I trained as a family physician and spent more than 16 years taking care of patients, primarily in an outpatient setting in Denver, Colorado. I did everything from delivering babies to delivering bad news. I loved every minute, but eventually, I was attracted to challenges offered on the business and regulatory sides of medicine. I applied to and was accepted by the University of Colorado, Denver MBA program in 1985. When I graduated, I started working part-time as a consultant and part-time in clinical care. As a communications consultant, with an MBA in management and marketing, hospitals engaged me to work with physicians to become better leaders and better communicators with patients. My public health experience enabled me to work with large companies to craft workplace safety policies.

In 1994, I landed my first big management job at the US Department of Health and Human Services, quite a place to start. I had 1,200 employees and 14 direct reports.

Toward the end of my first month on the job, I gave an order to an employee from another office. And then I waited to see the response. To my surprise, absolutely nothing happened. Apparently, no one had heard me. So, I gave it again . . . and got exactly the same result. Giving orders had worked well for me when I was a doctor. For better or worse, that’s the way the healthcare system works.

Not the way business works.