Category Archives: healthcare business

Authority Or Responsibility?


A few weeks ago during a question and answer session of a speaking engagement I was asked the following question: “What happens if I do not have the authority to make those decisions?”

I love this question, so I figured I would share my take on it with the broader audience.

People are often waiting to be given the “authority” or the power to make decisions. This is often used as an excuse, or a way of letting ourselves off the hook for not making a decision, making a change, or performing a task.

I do not have the authority, so I do not have to do anything about it.

Authority in many organizations resides at the top and cascades down. This structure allows for decisions to be made and for workers/people to be compliant to follow those decisions.

As long as we follow the decisions and directions, we keep our jobs.

Few of us will ever have the “authority” or be close enough to the top to make decisions in which people must comply with in order to be paid.

Forget about authority. Seek responsibility.

Responsibility is abundant. There is more than enough laying around for any of us to pick up and take.

Each of us has an opportunity on a daily basis to do something that requires us to be accountable, answerable, and responsible for doing something. It can be writing a letter, it can be guiding a patient to a waiting room, it can be answering a phone, it can be changing a workflow, it can be staying late to help transition care between shifts.

No one is asking us to do it. No one told us we must do it. It may not be written down in a job description, or a process improvement, or in a manual. It may not have been done before. It may not be something that we are paid to do. It may be risky. It may be weird. It may be odd.

It may also be the one thing that changes the perception for a patient. A family member. A physician.

Each of us has the ability to take responsibility. To do something.

If it succeeds, spread that acknowledgement around. Share it with others on your team. Commend others for the success. If it fails, stand up and take accountability for your decisions to act. Claim ownership for trying something different.

The more times we take responsibility the more people will realize that we are here to lead.

Leadership is not about a title , or the top of the organizational chart, or having authority.

Leadership is about taking responsibility.

I take responsibility at the N of 1.

As always you can feel free to email me at or follow me on Twitter @cancergeek


Todd Dunn: Design For People

If you read, listen, or watch anything this week I believe it needs to be this brief 17 minute video. In it Todd Dunn, Chief of Innovation at Intermountain Health, talks about his quest in Design For People.

It personally resonated with me.

I have spent the majority of my career in designing spaces for health and care around the world to deliver care at the N of 1.

Todd is masterful in his articulation, his example, and the personal story he shares on why context is king for design in healthcare.

In order for us to “Design For People” we need to move out of our context and place ourselves in the context of where the health and care is provided between a person as a patient and a caregiver.

Todd also beautifully articulates the 2 fundamental tools for effective empathetic observation and begins with this quote:

I believe empathy is the most essential quality of civilization ~Roger Ebert

The 2 tools needed are:

  1. Empathy: the emotional and social understanding of how people feel and want to feel
  2. Curiosity: the child like freedom to look, study, learn, listen, and ask questions to understand

There are even more wonderful tidbits from this video.

In all of my travels and all of my conversations, the one thing that is the common thread in all of health and care is that the people we care for want our empathy.

I want to thank Todd for his great work, his great insights, and for sharing this with me and allowing me to share it with the world.

Todd and I believe that empathy with design enables us to care at the N of 1.

As always you can feel free to email me at or follow me on Twitter @cancergeek