The Washington Post

A leader in health care, born out of the segregated South

The former HHS secretary talks to The Post's Lillian Cunningham about learning courage from his father and being the only black student in his medical school class. (Lillian Cunningham, Gillian Brockell and Julio C. Negron/The Washington Post)


Having grown up the son of a mortician in rural Georgia during segregation, Dr. Louis Sullivan went on to graduate from Boston University School of Medicine in 1958 as the only black student in his class. He would later become founding dean of the Morehouse School of Medicine and the U.S. secretary of health and human services during the administration of George H. W. Bush.

Sullivan is the latest interviewee in The Washington Post's ongoing "On Leadership" video series, which explores the personal experiences that have shaped prominent figures' character and views on leadership. In the video above, he talks about learning courage from his father. And in the extended interview below, he further discusses the lessons he's learned from his career in medicine and some of the management challenges the health professions still currently face.

He also authored an op-ed on the need to make medical careers more accessible to poor and minority students, which you can read here: "The outrageous cost of working in medicine."

Q. What was your first job?

A. My first job was working in the Bird’s Eye frozen food factory in upstate New York after my first year in college, during the summer of 1951. It was a hard job working the night shift. I lasted only a bit, then I went to Atlantic City and worked as a waiter. I could never beat the full-time waiters there at checkers or cards. They had skills and experience that really impressed me tremendously, and that showed me that — regardless of a person’s station in life — everyone has talents that can be developed.

Q. Who has most influenced your leadership style and character?

A. My father was a tremendous role model. Although I was born in Atlanta, by the time I was age 2 he had moved the family to rural Georgia to establish a funeral home. That was in the years of segregation. My father did a lot to improve the lives of blacks in rural Georgia. He formed a chapter of the NAACP; he worked against the white primary in Georgia, which excluded blacks from participating; worked to get them registered to vote; he sued the school board to require them to improve the educational facilities for blacks.

So what I learned from my father was a combination of all of those things. That is, to accomplish significant things required vision, perseverance, courage. I graduated from Morehouse College in 1954. That was the year of the Brown versus Board of Education Supreme Court decision. I had lived all of my life in a segregated environment, and I decided to apply to medical school in the Northeast and the Midwest, and I was accepted at Boston University. I was the first Morehouse College graduate accepted there, and I was the only black in my class. That was a tremendously satisfying experience, to see that I had the same capabilities that my colleagues had. This led to a larger life experience, and one that gave me tremendous confidence in working to change things along the way.

Q. You’ve dedicated a lot of effort over your career to getting more minorities into medicine. What do you see as the biggest remaining barrier to that today? 

A. There are a number of factors, but among them is the cost of medical education. The costs are high. As a result of that, some 60 percent of medical students today come from families who are in the upper 20 percent of our population. So we have a system where access to a health profession education is not equal. This is a barrier that has developed over the past three to four decades. Today, although African Americans represent some 12 percent of our population, they’re less than 5 percent of our physicians.

Medicine and the other health professions are science based, but they’re practiced in a social setting — and our society is becoming much more diverse racially and ethnically. This means the ability to communicate, to understand someone’s value system and history, plays an important role in the outcome between the health professional and the patient. That’s the rationale for having a more diverse workforce.

Opportunities should be available to anyone in our society who has the interest, the capability and the willingness to work hard to become a health professional. The financial barrier should not exist.

Q. What do you see as the biggest leadership and management challenges that hospitals and their administrators face? 

A. These are large organizations that are complex, where tremendous innovation is constantly underway. So you need to have strong leadership to manage all of this and to see that the patient always comes first. It takes strong leadership skills and technical skills to make sure that the system works effectively. That’s a challenge. But it’s also a great opportunity to improve the lives of Americans.

Q. What leadership lessons did you take from your experience leading the Department of Health and Human Services?

A. When I became secretary in 1989, it was my first time in government service. Most of the 124,000 employees in the organization didn’t really know me. I had a habit of walking every day for exercise, so I invited the employees to walk with me. It turned out that as I went around the country visiting our regional offices, I would have 25 to 200 of our employees join me. That was a great opportunity to get to know them, to share with them my goals for the department, and to hear from them about important issues.

I call this “leadership while walking around.” My tenure as secretary was greatly enhanced by building that relationship with employees.

I was also aware I had a megaphone for communicating with the American people, and I used it. I used it to encourage greater seatbelt use — we went from 47 percent of Americans using seatbelts in 1989 to now 90 percent or more using them — as well as the dangers of tobacco use, and the importance of prenatal care.

Q. Having led HHS yourself, what do you think of the job Kathleen Sebelius did and the problems with the rollout?

A. The Affordable Care Act was a very important act and I’m pleased that it was passed, though I’d be the first to say it is far from perfect. There are a number of flaws and deficiencies in it, but it’s better than what we had before — which was really an incomplete health system. Implementing legislation of that magnitude, with the projection that it would bring 32 million people into the system, was a very complex task. I’m not surprised that there were technical glitches at the beginning, but the public could have been warned of that inevitability. That should have been emphasized more.

I’m on the board of Grady Hospital, the public hospital in Atlanta, and we implemented an electronic health system about three years ago that had been around in other hospitals for a number of years. It still took us about a year longer than predicted to get it up and running — and that was a much smaller environment than this national system.

Q. What do you believe? And you can interpret that in whatever way resonates with you.

A. Well, first of all, I believe in the power of information and in the value of scientific inquiry. We’ve seen the result of that over the course of the 20th century. We’ve wiped out smallpox; we’ve largely eliminated polio; tuberculosis has been greatly decreased. All of these improvements, and many others, are the result of understanding more about biology. Knowledge really improves our world and our environment.

Finally, I believe in the fundamental goodness of people. All of us are often stressed in our lives — not enough time, not enough resources. But when there is a time of great stress in a community, usually we come together. That is the goodness of this country. While we have a number of imperfections, the direction our society is moving in is to address those imperfections.

Q. What’s your single best piece of advice?

Have clear goals and work hard toward them. You’d be amazed at what you can achieve.

Read also:

The outrageous cost of working in medicine

Lillian Cunningham is the editor and feature writer for The Washington Post's 'On Leadership' section.



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