Making a Better World - moving from the outside | [node:field-byline] | Healthcare Blogs Skip to content Skip to navigation

Making a Better World - moving from the outside

October 16, 2008
by Joe Bormel
| Reprints

"Making a Better World" - how to move from being an outsider

A friend reached out to me this week, frustrated because he wanted/deserved the CIO title, and not the Director of IS. He was already doing much of the CIO role (visionary leadership and operational management), had a decade of relevant experience and accomplishments, and had the best relationships he felt able to build. The organization didn't have anyone in a CIO role. The senior-most management team didn't want to change things.

I'm sure that scenario is very familiar to readers. Most of us have faced this kind of a challenge.

We kicked around and I'm sharing some ideas that I've found very clear and helpful. They come from Art Kleiner, whose distinguished career includes work with Peter Senge, Booz Allen (where he is Editor-In-Chief of strategy+business), and lots of great writing, including the book I'm drawing from here.

The Outside

Open conversations about any senior-most management team is off-limits for very legitimate reasons that are pretty self-evident. Our jobs, at any level of a company, are two-fold:

1) succinctly and constructively tell our superiors what we think, and,


2) do what we're told (with or without explanation of the why, at the superiors discretion).

Built into the second step is to faithfully (honestly) support our superiors, which includes not eroding the necessary power structure. The deeply emotional feelings about privilege, power and rank need to be put aside to focus on the work at hand. They do need to be understood, however, and they're critical to navigating the problem at hand.

Kleiner outlines, therefore, what not to do, i.e. dont follow your intuition, which, for all of us, is driven by those emotions: (This is excerpted from page 190 of his

linked book; go there for proper elaboration.)

what not to do: (common, sincere and wrong moves!)


Don’t try to bully the organization’s senior-most management team into improvement. For example, don’t angrily go to your bosses and say “Aren’t you ashamed of the way this organization excludes some people?” “Why haven’t you done anything about this?” … They’ll make a note to never let you into their office again.


Do not adopt a passive-aggressive campaign.


Do not put yourself down as a way to curry favor.


Do not put your hopes on a “Skunk Works” or other innovative operation buried within the organization


Don’t start a revolution. [it wont change the structure of the organization.]

what to do:

0. Introspect on why you want to change things.

1. Move deliberately to widen your group … done well, they’ll choose you.

2. Understand how the core individuals really define success and frame your project as a method or milestone for accomplishing their success.

3. Wait for the right moment before you ask for formal certification. … don’t rush that moment.

4. Learn how to hold high-quality conversations.

5. Get the whole system in the room.

6. “Amplify” positive deviance.

7. Articulate misperceptions.

8. Practice … all this takes time and skill. (page 197, middle of page)

The work that Kleiner describes demands that we bring positive emotions to work and stay positive. Absolutely essential.

I'm interested in the guidance that others might provide to managing this kind of a glass ceiling, being an outsider?



Six months have past since we dialogued.

Upon re-read, I notice that you're still right, especially about situation of a visionary CIO and a senior executive leader that is consumed by seemingly un-related issues.

At this past HIMSS (2009), I learned about visionary CIOs who have evolved to the CTO role. See my "who needs physicians" post for the analogous evolution of the CMIO organization structure and ways folks are meeting those needs.

Despite the 'more radical' perspective you shared, I've been advised that it's best to play both an inside and outside the organization strategy. The 'what not to do' and 'what to do' seem quite relevant for that inside strategy.

There are separate rules for the outside strategy - Tim Tolan has shared a framework in his posts.

Pete, would your thinking change if you knew that this was a very small organization?

I guess I am a little more radical. When faced with a situation like that I would brush up my resume' and start to get to know all the Exec Recruiters. The reality is that most organizations have a hard time promoting from within for VP positions. Let alone an organization that does not believe that IT is a senior leadership issue.
So I see two issues here. 1. An organization that has not made the mental transition of technology, and its place in the leadership of the organization. 2. My personnel growth.
Assuming they create a new CIO position, you would not get the respect that should go with the title. Your battle would just begin. That's when you have to ask yourself if the organization, that does not value you, that does not recognize the need for technology at that level, is it worth your time?
Starting fresh with new ideas and feeling valued always has a positive influence on your quality of life. Sometimes you have to say goodbye and give your organization a wake up call.

Thanks for the re-framing. Your perspective makes a lot of sense.

No not really. I think its still about professional development and cultural change. Sometimes you cant do both.