There is an adage that “culture eats strategy for breakfast and dinner.”

A friend asked me to articulate our bedrock principles.

Here is what I came up with:

Embrace purpose over business.

  • This tenet gets back to Simon Sinek’s TED talk The Golden Circle, which has been viewed more than 33 million times on the Internet. Sinek says that great companies focus on their purpose -- or their “why” -- as opposed to their business model. This relentless and authentic pursuit of shared purpose gives the team flow and aligns direction. We all want to be part of something bigger. NASA was the model organization for this when their purpose was “put the first man on the moon.” But once this was achieved, they lost their way. That led to disaster when NASA leaders ignored the Morton-Thiokol engineer who warned against sending the Challenger space shuttle up on a cold January morning. The engineer feared correctly that an O-ring, which protected the cabin from the solid fuel rocket below, would not work in the cold. This decision to launch cost seven astronauts their lives. Why? NASA was worried about a delay that may cost their funding. They lost their purpose and focused on the wrong thing. Unfortunately, that is getting more common in many businesses, including ours.
    • Our business model in medicine is rescue from failure, or financially benefit from treating the ill. Our purpose model is prevent failure, or keep people healthy.
    • Our business model in research is rankings, papers and grants. Our purpose model is to solve important problems to improve people’s lives.
    • Our business model in education is selectivity of the school, rankings and metrics of students and board scores. Our purpose is to inspire students to learn.

Do the right thing, even when it is hard, and make our culture safe.

  • We want truth tellers and to focus on our purpose. An interesting story about the Korean Air told by Malcolm Gladwell in Outliers. The airline had a worst-in-class crash history. When examined, it turned out that culturally, the pilots were seen as above all others in the cockpit, so when they made a terrible decision that would cause the plane to crash, no one in the cockpit would speak up. Crew management training was done, as it is in hospitals, to reaffirm that the purpose of the cockpit was to protect the passengers and safety of the plane, not the ego of the captain. They started speaking up, even if it was hard and turned Korean Air into one of the safest airlines.
  • I have previously blogged that Google found the only thing different on their best functioning teams from their other teams is psychological safety.

Change things so each of us would want to be part of our organization.

  • As we stated above, many organizations have prioritized business over purpose, which is why I think there is such dissatisfaction with many workers. Amazingly, survey after survey shows that most of us – up to 71 percent of workers in America – are unhappy in their jobs. Wow!! It is surprising, but true that cognitive workers (those that work in more complex jobs than on assembly lines) do their jobs less well if higher pay is the approach used to increase productivity. These workers need to be paid fairly, but work for autonomy, mastery and purpose. Workers thrive in environments of trust and community and want to do work that makes a difference. A smart person told me that people want three things – they want to be loved, they want to be safe and they want to win.
  • Herb Kelleher took over a failing LUV airlines and turned it into Southwest Airlines, which is famous for its culture. What is the secret? He decided to focus on building trust and community with his workers, rather than focusing on the customers. Happy employees that internalize the purpose give superior experiences to the customers.

Be bottoms-up, and agile – speed counts and the crowd is the wisest.

  • I am a big fan of bottoms-up approaches to sustainable success. I am a fan of the bottoms-up approach. Defining our purpose and empowering leaders to create solutions and build safety and community in their teams that moves towards the shared purpose is key. This meets the adage that fun is what you choose to do and work is what you have to do. Supporting creativity and safety in the workplace (remember cognitive workers – autonomy, mastery and purpose) leads to happier, more productive and more empowered workers. They own the mission and an entire team that shares the mission is formidable. This is the path to transformation.
  • There is a parallel information set about the benefit of having key organizational decisions made by a team of people with a broad knowledge set, even if the knowledge is not specifically in the area in question. This group will almost always make a better decision than a single expert. This may be because of the filters of individuals not being able to see as well as a group, that can apply their distributed intelligence to the issue. This observation was made famous in the book, The Wisdom of Crowds.

Real risk is the risk of omission not commission – be bold, failing is learning if you keep going.

  • Humans are risk adverse and fear loss more than celebrate gain. People that work in medicine are worse even than the average person. I know little Latin, but the statement I know is “Primum non nocere,” – “First, do no harm.” Malcolm Gladwell in Outliers told us that the secret to mastery is 10,000 hours of practice. That is a lot of failing and learning. To me, the greatest risk to any organization is not making mistakes, but instead, not daring to do great things. I believe we are all driven to higher purpose at our core. It is true that there are only a limited number of organizations that are part of the small signal, and most others are part of the noise. Instead of worrying about the risk of commission, we should focus on not missing the risk of omission.
  • Steve Jobs has a YouTube video called the Here’s to the Crazy Ones about people that changed the world. They often focus on their “why” or purpose. The end of the video states, “because the ones crazy enough to think they can change the world, are the ones that do”.

Be honest, have fun, see miracles and take care of yourself and family.

  • It is fascinating that one of the key attributes board of directors look for in their CEOs is honesty. Honesty is more than telling the truth, but it is also being comfortable with the fact that everyone knows almost nothing about almost everything. Nobel laureates, historic scientists, Rhodes scholars, everyone. Instead of not believing what we cannot see or know, what if we appreciated every moment, every person, every special event as it happens. What if we could see the miracles in everything (because they are always here – life, nature, beauty, friends, health, family, etc.) instead of never seeing it. This nuanced statement does not mean that one should not be curious, but the old statement, seeing is believing, but believing is also seeing. I have found strong belief since I have come back to West Virginia and my eyes are open to see the miracles I encounter many times every day. This makes all the difference.

Create accountability and trust.

  • While it is important to maintain accountability, it does not mean that we need to create a top-down measuring system to ensure accountability. The best way to do this is to hire great people and let them go. The Netflix slide deck on culture had a very enlightening concept – that when things change to create what feels like chaos, instead of making a lot of rules and processes that initially make people feel in more control, that Netflix continues to hire better and better people and let them navigate their areas more. Top-down rules and processes make organizations brittle and fragile, while bottoms-up approaches allow organizations to be more agile and flexible. Thus, great leadership, and more trust and more autonomy is the best investment for great organizations that navigate well in rough weather.

Invest in health and community.

  • Finally, we need to maintain a healthy workforce. I believe that health is where one’s biological age is less than their chronological age. The environmental things that increase biological age is sugar, cigarettes and perceived stress. In addition to these, other critical issues are connections to people, purpose and a mindset of abundance. The kind of work environment that facilitates community, love, purpose and safety for its members is a magnet for talent and results.

Hiring is critical. We try to live what we preach.

Culture first, talent second, but we must have both.

Trust and community are key.

This kind of culture lasts and works.

This is the rising of our commitment to lead with purpose and live our brand.

Change West Virginia to change the world.