“I think healthcare is more about love than most other things”
—Don Berwick

Dr. Berwick speaks of the relationship between the doctor and the patient and family. I believe this relationship is sacred. My job as CEO of Blue Cross North Carolina is hard. But it was so much harder on a recent weekend to give a new diagnosis of a certainly fatal disease of a less than 1-year old child to her parents and discuss palliative care options. I cried and they cried. Being a leader, particularly in healthcare, requires us to maintain sight of what is important and return to those things often as we lead.

Growing up, my parents stressed two things: service and education. I decided early on that I wanted to improve our health care system. I have had a sometimes-winding path to this goal - including work as a consultant, medical school and residency, an RWJ Clinical Scholar, clinical work as a pediatric hospitalist and two tours through government as a White House Fellow, the Centers for Medicare and Medicaid Services (CMS) as Chief Medical Officer, Deputy Administrator and leader of the CMS Innovation Center. With each step I have used five criteria that have allowed me to consider decisions while staying true to myself and my mission.

First, Family. My wife and I have four children, age 10 and under. I put them first as I make decisions.

Second, Impact. Better quality, lower costs, and exceptional experience for populations of people. The triple aim, as we better know it.

Third, People. In the beginning, I took jobs to work with specific mentors. Now, I look carefully at the people and culture where I serve to assess fit and how I could uniquely add value.

Fourth, Learning. How much will I learn every day? When I interviewed for my current job, I told them that they could hire an insurance executive who would be better on day one than me, but if they wanted someone who would improve every day and try to make a model of health transformation and a model health plan for the nation, then they should choose me.

Fifth, Joy in Work. Self-explanatory.

We also have a family mission statement, which was my wife’s good idea. We wrote it together right after we were married. It is too personal to share in detail, but it talks about family, public service, commitment to community, life balance, faith, etc. It is short but to the point and has guided us well.

At some point, you will have someone more senior than you who says you must do A before B and then C. My advice: ignore them. Choose your own path. During my journey, I was encouraged to go down a traditional academic path. I did not do it. Yet, somehow, I was elected to the National Academy of Medicine before I turned 40. It was poignant because it was almost the only accomplishment that my father (a PhD scientist), who passed away before I was elected, would have understood.

So please, decide on your criteria and mission for career and life. Write them down, share them if you wish. Then follow them! Passionately! When things are going well, review them. Are you still aligned with what is important to you? When you are at a crossroads to make a decision, review them again. They should help guide your choice.

I often get asked “what keeps me up at night?” Honestly, nothing as I fall asleep in 10 seconds or less. But if something did, it is the fact that I am always worried that someone is falling through the cracks and getting suboptimal care. We must continue to strive to build a more highly reliable health system that delivers better quality, lower costs, and exceptional experience to all people. We cannot do that without great leaders. So, choose your own path, use your mission as a guide and lead focused on a better health system for all!

Disclosures

Dr. Conway has nothing to disclose.

Mission-Driven Criteria for Life and Career

Disclosures