By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer

“Leadership requires two things: a vision of the world that does not yet exist and the ability to communicate it.”

– Author Simon Sinek

After being in leadership roles for 25 years, I have conflicted feelings about Simon Sinek’s central message in his famous 2009 TED Talk and book Start with Why: How Great Leaders Inspire Everyone to Take Action.
Sinek argues that communicating the underlying Why behind a company, a product, a service, or a proposal is key to engaged, charismatic leadership.

Not What your staff do.  Not How a service works.

But Why does our team come to work every day? Why is the basis of our inner motivation to work where we do, and to do the work we do.  It is a powerful idea and one missing from communications of uninspiring leaders.  It is undeniable that all of us as leaders need to effectively communicate the Why when are interacting with our staff, and when presenting new ideas to our executive leaders or governing board.

However, since this idea was popularized, I have seen troubling side to this:  leaders who passionately articulate the Why to justify an operational plan or regulatory framework (i.e. the How and What) which are not based on past experience or wisdom, not logically thought out, and really doomed to failure.  These leaders feel that their passion for a worthy Why renders mundane or unneeded activities such as starting with the wisdom of principles, weighing options, and seeking skeptical feedback.

For example, we all agree that eliminating health inequities is a very important goal and may be the Why that some of us are working in health care.  However, if my passion for this Why is so strong that I begin to believe that whatever ideas to reduce inequities that pop into my head are worthy of everyone’s support, without wisdom, analysis, or discussion, I’m likely to create programs or policies that will have significant unintended negative consequences.

Having passion and understanding and articulating the Why are important leadership abilities, but no less important than:

1. Having the wisdom to search out knowledge on what has worked and what has failed in the past to address this problem.  Learn from the past to prevent making the same mistakes.
2. Testing ideas on a smaller scale before spreading a new program widely.
3. Use the scientific method and an understanding of statistics (and not wishful thinking) to judge the success or failure of these pilots.
4. When the situation calls for widespread adoption of something new, use sound management principles, project management, and implementation science methodology.

Explaining the Why is motivating.  Having a well thought-out and logical What and How will still end up being a key to enduring success and excellence.

Acknowledge the importance of the underlying Why, but leverage your wisdom and experience to move to a sounder What and How.