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STAND UP FOR WHAT’S RIGHT

Leading isn’t a popularity contest, especially when it comes to your organization’s core mission and aspirational values.

Newly arrived leaders can shake up organizations in any number of ways. They can announce major cost-cutting measures, make significant personnel moves, introduce new strategies, advance new operational structures. As it turns out, they can also march in parades.

In early 2019, members of our recently formed LGBTQ+ caregiver resource group asked if Intermountain could sponsor Utah’s annual Pride Festival. At many health systems, this request might have been no big deal, but Intermountain had never aligned itself with the LGBTQ+ community in such a public way. Believing it important for people to feel comfortable and accepted at work, I agreed to the sponsorship. In June 2019, Intermountain hosted a booth at the festival, and I proudly marched in a parade alongside hundreds of our caregivers. Intermountain further affirmed its support internally with messages on screensavers, in social media posts, in employee trainings, and in other corporate communications.

I knew supporting Pride would stir emotions, but I hadn’t anticipated how much. One caregiver approached me at the parade with her 13-year-old daughter and told me, “This is the first time I’ve ever been able to acknowledge that my daughter is gay and the first time that she’s ever been able to do something associated with Intermountain that acknowledges that.” The phlebotomist at the laboratory I go to told me, “Marc, I’ve worked here for 35 years. I’ve been an openly gay woman the entire time, and I finally feel like I can bring my whole self to work.” Dozens of caregivers registered their excitement on our internal social media site and in our caregiver surveys. “I never thought I’d see this day,” one wrote. “I now know we’re welcomed and celebrated here,” said another.¹

Some caregivers with more traditional beliefs reacted differently. They expressed anger and frustration, arguing that we were ramming a progressive agenda down caregivers’ throats. “We are a hospital, not an engine for social change,” one caregiver wrote.² Some religiously observant caregivers felt we were condoning or promoting a lifestyle with which they disagreed. We were being too “trendy” or politically correct, they said, and it was damaging the organization. A few senior leaders and board members approached me, wondering if we had gone too far on this issue and were disrespecting our heritage.

Although I empathized with these critics and appreciated that they wanted the best for Intermountain, I respectfully disagreed with them, particularly the notion that taking a stand on behalf of inclusivity somehow marked a departure from our mission. As I saw it, the opposite was true. To help people live the healthiest lives possible, we needed to take the lead in defining health in society, including healthy social relationships. Internally, we couldn’t foster health unless we had an inclusive workforce where everybody could feel respected and accepted for who they are, nor could we deliver on our strategy of building a tightly integrated system if we allowed divisions based on race, ethnicity, gender, sexuality, and so on to remain intact. Diversity is so important that it stands as one of our organization’s stated values: “We embrace diversity and treat one another with dignity and empathy.”

In the wake of the festival, I continued to affirm our support for the LGBTQ+ community and for inclusivity, explaining its connection to our mission. I had come to this organization to drive progress. If we were to remain a model health system and deliver more fully on our mission, we needed to have uncomfortable but frank conversations clarifying our standards for how we treat people. I wanted to make us more welcoming not merely in relation to LGBTQ+ people but to any individual who might feel marginalized. The goal was to open our minds even wider and advance the core aspirations that had long guided us. Rather than simply publishing a statement on what we stood for, I wanted us to take action, doing something meaningful and visible in the community. Words are nice, but actions are so much more powerful. As leaders, we must practice what we preach.

Many leaders shrink from taking controversial positions related to the organization’s mission, thinking it too risky. But remaining silent is risky, too. It can alienate people, including younger employees and customers, who increasingly expect organizations to speak out about diversity, equity, and inclusion (DEI) and other pressing social issues. Leaders these days are often damned if they do and if they don’t, but I’d respectfully suggest they are more damned if they don’t. Speaking out carries important benefits, regardless of whether it also causes offense to some. By clarifying and affirming what the company really believes in, we can more sharply define the culture and galvanize stakeholders to adopt the mantle of change. Over time, strong, mission-oriented leadership sharpens an organization’s sense of self, focusing it to drive progress on behalf of its ideals.

The Pride Festival and the conversations it sparked didn’t change our culture overnight, but they did send a clear message about our mission and values that resonates to this day. As you might imagine, members of the LGBTQ+ community came away inspired. As Katy Welkie, CEO of Intermountain Primary Children’s Hospital and member of the LGBTQ+ community, puts it, “When you know that your organization accepts you as an individual fully and is going to be there for you, your family, and your culture, it makes you lean in and want to do more. You have a loyalty you didn’t have before.”³

If you’re not speaking out in a principled way, I hope you’ll start. Making trouble for its own sake is distracting and unproductive. But unless you’re reliably standing up for your organization’s mission or social purpose, you’re not much of a leader. There’s bad conflict and good conflict. Making waves to reinforce the organization’s social purpose and its underlying values is the good kind. As scary and unpleasant as conflict is in today’s polarized environment, we can’t let the prospect of it scare us. We owe it to our employees, customers, and communities to brave the turbulence of public discourse and lead them to stand up for what’s right.

ADVOCATE STRATEGICALLY

As you’ve probably surmised, speaking out isn’t just another leadership tactic for me. It’s a longstanding habit, a way I have of seeing and engaging with the world. Back in high school, I wrote a history paper exploring how Black slaves resisted white hegemony through music and humor. In college, I became fascinated by the movement to oppose apartheid by divesting from South Africa. When the AIDS crisis struck, I spoke up against the persecution of gay people, affixing a bumper sticker to my truck that read, “Fight AIDS, not people with AIDS.” I got some interesting looks from other drivers, but I didn’t care. As a second-year medical school student, when I first donned a white coat, I rounded out my look by attaching a pin that informed others that healthcare was a right, not a privilege. I believed in that concept then and still do.

Later, as an idealistic young doctor, I challenged the organizations for whom I worked to take responsibility for remedying injustices. At Cleveland Clinic, I spoke out against our policy of rejecting low-income patients covered by Medicaid. Our main campus abutted some of the poorest communities in the United States. We would care for residents when they needed help from medical specialists—the government reimbursed us well for that. But we didn’t accept these patients in our primary care clinics, where reimbursements weren’t so lucrative. Our policy forced these patients to venture outside their communities in search of care, making it harder for them to stay healthy and adding to the disadvantages they faced. As someone who had become a pediatrician because he wanted to serve and give a voice to underprivileged or marginalized children, I thought that was a travesty, and I let the powers that be know about it. Unfortunately, our policy didn’t change.

I also lobbied the Clinic to provide benefits to partners of LGBTQ+ employees. To me, providing these benefits only to heterosexual, cisgender employees was morally wrong. But I made a business case to my colleagues as well. We had tried to recruit a top doctor to serve as chairperson of one of our clinical departments, and she refused to come because her wife couldn’t receive benefits. As I argued, our policies were preventing us from accessing the portion of available talent that was LGBTQ+. How was that a smart move? We wound up changing our policy. A couple of years later, we were able to recruit this very same doctor.

At Cleveland Clinic, my focus first as a clinician and then as a leader was to push an organization committed to providing exceptional clinical care to adopt elements of a social mission. When I came to Intermountain, the context for my advocacy shifted. I was attracted to this organization in the first place because we had a long and storied history of dedication to a social purpose. Remember, Intermountain was charged at its founding with operating as a model healthcare system. We cared for people regardless of their ability to pay and channeled revenues back to local communities via healthcare financial assistance, community resources for the underserved, and improved health services and facilities. What I wanted was to prod people in the organization to lean further into this historic commitment, so that we could do even more good for patients, local communities, and society. Although our people remained deeply devoted to service, I felt it was time to take it to a new level. By advocating energetically on behalf of our mission and values, I hoped to shake up our culture and unleash new levels of vitality, focus, and mission-oriented innovation.

What I didn’t quite realize was how much I’d learn about advocacy. Here as in other areas, my tendency was to push forcefully—too much so, on some occasions. I learned the hard way that wise leaders pursue advocacy empathetically, strategically, and collaboratively. They take care not to cause undue offense or mire the organization in endless, unproductive conflict.

It’s important, of course, to advocate forcefully—we can’t just take a stand once and think we’re done. During my first couple of years at Intermountain, I spoke up on numerous occasions for a more diverse, inclusive, and equitable culture. In addition to personally marching in the Pride parade, I wrote letters to our local newspaper in support of transgender people; diversified our senior leadership team, which had been largely white and male; asked a senior leader to bring her wife to one of our board retreats (a step she had feared taking); oversaw the creation of our LGBTQ+ resource group; spoke out on behalf of undocumented immigrants who were working for Intermountain under the Deferred Action for Childhood Arrivals (DACA) program; and introduced the celebration of Martin Luther King Jr. Day.

In taking these actions, I sought to get people’s attention and shake them up a bit. I certainly succeeded, but with some negative effects I hadn’t anticipated. Although many caregivers supported my new statements and policies, others chastised me for disrupting the organization, calling me a “cultural wrecking ball” or worse. Some said I was a poor fit for Intermountain, even a bad person.

Public stands I took on other issues cost me support as well. Ask caregivers, and you’ll find many traditionally haven’t had the best diets on the job. Soda, chips, donuts, candy bars—we love that stuff and snack on them all the time. Unfortunately, a significant percentage of people in our local communities and in our workforce have paid the price for that behavior, suffering from high levels of diabetes and other chronic conditions. When I arrived at Intermountain, I wanted to broadcast the message that we’re not just here to treat patients when they get sick. We’re here to help prevent them from getting sick in the first place, and more broadly, to promote a healthier society. To make my point, I made one of my first actions as CEO taking all sugared soda and candy out of our vending machines, cafeterias, and gift shops.⁴

Many in the workforce went ballistic. What? He’s taking away our Twix bars? Many caregivers accused me of being heavy-handed and authoritarian. Even those who might have agreed with the dietary advice enshrined in my policy disliked their organization telling them what to do. “We are adults,” one caregiver wrote. “I would really like to be able to have the right to choose what I drink and eat!”⁵ To them, it seemed that I didn’t understand the experience of frontline caregivers very well. Taking care of sick patients was a stressful job. Couldn’t I appreciate the need for caregivers to reach for a sweet treat once in a while? And was it my place to make these decisions for them?

Discontent with the junk food ban took on a life of its own, becoming a rallying cry for some who didn’t like my other policies and felt I misunderstood the culture. Caregivers brought in bottles of sugared sodas and drank them openly in the break room as an act of rebellion. Patients and visitors also voiced their displeasure, noting that they, too, were adults who could make decisions for themselves. Many shared that being in the hospital was a stressful time, and they wanted comfort food like candy and soda. “If I want a damn Coke,” one wrote, “get me a DAMN COKE.”

My well-intentioned advocacy fell short, and I wished I could have a do-over. I was trying at this time to rally our organization to embrace other internal changes, such as controversial restructuring. With so much change happening at once, many of our caregivers understandably felt unsettled—they were used to a relatively stable, predictable organization.

It has taken a few years, but my team and I have managed to rebuild much of the trust that my early rush of advocacy eroded. Reversing our soda ban in 2020 certainly helped (more on this later), as did other efforts we made to support our caregivers during the pandemic. As regards diversity, equity, and inclusion (DEI), we gained more internal support for our policies in the wake of the 2020 murder of George Floyd. Not only did we hold dialogues across the organization, we adopted equity as one of our fundamentals of care, alerting people to the massive disparities in health outcomes that exist in our society along racial lines—disparities that the pandemic was laying bare as never before. Further, we identified specific areas of equity that mattered to us, adopted measurable goals, and launched dozens of clinical projects to render our care more equitable.

This new focus on equity and its implications for patients recast DEI for our caregivers, allowing us to make a far clearer link between it and our mission. That in turn normalized DEI in caregivers’ minds, removing it from politics and putting it firmly in the realm of health-care. Our caregivers care about serving patients, and they care about mobilizing data to improve clinical care. As many of them came to recognize, DEI wasn’t about some East Coast guy imposing a liberal agenda and taking jobs away from longtime employees. It was about our traditional mission of making all people healthier, regardless of who they were or their station in life. At a time when healthcare systems like ours were struggling to hire enough people, it also was about taking steps to compete better for the talent we needed to serve patients.

Our chief people officer Heather Brace notes that focusing on equity and linking it to the mission made it easier to have difficult conversations about identity.⁶ Mikelle Moore, our chief community health officer, agrees, observing that our clinical teams are really excited about grassroots equity projects “even though there might be some critics on the margins.”⁷ Filtering out the food fight on cable news and social media around this topic wasn’t easy. We had to get people focused on DEI around healthcare specifically, not politics. Doing so empowered us all to row in the same direction, steering our entire community toward better and more equitable health outcomes.

I don’t regret my early advocacy on behalf of our mission. I remain convinced that my public stands were correct. But if I had been a bit humbler and more culturally sensitive, I would have gone more slowly and achieved similar results with less stress on the organization. As leaders, we should pick our battles carefully. Some public stands are so important that we might be willing to suffer potentially serious consequences. Others, not so much. It’s vital to know the difference. Did I need to ban junk food in 2017? Maybe not. Would taking time to build up more trust first and allow people to get to know me have been a good idea? Perhaps. We can’t simply charge in as leaders and interpret the mission in new ways all at once. We stand to gain much more if we first take a measure of the organization, understand the degree of change people can manage, at what pace, and work with them.

STICK TO THE FACTS

On August 31, 2021, at a monthly Covid-19 briefing convened by Utah governor Spencer Cox, I did something that for me was quite unusual. With the highly contagious Delta variant of Covid raging, I stood up in a crowded room and took off my own mask to address the public. As I explained to the officials and reporters present, many of whom were unmasked, I made a practice at the time of avoiding large gatherings. My immune system was highly compromised, as I’d recently had cancer and undergone treatments, including a bone marrow transplant. If I contracted Covid, chances were much higher that I’d have a serious or even fatal case. But I was taking the risk for an important reason: to voice the challenges faced by our 42,000 caregivers and to implore members of the public on their behalf to take simple actions like vaccination and masking to prevent infection.

By this point in the pandemic, Utah’s public health situation was dire. Mask mandates and vaccines had become political lightning rods for many. Misinformation circulated online, discouraging people from taking these preventive steps and questioning the motives and integrity of caregivers. Meanwhile, the Delta surge was straining our system to the breaking point. Caregivers were turning away patients with other serious ailments or transporting them to other facilities—in the process, negatively impacting their care—since we just didn’t have the beds. Caregiver morale was plummeting to new lows. It’s hard enough to watch sick patients decline and die, but our caregivers were seeing deaths in young, previously healthy patients that proper masking and vaccination could have prevented.

At the briefing that day, I made a highly emotional appeal to the public to mask up, get vaccinated, and express appreciation to our caregivers. I did it in a very deliberate way. I didn’t harangue those who stubbornly ignored the science that supported masking and vaccination. I didn’t try to score political points by arguing for or against mask mandates or other government policies. I didn’t share my own political views or even my dismay that people refused to wear masks. Instead, I kept my remarks focused firmly on the facts. I relayed data about how full our intensive care units were and how many of those seriously ill patients had been vaccinated (almost none of them). I relayed data about how our caregivers felt and the messages they wanted to communicate. And I relayed data about my own situation, telling my audience: “I hope that all of you who aren’t wearing masks aren’t carrying the Delta variant, because if you are, you could kill me.”⁸

In advocating on behalf of their organizations’ mission, leaders often fail to achieve their desired impact because they stray from portraying objective reality. By talking about themselves and what they think, they can come off seeming overbearing and self-absorbed. By attempting to make political arguments, they can spawn unproductive, bad conflict, further polarizing their audience. The perils of straying from the facts became readily apparent to us at Intermountain during the pandemic. By sometimes taking political positions, our peers at other healthcare systems found themselves embroiled unnecessarily in controversies that inflamed tensions and made collaborative efforts on the part of their local communities less likely.

To be fair, neither we nor our peers had ever led organizations through a global pandemic before. And given the highly politicized nature of the public health discourse around Covid, which in the United States at least first appeared during a highly contentious election year, it was impossible for any health system to avoid controversy entirely. Despite our best efforts, we at Intermountain found ourselves pulled repeatedly into the political fray on issues ranging from stay-at-home orders to testing to masking to vaccines. Still, because we tried consistently to stay out of politics to the extent we could and focus on facts, we were a bit more successful than many other health systems in retaining broad credibility within our local community. We could focus a bit more on adapting to the shifting pandemic in partnership with political leaders, competitors, and others in our community, and a bit less on fighting unproductive political battles.

My remarks at the Covid-19 briefing were a good example. In our state, it was risky to deliver a strong pro-mask message consistent with our mission. If I had attacked people, I could have subjected Intermountain to massive attacks from those opposed to masking. Because I stuck to the facts, I managed to avoid further antagonizing audience members and perhaps even win a few over. People seemed to appreciate that a healthcare leader and a physician had spoken to them in a way that wasn’t patronizing or driven by a political agenda. Even our governor, whose personal reluctance toward wearing masks was well known, expressed his intention “to try to wear a mask more often—especially when I’m around unvaccinated people and immunocompromised people. I’m going to try a little bit harder, so that I can protect people like Dr. Harrison and others who are immunocompromised or struggling, and even those who have chosen to not get the vaccine.”⁹ The governor is a good man with a huge heart, and he would never intentionally put others at risk. I’ve always appreciated his ability to have a healthy discourse with me on all healthcare matters.

To my surprise, my remarks also helped to shore up our caregivers, who desperately needed an emotional lift. A couple of days after the briefing, when I was rounding at one of our facilities, a couple of them came up to me in tears, thanking me for my remarks. They had asked me to speak on their behalf, and I had done it in a way that I hoped would be constructive.

It’s necessary at times to take risks and wade into politically charged debates. But we can mitigate those risks not only by picking our battles carefully but by setting our egos aside and opting not to take the political bait that others might dangle. Let’s forget about trying to prove ourselves right and others wrong. Let’s forget about buttressing our own personal sense of self-righteousness. We stand the best chance of influencing others if we craft a strong, nonpartisan, factual case in support of our organization’s mission. And if we meet people where they are.

FOSTER A LOYAL OPPOSITION

In 2021, my leadership team and I announced we were closing over two dozen of our community pharmacies located in or near our clinics.¹⁰ The decision was ultimately an economic one: demand had dropped, and these pharmacies were no longer viable. We had made valiant efforts to salvage them, cutting costs and then seeing if we could find another company to run them for us. Nothing worked. Chalk it up to the internet. When we had started these businesses, the vast majority of consumers bought their prescriptions in person at local retailers. Now, they went online in increasing numbers and got their medications shipped to them. Pharmacies like ours were anachronistic and increasingly going the way of the dodo.

We reassured our workforce that the 250 caregivers who worked at these locations wouldn’t lose their jobs—we’d find options for them elsewhere in our organization or at other companies.¹¹ Nevertheless, many caregivers and others in our communities found the closures upsetting. Some accused us of being greedy and focusing on profits over a public mission. They feared we’d be making life more difficult for patients, many of whom have trouble obtaining medications and complying with their treatment regimens.

These were legitimate concerns, and we took them seriously. To ensure that patients experienced a smooth transition, we arranged for the seamless transfer of their prescriptions to local CVS pharmacy locations. Many other high-quality, community pharmacies also stepped up to make filling prescriptions convenient for patients. As we pointed out, closing our pharmacies didn’t represent a departure from our mission—it was actually a way of supporting it. We were losing about $11 million each year running these businesses. Wasn’t it better to take that $11 million and channel it back into cutting costs for patients or improving our ability to keep people well?

No leader likes discontent in the ranks. But on this occasion, I felt encouraged and even grateful that so many caregivers spoke up to voice their concerns. As I’ve learned, it’s important not just for leaders to take stands on behalf of what is right but for frontline people to do so as well. Employees with a license to dissent tend to be more engaged and committed to drive progress. They also tend to generate ideas and perspectives that leaders need to hear, even if they don’t agree, allowing organizations to pursue their missions more forcefully and comprehensively.

We can’t fully unleash our workforces’ potential unless we nurture a loyal opposition willing to dissent on behalf of mission and values. But how exactly might we do that? For starters, we can applaud people who have the guts to speak up instead of punishing them. That includes when these individuals go beyond words and take action on their own initiative to serve the mission.

During the late 1990s, when I worked in a pediatric ICU in Syracuse, New York, an adolescent came in who was near death from an infection. His kidneys had stopped working, and if we were to save him, he needed a special treatment to help reduce fluids in his body so his kidneys could hopefully get back online. The other doctors didn’t know about this treatment, but I did. Although I knew I was violating protocol, I borrowed a piece of equipment from the adult floor, set it up in the pediatric ICU, performed the procedure, and saved the boy’s life. As I saw it, our mission was to serve patients, and our policies in this particular instance prevented me from delivering on it. I couldn’t wait around to ask permission. I did what was required, creating a positive outcome for this patient.

Rather than reward me for taking the initiative, the organization punished me. The chairman of my department called me in and tore into me for violating protocol. He threatened to fire me but eventually relented. Do you suppose employees who receive such treatment, or who see others receiving it, will be more likely in the future to play the role of loyal opposition? Of course not. Employees who can’t help but make good trouble will eventually leave on their own accord or be fired. Others will just soldier on. They’ll keep their mouths shut, silently resenting the hypocrisy of an organization that talks about mission but punishes well-intentioned employees for taking the initiative and acting on it.

Remembering what it was like to be a member of the loyal opposition, I do my best these days to applaud dissent when I encounter it. I also actively encourage it, including while onboarding new members of my team. When conversing with Tiffany Capeles, our new chief equity officer, I specifically urged her to make people uncomfortable as part of her role. As I explained, I wanted her to ask really tough questions of people, taking care, of course, to choose her words carefully so as not to cause unnecessary offense. Our organization’s baseline tendency was to be too comfortable, and we needed to fight that. As I made clear, I wanted her to be bold and direct when she had to be.

Perhaps the most important step we can take to nurture a loyal opposition is simply to listen. When individuals raise concerns, as our LGBTQ+ caregivers did when requesting that we sponsor the Pride Festival, we can take those ideas seriously and address them. If we disagree with specific proposals, we can explain our positions and rationales as best we can. We can also maintain an open mind, entertaining the possibility that our people might be right. If indeed they are, we must be willing to muster our own humility and change our minds.

When caregivers objected to our pharmacy closures, I didn’t relent. We had performed extensive research and analysis and knew what we needed to do. But I have relented in other situations, most notably as regards our junk food ban. Two members of our leadership team—chief people officer Heather Brace and chief nursing executive Sue Robel—played the role of loyal opposition here, relaying to me the dip in morale we were experiencing because of our policy. I didn’t act on their advice at first, but to their credit, they persisted, arguing passionately that I was making a mistake by keeping the ban in place. They were making good trouble. With the pandemic hitting hard and some in our community vilifying healthcare, our caregivers were feeling diminished and unheard. They needed to know that their leader cared about what they were going through and was responding to their concerns.

In 2021, we announced that we were reversing course and would bring back junk food for sale in our facilities. Did I think my initial decision to implement a ban was misguided from a medical standpoint? Not at all. But is there value in giving people the freedom to choose what to eat and drink rather than dictate their choices to them? I now think there is. Our caregivers continue to think so as well. The reversal of our policy was warmly received and appreciated. In the dark days of the pandemic, it seemed to ease the burden, if only just a little.

Advocacy is a complicated proposition for leaders. We might find ourselves questioning the status quo in the course of advocating for our organization’s mission, but because we occupy power in our organizations, we also define the status quo for our followers. To lead effectively, we must project authority and decisiveness while also allowing space for dissent. Empathizing with the loyal opposition, we must harbor strong beliefs without allowing those beliefs to become too rigid. We must stand up for what is right and also, at times, admit when we could have done better.

SAY WHAT YOU REALLY THINK

Have you ever attended an industry event and wished that once— just once—a speaker would stand up, cut through the bullshit, and speak the truth? In 2018, I decided to take that risk. The occasion was a leadership forum for the healthcare industry sponsored by U.S. News & World Report. At my session, toward the end of a question-and-answer period, the moderator posed a provocative question: What would I do differently going forward to make U.S. News & World Report more relevant? I couldn’t help but articulate what I really thought. Each year, the magazine released its much-anticipated rankings of hospitals in the United States. These rankings, I argued, weren’t relevant anymore because they inadvertently drove up costs in healthcare, encouraging our national healthcare system to become even more burdened than it needed to be.

As I explained, the rankings mattered a great deal to systems like mine. Get a high ranking, and you can boost your reputation and entice more patients to choose you for their healthcare needs, increasing your revenues. Unfortunately, the drive for good rankings led to perverse behavior. Because the ranking methodology favored systems that offered advanced technology, leaders felt compelled to invest heavily in those technologies, even if having them didn’t impact patient outcomes all that much. An entire industry was wasting billions buying bells and whistles that didn’t really benefit patients, all so leaders could put banners in front of their hospitals reporting that U.S. News & World Report said they’re number one. Meanwhile, many patients were struggling to afford the care they needed.

It’s not every day that a participant in a conference calls out the conference’s sponsor so openly, albeit also respectfully and politely. Hearing my response, the magazine’s executive editor was nonplussed. “Well, Marc,” he said, “I guess we asked, and you certainly told us.”

I presumed I would be persona non grata at the magazine, but to their credit, organizers invited me back the following year (regrettably, I couldn’t attend, but we sent another member of my team). They also took what I said seriously, modifying their ranking methodology in ways that reward systems better for improving the value and affordability of their services. In this instance at least, a small dash of “principled insubordination,” as one academic expert calls it, appears to have had a positive impact, all because U.S. News & World Report kept an open mind and acted on it.¹²

Principled insubordination can help drive progress inside organizations, too, if we deploy it deftly. We can’t inspire our people to embrace progress if they don’t understand what it really means to realize the organization’s mission and values. And they won’t develop that understanding if leaders lack the courage to step up publicly when it counts, accurately interpreting the mission and defining and affirming what’s right. Can you take public advocacy too far? Absolutely. Companies aren’t political organizations. To avoid sparking unhealthy conflict, we should stay focused on our purpose and the service we render to the community, and we should stick to the facts. Let everyone know how committed we are, while avoiding partisan politics as best we can.

As I hope you agree, it’s not enough to run a great, high-performance organization. All of us also should try to make the world a better place and help our organization attain its highest aspirations. Once we’ve determined our organization’s purpose or North Star, we should stand up for it, even if we upset a few people, and even if we suffer a bit of blowback ourselves. Leadership isn’t a popularity contest. It’s a unique opportunity to make a difference, now and for posterity. If we stand up for what’s right and embolden our people to do the same, we just might succeed.