okay it's an honor to be with you guys here today I'll try to cover a bunch of stuff kind of quickly and then we can get to Q&A which a lot of times I think is the most thought provoking for for everyone uh first I will say that we've uh that the dev Village has has welcomed 20 ofe peers from the prior five six years into our ranks which is slightly ahead of my business school Al Mo
Harvard but I think we have about 16 or so uh and so we're infused with the wonderful talent and training that this place place gives you um what what I deci when I came to this uh this company in 1999 uh was that for this next phase of my life I wanted to really test the notion that companies can be a formidable Force for a good in the world while not sacrificing or ignoring their
uh capitalistic responsibilities or fiduciary responsibilities to their shareholders so that was the that was the the basic premise I think you guys may not face this but my generation I'm 55 I don't know how much younger Garf might be than me or or others that you come speak that our generation of Business Schools uh that implicit it was it was so pervasive of philosophy that
it was implicit as opposed to explicit was kind of the Adam what I call the Adam Smith notion of of capitalism which is that if you if you run a company or you're an executive in a company your job is to maximize profit within certain ethical boundaries that's your job and if you do that then sort of the Invisible Hand uh ends up having that work out pretty well for society and that was sort of the role definition U
and then uh I think many in your generation have the more more enlightened view uh that in fact the notion of defining business leadership is sort of amoral where it's about not breaking the law and behaving ethically uh but not with a broader moral conscience is is in fact philosophically uh wrong and unsustainable uh and then instead of looking at decisions like where you should place a factory or what
you should pay your the people that work for you uh or what that environment should feel like to folks instead of looking at that as sort of an aoral business decision uh that in fact those are highly moral decisions uh and that companies have this incredible infrastructure administratively and culturally in terms of communication and understanding of each other uh that
corporations can mobilize and do more good in the community while trying to hit their ears per share targets uh in in a month than most not for-profits can do in two years and to somehow have society that benefit from some sort of conscious intellectual and energetic mobilization of that is is a crime so so with that notion uh we launched our little uh our little Devita Adventure we
do call ourselves a village we say we're Community First and a company second a community that just happens to be organized in the form of a company this does not mean we don't care about profit um in fact our our stocks moved from about a buck 50 to 74 doll over the last 11 years so we're in the top 1% of S&P 500 companies over that period so we uh we have a lot of regard for our fiduciary responsibilities uh but that's
that's that's that's the means not the end is the basic notion so just as if you're the mayor of of Denver where we are headquartered you care about jobs right but you don't care about jobs in of themselves you care about jobs because that leads to a healthy economy which leads to good schools and good parks and good roads and the ability to stay competitive in an intense World U
so jobs are the the means not the end similarly what we say is that profits are fine if you look at them like tax to the government right it's okay to pay taxes to the government if the government is providing competent Services transparency fairness things like that then taxes are okay people get that Society has to work similarly profits to shareholders are okay as long as they're associated with fairness
transparency a fair deal things like that so I'm GNA pull away from all that for a moment and and and throw out 10 10 thoughts on on leadership um that we have taken to heart over the years as we try to infuse every aspect of what we do in the Dita village with this notion that we can be a force for good first of all in the lives of our teammates or citizens now we'll hit 40,000 I I think Tuesday of
next week we'll hit our 40,000 uh teammate or citizen uh we forced for good in their lives uh first and then second in our communities in the broader World um and so these are 10 thoughts that we've taken away and then we can kick whatever around you'd like to uh some of these again I I sensitive to in this setting because you're such a a thoughtful group and such a thoughtful
institution that that some of them are probably far more thought-provoking when I'm talking to a room filled with 55y old CEOs uh than they might be for you but but we'll play that out uh thought number one is is a phrase perhaps some of you have heard it this is not a dress rehearsal this is your life I got a lot of my friends who are just my my daughter's here I didn't didn't know this I know that I know that but so now
I have to tell the truth the um uh this is not a dress rehearsal this is your life uh and I got a lot of friends who are 55 successful uh wealthy and not very fulfilled and they're in a really tough spot as to figure out how to spend the balance of their life I got a lot of folks like that and what it tends to be is that they kind of lost track uh of of what their life was and whose life it
was and what their real what their real goals were which which leads me to thought number two and it's from a very very famous esteemed philosopher called John Cougar melon camp and he said the most important thing in life is to figure out the most important things in your life now say this to a group of Executives you a lot of people saying you know what a dumb self-evident thing to say you know
because I know what's most important in my life so I love this when I get to do it with smaller groups I say well write it down for me would you I mean I know it's dumb and self-evident but write it write it down in enough specificities so someone could sort of evaluate it and and and first of all people have a lot harder time writing it down than they thought with any sort of reasonable
specificity Beyond just saying you family and and whatever and very CT phrases and I say okay now I just like to spend a little bit of time going over your last couple years where you spent your money where you spent your time where you spent your emotional energy what are sort of the taale effects of all those things that you've done the last couple years and I just want to
compare all those allocations and those decisions and that energy to what you said was most important and what you find is a a very a non-trivial percentage uh the 42 to 58 year olds in the room don't feel very good about that match and it's just been a long time since they forced themselves to do it with written rigor uh versus just when they're toasting someone at a wedding or or maybe stopping at a stoplight or
something and and how ridiculous is it not to bring the same sort of analytical intellectual and written rigor to reviewing what's most important in your life and how your actions and decisions map map with that uh that you don't bring that kind of rigor to it that you do to all sorts of other decisions in your life it doesn't doesn't make doesn't make much sense in in our minds
so we try to bring rigor to that the third is just as beauty is in the Eye of the Beholder leadership is in the eyes of the lead it does not matter one bit not one bit what kind of leader you think you are you are the type of leader other people experience you to be period that is the type of leader you are you can believe that people misunderstand you that's fine but you are the leader other
people experience you to be and until you get to the point where you can sit in front of a group of people and say what they think your weaknesses are what your behavioral deficiencies are what your values are where you can say out loud what they are thinking what they say to their friend when they're having a beer with them about you in the same words that they use until you get to
that point where you can talk about it with that kind of knowledge openness and personal Comfort uh then you're not ready to be a full leader the I actually I'll tell the to my daughter's story I've and I I wonder if you even remember this Chrissy the so what I've done periodically is I get a 360 every year at my request so that an outside consultant comes in and and talks to everybody who works closely
with me about my performance and my behaviors and it includes getting an explicit score on each of our core values uh W with comments and I can't change a score it goes to the board of directors and it's shared with the top 3,000 people in our in our village so if I'm not walking the talk I'm held publicly uh to account and uh and periodically I've I've taken my 360 home uh I just actually distributed my most
recent one to my kids and to my wife uh and to my mother uh about a week and a half ago but I've I've done this periodically over the last 12 years and you may not remember this chrisy when she was about 12 13 I brought it home and she read it with the capacity that she could at that age and and I she came to dinner I said you know Christy what' you think and she goes she goes well
Daddy the you tell me that if you try your hardest that's that's what really counts that's what you tell me but the people say that when they try their hardest but disappoint you a lot of times you get angry with them and you make them feel bad now how do I I know where she went with that I I I sat there you like not knowing what to say to my daughter looking at me with her beautiful eyes and I I said I said Well
Chrissy Daddy just hasn't grown up enough yet in that way and she's just puzzled you know because Shew you're certainly old enough you're supposed to you're supposed to be grown up by now and I heard understand you're CEO and why in the hell would they pick someone not growing up to be CEO and you know supposedly successful according to my my vague sense is that you at least regard
yourself as successful and and uh and so it was good but but what also it led to in that particular case is for a while not that long but for a while was actually easier to discuss her report card cuz she knew Daddy didn't get all A's uh and so it was okay to start to talk more openly about some of that stuff but anyway to know what people are thinking about you how they experience
you as a leader is one of the first tests of whether or not in fact you are a leader as opposed to just a a manager fourth miscellaneous thought is people don't care how much you know until they know how much you care this one lots of Stanford and Harvard mvas need to hear it's said when we bring in our fresh crew every year and they say what's your single most important piece of advice
this is almost in my top one or two because what what tends to happen with you you people you're so smart you're so talented Lots you have a lot of ambition uh and you get out there and you're very intent on proving very quickly so that everyone knows just how capable of adding value you are just I mean your your formidable arsenal of intellectual and management skills and all that you
want to unleash it so that people know when in fact most of the people that are working with you or for you know very quickly that you have that Arsenal and that's not what they're wondering about they're wondering if you care about them they're wondering if you respect them they're wondering if you're a true team player or a fake team player uh that's what they're Wonder that's the question
in their brain not how smart you are they already know enough about you just because you went here and then you eliminate any doubts about you having been an admission mistake in the first two months of the job that's not the question but so often that's what folks like you are trying to prove in that first in that first spit of time thought number five uh management is a business skill
if you want to learn more about management go to business school study management study business leadership is a human skill you want to learn more about leadership learn more about human beings starting with yourself a lot of people write books about leadership and they say here's the here's the techniques here's the practices here's what leaders do and much more about leadership is about who you are not what you
do who you are what you're intentions are Etc can mean that widely varied sets of practices techniques Etc can be deemed totally acceptable motivational useful helpful inspirational to folks who work with you uh it's much more about about who you are as a human uh of course it doesn't suspend the need for certain native skills uh number six of 10 leadership is not a
function of position leadership is a function of behavior so do not fall into the Trap of well I can't really be a leader until they promote me to vice president I can't really be a leader until I become partner once I'm coo I'm G to do once I run sales then I can lead right now I'm living in a world that's fettered by all the imperfections of the people I work for and the people they work for and
yeah those are real constraints that affect what you can do but they don't affect whether or not you lead what do leaders do I I say this and at first it sounds again so dumb and self-evident leaders lead that mean it's not situational you don't wait for the right time you don't wait for the right title leading is a way of life it's not a it's not a temporary tactic it's not a tool it's not a
practice uh so leadership is a function of how you behave there are constraints on the impact you can have no one is suggesting you commit career suicide uh but leaders don't wait for the right time that's not that's not a leadership ability it's a it's a political preference uh leaders lead and it's not based on position uh miscellaneous thought number seven you may have picked up on this but not
reflected on it directly have you ever noticed that no one washes a rental car they very very rare because they don't own it and what so many leaders don't know is whether you have 10 people working for you or with you or 40,000 how well do you know to what extent they co-own the car to what extent is it just a job where they get put in a reasonable day's work for a reasonable days pay more or less in both
case or is it something more than that is there some element of implied social contract or explicit social contract do they in fact care about the health of the organization both in terms of how people behave and the business success or not is it a much more transactional utilitarian mutually morally Barren emotionally sterile relationship so how well do you know if the people actually
do co-own the car that you're that you're driving a lot of people have have no real clue and without calling the question without asking the question without letting the people speak about their degree of ownership or lack there of you are never going to get to the point where you have it just like with your own behavioral deficiencies if you don't get to the point where your people
are talking about whether or not the organization lives its core values where the people talk about their sense of philosophical emotional spiritual team ownership or not where they are talking out loud with honesty positively or negatively then you are not in the path to creating organization that adds distinctive sustainable value added to people's life outside of the paycheck outside of the paycheck we believe so
much that if we help people grow if we help people feel more fulfilled at work they will be better mommies daddies siblings kids citizens of their Community citizens of the world but if we drain them of energy with how we work with them if that relationship is excessively utilitarian then their ability to give to the world and give to their family is dramatically reduced by what we've
done miscellaneous thought number nine then it goes 9 to 12 that's a the uh a community produces most what it honors most and this one's very important at the Vita we reward business accomplishment big we give big Equity Awards we give big bonuses so we we love those people who put a lot of capitalistic points on the on the board and we reward them but we don't honor that behavior we honor human behavior so
we do things like with core value awards at at the throughout the organization but I'll just give an example at the senior level every January I'll send out a message to the top 140 leaders and say okay it's time for the annual core value nominating process so we take it very serious this year we got about 87 nominations and that's vice presidents above nominating other people we often
share the nominations so if if Tammy writes one for Fred might Sen out to everybody so everyone sees that Fred got nominated for the core value of Integrity or the core value of team with examples so Fred's honored even if he didn't win Tammy's honored because a thoughtful nomination is seen by the rest of the people say whoa Tammy took the time to write that and a very thoughtful way very substantive way we
do that for about eight weeks we'll be halfway through a dinner and I'll suddenly I'll stop the business discussion hand out a sheet that has 140 names and our seven core values and say okay the rest of the dinner's all about nominating you can nominate some at the dinner you can nominate someone not at the dinner but let's talk about it it's always amazes me if you talk to a CEO
and you go okay uh revenue is revenue important and the C looks at me like I'm brain dead and says yeah revenue is important KT I okay and you have meetings and reports and they go yeah these are really stupid questions of course we have meetings and reports and brainstorming sessions about how to protect revenue and grow a okay okay good I got it it's important so you have meetings and process and creativity and
brainstorming so how about expenses you got how you know same thing yeah this is all right now how about how about your core values so what's I said no what kind of meetings do you have talking about that what kind of metrics do you have what kind of initiatives do you have to improve people's individual and Collective behaviors versus the core values well we you know that's more
intangible we don't we don't kind of do that that's little UNC comfortable talking about we say my guys that that'd be as dumb as saying I don't that'd be as dumb as saying I don't have to tell my wife and kids I love them because it's assumed that's actually not a good idea not a good idea certain things need to be talked about especially because in day-to-day life in a business especially
if your boss is a Jerk It's hard to live the core values because the pressur budgets and aging parents and other things push those aspirational day-to-day behaviors out there's a wonderful Buddhist saying spiritual practice is what you're doing right now right so it's not about a speech it's not about every now and then a momentous decision that particular as a leader particular as an organization
leader spiritual practice is how you behave every little minute of every day and what kind of impact you're having on the other human beings and if you don't talk about it as a group we have a thing where every single executive who gets an annual professional development review from me the second section evaluates them on each of our cor values in writing in writing and so and so you
have those moments where I say hey John you other people experience you is very average in Integrity uh or This Is How They experience you from a team point of view or accountability or continuous Improvement these are our core values in writing because how can you possibly simultaneously hold the notion that yeah we take our core values seriously but we never talk about them and we never
comment on how individuals behaviors conform to that in a world where there's all sorts of pressures that can force you into a real ordinary average regression to the mean kind of behavior which in fact is what a lot of big companies are and we always say to people our cor values we're the only Fortune fored company where the people chose the name of the company the people chose the logo the people chose the Cor
values all by election let me go on to number 10 the uh and that is that intentionality rules intentionality rules that people can smell your intentionality and whether or not that your relationship with them is basically a means for advancing your career uh or your relationship with them is to some extent an end in itself uh that this is not about Charisma this is not about being articulate that in the
end a very high percentage of human beings can smell your human intentionality and that will dict whether or not they deem you a leader they're willing to follow uh or not whether that's someone who cares about their growth or not and it's one of the things about leaders is it's a Leader's job not to create followers it's a Leader's job to create other leaders when you think about growing an
organization and then maybe I'll do uh do one additional one before stopping the uh a lot of you are going to go on to pretty intense careers not for-profit world for-profit world government sector NOS whatever uh but it's a Buddhist saying one cannot pour from an empty cup you you cannot give what you do not have and so unless you have a way uh combined with whatever ambition you have which
sometimes is high combined with the pressures that you'll feel because of the positions you're going to be offered and take which will be high combined with that if you don't have a reasonably intellectually coherent pragmatic disciplined sense of what you're going to do to refill your cup uh then it's going to be hard for you to do that for others whether you got to refill your
cup physically emotionally mentally spiritually and however you define that if you don't do that then your ability to help other people keep their cups full uh will be dramatically limited you cannot give what you do not have others cannot give if you don't help them replenish their cup uh and so we Define our mission is not just wanting people to do a good job in our dialysis company
but we hope to create an environment a conversation and a process and a lot of things we do in the University so that the teammates that work for us become better mommies and daddies uh better cousins better citizens uh that's that's our objective when we talk about leaders at Dita it's not about creating Business Leaders it's about creating life leaders for whom business competence is a subset
of that but not the thing so I will stop there and now turn it to questions comments no embarrassing stories from Chrissy you're not a student here you're not allowed to speak so I understood from you that leadership was more about Behavior than skill so I would like to ask you what do you consider to be your behavioral shortcomings how did you find out about them and what are you doing to improve
them yeah thanks a lot actually I'll take a question from somebody else the uh the for me it's been quite a journey these last 12 years and and forgetting I I started this I was 43 and what I the metaphor I developed in the first couple years when some of the same negative stuff was popping up in my 360 every year the metaph for was it's like being an alcoholic that that when you're 40
and you still still have some of these behavioral deficiencies and you've been a CEO for a while uh you got to recognize that it isn't just so you someone gives you the feedback and you have an epiphany and suddenly you stop acting that way just like an alcoholic for the most part then I could tell you I just decided to stop and it was easy and and I'm never tempted uh and so so
for me on the on part of the questions in a number of these items I've literally had to give myself a daily score that if I waited for the next year I mean I'd be I'd be better for two weeks after the 360 and then I'd slowly regress back to my prior Behavior pattern and then it'd be 10 months before my next we 60 and then I'd be good for a month and and go back so I I literally got to the point uh where not
only did I Empower people to sort of raise their hand when I was doing the the bad naughties but second every every night I kept the spreadsheet with the score um to try to build my muscle uh memory my ability to recognize when I was going down the bad path so some I've eliminated over the last uh seven eight years and others I haven't um the one on getting angry with people when they end
up perform actually the last two 360s were the first ones where that was a minor uh minor point and not totally gone but a fraction of what it was before but it took me eight eight years of having it repeated uh in the old days another one was uh micromanagement uh a big one that's still in there uh was just two weeks ago is I uh my ratio of positive to negative negative feedback is not right uh that
I'll give too much negative feedback as relative to the positive uh and I I uh you think about refilling cups I'm I'm excessively Relentless and I don't mean that in a in a good way uh and so the two two big ones in there today still are the relentlessness that can just be draining for people and the ratio of positive to negative feedback I'm sure hi thanks for coming when you entered Avita you found a
company where morale was very low and people were feeling frustrated and scared of the situation ation how did you get them to believe in this new culture and buying into all these changes that you wanted to execute yeah it was hard the um so that the the the company if if a single Bank could ask for a single dollar we would have had to close our doors we were then six weeks of missing payroll on at that
point 10,000 people investigated by the SEC sued by shareholders uh no coo no CFO no CIO no VP of HR they'd all either been fired because of the implosion or quit we couldn't track our financial outcomes we couldn't track our clinical outcomes people pretty pissed off and uh the now in a way what I realized is that uh is that a a crisis is an opportunity for a leader uh the it's uh the metaphor
I use is is why do they pay so much money for Super Bowl commercial time you know stunningly whatever it is $3 million for a minute the the most in the world it's really simple they do it for the self-evident reason that everybody's watching and everybody's listening for for a leader in a bad spot it's like that the bad news is you're in a bad spot the good news is everybody is
watching and listening so if you can figure out with Clarity what messages you're trying to convey what do you really believe in people are going to pick up on it a hundred times faster than they would otherwise because of that differential intensity and the fact that you're doing it when times are bad so so one was we started talking about the core values and developing our own right away and and this was more intense
than you might guess because my first meeting was in a group about half this size and said okay we spend start to spend a lot of time talking about core values and a vision for the future well 23ds of the room thought that was a really dumb idea I said first of all you know we we don't trust you you're you're new and you get that Bane stuff and the last company you ran got taken over so
you're probably just here to fix this and and flip this take a bunch of money out and leave um and uh and even if you're sincere you're kind of dumb we can't barely meet payroll let's not start talking about core values so so a third of the room was literally insulted that I would be uh demeaning them by thinking that they'd fall for such a little bit of rhetorical flourish a
third said okay that's kind of the fat of the month or the quarter and maybe a third we interested one of the guys who was most skeptical is is now one of our svps right over there the uh and so uh and so we started uh we just started talking about it recognizing one of the things I say is that is that leaders speak their dreams because if you if you don't you probably won't ever pursue them and and the
metaphor I use is if if there are eight of us together here and we're near the mountains if there's if I'm thick and I'd like to climb the mountain but I'm afraid I won't make it I'll just say I'm going to go for a hike and I get halfway up the mountain I'm cold I'm tired I'm hungry I say am I glad I didn't tell must going to the top because I'll go back down and say I had a great hike if
I told him I was going to climb the mountain hold all the other facts constant uh halfway up cold tired hungry you're 10 times more likely to go to the top only because you told people you would human behaviors are like that if you say out loud to people particular a bunch of these people here are skeptical and I said I'd really like to have a special place uh where thousands of our people across all these small dialysis
centers that don't even have their own phone extension or or email address because they're Hands-On Blue Collar caregivers that we want them to feel differently about their company feeling unusual level of emotional trust and mutual social commitment without sacrificing performance and you know this knowing that a whole bunch of people that group are going to go that's probably that's but by my
saying it out loud despite knowing that a bunch of them don't believe it I know I'm going to work harder the next day to make the decisions on the margin to make it come true and so every eight weeks I got to call with a couple thousand people and literally set out loud the following question what is the incremental evidence that we are serious and competent about our mission and
values forget getting all the other business stuff about to turnaround cuz cuz that's the question people are asking and if I hadn't known I had to ask and answer that damn question out loud every eight weeks a whole bunch of times when I would have gone home at 10 o'clock at night instead of spending an extra hour thinking about what could we do on top of everything else to try to
move the ball forward and be a community first so bunch of little examples in metaphors but we I talked about it out loud uh there were times one night it was a group again about half the size I went up to my room and cried after that I talked because I knew so many people in the audience thought I was either saying things that were naive or foolish or insincere uh but we talked about it
and then what you find is that some people cross the bridge in our Parliament and they'll come up and say KT I'm I'm there I I want to be a co-owner of that vision and then it starts to spread and that's when it gets to the point where you let other people speak uh because in the end it doesn't matter what I believe or what I think it only matters what the people think so talking about it out loud talking about
it and and forcing ourselves to come up with specific real world examples of decisions or actions that reflected a differential emphasis on our mission and values for thousands of people and in small groups and then starting to let other people speak because in the end the people decide what kind of place it's going to be and they're the only ones that can make it the way they want
it to be it's our job to facilitate the conversation and get out of the way thank you sir what was the culture and your leadership style like at vivra and how did that experience impact you and decisions you made when you moved to Dita yeah I got very lucky uh the the leader the bosses I had at Bane uh and then and then the vivra environment I was regarded as a a very good team
builder at at Bane and at vivra but it was very different because at that point although I didn't know it yet the team building was a means and better Kent career higher stock price higher net worth was the end and it wasn't anything insincere about the the team these are legitimately happy teams but it was a much more sort of philosophically spiritually superficial thing it was a team created for a business goal and
everybody liked each other nothing wrong with it uh it was that quite quite fun and we would have we were a football team we would have bought a bunch of football games but we weren't dramatically affecting each other's lives or anything broader than our business purpose we were just advancing our careers and a reasonably team oriented way and uh and for me the decision to go to Dita was a very
tortuous family decision uh very tough whether or not I should do it and so I for the first time in my life I had to give serious life thought to what I job I should take and why uh because it was a very strong line of thought that I should take six months off and go into the not for profit World which was the plan and so I had to really stare at that I want to do this for ego reasons
to prove I could be CEO and turn around a bigger company make some more money or did I want to do it because I could do more good for the world and the answer was not obvious I mean it's not one of those things where it's 100 z z 100 so we went through a hellacious month as a couple uh thinking about it and so I I entered into the job with a lot more purpose and what I realized X months in
is that the means and ends had switched without me realizing it that that at the Vita The Profit has been the means uh and the community has been the end which is the opposite of what was before and it turns out there's a a very big overlap in what you do in terms of team building activities stuff like that but the texture of it is radically different thank you thank you hi um once
you set the culture in the beta how do you prevent uh people from being drained out so that they either leave or that culture just becomes that knowledge and it is not longer practi in the your company yeah yeah I'd say uh a couple of things we I still have the slide we we took this very seriously so if you're going to roll out a product roll a new strategy you do analysis you have a plan
you have Milestones you have metrics you talk about it so both kind of the intangible elements of a strategy of increasing Innovation or driving International growth or whatever and the tangible they're all very rigorous uh we said what we want to do across hundreds of small locations with people we can never even get in the same room with because they work different shifts and all the rest uh different days is we got
we have to have a plan so we had a very rigorous plan that included a focus on language if we don't get the language right where certain words have credibility and mean certain things we're toast I mean it's it's no different than trying to create a jingle for a commercial I mean no no product brand is legitimate unless it's sustainably authentic it's similarly for a for a cultural brand within an entity
so there's nothing wrong with talking about marketing it and thinking about language as long as it's authentic and if we didn't do that and develop our sayings like one for all and all for one we were dead with thousands of people who have never gone to college barely finished high school that we're never going to get to talk to live if we didn't come up with a language and then
imw that language of credibility we'd be dead so first of all we thought about language Traditions rituals it there's no you think about any society any tribe any Village they have Traditions they have rituals they have language because it's essential to passing along the culture and the Norms but companies don't do it because they don't think of themselves as communities but there's
nothing sort of stunning about it it's it's it's self-evident when you think about communities and then people turn their brain off when they think about companies so we did the language and the rituals and the Traditions uh second we put our money where our mouth is and we do things like every single teammate across the country every single citizen in the Dita Village is invited to a two-day Academy for many of our
teammates they've never been in a plane they've never checked into a hotel with a credit card right they come two days no applied training it's about our mission our values our history and get presented to and talked to by some of the senior person in the company we we put now over 30,000 people through this it's actually getting closer to 40 so number two is we invested so that it
becomes part of the DNA and then third we have a whole bunch of those traditions and rituals are automatically set up to reinforce you think why why does societies have Fourth of July Memorial Day Labor Day Christmas rashash Shana whatever they all do that to force people to step back and think about their lives and their society and their aspirations and their kids and their family and their tribe it's a very
natural thing a bun you were a part of communities or tribes that do that Geographic or cultural or religious so we do this we do the same thing and so things like those core value wordss hundreds of those happen automatically across our village every quarter which is just like having a Fourth of July parade only it's in a dialysis clinic where you're honoring some nurse for
being a the core value Award winner of team so we did the language and and uh we do the the reinforcing rituals and traditions in a very recurring systematic way on top of the ad hoc events uh and then we we put a lot of money in it and so our DV University classes have a highly unusual mix of stuff around self-reflection introspection life purpose and very unusual that that's our gift to
thousands and thousands of people whether they stay or go what that does mean is for those who stay the the DNA Devita is very strong so it's at this point it's locked and loaded uh you could take out a whole bunch of Executives but the the Corpus has it in their DNA thank you thanks for for your time uh my question is uh in my own experience I've struggled with managing uh performance with also the
need to make sure that the team is feeling fulfilled can you talk about how you've uh it doesn't sound like balanced but how you've kind of achieved both uh in your work with Dita yeah we feel uh strongly that there is zero conflict between performance standards and creating fulfilling environment there and so first of all you have but but we try we create that Clarity because if
you don't create that Clarity up front in particular with us we got 2 200 managers distribute out the company if if we don't give them the words and the language to have that locked and loaded it gets very difficult because when they're talking to a uh Tech patient care technician and going through the annual review and it's got the mission and values box you can't let that get in the way of the technical performance
it's it's important but it's got to be separate now we also talk about the linkage and that stronger Mission and values performance affects how the whole team does but we believe step number one is you have to have total Clarity that they are they are independent you can have a very strong performer from a technical point of view business point of view person who closes a lot of sales
who's terrible on the mission and values stuff uh and for us that's unsustainable they have to be reformed or go or you can have the opposite someone's great on Mission values fulfillment uh but weak on performance they have to go too uh because in a Community you can't afford unless you have enough productive citizens you can't afford to take care of the homeless and you can't afford to
reinvest in the schools so it's it's again we try to make decisions with that metaphor and just as a community can't doesn't want someone who's really wealthy but doesn't care and doesn't give any money to the parks and is a jerk and and uh takes advantage of other people in different ways you can't that really destroys the health of the village there uh similarly having people
who don't contribute and don't show up for work doesn't make for a sustainable so we used the metaphor we're very clear intellectually up front and then you recognize that there's always going to be some noise out there and that's appropriate because the fact is if you get someone uh who's really strong on Mission and values you you are willing to cut a little slack on the performance
side and and vice versa so so that's what we go for strong intellectual Clarity use of the village metaphor and so it's Common Sense everybody kind of goes yeah there's a little tension in the middle but they're separate thank you on a couple of occasions you alluded to Buddhist philosophies and I was wondering um to what extent does faith permeate into your professional life to the Persona that you project to the
company and um and your leadership philosophy yeah we uh we never talk about I never talk about faith at at work because we we an incredibly diverse group of folks and and so I I'm horrified that I can't go there without uh somehow uh creating noise sort of philosophical noise what we do talk about uh is the spiritual aspect of life separate from uh separate from the physical emotional and mental uh and we
we do put that aside and then that means very different things to very different people but so far no one no one wants that to be parsed through by by faith uh and we don't ever refer to anything out of this world we just say that for many of us there's a spiritual Elemental life or there could be uh and without putting any further label on it that seems to that seems to
work if I could just add um because the the subject matter that you deal with your employees must have to contemplate those issues you know if you have people on dialysis that have a you know fairly substantial mortality um do you do you um counsel does the company counsel its employees on how to manage those sort of issues or is that left up to the individual the um do we counil the
individual caregivers about how to interact with their patients exactly yeah yeah we do a pretty uh we do a pretty mediocre job of that uh maybe maybe mediocre is nice we we probably do an average job in it compared to our industry and that's lousy I I I would I would say this probably the honest answer we've just gotten good the last few years we one thing you start running things that are large and more complic
licated you get to be embarrassed at what you realize about your own organization so about four years ago after i' had already been there eight years we realized we do a terrible job of managing the death experience and and 15% of our patients die every year that's significantly lower than if you're in a a non- Devita Center uh where it's more about 18 so uh so we're really good um the butt 15% is a lot and
we while we had a good procedures around it um it we were not a we did not act like a community when it came to the dying thing both for our own teammates and for the families and so we established a Circle of Life program where we now do a bunch of things that both our teammates and our families uh are finding hugely beneficial to help them in their Journey towards death and
dealing with it right after and if you're in a clinic it can be tough you're 15% I means you're going to have a number of people dying every single year and of course for the family it's less often but more even more traumatic so that's the one area where we're now good uh proud but in the rest of it you know actually Lindsay you got Pat can you put that down because I this is one
of these things where it's dumb as it's going to sound I haven't really we haven't really faced up to that reality that outside of that we're still crappy so thank you hi so one of the things that a lot of us talk about really enjoying as part of our GSB experience is that it has increased our propensity to kind of look to others to achieve things that we're were interested in in achieving um to
that end I'm really curious to know about who some of the most impactful thought partners and mentors were for you as you kind of went through your business career yeah well first two for pre-b business I had two High School teachers Robert orth and John Marita both Math teachers who were just stunningly humble hardworking virtuous citizens and I was involved in student council in that and
they were incredibly giving and how they mentored me and I realize now how they built within me uh a reservoir of sort of citizenship orientation and aspirational stuff that then almost got killed by subsequent stages of my career uh but fortunately it was substantial enough that I could tap back into the aquafer uh much later the uh and then for me I two leaders at Bane Tom Tierney
and John donaho uh Dono is speak here with some regular the CEO of eBay uh that I worked for Tyne and donaho worked for me uh and then I got out of his way so he could take over the firm rather than push me aside the uh uh they were both uh very good very very much better than me at being well behaved every day I was much more erratic I'd build a great team and then I'd brutalize people
the next month and you know I was going like this and they were much more steady state and I really marveled at that and got to learn a lot and then I had one client uh in my ban days a guy named Dick Fontaine who I who I just latched on to and he's been sort of a a shaman for me ever ever since was just an elderly gentleman very wise who ask me very important questions and wouldn't let me get away with superficial answers
and still does that to this day so those those five people if I go outside the people like my wife uh are the ones that gave me uh gifts that I'll always be grateful for because I without those five again going outside the family uh there's I would have done a lot more damage than I have hi thank you uh you spent a number of years in Consulting and then have had a long career in industry and so I'm
wondering as you look back on some of the biggest lessons you've learned of the course of your career do you think that being in a Consulting role prepared you for the biggest challenges that you were then going to face or do you think it wasn't until you were sort of on the ground actually dealing with these issues that you were able to sort of figure out what the right way of dealing
with an issue either from an operational side or from a leadership perspective yeah so first of all someone says you spent a lot of years in Consulting and then you've had a long career in Industry that that're they're basically saying you're really old they they along this long that but separate from this length thing the uh uh I I think uh for a lot of the stuff that I'm talking about uh Consulting is
not good uh although some of the firms are wonderful and I love my time at Bay I've I absolutely loved it and as I told you two of my seminal mentors were from there uh but it's just not the same it's just not the same as the kind of accountability you have for human beings in a different type of organization uh both the type of people in there and their incredible career
Mobility that they have and and the Ambitions they have and all that and the dynamic uh is is very different they don't they don't want the gift that you can provide people who make $14 an hour and are never going to retire early uh and so so part of it's a need thing and then part of it's just the nature of the business um so having said that if you're sensitive to this so when I was
there I wanted to work on implementation cases I wanted to work for the clients I thought were the best leaders and so in that sense it was great because I got to be exposed to it's like going to Business School I got well I wasn't doing I was able to if given I wanted it I got exposed to lots of people from whom I learned a huge amount but it was it was because of my career path at that point as opposed
to something that would be available to everyone could be if they was pursued and and having said that I want to go back I for me so the question is to a lot of this kind of leadership philosophy stuff that's the answer as to whether or not my business career is better off because I did it I the answer is unambiguous yes that there's a very crudely stated there's sort two groups
of people which of course is always wrong there's people who are really smart and going to not be so good at managing getting stuff done managing organizations relating to people um and for them if they go into Consulting first they're just going to get better at their strengths you know they're going to get better at batting right-handed and they're never going to learn how to bat left-handed because
after four years it'd be a nightmare for them to shift because they were already remedial in that remedial remedial in that area and now they're triple remedial and so so what I always said is if if you think you want to run something for profit not for profit if you're really incredibly smart anal then don't go to Bay Mackenzie first go work on those weaknesses and learn how to run
stuff because you can always fall back you're still going to be smart in four years you're still going to be analytical and you can't miss that growth opportunity for working on your weaknesses because you need to have some of all of that if you want to be a good general manager CEO similarly if you're a good team Builder and and manager you're sort of task oriented stuff like project stuff that's your sweet spot and
but God you sort of Marvel at how some of people can do a case in half the time that you do and they get every important point and you only got two-thirds then I say get your butt into Consulting because then you work on work on that and so I think there's it's very much a situation person specific answer and for me I needed I needed to be more strategically aggressive than how I
thought I needed to to be more conceptual I needed to do better at coming up with paradigms that were collectively exhaustive and mutually exclusive so for me it was a gift and for me to shift into management was like okay I was I was born to raise that to to play that sport lot to learn but that just fits with my natural uh athletic orientation helpful thank you okay thank you he well thank you very much