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Sam Altman of OpenAI shares 17 things he wishes someone had told him. Hope you enjoy.


Today in health, it we're going to take a look at Sam Altman's blog, Sam Altman with open AI. What I wish someone had told me, we're going to delve into that really great list and fantastic for leaders before I get to that. A little apology for yesterday. I ascribed all this great stuff to ZAFA Chaudry.

And I'm doing these really early in the morning because I have a lot of stuff going on during the day. And it escaped me that the article I was referring to was sod. Chadri. And not ZAFA Chaudry. And so all those great things I said about ZAFA Chaudry, I think are true. I think he's a phenomenal CIO and I think he's well-written and whatnot. But all those great things I said about ZAFA yesterday are absolutely true of sod Chaudhry.

And I I apologize for making that mistake and Shout out to a sod for for a great article and great insights. Appreciate it. And hope he continues to write and we can benefit from it as a community. All right, let's get to it. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health set of channels and events dedicated to transform healthcare.

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All right, let's get to this article and. I really liked this article, Sam all by Watts's blog, actually. But what I wish someone had told me. And he has wow. 17 things. So I will try not to make this too long. But I think it is a really good list. Let's just get right to it. Number one optimism, obsession, self-belief raw horsepower and personal connection, or how things get started. It's interesting that he doesn't say how things get done.

They says how things get started. I believe this is true. For me, a lot of times things get started through conversations, discussions. Interacting with peers and then believing that something can get done. That others don't think can get done. I tell the story, actually, I rarely tell this story, but when I was starting the podcast, There was a, any number of advisers that I brought around and they told me. Hey, yeah, go ahead and start the podcast as a hobby, but you can't make money doing it. And and we started it and it quite frankly, it is how we make money today.

And it's it's a pretty significant endeavor. That was just one example. Another example is a 2 29 project and doing events. They said, Hey, there's too many events on the calendar. You don't want to do this. You don't want to go down this path. The 2 29 project. Has found a distinct niche within the world. And offering value to health system leaders. And it is often running.

So sometimes the conversations give you the ideas, people look at it and say, can't be done. And that optimism. And a belief. In making something happen, make it a reality. Number two cohesive teams, the right combination of calmness and urgency. And unreasonable commitment are how things get finished.

Long-term orientation is in short supply. Try not to worry about what people think in the short term, which will get easier over time. He says a lot in this one statement. Cohesive teams, the right combination of calmness and urgency. So it's people who understand the sense of urgency. If things aren't getting done. You are your giving up on a perishable item, which is time. And you are not making progress with the time that has been given to you and someone else will be, but it's also a matter of approaching these problems with a. An ability to think clearly. Calmly rationally. And to, look at problems from all different sides.

So it's not acting. With haste. It's acting with urgency and calmness. It's really a really interesting. And then long-term orientation is in short supply. Try not to worry about what people think in the short term. There's a certain amount of truth to that. It is really hard to do. It's really hard to not worry about what people are thinking in the short term, especially, we're in the media business over here. I know I'm talking about myself today, but we're in the media business over here and there's always somebody new, some new thing that people are are looking at.

And, we look at our ratings on a monthly basis. You. Are they going up? Are they going down and looking at trends and that kind of stuff? It's hard to keep a longterm orientation. On what our objective is. Anyway, and it's probably hard for you to do that as well, especially in the roles that you're in.

There's a lot of people who are looking at you. And relying on you, clinicians are relying on you. Patients are relying on you, the community's relying on you. It's hard to take any short-term losses. And think long-term. You have to deliver short-term on a lot of things.

And so it's hard to break out of that mindset from time to time. Number three, it's easier for a team to do hard, to do a hard thing that really matters than to do an easy thing. That doesn't really matter. Audacious ideas, motivate people. It is so interesting. When I came into St. Joe's as a CIO, we laid out some audacious goals. And what was interesting to me is a bunch of people left the organization. And a bunch of people that were stuck in the organization in various places elevated very rapidly because they were energized, they were engaged.

They were captivated by the vision. And we promoted some people very rapidly from frontline workers to to managers and even in, in one case to an executive. Because they got it, they just were, they were excited about it. They had the skills and the gifts. And they were teachable and away they went.

And and I really agree with this one, that it is better to have audacious goals and ideas and people will gravitate towards it. Number four incentives. Our superpowers set them carefully. I have found that a bonus programs and incentive programs over the years. Are. Are like playing with dynamite. I haven't played with dynamite.

I played with fireworks. And I have met people who have had fireworks accidents. I lost fingers and that kind of thing. It's it's playing with a powerful item. You have to be very careful. There are so many unintended consequences that happen when you said. Set up incentive programs. I take a lot of time around those incentive programs and you have to be very careful to not insent one behavior, whatever the incentives are, that's what people are going to do. Period.

And it's interesting how much the incentive program takes over the the salary. I have to constantly remind people. It's Hey, that's not in my incentive program. I'm like, yeah, that's what your salary is for. That's your job. Like you have to do these things. The incentive is the over and above kind of things, but you still have to do these things.

I shouldn't have to put your core job in your incentive program to get you to do your core job. That's what the, $80,000 a year as for, to do that work anyway. It's very interesting. Number five, concentrate your resources on a small number of high conviction bets. This is easy to say, but evidently hard to do.

You can delete more stuff than you think this is I, every CIO knows this. This is so critical to focus in on a few small bets that are going to have the biggest return. Even when the organization is wildly. Flailing at, a hundred different things. You as the CIO have to understand. Where to focus your resources.

And a lot of times the CIO can almost do the silent veto. I don't recommend the silent veto. I hate the silent veto. But by focusing a lot of resources on the things that are the bets that are going to deliver the most for the organization. And somewhat starving the ones that are. Silly, but be careful when you do that. You're opening yourself up. Number six, communicate clearly and concisely, always number seven, fight, bullshit and bureaucracy.

Every time you see it. And get other people to fight it as well. Do not let the org chart get in the way of people working productivity per their productively together. I used to have managers all the time who hated my management style because. Essentially I would get in the office early. Let's say five o'clock in the morning. I get my work done by about eight. And I would start walking the floor.

People would start showing up and I'd go into their office. I'd find out how things are going. What are your hobbies? What are you doing? That kind of stuff. And managers were intimidated by that. Like, why are you talking directly to them? And I would make it very clear to those managers that we do not want to have these bureaucratic lines where people don't feel like they can approach the CIO. And there were times where that was invaluable.

People came directly to me and said, Hey, there's a problem with our storage array. Are you aware of it? And I was not aware of it because the manager was trying to suppress it, hide that from me because he thought it Reflected on him. I'm actually not, I think it was a, her. But it reflected on her.

And so she was not escalating that information to me. And we had to work through that. So fight the bureaucracy at every turn. Number eight outcomes are what count don't let process a good process. Excuse bad results. There are people that are wired for process, by the way, they're wired to be operationally fantastic.

And they get an amort with the great process that they set up. Celebrate those people there they're worth their weight in gold. They're fantastic to be a part of your organization. But emphasize outcomes are what matter most. We have a a set of core values here, and one of our core values is effective.

Not busy. And it's that value right there. It's like outcomes matter. Being effective matters. Busy does not matter. I don't need to hear all the things that you did this week. I need to hear what we accomplished this week as an organization. Number nine, spend more time recruiting, take risks on high potential people with a fast rate of improvement. Look for evidence of getting stuff done.

In addition to intelligence. Yes. Value getting stuff done. Even above intelligence. Intelligence is great intelligence with getting stuff done. Is a fantastic as well. But getting stuff done is invaluable to you as a healthcare leader, period. Number 10 superstars are even more valuable than they seem, but you have to evaluate people on their net impact on the performance of the organization. And that's what I've found.

There are superstars that are net negatives to your organization and to the entire organization. And people hold on to them for a long time because they are superstars. And that's a mistake on the flip side, don't be so flipping with your superstars because they are difficult people. Superstars. The superstars that aren't difficult, people are rare. But superstars are generally difficult people.

They have thoughts, they have ideas. They have ways that they think things should be done. They need to be listened to so forth and so on. So they can be difficult people. We don't want to jettison all the difficult people because. Then you end up with a bunch of people just saying yes.

What do you want me to do? And that gets really old, really quick. Tell me what to do next. It gets really old, really quick superstars needs some in your organization. Don't let the toxic ones stay around. But the ones that are just difficult, but not toxic. Those are incredibly valuable people. Number 11 fast iteration can make up for a lot.

It usually. It's usually okay. To be wrong. If you iterate quickly. Plan should be measured in decades. Execution should be measured in weeks. So plans measured in decades. Execution measured in weeks. Wow. That's a massive statement. We could pick that apart for the next 20 minutes. Fast iteration makes up for a lot.

It usually is okay to be wrong and iterate quickly. I agree with that. Iterate to perfection. We have a thing called crappy first draft to get that crappy first draft out there and iterate to perfection iterate quickly. So we value getting stuff done, the crappy first draft, and we iterate getting to a better product.

In fact, one of our core values is better. We believe we can do better on everything that we are doing every day. So we're constantly trying to iterate to perfection plan should be measured in decades. Execution should be measured in weeks. I think that is. That's true. That's true for the most part.

Because some plans you look at in the short term and they, it looks like you've been successful, but if you look at them over the longterm, they have not been and let the numbers dictate if your plants have been successful or not. A lot of times we do not. We use a lot of anecdotal to measure our plans because we're afraid of actually using the numbers, use the numbers tell the real story. And execution should be measured in weeks.

That is a very challenging. Idea for us. To really, this is what agile is all about. You're looking at. As execution almost on days. What did we get done today? What did we get done tomorrow? And if you keep getting stuff done today over time, you're going to get a lot more stuff done, but focus on what's on your plate and get it. Get it done. Measure execution in weeks.

I like that. I'm going to think about that and maybe come back to that. Not in this episode though, because we're run, we've run out of time. I'm going to keep going though. Don't fight the business equivalent of the law of physics. I'm not sure what he's talking about there. But there are things that are immutable laws that that you have to take care of and don't fight them.

Number 13, inspiration is perishable and life goes by fast in action in particularly insidious is an, a particularly insidious type of risk. Inspiration is perishable and life goes by fast. Inaction is particularly insidious type of risk. I had to read that twice just to make sure I got it. But people get inspired, they get inspired to get inspired.

This is why we put on weight and we struggle with discipline. But I like the second half of this and I am. I'm reading these things separately. Inaction is a particularly insidious type of risk. Not getting something done today. Hey, I have a free day. Not getting something done with that time. Is an insidious type of risk because time is perishable.

I don't have the minute I just had, I don't get back. It's spent now. I spent it with you. I think that's valuable. How are you going to spend the minutes that you do have today? Both in work and in your personal life. 14 scale often has surprising emergent properties. I think that's true. I'm not going to expound on it. Number 15 compounding. Exponentials are magic. In particular, you really want to build a business that gets a compounding advantage with scale.

I will leave that one. That's I'd like that one for my business, but I'm not overly sure it's relevant for years. Get back up and keep going. Absolutely. Persistence, vigilance, whatever the word is. To take the hit, get up and keep going. Is important. You never know what's going to happen tomorrow. And just being, standing, just being around, it gives you the opportunity to see what might happen. And then the last one working with rate people is one of the best parts of life. Absolutely.

Don't tolerate idiots. Don't tolerate jerks. Especially in as much as it depends on you, if they work in your organization and you are. Allowing that to be a part of your culture and allowing that to be a part of your brand as an it organization out in the culture. That's problematic. Have the boldness have the courage to stand up to bullies jerks idiots. Especially if they're bringing that in now on the flip side. Have some empathy and compassion and try to understand why people are acting that way. If there is a, you. An underlying issue potentially.

There's something that can be worked out, worked through, worked on. That is a better approach than just jettisoning people all over the place. Which has been a failing of mine in the past. Empathy. See people for who they are now. Normally at this point I would run through all 17, but you can hit our website this week.

The articles right there. On the news page because it has been uploaded. And you can read the 17 items. I think there's a lot of value here for us. I rambled a little long today. Hopefully you'll appreciate it. I dunno. Break it down into two parts. Listen to it on Saturday.

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