We don’t often associate the word QUIT with leadership however; ceasing to do something that is not in keeping with our personal vision, mission, or ethics is a powerful leadership attribute. On Feb. 5th, CVS/Caremark announced that it will end the sale of tobacco products in its more than 7600 locations throughout the United States—I applaud this leadership decision.

The 50 Years of Progress report from the Surgeon General highlights our efforts to reduce the use of tobacco. Despite our best efforts, 5.6 million American children alive today will die prematurely from smoking-related diseases unless current smoking rates drop. The report concludes that smoking kills nearly half a million Americans a year, with an additional 16 million suffering from smoking-related conditions. It puts the price tag of smoking in the U.S. at more than $289 billion a year in direct medical care and other economic costs.

stop smoking and stay healthy

The decision by CVS/Caremark to cease tobacco sales is in keeping with it’s vision statement to improve the quality of human life. The implementation of the Affordable Care Act has pharmacies moving into the treatment arena through retail health clinics with a goal to improve quality of care and reduce health care costs. These clinics offer an alternative to acute care that might replace ER visits, or doctor office visits where there certainly wouldn’t be a counter within the office selling tobacco products.

Troyen Brennan, CVS Chief Medical Officer and Steve Schroeder, Former RWJF President and CEO provide a detailed explanation of this health related move in their JAMA article. The sale of tobacco products was not viewed as an activity that supported the vision of, “improving the quality of human life” by the CVS/Caremark executives. This leadership decision will remove nearly $1.5 billion in revenues annually, however, it addresses the ethical paradox inherent in promoting health while contributing to tobacco-related deaths.

Have you and/or your organization done a check-up on your activities to ensure that they are in keeping with your vision and mission?

Service ~ Belief ~ Trust

It is MLK Day and each year I choose to participate in the “MLK Day of Service” in recognition of the vision of Dr. King. One of my favorite service projects is working with the various community garden projects when the weather is warmer so I spent time today packaging saved seeds for those gardeners. Dr. Martin Luther King, Jr. once said, “Life’s most persistent and urgent question is: ‘What are you doing for others?’” Each year, Americans across the country answer that question by coming together on the King Holiday to serve their neighbors and communities. The MLK Day of Service is an opportunity for people from all walks of life to work together to provide solutions to our most pressing national problems. You can find out more about the day of service at www.mlkday.gov

We are called not only to serve but also to believe. In great measure, Dr. King gave us belief, not just his beliefs, but our own; a way to explain how we felt. He gave us words that inspired us to believe that one day, regardless of skin color, race, sex, or sexual orientation, we could not only live in a just and harmonious world but that we could trust one another. The people who gathered in the summer of 1963 to hear his “I have a Dream” speech trusted one another and it was indeed that trust that powered a movement that would change our nation.MLKDOS

I challenge you as a leader to trust those around you, to believe in the power of a small group of people and their ability to create and drive change and to serve your community.


Leaders learn the need for OPTIMISM.  Cynicism and pessimism occasionally serve a purpose but optimism is key for long-term results. I recently saw a post on a parenting blog about optimistic and pessimistic children that reminded me of a story I used to tell in management training.

It is the story of the optimistic child and the pessimistic child. The Father of  two young boys created a room full of all the latest toys and sent the pessimistic son in to play. Some time later, he checked back and the boy was sitting silently in the center of the room, the treasure of toys untouched. “What are you doing my son?” he asked, to which the boy responded, “If I play with the toys I am sure to break them and then they won’t be good anymore.” The Father filled a second room with a load of horse manure and sent his optimistic son into this room. Some time later the Father checked on this one to find that he was running around laughing and cheering and tossing the dung around. “What are you doing my son?” he asked, to which the boy responded, “With all this poo, there must be a pony in here somewhere!” pony

This coined the phrase “find the pony” used to encourage all of us to look for good in every situation. President Ronald Regan popularized the “find the pony” phrase when he used it in a press conference during his time in office.

Sometimes it is hard to stay optimistic in our changing world but optimism is the best outlook on life…looking on the bright side.  Do you have a method to stay optimistic in times of change? Can you remind yourself to look for the pony?


This week “Reflections,” a photo series by Tom Hussey caught my eye. The series depicts individuals well along in years looking at a reflection of a younger self. The photos are wonderful and melancholy. While they show the passage of time as it relates to our physical self, it made me think of the advise I frequently give scholars in our leadership programs,  “take time to reflect.” Leaders often pause and evaluate what they are thinking and doing to seek personal improvement. Time spent in reflection is a gift. Are you spending time on reflection each day? Do you have a personal development plan that addresses all aspects of your life including career, personal, family, spiritual, and physical?

By turning the mirror inward we can achieve what this wonderfully done series accomplishes…it gives you pause to think, about the passage of time and the lives we are living.

To view the entire series click here. Tom Hussey photographed this award winning campaign for Novartis’ Exelon Patch, a prescription medicine for the treatment of mild to moderate Alzheimer’s dementia. The highly conceptual photographs depicted an older person looking at the reflection of their younger self in a mirror.


A couple weeks ago I was invited along with other national leaders to a meeting at the Task Force for Global Health offices in Atlanta to discuss and plan for the development of Public Health Leaders. The group discussed the current and future global public health landscape and how to best prepare leaders to operate and be successful in this environment. 

photoIt was so fitting that we were meeting in the Bill Foege Conference room since two of the lessons I remember clearly from a Dr. Foege speech was the role of leadership in making sufficient decisions based on insufficient information and the role of coordinated action. Our task that day was certainly one full of uncertainty yet we came up with many viable approaches for leadership development.  And a primary objective of the day was to bring disparate views together to create a coordinated vision.

Dr. Foege, founded the Task Force on Global Health and is known for his role in eradicating smallpox.

“In retrospect it seems clear – we didn’t know how to eradicate smallpox when we started. But this was not a negative. It was a characteristic of all unsolved problems. We are always faced with making sufficient decisions based on insufficient information. If we had waited until all the answers were available, the work on smallpox eradication would never have started – selecting the target helped develop the appropriate tools and strategy.”
“While the lessons are many, what is the greatest gift of smallpox eradication in India and the world?  It is the demonstration, once again, that the coordinated action of dedicated people can plan a rational future.  This does not have to be a world of plagues, disastrous governments, conflict, and uncontrolled health risks.  It is possible to plan a rational future and smallpox eradication is a constant reminder that we should settle for nothing less.”

Back home in Kentucky groups, coalitions, committees, and workgroups are meeting to coordinate the activities in their communities based on their Community Health Assessment. They are creating a Community Health Improvement Plan by selecting one or two important issues to work on and then doing everything possible to create the conditions for that health related issue to improve. We should settle for nothing less. These coordinated efforts are tackling obesity, lack of affordable housing, teen pregnancy, prescription drug misuse, cardiovascular diseases, access to healthy food options and many more. Are you involved with a dedicated group of individuals seeking to create a rational future in your leadership role?


 Three Rivers DHD staff at the Accreditation Celebration

Three Rivers DHD staff at the Accreditation Celebration – Happy Faces!

This week I was honored to participate in the ceremonies at Three Rivers to celebrate the achievement of national accreditation status. They are one of 11 health departments in the first cohort accredited by the Public Health Accreditation Board (PHAB). The Three Rivers District Health Department Director, Georgia Heise, DrPH gathered the entire staff, county judges, commissioners, state legislators, and community partners to thank everyone for their part in this achievement. It was a lovely luncheon and ceremony to acknowledge that the district is operating in a way that meets the PHAB domains, standards and measures.  What struck me about the day was the sense of community both within the health department and the partners. As the staff, board, legislative leaders, and community partners made their presentations, there was a common thread focusing on the people or the faces that lie behind the work.

Community health, population health; the many faces of the three counties they serve and the impact on health were a primary focus. There were many stories of how an employee or program at Three Rivers had helped a father, sister, neighbor pursue a more healthy life.  Dr. Heise said, “The PHAB process has made us a more effective and efficient health department.  The designation of “accredited” let’s those we serve know that Three Rivers is always trying to improve and provide the best possible service in the most cost effective way possible.” The focus on those we serve reminds me of the quote:IMG_7146

“In everything we do, behind everything we say, as the basis for every program decision we make -we are willing to see faces.”

William Foege, MD, MPH

More on Dr. Foege next time

note – after a year of struggling to have a web presence KAPHTC will soon be unveiled and so I begin the blog again.


I experienced a sense of Pride at KPHLI graduation this past week. May is full of graduations and at each of those is an auditorium full of friends and relatives beaming with pride over the accomplishments of the graduate. This pride is not the kind St. Augustine described, “the love of one’s own excellence” but rather the pride that comes out of being proud of the time and commitment that another dedicated to a goal.

KPHLI graduation was last week, which is always exciting and a bit melancholy. The rewards of a years worth of work on solving a real life problem is presented through each team’s change master project. These solutions truly make a difference in the lives of people in the commonwealth. But many graduating scholars are sad to no longer have the weekly or monthly connection to their team. Have you ever been part of a learning team that was so powerful that you hated to see it end?

As managers can we create environments where our staff have this experience when working on projects? Perhaps if we approached our work more like we approach tasks in the leadership institute, with team learning …perhaps everyday could be filled with that feeling of pride or stated another way pride with purpose.