Monday, April 20, 2009

The Challenge of Being a Public Figure

Although I'm not really a public figure, I do enough presentations in my roles at BIDMC, Harvard, NEHEN, and HITSP to appreciate the challenges of highly visible corporate and government public figures. Here are my top 10 observations:

1. There is no downtime

While on a plane, train, or in any public space, you cannot be freewheeling with your opinions. Your communications must be thoughtful regardless of venue. Emails must be written with the assumption they will appear in The New York Times. While going about the activities of day to day living, you must always be "on". I've had deep conversations about IT strategy and government policy at the Wellesley Dump.

2. You must be a good listener

Public figures are assumed to have power and there will be many opinions about how to best use that power. Employees, colleagues, and the blogosphere will offer continuous advice as to the best path forward. All of this input should be gathered and acknowledged. Since every action you take will be documented and scrutinized, it's important to incorporate multi-stakeholder input into your decision-making.

3. You must hold yourself to high standards.

Watching the confirmation activities as candidates have been vetted in the new administration, we know that you must be a tax expert, avoid hiring domestic help, and shun association with lobbyists. The good news for me is that my tax returns are simple, I've never had domestic help, and I rarely get out much, so I have few opportunities for any conflicts of interest with lobbyists or other nefarious characters. I married the first woman I dated in college and this year is our 25th wedding anniversary. There are no experiences in my life thus far that Dr. Phil or Jerry Springer would find interesting.

4. You cannot be too extreme in your views

The press has recently observed that some of Obama's bold proposals have been tempered by political reality

Public figures listen to all sides of an issue then select a path forward that works for most people.

In a recent keynote I did with Senator Whitehouse (D-RI), he noted that politics is like topography - there are peaks and valleys of political issues. Some mountains, like single payer healthcare, cannot be climbed in the short term.

5. You rarely use formal authority

In many societies, policy can be made by benign dictators at an accelerated pace without debate. That's not the way policy is made in the US. Whether in institutions like Harvard University or in government, there is a process for everything. A leader can communicate a vision or assemble a guiding coalition, but rarely can a public figure just declare an action to be done by fiat.

6. It's more about responsibility than power

Public figures take responsibility for all the actions and events that take place in their sphere of influence. My experience has been that lofty positions come with huge responsibility but little power. Many public figures are like the General Secretary of the UN - charged with communicating a vision, organizing people, and moving issues forward, but without significant power to orchestrate rapid change.

7. Your communications will be interpreted in ways you never intended.

In my own small world of healthcare IT, I find it interesting to read blogs, articles, and news stories which interpret my actions and comments. People will find support for their own views, will extend my opinions to meet their needs, or will create controversy where none exists. I'm always amused when I read headlines such as "Was HITSP work shift a political maneuver?" since politics never crossed my mind when I thought about transport standards and simple EHR data content exchange.

8. There will be good days and bad days

As I begin each day, I never know what press, email, and unexpected events will occur. Some days have a relaxed schedule but turn into a firestorm of communication about controversies I did not anticipate. There is no potential for completing a day without some measure of angry emails, hostile phone calls, and unresolved issues. Each day, I look at the trajectory and the issues that were moved more forward than backward. On balance, if I feel that I've done everything possible to bring closure to my open issues, it's a good day.

9. You'll receive credit for things you did not do and blame for things you cannot control

Whenever I'm introduced at keynote addresses, my life summary sounds like I'm super human. The reality of being a public figure is that you'll get credit for many things done by people working for you or done by colleagues working with you. I constantly credit the team and institution with the accomplishments, not myself. Spreading the credit for success is easy since "Success has a 1000 fathers". However, when bad things happen, it's expected that the public figure will accept responsibility, even if the events were not directly controllable. Apologizing with candor and grace will be the subject of another blog. It's an important skill to have.

10. You cannot make everyone happy

There are so many special interests in the world today that there is no such thing as a policy or idea that everyone will accept. A solution based on 90% consensus means that 10% will feel wronged and will opposed the path forward. The best a public figure can do is listen, facilitate, communicate and then move forward with the optimal thinking at the time. Even while executing a well orchestrated plan, there will be naysayers, continued debate, and controversy. The public figure should continue to listen, provide mid-course correction as needed, and support forward progress.

I've known many public figures in my career - Milton Friedman, Edward Teller, Condoleezza Rice. I have some sense of the energy they require(d) just to be themselves. Next time you're feeling angst for a public figure, take a moment to empathize with their challenges.


Dr. A said...

Well done. Great post!

Claudio Luís Vera (@modulist) said...

Well, it sounds like you are a public figure for all intents and purposes. As interoperability and standards for EMR become bigger issues, your role will become pivotal.

One piece of advice: stay real, no matter what. Make mistakes, doubt yourself, and don't be afraid to voice your concerns. These are different, more transparent times, and social media allows you to be human.

Embrace Twitter more. You have a couple accounts but aren't following anyone. It's more than a place to drive traffic to your blog: it's your place to gather opinions, to get pointers to a good piece of research, to ask for help.

It's also the best venue to remind the rest of us that you're a time-deprived mortal. You have so much to teach us all as you make your transition into the spotlight.

Dr. Rob said...

That's a good dose of reality to anyone with ambition. The ring you grab probably has a chain attached to it.

nhrn said...

Does this detailed analysis of the public figure indicate your interest in running for public office in the near future??? Would be glad to be a member of your campaign staff.

David said...

Excellent post, John. We could all use your Rx for increased empathy with one another as we navigate these controversial and exciting times.

Ahier said...

One thing I have learned serving on our local City Council is that with every decision you alienate a portion of the community, until after a while you have alienated all the citizenry :-)

GreenLeaves said...

Thanks for the thoughts, insights and humor. Make the reading worthwhile.

Labandibar said...

John, reading your blog is like eating a box of candy. Some posts, like the lessons learned from the e-patient, are like caramel-filled chocolates. Not everyone can appreciate them. Others, like The Challenge of Being a Public Figure, are the chocolate-covered cherry of blog posts!

Metaphorical chocolate box aside, as a CEO, I must learn to abjure invective, husband my time, hold myself to the highest standards, while supporting others on their journey.

The sole rule I question (and this point was brought up by modulist) is whether it is necessary for a public figure to eschew extreme views. Many leaders have been more extreme than their followers. Examples include Ghandi, Mother Theresa, Caesar, Jesus, and Bonaparte.

As modulist said: "Stay real, no matter what." The reality is, we are living in an extreme situation. Just a few years ago, most people thought that anthropogenic greenhouse gas emissions were not a significant concern. Now there is every reason to believe that the IPCC's worst case predictions will come to pass.

Meanwhile, back at CareGroup, data center energy use is on the rise as storage requirements increase. What will be the eventual the carbon cost of EHR? Is it an extreme view to speculate that the U.S. medical system, though intensive resource consumption, pollution, and greenhouse gas emissions, could eventually cost more lives than it saves?
As a healthcare CIO, how can you play a pivotal role in the fight against global warming?

The Corsair said...

Good stuff. Also, have a sense of humor. There will be moments when your remarks are interpreted in ways that are infuriating. Take a deep, cleansing breath in those moments. Even in that there is humor to be found if you look hard enough.

John A. said...

On looking like a super human, have you read your bio lately? I have a full plate being a Director of Information Systems, volunteer on my communities emergency response team, and cutting the lawn once a week.

e-Patient Dave said...

In the past ten days, I myself have gotten an intensive course in this. I wrote my original post about the PatientSite->GH port on April 1, and that was fine. But when the Globe article hit on April 13 my life went out of control.

See, I worked hard (hours of extra editing) to be clear about what I said and didn't say, and in particular to say I had no observations on Google Health because I hadn't begun to use it, because I hadn't yet gotten any valid data into it. Then the Globe's reporter Lisa Wangsness *nailed* every detail correctly.

But wham, bloggers who wrote about the article about my blog post were saying that I'd predicted that Google Health would fail, and all kinds of things. Even this week I get contacted by reporters looking for me to sling some mud at The Big G.

And suddenly I have a large number of patients who are looking to me for my next assessment of something.

I'd go crazy except for my own personal development training, which largely boils down to a combination of what John and @Modulist say. The only way to keep my wits has been to keep it real. "To thine own self be true, and thou canst be false to no man."

Might still get some eggs thrown at us, though. Even us just-for-a-moment semi-public figures. :–) So yeah, John, I know what you mean, in a small way.

Unknown said...

Speaking of... I saw your comments in last week's Economist magazine. Good stuff...

Justin G. Decker said...

Great post! I think this applies to people in any leadership position regardless of how large the organization reporting to them. Thanks for your thoughts!

Justin G. Decker
Executive Director, Quality

Football Matches said...

Good stuff. Also, have a sense of humor. There will be moments when your remarks are interpreted in ways that are infuriating. Take a deep, cleansing breath in those moments. Even in that there is humor to be found if you look hard enough.

Recep Deniz MD