You have been at the forefront of tackling some significant and difficult issues. When have you really seen your leadership skills tested?
One thing that comes to mind was back early in the HIV era. I was at the National Institutes of Health. We were just beginning the early HIV clinical research. We were learning a lot, but not fast enough. People were dying, and we didn't have the knowledge or the medicines to effectively treat HIV infection. We were just beginning to test the first antiviral drugs, and people living with HIV and their advocates were upset because they weren’t hearing as much as they wanted to hear from NIH or from government. There were demonstrations at FDA, at NIH, downtown on the National Mall. During one of those demonstrations, an effigy of me was burned. Yes, a straw figure with my name was hoisted in the air and set on fire. That was hard because we were trying so hard to get answers, but the answers weren’t there yet.
What that made me and a lot of us realize is that we could do better at communicating. We could do better talking to people who had good reason to know what we were doing, what we knew and what we didn’t know. We had to take a hard look at how we involved patients in clinical research and ask, “How can we do better here?” I think that led to extraordinary changes at NIH in terms of how we communicate with and involve people affected by diseases in the research on those diseases. I think NIH today is a better place for some of those early demonstrations and early realizations by the research community. We now do a better job at asking for advice and bringing patients into the decision-making. I thank the activists who had the courage to make those very bold statements. They were scared, rightfully so, and we needed to listen to them more carefully.
How do you find committed employees and build a productive, cohesive work environment?
In my experience, when you have a clear and compelling mission, there are usually more people who want to contribute than you need. So the key is choosing the people who both have the right skills but, as importantly, people who fit together to create the right culture inside an organization. It means choosing people who will contribute to both the work and the culture of engagement and collaboration. In my experience these are usually people you want to spend time with, people who want to spend time with each other and to particularly learn from each other. I have seen over and over the power in diversity – bringing in people who have a commitment to the mission of the organization, but also diverse enough so the organization’s culture gets expanded and broadened.
What do you do to keep folks on an even keel in the midst of change?
I think being very transparent and very open and honest will help people feel trust and safe in the midst of change. It’s okay to be confused sometimes. And it’s particularly okay to express your confusion, as long as you commit to exploring what that confusion is about so you can resolve it and move on. I think part of that is creating a culture where you respect everyone’s voice. Different people have different perspectives and everyone deals with change differently. Allowing that to come out and honoring it makes a stronger organization.
What is your view of public service?
I think public service is a noble calling. I learned that early on from one of my first mentors, a congressman named Jim Symington. I saw him as a really smart, savvy, connected guy who could do anything in life he wanted. He chose public service because he felt he had a responsibility to “get it right” and make the best decisions for “the people.” And I thought, “Wow, that’s cool – he’s not working for a boss or a lot of money; he’s working for everyone.” From Congressman Symington and others, I learned about the covenant public servants have with the people we serve, and the importance of speaking truth and speaking clearly.
What’s some of the best leadership advice you’ve ever received?
One of the sayings that I’ve used for a long time comes from Eric K. Shinseki, the secretary of the VA. It goes something like this: “If you dislike change, you’re going to dislike irrelevancy even more.” To me, that advice means you either need to lead change or change will lead you.
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