Building and Sustaining Leadership in the US Public Health System PHLS Annual Program Sunday, Nov. 3, 2007 Consumer/Benefactor Panel Rex Archer, MD, MPH Director of Health Kansas City, Missouri “Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them” -Robert Jarvik

Leadership Competencies 1.Envision a better future 2.Accurately assess present reality 3.Not just tolerating, but actually drawing energy from the difference in order to drive change (without compromising the long term vision or denying present reality)

Envision a better future: Vision? Where there is no vision, people perish. -Proverbs 29: 18

A Health System: Health Protection for Life! Public Health Network Health Protection: Health Promotion, Prevention, and Preparedness Healthcare Delivery System Disease Care

Medical care and tertiary prevention Safety net programs and secondary prevention Primary preventionAddressing the social determinants of health Camara Phyllis Jones, MD, MPH, PhD Research Director on Social Determinants of Health and Equity

Differences in access to care Differences in exposures and opportunities Differences in quality of care (ambulance slow or goes the wrong way)

Accurately assess present reality Fisherman story Takers not just Givers (Pat Libbey) 1.Take Credit, invisible? 2.Take Responsibility, accreditation, and ask for $$ 3.Take Charge, PH as Incident Commander

Use the difference to drive change Negotiation skills Collaboration, win/win ( = 1.5) Isolation, win?/lose ( =.70) Subjugation, win/lose ( =.70) Mutual destruction, lose/lose, militant nonviolent resistance ( = -.25)

Use the difference to drive change Leadership development, the usual suspects? 1.Mentoring, apprenticeship, 2.Risk taking - Willingness to lose/relocate (live within your means, be able to survive 6-9 months unemployment) 3.Communication - Storytelling

A vision without a task is but a dream; A vision without a task is but a dream; a task without a vision is drudgery; a task without a vision is drudgery; a vision and a task is the hope of the world. a vision and a task is the hope of the world. - from a church wall in England - from a church wall in England