Tom Sullivan | December 2, 2020
When Mark Ganz officially steps down from his role as Cambia’s chief executive at year’s end, he will be retiring from the company but not, in his words, “spiritually retiring.”
Rather, Ganz intends to focus his energy on continuing to work on his “vocation” of transforming health care into a system that is more person-focused and economically sustainable for everyone.
Health Evolution Editor-in-Chief Tom Sullivan interviewed Ganz about how he led the company for 18 years, the need for leaders to stay attentive to the seduction of power, why CEOs should not tolerate the tyranny patients experience in the health care system, his advice to the next generation of chief executives, and more.
Health Evolution: How have you led Cambia over the 18 years you’ve been CEO? What have been your guiding principles?
Ganz: The most important principle is that we’re a people business. What makes Cambia go is not machines or technology, it’s every one of our 5,000 employees. My job has been to serve them by being clear about our company values and Cause – to serve as a catalyst to transform health care, creating a more person-focused and economically sustainable health care system. If I’m doing my job well, every employee should feel a personal connection to the company and our Cause. If they don’t feel that sense of connection, I’m not doing my job, our senior leadership has not done its job, and our board of directors has not either. That is the difference between servant leadership and the cult of personality in business. A servant leader puts the needs of employees first and exists to serve the people rather than people working to serve the leader.
Health Evolution: What is your advice for other CEOs earlier in their careers?
Ganz: Another principle is to stay attentive to the seduction of power that comes with a position. The moment you lose awareness and get caught up in it, that’s when people make mistakes, and act like they’re invincible. When CEOs make big mistakes, it’s almost always because they thought they could get away with it. So, my advice is to be really attentive because the temptations come in the most subtle ways and can lead you astray.
Health Evolution: If we consider those two — servant leadership and staying attentive — what other principles have guided you?
Ganz: A third principle is that our company is about serving people not populations. I think population health perpetuates a culture of arrogance where people in health care think we’re smarter than the people we serve, and we know better what they need. We should not tolerate that thinking for one more day. We serve people and their families by understanding and providing personalized services and solutions that meet their individualized needs – not the needs of a population.
Health Evolution: Many people would agree with no longer tolerating health care’s problems. What have you done at Cambia to change those?
Ganz: I am proud that Cambia has been a leader and advocate for creating transparency of cost and quality of care. Early industry initiatives resulted in a lot of discussions and measures but no clear way to judge quality or address cost. Instead, why not talk to real people, to find out what they want and then deliver it? It gets simple very quickly. Any hotel or restaurant chain can tell you this. Health care is not so mysterious and different. It starts with the experience you want to serve and is based on data about what people want. If you do that, you’ll deliver.
Mark Ganz, Cambia
Health Evolution: People have been trying to change that for decades. What progress have you seen throughout the course of your career? And what will it take to actually make that happen?
Ganz: We’re not there yet. There are companies making a living with transparency and cost, but we’re far from where it needs to be. I think Cambia was among the first to go all out, advocating for change and investing in solutions and creating companies like HealthSparq or MedSavvy. My mom always told me: “If you want to make lasting change, gentle pressure, relentlessly applied over time, gets results.” Our Cause is to serve as a catalyst to transform health care. We don’t say we’re going to transform health care. Rather, the idea is to create the tension on the system by moving it in a direction that is more person-focused and economically sustainable for patients and families.
Health Evolution: An enormous undertaking. How have you applied that ‘gentle pressure’?
Ganz: I always try to find the center pin, like in bowling. You hit that center pin and as that one falls it brings down the nine others. That’s how you scale change. So, it’s figuring out the center pins such as transparency of cost and quality. Another center pin is palliative care. We felt if we could help change how people experience chronic illness or end-of-life by raising awareness about the difference between a cure and healing – it would drive broader transformation in the industry. Palliative care was a vehicle to get people refocused on engaging individuals’ body, mind and spirit. That changes the culture of medicine to be more empathetic and focused on the needs of people and their families rather than the needs of the institutions. Another center pin was creating a diverse board of directors with more interaction with the management team. Moving away from a stodgy approach where management comes in with a wrapped-up plan in a Power Point and basically says to the board: “I dare you to say no.” Instead, we are paying board members to bring their best thinking, we’re actually asking for help that we can take back to do our jobs better. Harvard Business Review wrote an article about our board as being one of the most effective in the country in any industry.
Health Evolution: What would you say is the most difficult challenge you overcame in your career?
Ganz: For me in my career, it’s what I call the way in which culture responds to drivers of change. Gandhi had a great aphorism about it. “First they ignore you, then they laugh at you, then they fight you, then you win.” That explains what anybody who is trying to drive real change will face. Going through that cycle is not very fun and it can feel lonely having the conviction and belief that you’re on the right path. You have to persevere, take hope in progress and stay with it because you will win.
Health Evolution: What scares you about the future of health care
Ganz: I’m worried that instead of having an agile, nimble and creative person-focused health care system, we’ll have the bureaucratic system of today or that it becomes even worse. At the beginning of the pandemic I got sick with what probably was COVID. I could not get a test; I was the subject of rationed care. It was worse for the people who got a cancer diagnosis and couldn’t get care. COVID can kill, but so can cancer or heart disease. The other thing I worry about at a philosophical level is the lack of hope I see among other leaders. There is nothing courageous about pharma leadership raising the price of a drug 1000% that’s been around since the 50’s. You can tell they don’t really have hope that the system can change by the decisions they’re making.
Health Evolution: So what would you say to instill hope in those other leaders?
Ganz: I think leaders should have hope the system can change, with the ability to articulate the way out of the woods. The belief and courage to lead that change, and the willingness to take risks to make that change happen. Show that you believe the world can be different and then actually go do it. You must have the courage to stand up and fight for what you believe. If you don’t have hope, then you should not be leading what you’re leading.
Health Evolution: And what other advice would you give to leaders of the future?
Ganz: I love giving advice to leaders of the future when I have the opportunity. The first advice is to reflect honestly on want you want to accomplish and what will make you proud. If the answer is ‘I just want to make a lot of money and have a comfortable existence with a big bank account and a yacht,’ at least that’s honest and the people around you can evaluate whether you have a place in the organization. But I hope you will reach down to a more personal level to think about the difference you want to make. The second thing is if you really want to make change, you’re buying into one of the greatest pursuits a person can have, but it won’t be easy, you will gain some allies and friends as well as some true enemies. You have to recognize its hard work, and it’s going to cost you, but it will be worth it. You also have to create an environment in the company with a little organized chaos. You cannot be so focused on running like a swiss watch that you don’t create room for learning and innovation. That takes diverse personalities that disrupt – you have to be comfortable with that as a leader. Finally, beware of people who say they’re innovators, but their “innovation” is a new way to make money from enormous health care payment streams rather than making the health care journey better for patients and families.
Health Evolution: What’s next? Your new chapter? Plans for retirement?
Ganz: I’m retiring from a long career with a great company. But I’m not spiritually retiring. I have a lot of energy and focus for my vocation of transforming the health care system to make it more person-focused and economically sustainable for individuals and families. That cause still burns brightly. I will definitely continue to work in palliative care for the rest of my life. And, will be fighting the good fight to ensure the needs of people and their families are listened to and met. It is time the industry focuses squarely on those we were meant to serve — caring for their body, mind and spirit. Now more than ever is the time for hope.