Mission-Driven Leadership: My Journey as a Radical Capitalist

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9780525572794: Mission-Driven Leadership: My Journey as a Radical Capitalist
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In Mission-Driven Leadership, Mark Bertolini, the long-time chairman and CEO of Aetna, the Fortune 500 health insurance company, reveals that genuine leadership is not about dollars and market share but about improving lives and communities.

Mark Bertolini didn't get to the corner office through traditional means. He grew up in a blue-collar neighborhood in Detroit. Early in his career, he was known for his bare-knuckled leadership and hard driving competitiveness that helped him to turnaround several companies. But his ambition came at a cost as he ran roughshod over his colleagues and employees, and spent time away from his family. Two events served as wakeup calls for the hard-charging Bertolini. First his son Eric was diagnosed with incurable cancer, and Bertolini found himself confronting the healthcare industry firsthand, not as an executive, but as the parent of a deathly ill child, determined to save his son's life. And miraculously, after a year in the hospital, often at death's door--Eric was twice given last rites--his son recovered. The second wakeup call was a skiing accident several years later in which Bertolini broke his neck. As his life unraveled in the face of years of chronic pain, therapy, and medication, he realized he had to reinvent himself, emotionally, spiritually, and as a leader--or go under. Mission-Driven Leadership speaks to the lessons Bertolini learned about empathy, about helping employees and Aetna's customers take better care of themselves and each other, about the need to "find the divine in me," and the importance of getting out to meet with employees and customers face-to-face in town halls to truly discover their needs and better serve them.

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About the Author:

MARK BERTOLINI has been the chairman and CEO of Aetna, a Fortune 50 health insurance company, since 2010. He regularly appears in the national media to talk about high minimum wages, the importance of well-being in our lives, and the importance of universal health care.

Excerpt. Reprinted by permission. All rights reserved.:

1

Doing the Right Thing

 “Do things right” is a core value, seemingly beyond reproach as a corporate motto. When you’re at your job—either on the front lines or in a corner office—you do things right, or else you’ll fail.

But what if that truism isn’t true at all? Do things right usually means “follow the rules.” But what if the rules are flawed, suboptimal, or counterproductive? Most of us have a moral compass that allows us to distinguish between right and wrong. What’s trickier, however, is distinguishing between doing things right and doing the right thing. You can be following the rules but still be betraying your mission or your values.

This may seem like a subtle distinction, but understanding it sets apart those who want to make positive change from those who just want to reinforce the status quo. It’s a lesson I’ve learned many times in my life.

When I was attending college in the late 1970s, I worked evening shifts in the emergency room at St. John Hospital and Medical Center in Detroit. I was the department coordinator, which meant I sat at the front desk and performed triage, deciding who among our incoming wounded or stricken was most in need of immediate attention. The ER was also a Level I trauma center, one of the busiest in the nation, a place that was turbulent, tragic, and exhilarating all at once. I liked being part of the action.

At least once a night a patient arrived who’d had a heart attack, and sometimes I would jump on the gurney to relieve the EMT guys. I’d have a Marlboro in my mouth, the ashes falling on the patient as I was doing compressions. That was perfectly acceptable back then. As we approached the oxygen room, I’d yell, “Take it out of my mouth!” since a cigarette—amid the flammable anesthesia--could blow up the place. Someone would snatch the Marlboro just before we entered.

We once admitted a woman who’d had a heart attack but was also suffering from lung cancer. I was doing compressions but could feel her bones crack because the cancer was so advanced. I yelled to the doctor, “I’m crushing her ribs!” He told the nurse to give her twenty milligrams of Demerol and administer it “PRN”--as needed--until she passed away.

Euthanasia. Happened all the time.

On another occasion, a buddy’s father was rushed in while he was having a heart attack. I did compressions on him, urging him to hang on. After he was taken to a cardiac room, he was intubated while others worked on him. I came in and out of the room, relaying information about his medical history, gleaned from his family, while he lay unconscious. He survived and was sent to the coronary care unit. Three weeks later, after he was discharged, he walked into the ER and informed me that he had heard everything I was saying while he was unconscious. “It was like I was sitting in the corner of the room, up in the air,” he explained. “I could hear everything you said.”

Working in the ER was about life and death as well as the occasional out-of-body experience, but it was also about how we assign different value to human life, based on wealth, influence, or privilege. Our failure to treat all people as equals was casual and easily accepted, and it left a powerful mark.

One night I was at the front the desk when a young man, lying on a gurney, was hustled through our sliding doors. Shot twice by a .22-caliber handgun, he was bleeding from his ear but had no exit wounds. He didn’t have his wallet; we didn’t know his name. But we saw, in his X-ray, his fate: the image showed the bullets lodged in his brain, like two white islands in a sea of gray.

The doctors spent forty-five minutes evaluating him, but the victim was dead on arrival, another nameless casualty of Detroit’s mean streets. The doctors had no other option but to send him to our morgue.

Later in the evening, the police arrived with the victim’s wallet. He had been a college student who also worked as a cabdriver, and he had been murdered on the job while getting robbed. Now that we knew who he was, it was my responsibility to notify his parents.

I called the number and identified myself.

“What are you bothering me for?” the man said. “I’m not on call.”

“Who is this?” I asked.

He told me who he was, a senior doctor at St. John Hospital.

“Your son is in the ER,” I said. “He’s had an accident, and you need to come down here.”

“What happened?”

“You need to come down here.”

When I hung up, I informed the staff who the victim’s father was and that he would be here shortly to identify his son. It was like an alarm sounded. Assistants scurried to the morgue and retrieved the body, and the doctors spent another half hour trying to revive him—to raise him from the dead, literally. When that failed, they cleaned the wound to make the body more presentable to the father.

Even in death, status had its privileges.

I eventually realized that we operated based on an unwritten social hierarchy, and we allocated our resources accordingly. Those who had money and influence received preferred treatment while everyone else waited in line. That was, in this ER, doing things the right way, according to custom, consistent with expectations. I couldn’t change anything. I was too junior. But I found ways to convey my opposition.

The ER was typically overcrowded, often due to the neglect of those who worked in the system. A patient would notify his doctor of an urgent medical problem, but the doctor, either out of laziness or lack of capacity, would not want to admit him until morning, so that patient came to the emergency room. Other patients who lacked clout or connections showed up because they had no other place to go. But we had no available beds, so we became a holding station of last resort. Sometimes we’d have thirty patients lying on gurneys in the hallway. I called them “patients under the clock.” They were often drug users, homeless people, misfits; the disadvantaged and the dispossessed. Some had chest pains; others had broken hips; others, we weren’t even sure. The hospital had the room and the resources, on the floors above, to care for these individuals, but it wasn’t a priority. So there they lay, all night, under the clock.

One night I took their names and made out a “VIP Notification List,” and then slid that list under the door of the hospital CEO so that he would see it first thing in the morning.

I wanted him to know that these were the people—VIPs all—whom we failed to serve the night before in the emergency room. 

My insubordination could have gotten me into trouble, but it was the right thing to do.

That kind of attitude has led me to take some defiant stands in the workplace, but it has also helped me realize many of my goals. My colleagues may not always agree with me, but I believe they know that I’m driven to do the right thing, particularly in those instances when I’ve upset conventional wisdom or challenged powerful interests.

I also fight for what I believe in, which came from my youth. I grew up in a family and a community that, one way or another, was always under the clock.

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