We all know how important leadership is in every organisation. Because it represents what the organisation stands for. But how do you define a leader? Someone who knows how to steer the organisation towards its vision? A person who is steadfastly goal-driven? For Prof. Tan Ser Kiat, Group CEO of Singapore Health Services (SingHealth), true leaders are adapters; people who are not afraid to change their course for a higher reason, even if it means sacrificing profits, their jobs, their reputation, or even their lives.
SingHealth is the largest healthcare group in Singapore. This year, it is celebrating its tenth anniversary. Tan, who brings with him nearly four decades of experience in public healthcare, was the founding CEO of the organisation. Under SingHealth are three hospitals: Singapore General Hospital (SGH), KK Women's and Children's Hospital, Changi General Hospital, as well as five National Specialty Centres and nine polyclinics.
McCoy and the Sadhu
Speaking to a group of SMU students, as part of the Wee Kim Wee Centre CEO talks, Tan told the story, The Parable of the Sadhu, of how Bowen H. McCoy, a Wall Street investment banker, had crossed paths with a sadhu, a Indian holy man, during a trekking expedition in the Himalayas. McCoy, along with the other climbers, stopped for a while to help the almost naked and barefoot man, who was suffering from hypothermia. They gave him food and clothing but because their goal was to complete the expedition, they carried on their journey, neglecting to consider if the man could survive the cold on his own. In his own account, McCoy admits that he did not know what eventually happened to the sadhu. In retrospect, McCoy feels that he could have done more to care for the man he and his party left to fate at 15,500 feet.
How many of us would have reacted as Bowen had? Tan asked. Would we have gone out of our way to help, or would we continue our climb to our peak? This story, he said, illustrates how we can sometimes be so focused on our own achievements that we become blind to basic human values. The real test happens when we are under stress or rushing through our work.
Tan felt that there are two valuable lessons to be learnt from the Sadhu story for leaders. The first lesson is that everyone plays a part. But we also need to be committed to a good outcome together, he said. The second lesson is that individual sets of values and cultures form the foundation of corporate values and ethics.
Giving an example of individual sets of values, Tan related the story of how a SGH nurse went beyond the call of duty to open her house to a leukaemia patient from China, who had come to Singapore for treatment. Ms Chong, the nurse, noticed that the 21-year-old patient would always arrive alone in the hospital, wearing the same blood-stained T-shirt. She later learnt that he had been staying all alone in a rented flat, and was too ill to wash the blood from his frequent nose bleeds off his T-shirt and bed sheets. For three months, Chong took care for the patient before he went back to Shanghai for a bone marrow transplant.
Encounters like the one between McCoy and the Sadhu are common in the medical world, Tan said. He recalled the case of a SingHealth patient who had incurred bills so hefty that he could not afford to pay. The bills included a three-month stay in the Intensive Care Unit, several major operations and drugs. Considering the circumstances of the patient, Prof Tan chose to waive significant charges, with the support of his board of directors - a decision motivated by one of the core values of his organisation: Compassion.
He recounted the 2003 SARS (severe acute respiratory syndrome) crisis, or as he put it, one of the darkest years for healthcare. Many of us were scared. We didn't know what we were dealing with, said Tan, referring to the regional pandemic which eventually took the lives of nearly 800 worldwide including 33 in Singapore. Yet, despite the danger of infection, many doctors and nurses went about their duties fearlessly.
One of the doctors from SGH, Dr Alexandre Chao, was holidaying with his wife and kids in the US at that time when he heard of the crisis, Tan shared. The vascular surgeon cut short his leave so that he could come back to help out when many of the other doctors and nurses became ill. Sadly, Chao, the only son of a famous forensic pathologist, the late Professor Chao Tzee Cheng, got infected while operating on a SARS patient and died. For Tan, Chao demonstrated leadership because he was courageous, self-sacrificing, and he did what he thought was right by his values.
Take a 'Chance' and 'Charge' towards 'Challenges'
It is important for a leader to know how and when to seize opportunities. Tan explained that most scientific breakthroughs in the world follow what he calls the cha cha cha theory. The first 'cha' is 'charge'; the second is 'challenge'; and the third stands for 'chance'.
'Charge' refers to the ability to focus on areas that are most critical, and resolving issues that might hinder success. To put this in context, he raised the example of how a team of doctors had resolved a mysterious series of deaths. According to him, there appeared a series of cases in Singapore where people would drop dead from sudden heart attacks. Doctors worked to narrow the potential causes and then zeroed in on a treatment. So when major problems arise, leaders need to look at all the factors, think out of the box, and solve the problem, he said.
In the scientific world, conventional principles or wisdom may not always work. This is why leaders need to 'Challenge' the status quo; the tried and tested. Many new theories and approaches are discovered that way, he said.
A lot of medical breakthroughs are also the result of taking 'Chances'. Tan spoke of the 'Tan EndoGlide', a device invented by Prof. Donald Tan, Medical Director of Singapore National Eye Centre (SNEC). This is a mechanism designed to glide through endothelial cells. Where in the past there would be a 30-40% chance of damaging the donated cornea in cornea transplants, this mechanism reduces that risk quite dramatically. The person behind this innovation drew inspiration from USB thumb drives - and so, the Tan EndoGlide is designed to mimic the way in which thumb drives are inserted into computer ports.
The West African river blindness epidemic of the 1970s provides another case in point. Caused by parasitic worms transmitted by black flies, nothing much could be done to alleviate the situation, except to spray insecticides. During that time, William Campbell, a scientist with US pharmaceutical giant Merck, was developing a drug to treat parasitic worms in horses. He discovered that those worms were a close cousin of the parasites transmitted by the black flies, and so he worked with the pharmaceutical company's then CEO, Dr P. Roy Vagelos, to find support for research into a human cure.
Researching and developing the drug would incur huge costs, and there was a good chance that Merck might end up losing money. Still, Vagelos did his best to rally support from his board of directors. When the drug was eventually developed, it was priced very low so that most people would be able to pay for it. However, many Africans still could not afford the drug. So Vagelos made a bold decision to give the drug away, free of charge.
Difficult but defining moments
Tan said that Vagelos chose to go with an option that most businesspeople would not have considered. In doing so, he showed others that he was a leader who believed in fulfilling the bigger objective of working to save lives. Doing well means doing it right rather than doing it for commercial reasons. He added that this underlies his philosophy in hiring healthcare professionals at SingHealth.
When looking to hire or promote a member of his staff, Tan and his management team would take the effort to study how that person has demonstrated care and compassion. This, he believes, is crucial because compassion has the power to inspire, and leadership from the heart makes all the difference when organisations confront their darkest moments. So if any of his employees were to meet a sadhu on their way to the mountain peaks, Tan would always expect them to follow their heart.