 applying the stop doing principle in healthcare, 00:40:17.190 --> 00:40:19.309 where yes, every task often does seem critical, 00:40:19.809 --> 00:40:22.590 that requires immense courage and absolute clarity 00:40:22.590 --> 00:40:24.630 of purpose, tied directly back to your hedgehog 00:40:24.630 --> 00:40:27.809 concept. It means constantly asking, what are 00:40:27.809 --> 00:40:30.510 we doing that is merely good, but doesn't contribute 00:40:30.510 --> 00:40:32.590 directly to what we can truly be the best in 00:40:32.590 --> 00:40:35.150 the world at? What activities don't genuinely 00:40:35.150 --> 00:40:38.570 ignite our passion or disproportionately drive 00:40:38.570 --> 00:40:41.300 our core mission? For a hospital, it might mean 00:40:41.300 --> 00:40:43.639 rigorously evaluating which specialized services, 00:40:43.820 --> 00:40:45.900 even if they generate some revenue, don't align 00:40:45.900 --> 00:40:47.659 with their hedgehog concept. Perhaps they're 00:40:47.659 --> 00:40:49.519 better delivered by other institutions that can 00:40:49.519 --> 00:40:51.900 be world -class in that specific area. Strategic 00:40:51.900 --> 00:40:54.119 focus, even if it means letting something go. 00:40:54.420 --> 00:40:58.000 Yes. For a research lab, it could mean discontinuing 00:40:58.000 --> 00:41:00.119 research lines that, while may be interesting, 00:41:00.599 --> 00:41:02.699 are unlikely to lead to breakthrough discoveries 00:41:02.699 --> 00:41:05.760 given the lab's unique strengths, even if external 00:41:05.760 --> 00:41:08.019 funding is available for them. It might mean 00:41:08.019 --> 00:41:10.920 saying a polite but firm no to grant opportunities 00:41:10.920 --> 00:41:14.159 that fall outside the hedgehog. Or ruthlessly 00:41:14.159 --> 00:41:17.300 streamlining administrative processes that drain 00:41:17.300 --> 00:41:20.619 valuable time from direct patient care or research, 00:41:21.059 --> 00:41:23.300 even if they've always been done that way. Challenging 00:41:23.300 --> 00:41:25.829 the status quo. Exactly. The goal is to focus 00:41:25.829 --> 00:41:29.250 finite resources, time, talent, capital on the 00:41:29.250 --> 00:41:30.949 areas where the organization can have the greatest 00:41:30.949 --> 00:41:33.590 impact and achieve genuine excellence. Okay, 00:41:33.929 --> 00:41:36.750 sixth principle. In a world where medical technology 00:41:36.750 --> 00:41:39.849 is advancing at an almost dizzying pace, AI, 00:41:40.510 --> 00:41:42.789 digital health, they're often heralded as the 00:41:42.789 --> 00:41:44.889 ultimate solutions, aren't they? Technology is 00:41:44.889 --> 00:41:46.809 frequently seen as the primary driver of change, 00:41:47.170 --> 00:41:49.579 the silver bullet for progress. What did your 00:41:49.579 --> 00:41:51.739 rigorous research actually reveal about its role 00:41:51.739 --> 00:41:53.599 in the good -to -great transformation? Was it 00:41:53.599 --> 00:41:56.179 the magic solution, many assume? It's a pervasive 00:41:56.179 --> 00:41:58.300 assumption, isn't it? And we actually found something 00:41:58.300 --> 00:42:01.699 quite contrary to popular belief. The good -to 00:42:01.699 --> 00:42:05.079 -great companies never used technology as the 00:42:05.079 --> 00:42:07.760 primary means of igniting a transformation. Never. 00:42:08.159 --> 00:42:11.099 Never as the primary spark. Technology alone 00:42:11.099 --> 00:42:14.309 cannot make a company great. However, And this 00:42:14.309 --> 00:42:16.789 is the vital paradox. Once they had their clear 00:42:16.789 --> 00:42:19.650 hedgehog concept and the right people and the 00:42:19.650 --> 00:42:22.469 disciplines in place, then they were pioneers 00:42:22.469 --> 00:42:24.829 in the careful application of carefully selected 00:42:24.829 --> 00:42:27.469 technologies. Okay, so not the initiator, but 00:42:27.469 --> 00:42:30.130 maybe an amplifier. Exactly. Technology acted 00:42:30.130 --> 00:42:33.030 as an accelerator of momentum, but only after 00:42:33.030 --> 00:42:35.849 the hedgehog concept was clear, only after the 00:42:35.849 --> 00:42:37.690 right people and discipline culture were firmly 00:42:37.690 --> 00:42:40.710 in place. It amplified the core mission. It didn't 00:42:40.710 --> 00:42:42.769 define it or create it. They understood technology 00:42:42.769 --> 00:42:45.769 as a tool. not a strategy in itself. Consider 00:42:45.769 --> 00:42:48.250 Walgreens again. They invested heavily in Intercom, 00:42:48.409 --> 00:42:50.670 their satellite system linking all stores, long 00:42:50.670 --> 00:42:52.710 before others in the industry. They pioneered 00:42:52.710 --> 00:42:54.789 scanners, robotics, and their pharmacies. Early 00:42:54.789 --> 00:42:57.769 adopters then. Yes, but crucially, this wasn't 00:42:57.769 --> 00:43:00.510 to create their convenience concept. It was to 00:43:00.510 --> 00:43:03.309 accelerate it. make it faster, more reliable, 00:43:03.489 --> 00:43:06.710 more pervasive. When the internet emerged, they 00:43:06.710 --> 00:43:09.170 deliberately integrated it to enhance their existing 00:43:09.170 --> 00:43:11.909 convenience model, online prescriptions for drive 00:43:11.909 --> 00:43:14.250 -through pickup, that sort of thing, rather than 00:43:14.250 --> 00:43:16.530 panicking, chasing the dot -com bubble without 00:43:16.530 --> 00:43:18.750 a clear purpose, which many comparison companies 00:43:18.750 --> 00:43:20.869 did, much to their detriment. Sticking to their 00:43:20.869 --> 00:43:24.610 hedgehog. Yes. Similarly, Fannie Mae. Transformation 00:43:24.610 --> 00:43:27.710 began in 81, but they only became a pioneer in 00:43:27.710 --> 00:43:30.489 technology. those sophisticated algorithms for 00:43:30.489 --> 00:43:32.829 mortgage risk assessment and processing in the 00:43:32.829 --> 00:43:35.829 early 1990s. After their hedgehog concept was 00:43:35.829 --> 00:43:39.030 solid, their core business model was sound. Technology, 00:43:39.070 --> 00:43:40.929 in their case, was called the second wind of 00:43:40.929 --> 00:43:43.690 the transformation, amplifying already established 00:43:43.690 --> 00:43:46.530 momentum. And Gillette, the razor blade company. 00:43:46.670 --> 00:43:49.489 pioneers in manufacturing technology. Protecting 00:43:49.489 --> 00:43:51.809 their blade -making secrets like Coca -Cola protects 00:43:51.809 --> 00:43:53.889 its formula. Their investment in things like 00:43:53.889 --> 00:43:56.289 laser welding for blades was testament to technological 00:43:56.289 --> 00:43:59.210 pioneering within their already world -class 00:43:59.210 --> 00:44:01.909 core competence. The critical question for these 00:44:01.909 --> 00:44:04.210 companies was always, does this technology fit 00:44:04.210 --> 00:44:06.949 directly with our hedgehog concept? Does it accelerate 00:44:06.949 --> 00:44:09.150 what we could be best at? The asset test. If 00:44:09.150 --> 00:44:10.789 the answer was yes, they became a pioneer in 00:44:10.789 --> 00:44:13.409 its application, invested heavily. If no, they 00:44:13.409 --> 00:44:15.889 asked if it was needed at all. If so, maybe just 00:44:15.889 --> 00:44:19.199 seek parity. Otherwise, ignore the hype. Avoid 00:44:19.199 --> 00:44:21.460 that technology trap of adopting innovations 00:44:21.460 --> 00:44:24.039 just for their own sake. This raises a really 00:44:24.039 --> 00:44:26.199 crucial question for health care today. With 00:44:26.199 --> 00:44:29.179 this constant, often overwhelming flood of advancements, 00:44:29.400 --> 00:44:32.980 medtech, AI, digital health, how can medical 00:44:32.980 --> 00:44:37.250 institutions avoid this technology trap? Adopting 00:44:37.250 --> 00:44:39.130 innovations just because they exist, because 00:44:39.130 --> 00:44:41.550 they're new, rather than as true accelerators 00:44:41.550 --> 00:44:43.570 for their core mission, whether that's patient 00:44:43.570 --> 00:44:47.090 care, specific research areas, or hospital efficiency. 00:44:47.670 --> 00:44:49.469 And maybe you could give us a good example of 00:44:49.469 --> 00:44:51.570 technology accelerating a medical breakthrough 00:44:51.570 --> 00:44:54.690 rather than initiating it. It's a pervasive end. 00:44:55.000 --> 00:44:57.079 and frankly, expensive challenge in healthcare. 00:44:57.599 --> 00:45:00.840 The technology trap is incredibly real. Institutions 00:45:00.840 --> 00:45:03.539 adopt the latest shiny gadget, the newest AI 00:45:03.539 --> 00:45:06.440 platform. Because it's new, it promises a future, 00:45:06.960 --> 00:45:08.659 rather than because it rigorously aligns with 00:45:08.659 --> 00:45:10.800 their hedgehog concept and core strategic priorities. 00:45:11.019 --> 00:45:13.179 To avoid this, medical institutions must first 00:45:13.179 --> 00:45:16.099 achieve absolute clarity on their core purpose, 00:45:16.400 --> 00:45:18.619 their unique contribution. What is their hedgehog? 00:45:18.860 --> 00:45:21.400 For instance, if a hospital's hedgehog concept 00:45:21.400 --> 00:45:23.800 had to be the best in the world at complex cardiac 00:45:23.800 --> 00:45:26.139 surgery with superior patient recovery rates, 00:45:26.440 --> 00:45:29.460 then investing in and pioneering advanced robotic 00:45:29.460 --> 00:45:32.840 surgical systems could be a true technology accelerator. 00:45:33.739 --> 00:45:36.159 It directly amplifies what they already aim to 00:45:36.159 --> 00:45:39.090 be best at. It directly improves their economic 00:45:39.090 --> 00:45:40.750 denominator, those recovery rates. That makes 00:45:40.750 --> 00:45:42.610 sense. It's not about buying the robot just because 00:45:42.610 --> 00:45:45.469 it's available. It's because it precisely enhances 00:45:45.469 --> 00:45:47.650 their core mission, their unique excellence. 00:45:48.449 --> 00:45:51.150 A strong historical example of technology accelerating 00:45:51.150 --> 00:45:53.789 rather than initiating. Think about advanced 00:45:53.789 --> 00:45:57.130 diagnostic imaging, specifically ultra high -resolution 00:45:57.130 --> 00:46:00.170 MRI or PD scans and oncology. Right. Imaging 00:46:00.170 --> 00:46:02.449 and cancer care. The underlying physics of these 00:46:02.449 --> 00:46:05.300 technologies existed for some time. But their 00:46:05.300 --> 00:46:07.519 pioneering, disciplined application in cancer 00:46:07.519 --> 00:46:10.059 care didn't create the mission of treating cancer. 00:46:10.599 --> 00:46:14.119 That mission was already there. Instead, it accelerated 00:46:14.119 --> 00:46:17.260 the ability of oncologist surgeons to precisely 00:46:17.260 --> 00:46:20.059 identify tumor margins, to monitor treatment 00:46:20.059 --> 00:46:23.079 response with unprecedented accuracy, to ultimately 00:46:23.079 --> 00:46:25.619 refine and improve patient outcomes dramatically. 00:46:26.280 --> 00:46:28.860 The focus remained squarely on the patient, on 00:46:28.860 --> 00:46:32.079 the disease. Technology served as a powerful 00:46:32.079 --> 00:46:35.860 enabling tool. not the driving force. This ensures 00:46:35.860 --> 00:46:38.539 resources are invested strategically, with purpose, 00:46:39.019 --> 00:46:41.079 not just chasing every new technological wave 00:46:41.079 --> 00:46:43.059 that comes along. So many leaders, and I think 00:46:43.059 --> 00:46:45.360 patients too, often look for that single miracle 00:46:45.360 --> 00:46:47.340 moment in transformation, don't they? A sudden 00:46:47.340 --> 00:46:49.539 breakthrough, a grand announcement, maybe a new 00:46:49.539 --> 00:46:52.039 drug that changes everything overnight. But your 00:46:52.039 --> 00:46:54.199 research found something quite different. It 00:46:54.199 --> 00:46:57.059 suggests a far more gradual, maybe... less dramatic 00:46:57.059 --> 00:47:00.320 process. Absolutely. We found that great transformations 00:47:00.320 --> 00:47:03.019 never happened in one fell swoop. There was no 00:47:03.019 --> 00:47:05.519 single dramatic breakthrough moment that accounted 00:47:05.519 --> 00:47:08.159 for the change. Instead, they were a cumulative 00:47:08.159 --> 00:47:11.199 process. It resembled relentlessly pushing a 00:47:11.199 --> 00:47:14.099 giant heavy flywheel. The flywheel? Yes. Pushing 00:47:14.099 --> 00:47:16.760 it in one consistent direction, turn upon turn, 00:47:16.980 --> 00:47:20.059 building momentum, until eventually a point of 00:47:20.059 --> 00:47:22.559 breakthrough is reached. No single push, no matter 00:47:22.559 --> 00:47:24.800 how large, accounted for that ultimate breakthrough. 00:47:24.980 --> 00:47:27.289 It was the sun. of consistent efforts accumulated 00:47:27.289 --> 00:47:30.409 over time often years even decades so slow steady 00:47:30.409 --> 00:47:33.309 consistent pressure exactly this means there 00:47:33.309 --> 00:47:36.690 was no miracle moment no grand program launch 00:47:36.690 --> 00:47:40.090 no splashy tagline or single event designed to 00:47:40.090 --> 00:47:42.510 signify the transformation it was an organic 00:47:42.510 --> 00:47:45.510 evolutionary process often unnoticed externally 00:47:45.510 --> 00:47:48.150 until significant momentum was truly achieved 00:47:48.400 --> 00:47:51.079 From the inside, executives described it as just 00:47:51.079 --> 00:47:53.559 a series of good decisions, diligently executed, 00:47:54.019 --> 00:47:56.480 accumulating one on top of another. For example, 00:47:56.719 --> 00:47:58.579 Kimberly Clark's dramatic shift, even selling 00:47:58.579 --> 00:48:01.260 the mills, described by its leaders as a gradual 00:48:01.260 --> 00:48:04.179 cumulative evolution over years. Newcore, the 00:48:04.179 --> 00:48:06.420 steel company. initially just trying to avoid 00:48:06.420 --> 00:48:08.679 bankruptcy, eventually became the number one 00:48:08.679 --> 00:48:11.000 steel company by consistently applying its hedgehog 00:48:11.000 --> 00:48:13.719 concept, building mini mills, gaining customers 00:48:13.719 --> 00:48:16.219 incrementally over decades, not through a sutter 00:48:16.219 --> 00:48:18.619 flash of brilliance or a single master stroke. 00:48:18.880 --> 00:48:21.099 And you contrast this flywheel effect with something 00:48:21.099 --> 00:48:22.960 you call the doom loop, which you observed in 00:48:22.960 --> 00:48:25.260 the comparison companies. What does that look 00:48:25.260 --> 00:48:27.539 like and why do so many fall into it? The doom 00:48:27.539 --> 00:48:30.579 loop. It's characterized by chronic inconsistency. 00:48:31.179 --> 00:48:33.679 Companies lurching erratically from one new strategy 00:48:33.679 --> 00:48:36.400 to another, launching big splashy programs that 00:48:36.400 --> 00:48:38.420 quickly fizzle out, constantly searching for 00:48:38.420 --> 00:48:41.000 a new savior leader to fix everything, making 00:48:41.000 --> 00:48:43.559 acquisitions just for growth without a clear 00:48:43.559 --> 00:48:46.019 unifying concept. Chasing the next big thing, 00:48:46.360 --> 00:48:49.139 constantly changing direction. Precisely. And 00:48:49.139 --> 00:48:51.800 crucially, new leaders would often stop an already 00:48:51.800 --> 00:48:54.119 spinning flywheel, maybe one that was just starting 00:48:54.119 --> 00:48:56.380 to gain momentum, and throw it in a completely 00:48:56.380 --> 00:48:59.840 new, often incompatible direction only to repeat 00:48:59.840 --> 00:49:03.010 the cycle. starting over, losing all prior momentum. 00:49:03.510 --> 00:49:06.269 It's exhausting and ineffective. Warner Lambert, 00:49:06.269 --> 00:49:09.250 for instance, went through three major restructurings 00:49:09.250 --> 00:49:12.090 in less than two decades, cut 20 ,000 people, 00:49:12.369 --> 00:49:13.989 always searching for quick breakthroughs. They'd 00:49:13.989 --> 00:49:16.590 get a brief burst of results, maybe, then slacken, 00:49:16.929 --> 00:49:18.949 never achieve sustained momentum. Eventually, 00:49:18.949 --> 00:49:22.130 they were acquired. Lost their way. Yes. Harris 00:49:22.130 --> 00:49:24.170 Corporation, another example, initially built 00:49:24.170 --> 00:49:27.349 momentum with a clear concept, but a new CEO 00:49:27.349 --> 00:49:30.760 stopped that flywheel. completely divested its 00:49:30.760 --> 00:49:32.800 core profitable printing business for an ill 00:49:32.800 --> 00:49:35.960 -fated venture into office automation. The company 00:49:35.960 --> 00:49:38.539 went into steep decline. They consistently sold 00:49:38.539 --> 00:49:40.780 the sizzle, new products, new initiatives, but 00:49:40.780 --> 00:49:42.820 never delivered the stake of consistent disciplined 00:49:42.820 --> 00:49:45.980 execution. The flywheel, by contrast, applies 00:49:45.980 --> 00:49:48.360 to both external stakeholders and internal teams. 00:49:49.039 --> 00:49:52.750 When people, the investors, or critically, Employees 00:49:52.750 --> 00:49:54.869 see consistent, tangible results coming from 00:49:54.869 --> 00:49:56.909 disciplined actions aligned with a clear concept. 00:49:57.510 --> 00:49:59.510 Enthusiasm builds organically. They line up with 00:49:59.510 --> 00:50:01.710 enthusiasm. It becomes infectious. People want 00:50:01.710 --> 00:50:03.369 to be part of something that is clearly working, 00:50:03.550 --> 00:50:05.929 building momentum, achieving real impact. One 00:50:05.929 --> 00:50:08.530 turn of the flywheel at a time. This seems particularly 00:50:08.530 --> 00:50:11.469 relevant in medical research, where true breakthroughs 00:50:11.469 --> 00:50:15.150 often come after years, maybe decades, of incremental, 00:50:15.429 --> 00:50:18.309 consistent effort, rather than that single eureka 00:50:18.309 --> 00:50:21.849 moment. Professor Imam, how does this flywheel 00:50:21.849 --> 00:50:24.389 concept help medical professionals manage that 00:50:24.389 --> 00:50:27.530 immense, often relentless pressure? Pressure 00:50:27.530 --> 00:50:30.289 for quick results for dramatic breakthroughs 00:50:30.289 --> 00:50:32.329 in patient care or research, especially pressure 00:50:32.329 --> 00:50:35.329 coming from funders or the public. That pressure 00:50:35.329 --> 00:50:37.550 for quick results for the instant breakthrough, 00:50:37.989 --> 00:50:40.449 it's enormous in medicine and research, driven 00:50:40.449 --> 00:50:42.989 by urgent patient needs, tight funding cycles, 00:50:43.489 --> 00:50:46.690 media expectations. It's intense. The flywheel 00:50:46.690 --> 00:50:48.989 concept is a vital counter -narrative to this. 00:50:49.349 --> 00:50:51.429 It helps medical professionals understand that 00:50:51.429 --> 00:50:53.929 enduring success isn't about one grand discovery 00:50:53.929 --> 00:50:56.429 or a single revolutionary clinical trial that 00:50:56.429 --> 00:50:58.590 solves everything overnight. It's about the relentless, 00:50:58.610 --> 00:51:01.190 consistent application of scientific rigor, meticulous 00:51:01.190 --> 00:51:03.869 patient care, continuous improvement, day after 00:51:03.869 --> 00:51:06.230 day, year after year. The long game. Exactly. 00:51:06.429 --> 00:51:08.909 For a research team, it means understanding that 00:51:08.909 --> 00:51:11.610 each well -designed experiment, each carefully 00:51:11.610 --> 00:51:14.809 analyzed dataset, each rigorous peer -reviewed 00:51:14.809 --> 00:51:17.570 publication, each collaborative discussion, however 00:51:17.570 --> 00:51:20.210 small it seems, is a crucial turn of the flywheel. 00:51:20.409 --> 00:51:23.030 It's the cumulative effect of these disciplined, 00:51:23.030 --> 00:51:25.710 consistent efforts, all aligned with our hedgehog 00:51:25.710 --> 00:51:28.230 concept, say, being the best in specific gene 00:51:28.230 --> 00:51:30.530 therapy for a rare disease that eventually leads 00:51:30.530 --> 00:51:33.269 to a clinical breakthrough or a fundamental scientific 00:51:33.269 --> 00:51:35.769 discovery. It's about celebrating those incremental 00:51:35.769 --> 00:51:38.690 wins, demonstrating the visible, tangible progress 00:51:38.690 --> 00:51:41.070 that builds internal confidence, attracts further 00:51:41.070 --> 00:51:43.510 resources, drags talent, making the long game 00:51:43.510 --> 00:51:46.070 sustainable. And in patient care? In patient 00:51:46.070 --> 00:51:48.429 care, it's about consistent adherence to best 00:51:48.429 --> 00:51:51.119 practices. continuous professional development, 00:51:51.780 --> 00:51:54.559 iterative refinement of care pathways. Each improved 00:51:54.559 --> 00:51:57.260 patient outcome, each successful discharge, each 00:51:57.260 --> 00:51:59.400 instance of compassionate care, consistently 00:51:59.400 --> 00:52:01.800 delivered. That contributes to the hospital's 00:52:01.800 --> 00:52:04.139 reputation, its expertise, its overall capability. 00:52:04.619 --> 00:52:07.079 Turn by turn, the flywheel teaches patients. 00:52:07.750 --> 00:52:10.570 Persistence. It ensures leaders manage expectations 00:52:10.570 --> 00:52:13.230 by focusing on consistent effort, verifiable 00:52:13.230 --> 00:52:16.409 progress, rather than chasing every new fad or 00:52:16.409 --> 00:52:18.429 promising a miracle cure that hasn't been earned 00:52:18.429 --> 00:52:20.929 through years of disciplined, cumulative work. 00:52:21.489 --> 00:52:23.429 When the team sees that their sustained efforts 00:52:23.429 --> 00:52:25.630 do lead to better results, they're intrinsically 00:52:25.630 --> 00:52:27.960 motivated to keep pushing that flywheel. We've 00:52:27.960 --> 00:52:30.320 spent this deep dive exploring how organizations 00:52:30.320 --> 00:52:32.980 achieve sustained great results. But what about 00:52:32.980 --> 00:52:35.480 enduring greatness? What does it truly take to 00:52:35.480 --> 00:52:37.820 build something that lasts for generations, that 00:52:37.820 --> 00:52:40.980 remains iconic, relevant, even in an ever -evolving 00:52:40.980 --> 00:52:43.219 field like healthcare? Is there something beyond 00:52:43.219 --> 00:52:46.019 just being great? This takes us directly to the 00:52:46.019 --> 00:52:47.960 connection with our previous work, the Build 00:52:47.960 --> 00:52:51.219 to Last research. Achieving sustained great results, 00:52:51.300 --> 00:52:53.699 which has been our focus in this deep dive, is 00:52:53.699 --> 00:52:55.800 essentially a prequel to becoming an enduring, 00:52:55.800 --> 00:52:58.880 iconic organization. The two frameworks are deeply 00:52:58.880 --> 00:53:00.840 interconnected, but distinct in their focus. 00:53:01.579 --> 00:53:03.940 So good to great comes first, then built to last. 00:53:04.280 --> 00:53:07.139 In essence, yes. The key to enduring greatness, 00:53:07.380 --> 00:53:10.219 the built to last idea, is to discover and embed 00:53:10.219 --> 00:53:13.889 a core ideology. This ideology comprises enduring 00:53:13.889 --> 00:53:16.710 core values and a purpose that goes beyond just 00:53:16.710 --> 00:53:19.269 making money, or in healthcare, beyond merely 00:53:19.269 --> 00:53:22.050 treating symptoms or performing procedures. This 00:53:22.050 --> 00:53:25.030 ideology serves as an unwavering anchor. It provides 00:53:25.030 --> 00:53:27.869 a fundamental sense of identity, direction. While 00:53:27.869 --> 00:53:30.269 everything else, strategies, practices, technologies, 00:53:30.449 --> 00:53:32.869 leaders, is continually stimulated for progress 00:53:32.869 --> 00:53:35.610 and adaptation, it's the dynamic of preserve 00:53:35.610 --> 00:53:38.210 the core, stimulate progress. Preserve the core, 00:53:38.289 --> 00:53:40.829 stimulate progress. Okay. Think of Hewlett -Packard. 00:53:40.960 --> 00:53:43.400 They're founders, Bill Hewlett and David Packard. 00:53:43.880 --> 00:53:46.559 They focused first on who building a great company 00:53:46.559 --> 00:53:48.900 with like -minded people before they even figured 00:53:48.900 --> 00:53:51.900 out what products they would make. Later, they 00:53:51.900 --> 00:53:55.340 instilled deep core values, technical contribution, 00:53:55.780 --> 00:53:58.260 respect for the individual, a belief that profit 00:53:58.260 --> 00:54:00.519 wasn't the fundamental goal, but a byproduct. 00:54:01.059 --> 00:54:04.440 These values became the unchanging core. Or consider 00:54:04.440 --> 00:54:07.139 Merck's longstanding philosophy, medicine is 00:54:07.139 --> 00:54:09.800 for the patient. Profits follow a powerful statement 00:54:09.800 --> 00:54:13.019 of purpose indeed this core purpose guided their 00:54:13.019 --> 00:54:15.500 decisions even difficult ones Like giving away 00:54:15.500 --> 00:54:17.619 a drug that cured river blindness when patients 00:54:17.619 --> 00:54:19.539 in affected regions couldn't possibly afford 00:54:19.539 --> 00:54:22.719 it They preserve that core ideology that foundational 00:54:22.719 --> 00:54:25.500 commitment while constantly stimulating progress 00:54:25.500 --> 00:54:27.800 in their research and development Never resting 00:54:27.800 --> 00:54:31.059 on their laurels. So for a medical audience This 00:54:31.059 --> 00:54:33.960 could mean embedding a core purpose, like advancing 00:54:33.960 --> 00:54:37.360 human health or maybe pioneering compassionate 00:54:37.360 --> 00:54:40.260 care, something that transcends individual clinical 00:54:40.260 --> 00:54:42.679 achievements or departmental goals, becomes the 00:54:42.679 --> 00:54:45.539 very DNA of the institution. Professor Imam, 00:54:45.760 --> 00:54:47.860 what's an example of a medical institution that 00:54:47.860 --> 00:54:50.619 you believe truly embodies this preserve the 00:54:50.619 --> 00:54:53.920 core, stimulate progress philosophy, maintaining 00:54:53.920 --> 00:54:56.199 its unique identity while constantly evolving 00:54:56.199 --> 00:54:58.840 at the cutting edge? A profoundly compelling 00:54:58.840 --> 00:55:01.000 example in the medical field, I think, that embodies 00:55:01.000 --> 00:55:03.780 this preserve the core, simulate progress philosophy, 00:55:04.199 --> 00:55:06.599 would be institutions like the Mayo Clinic. Ah, 00:55:06.900 --> 00:55:09.420 yes, Mayo Clinic. Their core ideology, deeply 00:55:09.420 --> 00:55:11.219 embedded since their founding over a century 00:55:11.219 --> 00:55:14.340 ago, revolves around one simple idea. The needs 00:55:14.340 --> 00:55:16.750 of the patient come first. This is their unchanging 00:55:16.750 --> 00:55:19.309 anchor. A profound, almost sacred commitment 00:55:19.309 --> 00:55:22.329 to integrated patient -centered care. A collaborative 00:55:22.329 --> 00:55:24.389 model of practice where specialists work together 00:55:24.389 --> 00:55:26.690 for the patient. A dedication to education and 00:55:26.690 --> 00:55:28.750 research to continuously improve patient outcomes. 00:55:29.230 --> 00:55:31.769 This unwavering core purpose is what they zealously 00:55:31.769 --> 00:55:35.920 preserve. The constant core. Yes. However, Everything 00:55:35.920 --> 00:55:40.699 else around that core is really... AO Clinic 00:55:40.699 --> 00:55:42.820 has pioneered numerous advancements in medical 00:55:42.820 --> 00:55:45.179 technology, surgical techniques, research methodologies. 00:55:45.679 --> 00:55:47.519 They continuously adapt their organizational 00:55:47.519 --> 00:55:50.099 structure, adopt new digital health platforms, 00:55:50.539 --> 00:55:52.719 embrace novel diagnostic tools and therapies. 00:55:53.119 --> 00:55:55.820 They invest heavily in genomic medicine, AI for 00:55:55.820 --> 00:55:58.199 clinical decision support, advanced regenerative 00:55:58.199 --> 00:56:01.119 therapies. The list goes on. Always innovating. 00:56:01.420 --> 00:56:04.699 Always. But... And this is crucial. Every single 00:56:04.699 --> 00:56:06.820 one of these innovations, every strategic decision, 00:56:07.119 --> 00:56:09.719 must ultimately serve and amplify that core purpose, 00:56:10.079 --> 00:56:12.739 putting the patient's needs first. They evolve, 00:56:12.780 --> 00:56:14.900 they innovate at the cutting edge, but they never 00:56:14.900 --> 00:56:16.739 lose sight of who they are and what they fundamentally 00:56:16.739 --> 00:56:18.880 stand for. This allows them to remain iconic, 00:56:19.219 --> 00:56:22.500 relevant, and great across generations of medical 00:56:22.500 --> 00:56:24.500 advancement. Professor Imam, this has been an 00:56:24.500 --> 00:56:27.239 absolutely invaluable deep dive. It truly reframes 00:56:27.239 --> 00:56:30.159 how we might think about greatness. To recap 00:56:30.159 --> 00:56:33.000 for our listeners. Achieving sustained greatness, 00:56:33.179 --> 00:56:35.980 whether in a multinational corporation or a hospital 00:56:35.980 --> 00:56:38.019 department, it's not really about grand gestures 00:56:38.019 --> 00:56:40.659 or magic bullets, is it? Not at all. It's a disciplined 00:56:40.659 --> 00:56:43.440 cumulative process, starting with level five 00:56:43.440 --> 00:56:45.900 leadership, that paradoxical blend of personal 00:56:45.900 --> 00:56:48.780 humility and fierce professional will, then getting 00:56:48.780 --> 00:56:51.019 the right people on the bus and in the right 00:56:51.019 --> 00:56:53.519 seats, courageously confronting the brutal facts 00:56:53.519 --> 00:56:56.699 of your reality while never losing faith, focusing 00:56:56.699 --> 00:57:00.059 on a crystal clear hedgehog concept, fostering 00:57:00.059 --> 00:57:02.190 a pervasive culture of discipline that actually 00:57:02.190 --> 00:57:05.489 empowers rather than stifles. And finally, using 00:57:05.489 --> 00:57:08.329 technology not as a savior but as a powerful 00:57:08.329 --> 00:57:11.070 accelerator for momentum already built. It's 00:57:11.070 --> 00:57:13.429 really a profound shift in perspective. Precisely. 00:57:13.769 --> 00:57:15.349 These principles, though derived from extensive 00:57:15.349 --> 00:57:18.190 corporate analysis, offer a remarkably powerful 00:57:18.190 --> 00:57:20.989 and, I think, practical framework for mid -senior 00:57:20.989 --> 00:57:22.989 medical professionals striving for excellence. 00:57:23.369 --> 00:57:25.369 In their practice, their department, their research, 00:57:25.670 --> 00:57:28.050 they show that greatness isn't an accident. or 00:57:28.050 --> 00:57:30.510 stroke of luck. It's a direct result of deliberate, 00:57:30.769 --> 00:57:32.909 consistent choices and persistent disciplined 00:57:32.909 --> 00:57:35.530 action. And perhaps the most provocative thought 00:57:35.530 --> 00:57:38.250 for you, our listener, to maybe mull over long 00:57:38.250 --> 00:57:41.690 after this deep dive ends. If your work is something 00:57:41.690 --> 00:57:44.269 you truly care about and you believe in its purpose 00:57:44.269 --> 00:57:47.429 deeply enough, then trying to make it great becomes 00:57:47.429 --> 00:57:51.170 not so much a question of why, but a clear, compelling, 00:57:51.389 --> 00:57:54.480 and ultimately achievable path of how. If you 00:57:54.480 --> 00:57:56.559 found this deep dive valuable, please do consider 00:57:56.559 --> 00:57:58.599 leaving us a rating and sharing it with a colleague 00:57:58.599 --> 00:58:01.199 who might benefit. Thank you so much, Professor 00:58:01.199 --> 00:58:03.179 Moe Mom, for your incredible insights today. 00:58:03.360 --> 00:58:05.179 Thank you. It's been a pleasure. And thank you 00:58:05.179 --> 00:58:07.619 for listening. We'll be back next time with another 00:58:07.619 --> 00:58:10.239 deep dive into the world's most compelling ideas.