Book Review: Contagious – Why Things Catch On

One of my new favorite things to do is to wander around the Amazon Books store in our neighborhood. To the chagrin of my wife, anytime we go for a walk, I enjoy going into the store, always heading straight for the business/management section, just to see what they have in stock that day.

The store is small and is designed in such a way to encourage its customers to get-in, spend money, and get-out. Unlike most bookstores, there are no places to sit, no quiet nooks to hang out and read, and no coffee bar. This conscious decision for such a set-up has made me even more interested to try to figure out how they determine what books to keep in inventory.

I was doing my usual walk through a couple of weeks ago and stumbled upon an orange book called, Contagious by Jonah Berger. The book said “New York Times Bestseller” on the cover, but I didn’t recall ever seeing it on the list, which I check weekly. I thought to myself that I had already read The Tipping Point by Malcolm Gladwell, which covers the same topic. Still, the psychology about why certain things “go viral,” has always interested me, and it applies to my everyday work of trying to spread a concept and story through the culture of a large organization. I added it to my audible wish list and downloaded it the next time I had a credit. I am so happy that I did.

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When I started listening to it, I found out in the book’s introduction that Jonah Berger teaches at the Wharton School at the University of Pennsylvania. He focused his research after reading The Tipping Point and wanted to learn more. After years of further study, Berger identified 6 principles to what makes something “go viral”. They are:

  1. Social Currency
  2. Triggers
  3. Emotion
  4. Public
  5. Practical Value
  6. Stories

Berger uses a variety of examples (the $100 cheesesteak and a hidden speakeasy called “Please Don’t Tell”) as well as anecdotes to explain how each principle works and how they fit together.

In addition to being an entertaining and easy read, Contagious holds valuable lessons on an extremely important subject. Knowing how ideas spread is one of the most important competencies of a leader. Setting a vision and a strategy to achieve that vision are insufficient if they are not communicated effectively to members of the organization. A vision and strategy will only ever be a thought exercise if the entire organization doesn’t know what the vision and strategy are or how to connect their work to the overall direction of the organization. Ideas, stories, and messages that are important to the future of the organization must be packaged in such a way that makes them contagious.

Some leaders assume that once a strategy is set, it will automatically cascade to the rest of the organization. But, a message going “viral” in an organization does not happen automatically. Leaders must use psychological principles, like the ones described in Contagious, to make change happen in an organization. Marketing a strategy to employees is equally as important as marketing the product to the customers. Contagious helps to uncover how to do both.

KEY TAKEAWAY: Leadership is about communicating vision and strategy so that it spreads to the entire organization. The six principles in Contagious can help leaders effectively package messages to proactively engage both organizational stakeholders and customers.


Contagious is available for purchase on Amazon for $17.00 (does not include Prime discount).

Can empathy be taught?

On May 29th, I spoke to the leaders at Adventist HealthCare at our semiannual Mission in Motion conference where patient experience was the theme of the day. As part of the plenary session I explained to our leaders why I am so passionate about the work of improving patient experience.

One of the reasons, I explained, was that last year, we touched nearly 80% of our community within 1-degree of separation. By one degree of separation, I am assuming that each employee and each patient has at least, on average, one other member of their household. For example, if we treated a mother, her experience in our care would have influence on her whole family. Imagine if we demonstrated kindness and compassion in a way that exceeded the patient’s expectations. If our team and our patients take those behaviors home, imagine the multiplier effect it could have of people leading by an example of deep kindness.the war for kindness

If you attended the Mission in Motion conference, you would promptly leave the plenary for a mandatory breakout session on selecting the right employees for the job. The session educated attendees on certain behaviors, like empathy, which lead to kindness and compassion that can’t be taught. If leaders do not follow a good process for hiring, it may hurt the whole group. This conventional wisdom is present in the literature around excellent service organizations, like the Ritz-Carlton, that deploy a rigorous hiring process to prevent “bad apples” from entering the bunch.

Enter Stanford University psychologist Jamil Zaki, who presents a compelling challenge to the notion that empathy is not a learned trait. In his recently published book, The War for Kindness: Building Empathy in a Fractured World, Zaki describes how his work and research can help people become more empathetic.

Zaki describes his childhood living in parallel worlds after his parents divorced. He described this experience as an “empathy gym,” noticing how two people could have completely different and yet totally valid views of life. He has created a similar type of course at Stanford, sending students to various exercises and experiential learning environments to build their empathy muscles. While the work is rigorous and difficult, he has shown results.

Further, Zaki shows his work in a way that builds trust in the research. At the end of the book, he takes the reader through each study mentioned, chapter by chapter, and rates the quality of the research on a 5-point scale. While some of the research is yet to be validated, it is certainly interesting, controversial at times, and quite progressive.

The initial set up of the book is quite dense, describing several research studies, as well as a general orientation to historical notions on empathy. It was worth the dense crash course to get to the stories and real world examples of building empathy. Zaki takes us through experiments in using literature to stop recidivism, truly understanding “compassion fatigue” in hospitals, and positive and negative impacts of technology on empathy.

The War for Kindness has many implications. It is a helpful roadmap for how we can be more kind, compassionate, and empathetic as a society. It has challenged my thinking on hiring in health care. While I still strongly believe that systems and processes help protect the team and enhance service, I now believe that a motivated candidate can be taught how to empathize. I also believe that we must coach motivated caregivers to have empathy in a way that does not cause burnout or eventually result in emotional numbness towards patients.

I have already bought copies of this book to give away to friends and colleagues, because it is powerful, hopeful, and challenges assumptions about how we can repair our seemingly broken world. It is surely worth the read not only if you lead people, but if you are interested in making society a better place (this should be everyone!).

KEY TAKEWAY: Can empathy be taught? Jamil Zaki in The War for Kindness argues that it can be. The implications in healthcare mean that our team members would benefit from a culture that has built in systems to train people on demonstrating empathetic concern for patients. This is a must-read book.


The War for Kindness is available for purchase on Amazon for $27.00 (does not include Prime discount).

Presenting information Exceptionally

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The cartoon above is from the New Yorker and it is one of my favorites. For those of us whose days are spent in the Microsoft Office suite of applications, we know that “death by powerpoint” can feel all too real.

We have all seen the seemingly endless bullets and presenters reading off their slides as if we are illiterate. I have experienced countless presentations, especially at conferences, that are graphically busy or unreadable (my biggest pet peeve is the “Sorry, you probably can’t read this”), presentations that drag on, or do not reach a clear conclusion. Powerpoint has been so misused that some organizations have taken deliberate steps away from it, including the US Military in 2010 and Amazon who banned it for executive presentations in 2018.

I would argue that powerpoint is actually an important presentation tool, but only if used correctly. Organizations that use it well have developed a set of rules that keep the audience’s attention and helps to form a narrative. TED Talks, the popular and informative non-profit series of presentations encourages speakers to use powerpoint as a visual aid – no bullets. Many of the talks accomplish the goal of “spreading ideas” often because of the images on their slides.

By way of a quick example, On his show Last Week Tonight, John Oliver presents on a complex topic every week, using a presentation style where the “slides” he shows add to his narrative. During this current season of the show, he presented on Robocalls. Oliver used images and graphics that can be used in a powerpoint type presentation.

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There is no reason why we cannot present information like John Oliver. Oliver, like many other compelling speakers, uses age-old techniques that work to not only present information, but, more importantly, have the audience remember and internalize the message.

Thats where Five Stars: The Communication Secrets to Get From Good to Great by Carmine Gallo is most helpful. In his book, Gallo discusses age old techniques dating back to Aristotle that detail how to deliver information in a compelling and memorable way.

51rO+WElUrL._SX327_BO1,204,203,200_Before I talk about some of the book content, it is important to note that this book is focused on presenting information in a way that customers understand. He references many different case studies, including one in healthcare, discussing excellent communicators and how they use presentation to create 5-star customer experiences. While there are tricks and tips in this book, they come at the end after he discusses the cultures of organizations whose team members consistently and reliably communicate with their customers in a service-oriented way.

My favorite anecdote on this point is one about  theonline shoe sales giant Zappos CEO Tony Hsieh (pronounced SHAY). Hsieh believes in training customer service team members to present well, but that is not done by scripting them. To demonstrate how customer friendly the staff has been trained to be, he would call the Zappos customer service line in front of reports and ask a random question like, “can I order a pizza?”. The staff would then help the customer in any way they can, which in this case was to help them order a pizza.

With a supportive culture that engages and empowers, the tactics are simpler to learn and implement to create 5-star outcomes and are contained in this book. Those tactics include using compelling visual aids, crafting a story using the three-act-play narrative structure, and including credibility (ethos), emotion (pathos), and logic (logos) to keep your audience engaged and following along. Gallo also discusses how most compelling stories are presented in about 10 minutes or less.

At its foundation, a presentation, whether to a group or one on one is a form of a social contract. The presenter will offer the listener new information and hold their attention while doing so. In exchange, the listener will take their time to listen to the presenters ideas and engage with them. Presenters often take that for granted, but should not.

KEY TAKEAWAY: Presenting information, when done well, is a powerful tool for leaders who want to shape a culture of good communicators. Good presentations use stories as well as the credibility of the speaker, emotion, and logic to make its points and engage the audience. 


Five Stars is available for purchase on Amazon for $27.99 (does not include Prime discount).

Leaving a legacy in a role with no job description: The Gatekeepers and the Chiefs of Staff to the President

The Gatekeepers by Chris Whipple is an enjoyable read all about the role of the Chief of Staff to the President of the United States and the men (so far only men have served in the role) who have held the title.

The President’s Chief of Staff is a peculiar, non-elected and non-Senate confirmed role and its definition is wholly dependent on how the President and his Chief of Staff craft it intentionally or by inertia. The amorphous nature of the role is part of what makes it so unique and extremely personality-dependent, which gives depth to both the stories and the characters in the book.

The GatekeepersThe Gatekeepers is filled with many excellent anecdotes that give the reader an insider’s view into the workings of the White House during different administrations. For example, Donald Regan, President Reagan’s second Chief of Staff was not long for the job after hanging up on the First Lady.

Each Chief of Staff defines the job a little bit differently such as using different analogies or nicknames; a CEO and COO, Chairman of the Board and CEO, spokes of a wheel, reality therapist, heat shield, or the Secretary of S**t. But, what they all had in common was a seemingly impossible job, with no clear job description, that serves at the pleasure of the most powerful person in the country.

There are descriptions of the men who performed the job exceptionally, such as H.R. Haldeman (Nixon), Vice President Dick Cheney (Ford), James A. Baker III (Reagan and Bush 41), and Leon Panetta (Clinton). They all approached the job humbly, taking advice from many past Chiefs of Staff and studying the role. They had a plan coming in and clarified their role with the President, the Cabinet, and other advisors. Finally, they were all able to play both good cop and bad cop when needed.

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There are also descriptions of the lackluster Chiefs of Staff, such as Hamilton Jordan (Carter), Donald Regan (Reagan), and John Sununu (Bush 41). These men approached the job arrogantly, had oversized egos, couldn’t manage, some became the subject of scandal and did not generally treat people in and out of the White House well or fairly.

Other than just being an enjoyable, interesting, and provoking read, The Gatekeepers has been on my mind for two other reasons: 1) The emphasis on the structure, or lack there of, of the role and 2) The beyond-partisan bond that the Chiefs of Staff share with each other.

In my current role, I am the first full time executive leader of patient experience for our health care system. I frequently think about structure and foundation of the position in order to make sure the role is successful well beyond my tenure.

The book describes how H.R. Haldeman’s “staff system” was the foundational structure for every Chief of Staff that followed his tenure. The great Chiefs of Staff who followed like Cheney, Baker, and Panetta used Haldeman’s system as a starting point and tailored the role to the current administration from there. Haldeman also correctly identified that his main job was to protect the President’s most important asset: his time.

My goal is to create a similar approach and program that serves as a solid foundation for getting the job done today and in the future. I work tirelessly to read and research, as Haldeman did, to make sure that I am setting up patient experience at the organization for success in the future. I still have more work to do, but I believe it is critical work in starting a new function, no matter what the size or the scope of the organization.

The Chiefs of Staff are a bit like a fraternity and usually get together at the beginning of a new administration. This bi-partisan group shares wisdom with the incoming Chief of Staff and shares their experience and answers any questions. Meeting past Chiefs provides an opportunity for a new person in the role is indispensable, especially because the job description is so malleable. The humble Chiefs understand this dynamic and take the advice seriously. It seems that the current Chief of Staff can always call any of the others for guidance or advice.

Not only a great read, The Gatekeepers contains many good lessons in leadership and “followership”, helping an executive leader accomplish their goals. It is a great read for anyone interested in politics, business, or organizational development.

KEY TAKEAWAY: In a role without a real job description, relationships, structure, and adaptation are essential. Further, understanding your role in relation to a CEO when you are in the senior leadership of an organization involves humility, keeping your ego in check, and establishing and following clear rules for communication, preserving everyones most important asset: their time.


The Gatekeepers is available for purchase on Amazon for $17.00 (does not include Prime discount)

If you work with people, work on culture

In my current role as a patient experience leader for a health care system, a large part of my focus is on culture. If you are already familiar with this blog, you have already seen me discuss culture a lot in the context of leadership and in book reviews. I talk so much about culture because it is what makes systems and processes work reliably and without constant auditing.

For years, I have been working to put the pieces together in terms of how to build culture. Using ideas from authors like Simon Sinek, Malcolm Gladwell, Joseph Michelli, and Adam Grant (to name a few), I have created my own definition of leadership and have advocated for articulating a vision and creating systems and processes to bring that vision to life. However putting the pieces together both from research and experience, has at times has felt like a struggle.

Culture CodeThen along comes Daniel Coyle, author of the best-selling book The Culture Code. In this book, Coyle has compiled a clear and well explained definition around the common characteristics of organizations with exceptional cultures that lead to consistently excellent outcomes. Using examples from organizations like Pixar, the San Antonio Spurs, the famous Upright Citizens Brigade improv group, and Navy SEALs, Coyle shows us what these organizations do differently that allows them to deliver results for the enterprise and its people.

The three over-arching characteristics that every group has in common are:

  1. Build Safety
  2. Share Vulnerability
  3. Establish Purpose

Under each of these simple two-word ideas are many different anecdotes, research studies, and case studies that show not only what these concepts mean, but what building them entails for leaders.

He also delves into the nuances of these concepts that may vary depending on the business. For example, in the book he compares organizations that build a culture for high service reliability (Union Square Hospitality Group – think Shake Shack) vs. creativity and innovation (Pixar).

Health care service delivery is an example of a setting where the culture must be built for high service reliability. Much of this work involves creating genuine connections with patients and their families, which helps determine how to meet their needs both including bridging the gaps in their understanding of their condition, the treatment, the workings of a hospital, and the health care system at-large.

Coyle covers the impact of empathizing with the patients in order to the increase their health outcomes and covers how to create an environment for the staff that promotes empathic behavior.

In the book, Coyle discusses a Harvard neurologist named Marci who researched the impact of listening in the medical setting. She studied non-western healers who used methods that were scientifically questionable, yet found that some practitioners had remarkable results.

To explain these outcomes, she says, “What these healers all had in common was that they were brilliant listeners. They would sit down, take a long patient history, and really get to know their patients…They were all incredibly empathic people who were really good at connecting with people and forming trusting bonds. So that’s when I realized that the interesting part wasn’t the healing but the listening and the relationship being formed. That’s what we needed to study” (Coyle p.154).

In health care, we tend to think of communication as “provider to patient”, with the patient simply answering the provider’s questions. As I take a few steps back think about it, wouldn’t someone want to feel known as a person, and not just by a diagnosis? Just listening to the patient gives the provider an opportunity to create that relationship.

Culture in the health care setting, because of the nature of the work at times being life-or-death, is especially important. Guides like The Culture Code help us build those cultures in a safe and sustainable way.

KEY TAKEAWAY: The best companies are deliberate about building their cultures. In health care, specifically, culture can deliver superior patient outcomes if there’s a focus on the caregivers and seeing the patient as a person, rather than a diagnosis.


The Culture Code is available for purchase on Amazon for $28.00 (does not include Prime discount)