Leadership is often discussed in terms of strategy, decision-making, and results. Those matter. But there’s another responsibility that doesn’t get as much attention, and it shapes everything else: Setting the tone. Whether it’s intentional or not, leaders establish the environment in which their teams operate. How they communicate, how they respond under pressure, what they tolerate, what they prioritize—all of it sends a signal. And over time, those signals become cul

When people talk about the FDA approval process, the conversation usually splits in two directions. One side argues it takes too long. The other argues it exists for a reason. Both are right. The challenge isn’t choosing between speed and safety. It’s understanding that the FDA approval process is designed to manage risk in a system where the consequences of getting it wrong are significant. That makes the balance more complicated than most headlines suggest.

The race almost ended before it started. There was a 10-car pileup before we even got going. In this series, that’s not something you expect to see. Cars were checking up. The field compressed quickly. There was nowhere to go, and everything happened at once. In moments like that, you don’t have time to think through options. You react.

There’s a psychological reason busyness is so appealing. Responding to messages, attending meetings, and resolving immediate issues creates the sense that work is getting done. These activities are visible and measurable. They create the appearance of momentum. But they often focus on short-term inputs rather than long-term outcomes. Many leaders find themselves spending entire days reacting rather than directing. The schedule fills itself with operational issues, leavi

For more than a decade, policymakers have promoted value-based care as the future of American healthcare. Pay for outcomes. Reward quality over volume.Lower costs while improving patient care. On paper, it makes sense. In theory, it aligns incentives. In practice? The results are more complicated. If we’re serious about healthcare reform, we need to ask a straightforward question: Is value-based care actually delivering measurable results, or are we just relabeling the

There’s a phrase I’ve heard hundreds of times over the years: “Let me think about it.” In some cases, it’s justified. But more often, it’s a stalling tactic. A way to avoid risk. A cover for not wanting to be wrong. And in leadership, indecision is a decision. It just tends to be the most expensive one.

Every new year starts with noise. Resolutions. Predictions. Overwhelm disguised as motivation. But if there’s one thing I’ve learned in leadership, whether in the boardroom, on the track, or at the Foundation, it’s that starting strong doesn’t mean doing everything. It means doing the right things, on purpose.

Transparency sounds like a good thing. And in many cases, it is. But in healthcare policy, I’ve seen a troubling pattern: Transparency gets weaponized. Not to inform decisions. Not to improve outcomes. But to delay progress, justify inaction, or create political cover.

There’s a myth in leadership that experience automatically makes you better. But I’ve learned, on the racetrack, in health policy, and in research funding, that experience without adaptability is just a heavier anchor. The world changes. Fast. And if you’re clinging to “what used to work,” you’re not leading. You’re coasting.

For decades, we’ve known Medicare’s financial challenges were coming. The math hasn’t changed. The program continues to spend more than it brings in, and the demographic reality is unavoidable: more retirees, fewer workers, and escalating healthcare costs.

There’s a common trap leaders fall into: They assume because they’ve seen something before, they know exactly how to handle it now. I’ve seen this play out in racing. I’ve seen it in healthcare policy meetings. I’ve seen it in boardrooms. And I’ve learned that past experience can mislead you if you treat it like gospel.

If you want to slow progress down, wrap it in red tape. That’s the reality for far too much medical research in this country. Scientists with bold ideas spend more time formatting grant proposals than actually running experiments. And when the funding does come through, it’s often a year too late, tied up in approval cycles, institutional requirements, and layers of administrative overhead. The worst part? Some of the most promising ideas never even get submitted. They’re too

Everyone seems to be chasing work-life balance. It’s become one of those phrases people throw around in performance reviews, wellness programs, and leadership retreats. The idea sounds great: work hard, but not too hard. Make time for family, fitness, and fun. Keep everything “in check.” But here’s the problem:

Leadership doesn’t always come with the most years on your resume. In fact, some of the strongest leaders I’ve seen were not the most experienced person in the room. They didn’t know everything. But they knew how to carry themselves, how to make decisions, and how to guide the group without pretending to have all the answers. That’s what confidence in leadership actually looks like. It’s not loud. It’s not about titles or dominance. It’s about presence...

Across the country, the cost of living looks very different. What it takes to live in New York City isn’t the same as what it takes to live in Charlotte. But when it comes to federal tax deductions, Medicare policy, and national funding structures, we often treat every place and every taxpayer as if they’re operating in the same economy...

We don’t like to think in limits. But whether it’s your personal budget, your long-term goals, or a global energy transition, finiteness controls everything. It’s the reality we don’t want to face: our resources, time, and attention are all finite. And when we forget that, we make poor decisions, both individually and collectively...