The President and The Swami

photography of mirror building
Ivey Business School, London

It was a cold November evening in London. The sun had started to set by 4 PM.

Our days would start at 8 AM when the sun was barely visible. By the time the day would end, it would be dark again.

But on this particular day, after a hasty dinner, a group of fresh faced business school students were crawling back to the school. Dressed in suits and heels, their legs and ears were shivering in the subzero temperature as they walked across the campus to the session, ready to impress.

The big firm was coming today. One of the most prominent management consulting companies was over to recruit today. They had driven a few hundred kilometers to visit this campus, and find the best and brightest of Canada to join their firm.

It was an informational night. Their goal was to talk about their firm (but everyone already knew all about it of course). But really, their goal was to get a feeling of the people and get an insight on who might be the right material for their firm.

The presentation ended, the cocktail hour began. And everyone immediately swamped the one partner who was there.

Everyone started asking questions, hoping to impress and leave just enough of a mark to be memorable and make their odds of getting the job more likely.

What’s it like to work as a Partner? What are some of your biggest challenges? What do you look for in a candidate? How do you progress? What’s the most interesting challenge you’ve faced?

The partner was quick in answering all these questions. There was a practiced manner in his answer, as if he had encountered these same queries dozens of times before.

It’s very challenging but very interesting…

Yes, this one time I advised the CEO of a major auto firm…

Of course, here’s my card. Good talking with you…

He was polite, to the point, and cordial.

The crowd cleared away. I was convinced that this wasn’t the job for me at that age. I decided I could just be me (something very hard for me at the time) and have an actually meaningful conversation.

I wandered over to the partner as the hour came to an end, and all the business cards were handed away to the eager b-school students, who would undoubtedly send him an email the next day saying what an absolute delight it was to talk with him.

He looked exhausted. Turns out, he had just flown in from Europe the day before, and he had to come here for recruiting. No one had asked him about that. We had a good conversation about that.

But there was a genuine question burning inside of me that I wanted to ask him: “All these years you’ve been at the firm helping others turn their businesses around. You’ve worked with Fortune 100 CEOs. You’ve traveled the world…”

The partner got ready to give a rehearsed answer to a question he was anticipating. What do you enjoy most about all this? was perhaps the question he thought I would ask.

“…in all this time, what have you learned about yourself?”

He paused. He looked away for a while, staring into the space. He turned to me and said:

“You know, I’ve been doing this for 10 years now. No one has ever asked me this question. I…don’t actually know.”


This is the real question that I am obsessed with. In everything we do, what have we learned about ourselves?

I think this is the real challenge of leadership at the highest rungs of corporations, governments, non-profits, and even start-ups. Leaders are obsessed with creating a great company, serving customers, serving their employees. They constantly upgrade their skills, their tools to make them more productive, more informed, more ready.

And perhaps that’s you too. Relentlessly trying to change everything that the world throws at you.

And it’s never enough. The world moves forward. The day ends and each peak conquered becoming unfulfilling after a while.

Of course this is unfulfilling. There is a lot of criticism of capitalism that asks the question: how much is enough? We expect Wall Street to change, to not demand such expectations from companies. We expect businesses to stop marketing to us, making us desire things we don’t really need.

We criticize a culture that is bent on shopping, binging on TV and movies, and being in a perpetual state of adolescence.

And nothing changes. It is unfair to criticize the system without looking at the root cause of all this.

I believe this outwards orientation is at the heart of everything.

This doesn’t apply just to corporate CEOs, government officials. This is not just about leadership at the highest levels, but it’s about you and me. Those who are trying to live together everyday.

But there is a different model of leadership, of being, that also exists. One where “enough” is a natural byproduct. One where it is much easier to get into action, work, and have the wisdom to stop.

That’s what this is about.


Few Americans have heard of Dr. APJ Abdul Kalam. But for more than a billion people, he was the most popular President of India. A rocket scientist, an inventor of low cost stents, an author of books, amongst many other things.

He was a humble man. When he won the most Presidency by the widest margin in the history of the country, he had barely 1 bag of clothes to pack as he moved to the Presidential mansion.

He was loved deeply. His mission was to put “Wings of Fire” in children to make them soar beyond whatever circumstances they faced.

He himself came from a humble background. Born to a fisherman’s home in a Muslim community in a corner of India, it was his curiosity and focus on his work that helped him climb up to the highest ranks.

But this isn’t about his accomplishments.

It is about his realization in the last decade of his life that inspired him to make a radically different set of choices. This, more than anything, became the final calling of his life. Sharing this insight became the most important project of his life, more than launching rockets and inventing medical devices.

What realization was this:

“Who am I really? Am I so-and-so with a certain past and a certain body and personality and certain roles, talents, weaknesses, dreams, fears and beliefs? Others may define me in these ways, but that is not who I really am. Who I really am can only be discovered through deeper questioning and exploration, and through a subtler experience of that which is beyond all ideas about myself. It can only be revealed when the mind is quiet and no longer telling me who I am. When all the preconceptions about myself are stilled, what remains is who I really am: consciousness, awareness, stillness, presence, peace, love and the Divine. You are that which is nameless, and yet has been given a thousand names. “

Since that moment, his work became to talk about this vision about how to manage in the unprecedented changes that we face.

It was his experiences with the great Hindu teacher Pramukh Swami Maharaj that brought him this realization.

Pramukh Swami Maharaj (left) with Dr. APJ Abdul Kalam (right)

The outcome of this?

He wrote in his final book, Transcendence:

“No maneuvers are required anymore, as I am placed in my final position in eternity.”

A profound feeling of satisfaction and completeness. But not one that makes one inactive, unengaged from the world. But a freeing realization to engage more deeply in life and strive to make a greater impact.

I believe that is what we need more than ever. This newsletter is really about the vision that Dr. Kalam had while holding the hand of Pramukh Swami Maharaj:

“In a revelatory flash, I realized that the struggle between happiness and unhappiness that had so far been the story of human existence–and the struggle between peace and war that had been the history of the human race–must change. I heard in the silence of his grip on my hand ‘Kalam, go and tell everyone that the power that would lead us to eternal victory amid these struggles is the power of good within us…The vision would be greater than any other goal ever aspired to by humanity.’ “

This is what we need more than ever right now. It is not an abstract aspirational aim, but a real state to cultivate.

Please join me as I spend the next year going through this theme. It is this vision that we want to explore.

It is not about religion or meditation or mindfulness, but something that engages the whole intelligence, body, emotions, and soul. This vision will take us down many paths. It will take us through the fields of psychology, business, economics, culture, spirituality, history, leadership, and a whole host of other disciplines.

This is about becoming the complete person. And this has massive implications for our economic systems, how we lead businesses, organizations, our families, and our communities.

Join me as I try to understand the pieces of this vision and how to put it all together. And please do share with other friends, colleagues who might be interested in this. It makes a difference.

How do you think the world would look if this is how leaders led? If you led your life from the place Dr. Kalam writes about?

How to Lead: Empathy, Trust & Respect

Our models on leadership are broken. We know a lot about WHAT it takes to be a leader. We know good leaders are meant to have a vision, motivate others, forge a path, and take their team there.

There are also many truisms related to leadership. For example, Simon Sinek says ‘Leaders Eat Last’. They lead by example, etc. But what’s often lost is the HOW behind it. Behind the lofty words and intentions, there’s a big void where practical skills are ignored.

Continue reading “How to Lead: Empathy, Trust & Respect”

The Secret Spirituality of Leaders

At the top of the tallest sky scrapper in the city, we were sitting in a cozy executive lounge. I was meeting with the CEO of a major national bank, a chance encounter where I was not his employee nor interviewing him for anything. I was not there to sell him anything either.

The conversation we had there was a conversation I saw repeated over and over again. Whether it be in homes of successful entrepreneurs or in late night conversations with powerful government officials in Switzerland. 

I was trying to grasp and understand what made them unique. Often coming from nothing, these incredible men and women have started large organizations: startups and corporate behemoths. They carry considerable influence and power. I have always been curious to know how do they handle life, the tough decisions they face daily.

Leading anyone, let alone yourself can be exhausting. Startup founders, entrepreneurs, and real change-makers face a lonely journey to the top. We see short-sighted thinking, we see mental breakdowns. We see politics and drama play out. 

But in many cases, we also see resilience. We see incredible strength of character. We see growth and progress, and real empathy to do the right thing, even in the face of ridicule. We see values and principles.

In speaking to me candidly about their ups and downs, they have confessed one thing that we barely ever talk about in any of the thousands of articles that are being churned out daily about success, productivity, entrepreneurship, pop-psychology.

It is this: Faith in a Higher Power is the ultimate source of strength.

They have all admitted to prayer as a source of strength as well. One CEO of a major global fashion brand said: “Everyday, I pray to God to give me the strength to do this work. Because I alone am not capable of doing this myself.”

This person is worth $200+ million dollar.

I’ve seen this played out so often. And yet, most success literature doesn’t talk about this at all.

It almost seems that we are hiding from this truth in trying to be secular. Mindfulness and meditation are safe placeholders for spirituality, but they are incomplete. They are aids in deepening your faith, but not an end in themselves.

The true lessons of spirituality are not tied to one particular religion either, they are universal. And these lessons can help us be better leaders. Either for our teams and organizations, or in our private lives as we lead our families and our lives.

That’s what this publication is about.

It is about embracing faith. This is not about proselytizing. For true spiritual principles are timeless and not bound to any particular religion.

The only thing required is faith to move forward and deepen a relationship with your true self and a higher power.

Everything else follows from that.

Has Faith Played a Role In How You Lead?

If so, share your thoughts below on how exactly faith and spirituality helps you lead yourself and others better.

Does Leadership Training Work?

Leadership is not a noun. It is a verb. Leadership happens daily, in practice.

At its heart, leadership training is about passing on skills to people so that they can effectively read, listen, influence, inspire, coach, and guide themselves and others.

  • To read yourself effectively, you need to be introspective. To read others, you need to be empathetic.
  • To listen to yourself, you need to create space to let the inner voice speak. To listen to others, you need humility and openness to see the world differently.
  • To influence yourself, you need the tools, strategies, and guides to work on the right things. To influence others, you need to coach them, ask them the right questions to let them grow themselves. You also need integrity, strength, and decisiveness.
  • To inspire yourself, you need a powerful “why”. To inspire others, you need to connect the work with their big purpose.

Can leadership training teach this?

I believe it can plant the seeds for these qualities to emerge in the right people in the right situation. And the more seeds you plant, the higher the likelihood of them sprouting, growing, and flourishing.

A training session can last for 1 day or even 1 week. But it’s up to the person to change their values, mindset, beliefs, and actions. That work is done on a daily basis.

That’s what actually matters.

Frequent Leadership Training is exactly what can help nurture the plant as it takes hold and grows.

Overcoming ingrained habits, mindsets, beliefs, and values can take a long time. Just like losing weight, starting a new diet, you need constant reinforcement, motivation, and recognition to keep going.

So, Leadership Training can work—really well! As long as it happens frequently. As long as one builds atop another. As long as the person has an interest in getting better as a leader.

In those situations, yes it can work.

I’ve led leadership workshops in rooms where the entire audience was completely disengaged. It took everything in my power to connect with their current challenges to make some of them interested in it.

I’ve also been in rooms where eager people who had just been promoted were looking for ways to be more valuable to their organization and their teams, and were committed to being active, engaged, and consistent practitioners in this process.

The later group wins. Always.

Your Thoughts

What has been the most effective leadership training for you? Did it even take place in a traditional professional setting or elsewhere? What was more valuable about it? Share your thoughts below to help others.

How SMBs can embrace Stakeholder Capitalism

In this post, you will see why small & medium sized businesses need to engage in stakeholder capitalism and how to do it.

When you pull back through the political drama of the World Economic Forum, there is one key point that the forum is advancing. It’s this: businesses need to exist for more than just the shareholders. It needs to exist to serve all stakeholders.

This seems hopelessly out of reach for most businesses, when there are more immediate demands that they need to address. Payroll, hiring and retaining key employees, receivables, etc seem much more urgent.

In face of these daily challenges, shouldn’t the owners of the company put their own interests first? Not taking steps to reshape your business can be fatal in the long-term. Especially for small businesses that can feel the effects of any change in the economic climate.

The best way to serve your own interests is to engage in Stakeholder Capitalism.

Stakeholder Capitalism is not about putting the business owner’s interests at the expense of everyone else. It is instead about holding it on an equal footing with all other stakeholders that touch your business.

Now more than ever, founders and business owners of small, medium, or large companies need this if they are to recruit & keep top talent and grow—in good times or bad.

Engaging in Stakeholder Capitalism is the best way to do it to stay competitive and relevant in the marketplace for customers, vendors, and talent.

How to Make Stakeholder Capitalism work for Small & Medium Sized Businesses

1. Expand the business purpose and mission. 

Small businesses often exist to serve its owners, but expanding its mission can mean a shift in actions to improve the business.

For example, a dentist can exist not just to make a living, or as most cliched ads say “to make you smile.” But instead, a dentist exists to improve public health in a community. The scope of activities that the office now stands for grows.

In service of such a larger mission, the dentist is more likely to do more outreach work. It means speaking. It means working with healthcare providers and holistic practitioners to improve health of the community. The goodwill, authority, and trust that comes with acting on such a bigger purpose and mission can grow the business and create a line-up of talented staff that wants to work for such a person. It means using the office in the off-hours to host learning workshops for members of the community.

And if this works at the level of a dentist, it can definitely work for larger businesses.

Is your mission and purpose centered around your needs, or is it an expansive vision that incorporate all stakeholders? The first step of stakeholder capitalism begins with growing that.

2. Re-map the value. 

This means looking at value creation in the organization with a fresh lens. While previously the dentist generated value when she was working on a patient, now the dentist is generating value when she is also engaged in education, outreach, or taking a leadership position in her community to improve public health outcomes.

She is becoming the hub of these activities and conversations in her community, and she is emerging as a leader in it through the sole virtue of her accommodating the dialogue.

This can be scary at first. But as the hub of creating greater health in her community, she is going to attract more customers, more media, and better talent to work with her clinic.

Have you looked at exactly what parts of your business generate value for stakeholders? How would it change if you embraced a bigger vision?

3. Engage others in the conversations

Whether it be vendors or employees, stakeholder capitalism is an inclusive model of growth. Management and the workforce are removed from one another. But stakeholder capitalism demands that everyone becomes an active participant in the conversation on how to create greater value.

Demanding that from employees and creating that for vendors and customers is where the magic happens.

After screening for technical skills, and overall personality fit with the business, also understand their alignment with your bigger mission & purpose.

Help vendors understand your greater vision and back it up with news at every interaction with the vendor. This is about walking the talk. This is likely to galvanize both vendors and employees to step up and find greater ways of contributing to this broader vision, while enriching themselves in the process.

A dentist who is on a mission to not just get patients in chairs, but to improve public health in her community is likely to develop a closer relationship with her vendors and employees. Vendors are likely to spotlight her in their trade publications (expanding her reach further), but also make her an example for others to follow.

This type of leadership gives even small businesses an unbeatable advantage – even in hard economic times.

Have you involved your stakeholders in a conversation about your bigger vision? How can you involve them more frequently?

4. Adapt Incrementally

Finally, evolve your mission, purpose and change the business when time comes. This is supposed to be a co-creative process. When you engage in dialogue with other stakeholders in the service of your mission, try to understand their pressing needs, wants, and desires. Understand what is most important to them.

A dentist might find that her patients struggle mostly with diet and nutrition in order to keep their dental health sound. Her next steps might involve partnering with a nutritionist or dietitian or even a meal-prep company and providing another level of service to her stakeholders.

This can lead to untapped revenue potential while also serving her stakeholders in greater ways than ever before.

The Business Roundtable, leading executives from across the world are embracing this. Now is the time to do the same for your organization, whether it be a small, medium or fast-growing business.

Have you engaged in a dialogue with your stakeholders to understand what other things they are looking? Have you tried serving those needs? Stakeholder Capitalism is not a seasonal trend, but here to stay.

How to Create Clarity in Any Situation

Cutting through the clutter of indecision is the most energizing feeling you can create for yourself everyday. I want to show you how to create this clarity on demand.

If you’re leading the rudder of your life, or if you’re leading other people , feeling clear about what you’re doing and what you’re being is the most important work you can do. It is the juice that powers all decisions you make.

Here’s the thing: it’s hard to do this. There are more options on what to do then ever before. There are competing priorities. There’s a new bestseller book telling you to zag when you want to zig. And then that new podcast you heard last night is telling you something else entirely.

Our minds our completely overrun with thoughts. Our hearts are being trampled by a million feelings, priorities, guilt, and panic. No wonder it is hard to know what to do. Especially if you’re a leader.

In my work, I have to consistently create clarity both for myself and my clients. I am often placed in unknown situations where I have little knowledge about the organization, the different leaders within it, and various moving pieces within it. Not to mention limited industry knowledge.

Just this morning, I struggled through an important life decision. I had an answer at the end of 20 minutes.

Unfortunately, we often push away these decisions that have been keeping us stuck. And then, in a moment of panic, we decide haphazardly.

Other times, we are extremely intellectual and reasoned. Sometimes, the decisions we make in this state don’t always stick with us in the long run. It is hard to sustain such a state when we take action on this decision.

So what’s the alternative? Let’s first try to understand what creating clarity should NOT sound like.

3 Misconceptions About Creating Clarity

  1. I just need to think more clearly”

    Clarity is a whole-body shift in your state. This means any exercise or activity that gives you clarity should involve your whole self. It shouldn’t be just an intellectual exercise. This means you must engage not just your mind and thoughts, but also your feelings, and your gut.
  2. “I just need to get smarter.”

    There is a large group of people now getting better at critical thinking, understanding logical fallacies, and absorbing mental models. I believe these are all enormously useful tools.

    But as a leader, your work touches people–other human beings. This means involving your gut is equally important. You cannot blame people for the situation you are trying to find clarity for (in accordance with Principle in my guide The Principles of Organizational Breakthroughs: A Practical Guide for Leaders).
  3. “It has to feel easy.”

    Clarity does not mean easy. The situation can still be complex and difficult, but you should feel like a big blockage of energy has just been unblocked.

What Clarity Feels Like

Having clarity should feel like a major anchor being cut out. Your boat should have more buoyancy. Of course if the waters you are navigating in your life are turbulent, clarity can be terrifying when you are confronted with what you have to deal with.

But that level of clarity is also calming when all your analysis-paralysis dies away. Now you are free to act.

Aside: I work with organizations to do this in a structured and systematic way about larger problems. See here on how I can help your organization.

How to Create Clarity

I find that creating clarity really is a function of introspection. Introspection can be a hard topic to fathom because people think it’s about meditation (which is enormously helpful of course).

You cannot introspect if your internal state is agitated either. You cannot think clearly if your emotions are all over the place. This is when we make terrible decisions.

Instead, we can try to run both tracks in parallel and see what clarity emerges from it.

Here’s how it works:

  1. Take a sheet of paper. Yes, paper and pen please (or pencil). Not a computer.
  2. Start writing. Anything and everything that comes into your mind. Even the side priorities (especially the side priorities). Write down the dialogue that is happening when your mind is saying one thing and then another and then something contrary yet again. Just free-write without any censorship.
  3. Keep writing. Do it until you “get it.” On average, it took me writing 2-3 pages before I could process the decision in front of me. Now it takes me on average 1 page.

This applies to writers as well as non-writers. Writing is a way to process your feelings, emotions, as well as your thoughts.

The clarity you get from this exercise will stick with you and allow you to decide and follow through with confidence.

Why it Works

Your internal chaos soup needs acknowledgement. Letting the soup bubble inside of you is counter-productive. It tends to overflow and cause a mess.

When you write without censoring yourself, even little single thought, feeling, and expression that comes into your mind about something, you will find that a lot of the tension going out of you.

It will also force a lot of thoughts that are buried deeper, which often already contain the insight you are looking for to emerge.

This is also the primary tool that thousands of artists use to get creative on demand. What is being creative if not creating clarity or insight on demand about a situation (whether it be a canvas, a blank sheet, or a stage)? It is based on Julia Cameron’s excellent book The Artist’s Way.

Don’t take me for my word. Try it.

How do you create Clarity?

What are your most important habits, rituals, or tools to help you get clarity about your priorities? About cutting through the stuck feeling in making decisions? Have you tried the free-writing exercise above? How did it go?

Let me know what you think below.

A Practical Guide to AI Strategy in Healthcare

Most healthcare organizations want to use AI for operational efficiencies. This is missing the mark to think about deploying it strategically. No wonder senior management and other staff are often skeptical.

I want to put forward a practical outline on how to think about healthcare innovation (including AI) strategically. Not just as “tech” to throw at a problem. Not as a shiny buzzword that means nothing.

The MIT Technology Review & GE Healthcare published “The AI Effect” to talk about the changes taking place in healthcare as they use more artificial intelligence. It is a survey of 900 healthcare professionals.

Let’s understand what the report says, and try to dig deeper and find more constructive ways to resolve some big challenges.

The primary case they put forward is that AI is “is making health care more human.” The report states that AI is all out to disrupt healthcare. It talks about all the progress it has made already and will continue to make. It talks about all the ways it will continue to bring massive changes to the healthcare industry as a whole.

Despite this, the real data and stories don’t always paint a rosy picture. The most public of this is of course IBM Watson’s implementation. The stories on it show repeatedly that the return on such a solution was underwhelming. (See here, here, and here)

I believe there is a structured way of approaching this problem to get the greatest benefits from AI in a healthcare setting.

I also believe that one-size-fits-all is not the right approach as you think about AI in your specific situation.

Let’s go back to the report. Some key survey results taken from the report are as follows.

  • 79% will increase budget of AI Applications.
  • 72% of respondents to this survey show interest¹ in implementing AI.
  • 74% of health-care institutions are developing or planning² to develop AI application algorithms.
  • 93% agree that AI has improved the speed and accuracy with which patient data is analyzed and shared.³

These numbers need greater context. Let’s try to understand the deeper meaning of these numbers.

¹ Interest is one of those nebulous words that mean nothing. As a publication that focuses on technological innovation, of course “interest” suggests “72 percent of leaders ARE implementing AI”. But anyone who has ever sat in an office to actually get a sale understands that “interesting” can often be double-speak for “we’ll let others do AI in healthcare first because we’ve got more important things to do right now.”

² Planning is another word that means little. Organizations “plan to” become the leader in their field. Very few manage to do so. This is similar to me “planning to” become like Bruce Wayne.

³ By how much? What are the quantifiable benefits here? This kind of abstract language is what makes deciphering a lot of these reports so frustrating.

This tension plays out nicely in the next section which talks about the challenges.

  • Less than half (~45%) of respondents believe that AI has helped increase consultation time and time to perform surgery and other procedures.
  • In contrast, more than 1/2 of respondents planning to deploy AI raise concerns about medical professional adoption, support from top management, and technical support.
  • Integrating AI applications into existing systems is challenging for 57% of respondents.

The one silver lining here is that 79% indicate that AI has helped avert health-care worker burnout. While the above numbers are promising, there is a distinct lack of strategic thinking about the benefits of AI in a healthcare setting.

The report briefly summarizes all the challenges in a short section as follows:

“Among those was skepticism about the provable benefit and overall cost of AI as top factors hindering its adoption. Hospital administration is generally more skeptical than medical staff. Another hurdle is the disruptive impact that AI has on existing processes; a third is the difficulty of integrating AI applications into existing systems.”

The Juice is in the Details

The juice is in the details. What do you invest in? How does it deploy? What is the process used to deploy it? And how do you think about it in a structured yet holistic manner? Is AI even appropriate or are there lower hanging fruits available?

I want to propose a 5 Step Process for medical professionals to think about Artificial Intelligence within their healthcare organization. This is about elevating the case for AI in healthcare as a matter of sound business strategy.

The Five-Step Process to Build Strategic Healthcare AI & Innovation Cases

First, Start with Organizational Challenges & Values

Ask yourself, what are the key challenges facing the organization right now? Is it doctor burnout and turnover? Is it frivolous lawsuits? Is it long patient wait times? Is it increasing costs? If so, where?

In short, which issues are having a strategic impact on the organization itself?

Compare and contrast this with the organization’s principles, values, and priorities. Perhaps long wait times are not important after all to its stakeholders if you compete on being a low cost provider. Perhaps perfect diagnosis is not as important as giving people care that is “good enough” (no, not every case is a life & death situation and sometimes good enough is well…good enough to let the patient’s body heal itself).

A deliberate approach to healthcare innovation in your organization starts with asking: what do people we serve need? As leaders & decision-makers, this means understanding the needs of patients, as well as needs of providers themselves.

This is not about “healthcare innovation” it is about “healthcare innovation for you and your organization.”

Second, Understand Root Causes

It is surprising how few organizations in healthcare settings properly map out the root causes of a problem or situation. Solving the top-layer problem can leave a deeper issue to fester and metastasize. Getting to the root of an issue is key.

I talk about a root causes analysis in my Principles of Organizational Breakthroughs: A Practical Guide for Leaders which you can download by signing up for the Clarity Weekly newsletter.

In brief, get to the root causes of the organization issues and priorities. Understand both the quantitative and qualitative manifestations of these root causes.

For example, Dushyant Sahani from the University of Washington Medical Center makes the case of using AI for smarter scheduling so that more patients can be seen every day by doctors.

But perhaps the issue isn’t scheduling of doctors’ time. But perhaps the issue is under-staffing of doctors in the first place. In which case, “smart scheduling” is likely to cause greater burnout.

For such an issue, you can collect real data on what it costs to hire a doctor, and what it costs the organization when they burnout. Using this as a comparison to the benefits of AI will create a better case and lead to a better outcome.

Third, Create Options to Solve Root Causes

Is AI the right solution to solve these underlying root causes? If so, proceed further with understanding how to do it. If not, you have to use good old-fashioned Human Intelligence before deferring to anything Artificial.

Perhaps software is the right solution. Perhaps it isn’t.

To extend the example further, if the root cause is doctor burnout, a smart scheduling piece of AI won’t help. What would be the most effective ways of dealing with doctor burnout? Reducing patient workload? Would it be reducing the paperwork? Would it be a better match of a patient with the doctor’s interests and qualifications? Or would it be something else entirely such as allowing for greater doctor involvement in management?

Each of these questions points to a different solution. Some powered by Artificial Intelligence and some powered by Human Intelligence.

Fourth, Understand Second-Order Consequences

This is where people have been failing. As it mentions above, “integrating AI applications into existing systems is challenging for 57% of respondents.”

As a medical professional leader, it is your responsibility to think through the ripple effects of implementing such a change throughout the organization and understand the soft costs and cultural challenges ahead of time.

You need to create action plans and contingency plans as these second-order consequences play out in your organization. What will you do with them?

In the case of doctor burnout, say you choose to introduce AI tools to reduce paperwork. If so, how will non-medical professionals interpret this change? What would be the training time required to onboard everyone on this new platform? Does it impact other staff in the organization who have to interpret this data? How so? What is its accuracy?

This is the time to involve all stakeholders in the discussion and foresee issues.

This is sometimes overlooked.

Dr. Rachael Callcut says that “It’s challenging working to move the field forward in a transformative way with artificial intelligence. There has to be alignment in vision, commitment to exploration, and mutual excitement. Everyone involved needs to be willing to push forward into a sometimes unproven space. If we are afraid to fail on a project and thus, don’t take it on, the opportunity to change the future will pass us by.”

The very reason this happens is because leaders in one silo don’t involve everyone. It is hard to have mutual excitement about anything where you feel something is being pushed down your throat with a change. Involving stakeholders early in the process goes a long way.

An aside: I often notice a negative or adversarial force at play between medical professionals (who are used to giving advice for living) and staff, administrators etc who have to run the organization. I believe for any successful decision and subsequent implementation, medical professionals need to let go of “doctor-knows-best” and administrators at the same time need to engage with doctors earlier in the process. They also need to assist medical professionals in thinking through these 2nd order consequences more thoroughly.

Finally, Decide & Execute

Only after going through this exercise can you make an informed decision about AI in your healthcare organization. This also makes selling internally a lot easier if you have involved different stakeholders in finding root causes of the organization’s major concerns and mapping out the second order consequences of the options you have on the table.

What do you think?

There are major innovations possible in healthcare in the coming decade. But we need a systematic and strategic way of thinking about it.

What nuances, caveats, or other points would you bring to make the discussion of healthcare more strategic, systematic, and practical?