Are You A Leader Or A Manager?

In many of my speaking engagements, I use the following phrase:

The words that we use build the world of healthcare. Your words, impact my world, my journey, as a patient inside of healthcare.

Yet I am bombarded by the words of manufacturing when I walk the halls of hospitals and clinics on a weekly basis.

Last week I spent time in Toronto, Ohio, and Puerto Rico at several different hospitals.

I overheard administrators and physicians using words and phrases that resemble the manufacturing lines of Ford rather than the service of healthcare.

Operational efficiency.

Asset utilization.

Fleet management.



Unplanned downtime.


Days cash on hand.

I understand the utility of the above words to measure the “business” of medicine.

In the management of healthcare, and all of the people, process, and technology it encompasses.

That is the fundamental problem with healthcare, we have created an institution of administrators and physicians that have become managers, or managed.

Seth Godin defines managers as people that work to get their employees to do what they did yesterday, but a little faster and a little cheaper. (sounds a lot like productivity, efficiency, and utilization)

Seth reminds us that leaders, on the other hand, know where they’d like to go, but understand that they can’t get there without their tribe, without giving those they lead the tools to make something happen.

Managers seek authority.

Managers want to be at the top of the organizational chart so that they know who to ask permission and whom they can get to do the same thing tomorrow while doing it faster and cheaper.

Leaders take responsibility.

Leaders care less about organizational charts, permission, and the applause of crowds.

Leaders do.

Leaders act first and apologize later.

Leaders take the time to listen, understand, set a vision, and empower those within their tribe to do and act as well.

Leaders understand the measurements of the past, of today and use that “history” to break free of those constraints to build a future that is very different from our past.

Leaders do not want to build a bigger, better, faster, cheaper widget.

Leaders want to build the “service” that we all desire and run out to tell our friends and family.

Leaders meet the needs to enable the wants.

Healthcare has more than enough managers.

Healthcare needs leaders.

Leaders that delight at the N of 1.

When you look in the mirror, ask yourself, are you a manager or a leader?

I lead at the N of 1.

As always feel free to email me at or follow me on Twitter as cancergeek.




The Language We Use

Many of us working in healthcare are required to take a special class called medical terminology. A class that teaches us the Latin root words, meanings, and spellings of the language of medicine. 
Words such as ipsilateral, decubitus, prone, bacteria, cardiology, ischemia, carcinogenic, colitis, and viscera. 
As we progress from medical terminology in the clinical setting and begin to move into the business terminology used in the administrative setting of healthcare, the vocabulary changes. 
We have to take another class to learn words, phrases and acronyms like ROI, productivity, efficiency, utilization, asset management, days cash on hand, and 30 day readmission. 
Many of the clinicians and administrative leaders have been so far removed from the communities they serve that they continue to use the above language in their interactions. 
Some physicians say, I’m sorry Ms Smith, you have cancer. 
Another group of physicians may say, I’m sorry Ms Smith, you have breast cancer. 
Other physicians may say, I’m sorry Ms Smith, you have stage 2B, invasive lobular carcinoma with lymph node involvement, T2N1M0. 
It is not that any of the above deliveries are wrong or right, it is about understanding which delivery is best for the patient you are informing. 
Are you using their language? Their native tongue? Are you communicating in the style, format, and mode that they prefer whether it is verbal, written, or maybe even images and pictures. 
When I made the choice to use the “F” word in the name of my company, Good Fucking Health Care, that was part of my point. 
To remind all of us that it is not about the language we use, but it is about the language the people, individuals, and patients we serve in our communities use. 

We cannot continue to expect our communities to adopt and adapt to our language. 

We cannot continue to use specialized clinical and administrative language and then complain when patients in our communities just don’t understand. 

If we want to truly “engage” and “empower” our communities we will show up where they convene. 

We will show up and learn the language our communities use to share their stories. We will speak in their native tongue. We will communicate in the communities preferred format. We will do all of the above on their time, at their pace, and to meet their expectations, not ours. 
It’s not sexy. It’s not attractive. It’s not easy. It’s not simple. It’s cannot be done in one day. 
It’s work. 
It’s the fucking hard work that not everyone wants to do because it takes time. 
Time not spent in the 4 walls of the medical industrial complex. 
Time spent in our hoods, our barrios, our tribal lands, our rehabilitation and transitional homes, our mosques, our community rec centers. Time spent in the places we don’t often go because it’s not part of our personal norm. 
It is time healthcare leaders cease managing and begin leading.
To become a leader it takes time, hard work, and grit. 
To be the leader and change the status quo of healthcare it takes even more time because you need to listen to the entire community you serve.  

The people. La Raza. 

Leading by listening. Listening to understand. Understand to articulate the communities needs. Needs that will become our roadmaps for action. 
Actions that will deliver care at the N of 1. 
As always feel free to email me directly at or connect with me on Twitter or Instagram as cancergeek.

Enjoy this ode to my La Raza: