2 This is the questionnaire in chapter 1 of Narcissistic Leaders: Who Succeeds and Who Fails (Boston: Harvard Business School Press, 2007).
3 “Expanding the Innovation Horizon, the Global CEO Study 2006,” IBM Business Consulting Services.
4 For examples of types of collaboration in the knowledge workplace, see Charles Heckscher and Paul S. Adler, eds., The Firm as Collaborative Community: The Reconstruction of Trust in the Knowledge Economy (Oxford: Oxford University Press, 2006). Also by Heckscher, The Collaborative Enterprise: Managing Speed and Complexity in Knowledge-Based Businesses (New Haven, CT: Yale University Press, 2007).
5 Lynda M. Applegate et al., “IBM: Uniting Vision and Values,” Case 9-805-116 (Boston: Harvard Business School, 2006).
6 This research finding by Mitzi Montoya-Weiss of NC State University and Anne P. Massey of Indiana University was reported in CIMS Technology Management Report, Center for Innovation Management Studies (NC State University, Winter 2006–2007).
7 Kwame Anthony Appiah, The Ethics of Identity (Princeton, NJ: Princeton University Press, 2005), 117. Appiah goes on to write: “The social identities that clamor for recognition are extremely multifarious. Some groups have the names of the earlier ethnicities: Italian, Jewish, Polish. Some correspond to the old races (black, Asian, Indian); or to religions (Baptist, Catholic, Jewish). Some are basically regional (Southern, Western, Puerto Rican). Yet others are new groups that meld together people of particular geographic origins (Hispanic, Asian American) or are social categories (woman, gay, bisexual, disabled, Deaf) that are none of these. And, nowadays, we are not the slightest bit surprised when someone remarks upon the ‘culture’ of such groups. Gay culture, Deaf culture, Chicano culture, Jewish culture: see how these phrases trip off the tongue. But if you ask what distinctively marks off gay people or Deaf people or Jews from others, it is not obviously the fact that to each identity there corresponds a distinct culture. ‘Hispanic’ sounds like the name of a cultural group defined by sharing the cultural trait of speaking Spanish; but, as I’ve already pointed out, half the second-generation Hispanics in California don’t speak Spanish fluently, and in the next generation the proportion will fall. ‘Hispanic’ is, of course, a category that’s as made-in-the-U.S.A. as black and white, a product of immigration, an artifact of the U.S. census. Whatever ‘culture’ Guatemalan peasants and Cuban professionals have in common, the loss of Spanish confirms that Hispanic, as a category, is thinning out culturally in the way that white ethnicity has already done.”
8 Allison Maitland, “Le Patron, der Chef and the Boss,” Financial Times, January 9, 2006.
9 These were Thailand, Taiwan, South Korea, China, Hong Kong (then independent), Malaysia, Singapore, Indonesia, and the Philippines. When Lindahl first asked me to go to these countries, I wasn’t sure that Asians would be open with me. I said I’d test my ability by trying Thailand and Taiwan. Before leaving, I read as much as I could about the culture and history of these countries. I went first to Bangkok and was pleasantly surprised how open the Thai managers were, giving frank opinions about the expats. I remarked on this to one Thai manager who said, “Most foreigners come and just tell us what they want us to do. You understood how important to us is Buddhism, and you listened.”
10 The Chinese government has recently become more favorable to Confucius as a means of indoctrinating respect for their authority. Richard McGregor, “The Pursuit of Harmony—Why Fast-Changing China Is Turning Back to Confucius,” Financial Times, April 12, 2007, 11.
11 Geert Hofstede, “Cultural Constraints in Management Theory,” in Leadership: Understanding the Dynamics of Power and Influence in Organizations, ed. Robert P. Vecchio (Notre Dame, IN: University of Notre Dame Press, 1997), 479.
12 Marcus Buckingham and Donald O. Clifton, Now Discover Your Strengths (New York: The Free Press, 2001).
13 Adapted from P. T. Costa Jr. and R. McCrae, “Trait Psychology Comes of Age,” in Psychology and Aging, vol. 39, Nebraska Symposium on Motivation, 1991, ed. Theo B. Sonderegger (Lincoln, NE: University of Nebraska Press, 1992), 169–204.
14 Richard Olivier uses this theory in his mythodramas (www.oliviermythodrama.com), as does Carol Pearson in her books and seminars (www.herewithin.com).
15 Michael Maccoby, Narcissistic Leaders: Who Succeeds and Who Fails (Boston: Harvard Business School Press, 2007).
16 Descriptions of the mixed types can be found in the appendix of Narcissistic Leaders.
17 Sigmund Freud, Libidinal Types, vol. XXI, The Standard Edition of the Complete Psychological Works of Sigmund Freud (1931; London: Hogarth Press, 1961), 215–220.
18 Ibid.
19 The questionnaire is published in chapter 1 of Narcissistic Leaders. Richard Margolies used the questionnaire in leadership workshops with the U.S. Army Corps of Engineers. Most of the business media managers at VNU have marketing personalities. Matt Downs and Michael Anderson, while students at Stanford Business School under the direction of Charles O’Reilly, gave the questionnaire to executives of Bay Area businesses. Nine of ten high-tech entrepreneurs were narcissists and six of seven manufacturers were obsessives.
20 Tony Barclay, interview with author, March 9, 2007.
Chapter 6
1 Stefan Stern writes “When 50 executive MBA students at a leading international business school were asked recently what word they would use to describe themselves, they opted for labels such as ‘catalyst’, ‘change-agent’, ‘consultant’ and ‘leader.’ None of them wanted to be thought of as a ‘manager.’ ” Financial Times, December 19, 2006.
2 Dee Hock, One from Many: VISA and the Rise of the Chaordic Organization (San Francisco: Berrett-Koehler, 2005).
3 Bryan Huang, interview with author, August 1, 2005.
4 Ibid.
5 Judith Block McLaughlin and David Riesman, Choosing a College President, Opportunities and Constraints (Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching, 1990).
6 Paul S. Adler, “Beyond Hacker Idiocy: The Changing Nature of Software Community and Identity,” in The Firm as Collaborative Community: The Reconstruction of Trust in the Knowledge Economy, ed. Charles Heckscher and Paul S. Adler (Oxford: Oxford University Press, 2006), 179–198.
7 Michael Maccoby, “Learning to Partner and Partnering to Learn,” Research Technology Management 40, no. 3 (May–June 1997): 55–57.
8 Jay R. Galbraith, “Mastering the Law of Requisite Variety with Differentiated Networks,” in Heckscher and Adler, The Firm as Collaborative Community, 179–198.
Chapter 7
1 See, for example, Anna Bernasek, “Health Care Problem: Check the American Psyche,” New York Times, December 31, 2006.
2 Richard Normann and Niklas Arvidsson, eds., People as Care Catalysts: From Being Patient to Becoming Healthy (Chichester, UK: John Wiley & Sons, Ltd., 2006).
3 This failure is described in Haynes Johnson and David Broder, The System : The American Way of Politics at the Breaking Point (Boston: Little Brown, 1997).
4 Simmons benefited from a talented and dedicated staff. Margaret Rhoades, PhD, and later Patricia Q. Schoeni were executive directors of the coalition, and Mark A. Goldberg was the policy expert.
5 Building a Better Health Care System: Specifications for Reform can be found at www.nchc.org.
6 The commission Simmons first organized also discussed the self-inflicted causes of illness such as smoking, obesity, and lack of exercise. Clearly, if Americans improved their habits—eating, drinking, exercise—the cost of health care would be reduced. One political leader, Mike Huckabee, former Republican governor of Arkansas, instituted programs to reward employees for healthy behavior. At a Coalition meeting on July 10, 2006, he pointed out that companies now reward employees for being sick, giving them time off and health care. Huckabee believes that if comprehensive reform can be shown to work in a state, its chances increase of being adopted by Congress.
7 Stanford University economist Allan C. Enthoven has written extensive
ly on what it would take to create the conditions that would allow for a competitive market that could control costs while increasing quality. These include: (1) universal coverage; (2) a standard insurance package, so consumers could compare price and quality; (3) at least three independent insurance or provider systems competing in every part of the country; (4) transparent information about price and outcomes measures; and (5) government oversight and regulations. (A. C. Enthoven, “Market Forces and Efficient Health Care Systems,” Health Affairs , March–April, 2004, 25–27.) Michael Porter, the distinguished Harvard business strategist, is a strong advocate of market competition among providers on the basis of measured results. We are a long way from getting the necessary measurements, but even if they were available, this would not necessarily control costs, since the most effective doctors could raise their rates. (M. E. Porter and Elizabeth Olmsted Teisberg, Redefining Health Care: Creating Positive-Sum Competition to Delivery Value [Boston: Harvard Business School Press, 2006].)
8 The Hospital Experimental Payment (HEP) program was cutting costs in Rochester hospitals that agreed not to compete in areas requiring costly technology, but rather allow each hospital to specialize. This program was initiated by community leaders. See J. A. Block, D. I. Regenstreif, and P. F. Griner, “A Community Hospital Payment Experiment Outperforms National Experience: The Hospital Experimental Payment Program in Rochester, New York,” Journal of the American Medical Association 257, no. 2 (1987): 193–197. Griner told me that the cooperation/collaborative started to unravel when George Pataki was elected governor. He was a strong proponent of competition in the healthcare field. At about the same time, HCFA (Health Care Finance Administration) decided that the experiment had gone on long enough, and the experiment was a success (HCFA had granted a waiver for Medicare and Medicaid to participate in the experiment). So, fracture lines were already present when Kodak then took a public position favoring a more competitive environment. The program ended with the result that costs rose as all hospitals bought the same expensive technology.
9 Paul Griner et. al., Managing Change (Washington, DC: Association of American Medical Colleges, 2000).
10 These included: Polly Bednash, PhD, RN, FAAN, Executive Director, American Association of Colleges of Nursing; Roger Bulger, MD, President, Association of Academic Health Centers; Paul Griner, MD, former President, American College of Physicians and Vice President and Director, Center for the Assessment and Management of Change in Academic Medicine, Association of American Medical Colleges; Federico Ortiz Quesada, MD, Director, International Relations, Mexican Ministry of Health; Stan Pappelbaum, MD, former CEO, Scripps Health; Richard Riegelman, MD, MPH, PhD, Dean, School of Public Health and Health Services, George Washington University; Henry Simmons, MD, President, National Leadership Coalition on Health Care.
11 The full report Leadership for Health Care in the Age of Learning was published by the Association of Academic Health Centers in 2001. It can be found at http://www.maccoby.com. Parts of this chapter have been published in Michael Maccoby, “Health Care Organization as Collaborative Learning Communities,” in The Firm as Collaborative Community:The Reconstruction of Trust in the Knowledge Economy, ed. Charles Heckscher and Paul S. Adler (Oxford: Oxford University Press, 2006), 259–280.
12 Although I have a PhD rather than an MD, I went through psychoanalytic training together with psychiatrists and apprenticed under Erich Fromm and practiced in my own cottage industry. I can appreciate the traditional physicians’ point of view.
13 Roger Bulger, The Quest for Mercy, the Forgotten Ingredient in Health Care Reform (Charlottesville, VA: Garden Jennings Publishing, 1998).
14 Paul Starr, The Social Transformation of American Medicine (New York: Basic Books. 1982); George Rosen, The Structure of the American Medical Profession, 1875–1941 (Philadelphia: University of Pennsylvania Press, 1983).
15 Louis M. Savory and Clare Crawford-Mason, The Nun and the Bureaucrat: How They Found a Simple Elegant Solution to a Deadly National Problem (Washington, DC: CC-M Productions, Inc., 2006).
16 “How the VA Healed Itself,” Fortune, May 15, 2006.
17 After the Institute of Medicine reported almost 100,000 Americans die each year in hospitals due to mistakes and poor practice, Donald Berwick, MD, a professor at Harvard Medical School led an eighteen-month campaign that engaged 3,100 hospitals (“Hospital Initiative to Cut Errors Finds About 122,300 Lives Saved,” Wall Street Journal, June 15 2006); see also Donald M. Berwick, MD and Lucian L. Leape, MD, “Perfect Is Possible,” Business Week, October 16, 2006, 70–72.
18 Ian Urbina, “Rising Diabetes Threat Meets a Falling Budget,” NewYork Times, May 16, 2006.
19 Clyde H. Evans and Elaine R. Rubin, eds., Creating the Future (Washington, DC: Association of Academic Health Centers, 1999).
20 Normann and Arvidsson, People as Care Catalysts.
21 In Pursuit of Greater Value: Stronger Leadership in and by Academic Health Centers (Charlottesville, VA: University of Virginia Health Center, 2000).
22 From the Mayo clinic Web site: www.mayoclinic.org/about/history.html.
23 Ibid.
24 Mayo’s tax-exempt status is based on its research mission; IHC’s is based on its willingness to serve patients without regard to their ability to pay.
25 Brent James, interview with author, November 16, 1999.
26 Other Mayo-type integrated healthcare organizations that we did not study are the Scott-White Clinic in Albuquerque, New Mexico, and Dartmouth-Hitchcock Clinic in Hanover, New Hampshire, which has been a leader in sharing information on quality.
27 Quotation from Brookings Institution Leadership Laboratory, September 16, 2005.
28 I haven’t described Kaiser-Permanente in this chapter, mainly because it has taken a similar path to that of Intermountain. However, many observers view Kaiser as a model for the future of health care. See Steve Lohr, “Is Kaiser the Future of American Health Care?” New York Times, October 31, 2004.
Chapter 8
1 For example, fourteen urban school districts have on-time high school graduation rates lower than 50 percent; they include Baltimore, Detroit, New York, Milwaukee, Cleveland, Los Angeles, Miami, Dallas, Denver, and Houston; see Gregg Toppo, “Big-City Schools Struggle with Graduation Rates,” USA Today, June 20, 2006.
2 See Tough Choices or Tough Times: The Report of the New Commission on the Skills of the American Workforce (Washington, DC: National Center on Education and the Economy, 2007).
3 Lawrence Mishel, Jared Bernstein, and Sylvia Allegretto, Economic Policy Institute: The State of Working America 2006/2007, http://www.epi.org/content.cfm/datazone_dznational.
4 The report of the New Commission on the Skills of the American Workforce doesn’t even mention these jobs. Yet, there is a shortage of competent skilled workers. This is the case also for factory work as reported in Barbara Hagenbaugh, “Wanted: Factory Workers,” USA Today, December 5, 2006..
5 My description is based on the profile by Mark Singer in The New Yorker, June 5, 2006; and the article by Yukari Iwatani Kane and Phred Dvorak, “Howard Stringer, Japanese CEO,” Wall Street Journal, March 3, 2007.
6 Daniel Greenbert, Free at Last: The Sudbury Valley School (Framingham, MA: Sudbury Valley School Press, 1995).
7 Nick Anderson, “Learning on Their Own Terms, Maryland School With No Curriculum Challenges Conventions,” Washington Post, April 24, 2006.
8 “Reality Check 2006, How Black and Hispanic Families Rate Their Schools,” Public Agenda, http://www.publicagenda.org.
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