I have been in Boston for a few months now, and the weather has turned. We were robbed of a spectacular New England Fall. Some blamed the hurricane; some the earthquake; the more scientific amongst us, the temperature.
Fall was delayed as the chlorophyll rich leaves persisted due to the stimulation of an atypically warm and sunny October/November. After weeks of patiently waiting for the leaves to change colour, they changed abruptly and fell almost without anyone noticing.
Around the same time, Don Berwick was quietly making ready his notes for his successor as he was preparing to leave his 16 month stint as administrator for CMS (Centers for Medicare and Medicaid Services). Some would argue, we were robbed of a spectacular fall and a spectacular CMS administrator…
The reasons for leaving so soon were political and a good deal less elegant than the autumnal example above. He was a "recess appointment" - he was not supported by non-democrats when he was proposed by Obama and was appointed through the back door as a result. Due to this, he could not stay in post any longer.
Those who will pick up the baton, train or smooth the path for the next generation of leaders, would do well to observe Don Berwick's shining example
Whatever your political ideations it’s difficult to argue with the guiding principles of his tenure at CMS – "better health care, better overall population health and lower costs" – and his attempts to turn this large organisation into a force for improvement and innovation.
In the short time he was there, his other achievements* included:
- Reducing CMS bureaucracy whilst increasing its responsiveness;
- Altering CMS payment mechanisms from volume based to outcome based;
- Setting up Partnership for Patients (a system of grants to reduce hospital acquired preventable conditions by 40%);
- Setting up the Center for Medicare and Medicaid Innovation.
His example is excellent, the bar has been set extremely high, and there are many lessons for us all to learn.
He has an outward appearance of a most jovial science professor (minus the beard) and a twinkle in his eye that always remembers you. He has a warm manner that effuses time to talk and listen. Indeed, his appearance fits well with his original career choice as a paediatrician. The passion he has for improvement comes across at all times.
He talks of finding improvers within organisations that have a "sparkle in their eye" and "fire in their belly": qualities that he has in abundance.
For the last 30 years, he has been one of the foremost benign human influences on international quality, safety improvement and the delivery of true patient-centred healthcare.
He has helped make learning from the improvement methodologies of industrial companies like Toyota mainstream, making health care look outside itself to accelerate its learning and with it, its performance. There is simply not enough time to talk about all of his accomplishments. One article is however worth mentioning.
This humble leader is well worth listening to, and I urge you to do it.
Particularly at your darkest hours, when the system conspires against your efforts to serve patients; the moments when your organisation seem to resist your attempts to improve; and when the day to day administrative demands seem to take you away from the reasons you first went into health care.
I was privileged enough to hear him speak in Orlando at his reception of the Picker award last week. It was a great speech, full of patient stories, examples of inspiration and infectious outpourings of enthusiasm.
I left the auditorium (along with the other 5,600 attendees) somehow feeling lighter, smiling, talking with people I had never met before of how moved we were and how lucky we were to have been there.
The qualities of leadership that he continually demonstrates are a lesson for us all. Those who will pick up the baton, train or smooth the path for the next generation of leaders, would do well to carefully observe his shining example.
"Example is not the main thing in influencing others, it’s the only thing."
Albert Schweitzer
* Meyer, H; Health Affairs December 2011 vol.30 no.12 2277-2285
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