1. Bolwell, Brian J. MD, FACP

Article Content

Every now and then, I pick up a book on leadership that I read many years ago and skim through it or revisit it in its entirety. I hope to find something that I missed, or something that did not stick with me when I read it the first time. Recently, I did so with a book I read about 7 years ago entitled Seven Pillars of Servant Leadership by James Sipe and Don Frick. The fifth pillar outlined is foresight. As I was re-reading this chapter, it was clear that I had completely missed what the authors were attempting to say. The content seemed both new and relevant.

leadership; cancer c... - Click to enlarge in new windowleadership; cancer care. leadership; cancer care

The authors define foresight as having a sense for the unknowable and to be able to foresee the unforeseeable. Leaders with foresight appear to see a little further ahead than others. The authors explained "foresight is the ability to foresee the outcome of a given situation...understanding lessons from the past, realities of the present, and likely consequences of a decision for the future. It is deeply rooted in the intuitive mind."


They believe foresight is a key characteristic of servant leadership, and I couldn't agree more.


I think there are two types of foresight. The first is a sense of intuition-some may call it listening to your gut. Malcolm Gladwell's book, Blink, expertly illustrates the characteristics of this type of foresight, as well as the importance of paying heed to it. There is a mountain of leadership books that discuss the power of intuition and state that we should listen to our intuition or gut. I think this is true. Clearly objective facts are the fundamental building blocks of decision-making, but listening to one's intuition can be useful.


The different part of foresight is a bit more down to earth, but no less seemingly intangible. It involves contextual intelligence, the importance of learning from the past, and understanding the salient issues of the present to predict what is likely going to happen in the future. As I attend leadership and executive meetings, I believe this is a skill in short supply among leaders and I wish I knew why. It takes looking at goals or metrics in both the present and the future while keeping in mind the knowledge gained from the past. Not an easy feat. I didn't always have the ability to do this, but I believe this skill has influenced many of my decisions as a leader.


Anybody in an executive leadership position has metrics that are important, but the universal metric that affects all in leadership is that of financial results of your organization. While it is very difficult to predict how the economy will do in the next year, or the stock market, if you pay attention to the drivers of your organization and are aware of clinical breakthroughs, market trends, strategic recruiting, and potential business alliances, it is quite possible to forecast your future financial performance with reasonable accuracy. Yet many leaders appear unable to do this. Why? My guess is that they do not have an ability to connect lessons from the past with analysis of the present. They do not see the relevance of past history and cannot connect historical themes to current and future performance. It is not always a direct correlation and takes a bit of imagination at times. However, this inability to connect past with present clearly limits their effectiveness as a leader.


Fortunately, Sipe and Frick suggest five steps to "nurture your foresight." They are simple, and they make sense.


1. Analyze the past. This is very important, and I agree.


2. Learn everything there is to know about the issue at hand. This is quite obvious, but in reality, this is easier said than done. Such analysis is labor-intensive and takes time and energy. But it leads to better foresight. Not enough leaders take the time to really drill down to what is causing current performance-what is driving current results. This work is essential if you want to develop foresight.


3. Let the information incubate. If you put the issue on a shelf for a few days (or longer), the authors believe that you must trust that productive thought is still occurring. This also makes sense to me. I have lived it. Rapid answers to complex problems often fall short; giving yourself ample time to fully digest and incubate a problem is a better approach. Key to this is to trust the process of incubation.


4. Be open to creativity and inspiration, wherever and whenever it strikes. Inspiration comes at the strangest times, often when my mind is focused on another task. My clearest thinking often occurs during my morning workouts. It would be a shame to lose the insight gained during that time because I wasn't in my office, conveniently seated at my desk. When these ideas pop into your head, it's important to listen to them. It's important to consider them. Frame them with facts and rational thought, but do not dismiss your intuitions.


5. Share your insights with trusted colleagues. There are two reasons for this. First, you may be totally wrong. Your brilliant intuitive idea may be completely off track. Or you may have omitted a key piece of information. Or you may be unaware of appropriate context. You may think of tens or hundreds of ideas, but you only need one that works. And, the other ideas you didn't use, I guarantee will come into play at a later date. You need the freedom for inspiration and the sounding board of trusted colleagues. The bottom line, vetting the idea is key. Second, if you are committed to your foresight-to seeing what is unseeable-then it is a good idea to socialize the idea to your leadership team to allow plenty of time to determine how to operationalize the idea.



I acknowledge that, in most cases, I am not the smartest person in the room and yet somehow I have cultivated foresight. It is imperfect, and my forecasting ability is not always right, but I think it is a differentiator. It speaks to the importance of connecting historical lessons with a deep analysis of the present. It also speaks to being open and willing to listen to ideas that pop into your head out of nowhere and the ability to articulate your forecast of the future in a way that is heard, understood, and hopefully operationalized for the betterment of your organization. Foresight is important. Give these five steps a try and maybe you can improve yours.


BRIAN J. BOLWELL, MD, FACP, is Chairman of the Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner School of Medicine. Cleveland Clinic is a top 10 cancer hospital according to U.S. News & World Report.


Straight Talk: Today's Cancer Centers

Brian J. Bolwell, MD... - Click to enlarge in new windowBrian J. Bolwell, MD, FACP. Brian J. Bolwell, MD, FACP