Singapore Productivity


In my Asian work and travels there has been a lot of talk and interest surrounding Singapore’s declining productivity. The Singapore Training and Development Association (STADA) asked if I would provide an article for their web site slanted toward organizational change processes in productivity improvement and that is what you are reading here.  The article, along with reports from STADA members on ASTD’s certificate programs and recent international conference in Chicago, IL can be found by following this link.

Singapore’s government has stepped up, providing funding, underwriting extensive training and supports the development of organizational change agent capabilities. All of these are good, positive steps to increase productivity, but…

The approach needs to be as complex as the situation meaning that a systemic approach, rather than a collection of pointed and well-intended actions that are unlinked or not inter-connected so as to drive productivity.

Taking a step back to address the overall situation, setting a well-understood context, structuring assets for success and engaging the people will give management and the government a systemic view of the problem and also form the basics of a systemic plan to improve it.

Set Context:

In managing any change or problem executive management must accomplish an analysis of the situation to determine where they are and where or what they want to accomplish. In other words, determine a desired future state and with that as a goal, start building a bridge of activities what will reach it from your present state.

Certainly you will want to get senior management to articulate:

  • How you define productivity and what they want it to be? How will they know when the organization gets there? Metrics?
  • What are the risks of failure and at what cost to the organization and the enterprise?

Structure For Change:

Once you are clear as to where you are and where you want to go, you will need to establish a special structure to work the organization through the productivity improvement processes.

Form follows function so given your “charter” to move to your desired state look at how you will organize to resolve your productivity issues. Select change leaders, project managers/change agents.  Put the right people with the right skills in the right places, and if they do not have the skills, skill them up to enable them to do the job. Also, insure that they are supported with the right tools and technology to enhance efficiencies, make them more productive and to insure success.

Change leaders need to be designated and these are the people who have the political, economic and logistic powers to say “do it!” Without them totally committed to engage in productivity initiatives, as well as providing the people, space, budgets and support to the effort, you will be wasting your time.

Change Agents are the project managers, the ones who actually are doing the work. In the best case scenario, change leaders can step up and perform also as change agents, but generally change agents work FOR AND WITH change leaders as their “agents”, deriving their power from the change leaders. Change agents must understand how change is planned for, implemented and managed. The field of change management has many concepts, tools and techniques that are tailored to project and organization. Without change-savvy change agents, all the good intentions in the world will not change the organization.

Each key change leader should have a change agent and should have a change team or project team to develop their implementation plan and to work the productivity initiatives within their areas of responsibility. Establishing a network of change leaders and change agents throughout the organization helps to insure that resources, focus and efforts are appropriately change-oriented.

There will always be resistance to any change of what is considered “normal” or “status quo.” You must anticipate the resistance, plan for it and engage in resolving it throughout the change processes. Communications, especially upward communications are one of the essential ways to mitigate resistance.

Cultures are everywhere and serve as the environment in which change takes place.  Organizations have different cultures by level, function and geography. And the organizational culture resides within industry, local and national cultures, all of which need to be considered in light of what culture could do to disrupt your change efforts.

Your very best, and smartest, way of dealing with culture is to ensure that the changes are within the cultural values and beliefs. Change agents must be sensitive in their setting of the context of changes so as to make the connection that these changes are OK for us.

Engage all of your people:

Once structured for change, sell the desired state through a multi-faceted communications program and activities. Make the “why” connection with each and every level and functional area within the organization so as to get their attention, but to generate the motivation that “we have to do this.”

Get everyone involved, especially management. Announce the specific names of senior management responsible for success factors along with the names of those change agents/project managers who will be driving the initiatives for management. Invite engagement from the employees and announce incentives and rewards which will be bestowed upon accomplishment of milestones.

Make productivity improvement “worth it” for all.


Look at how you do your work. Have the employees lay out their particular processes…without management present. You don’t want management to be dictating what the process is or will be, so let the employees describe the real way they work. Bring in experienced facilitators or consultants to work these employee teams if your change agents are not skilled up in this area.

Once the “as-is” processes are graphically laid out, streamline them with the goal being to streamline and maximize technology, tools and expertise in all work flows, processes and procedures. Specifically, eliminate redundant activities along with administrative and management delays.

Management then reviews the recommendations.

The re-engineering process will help in identifying candidates for outsourcing.  Outsource those functions to enhance productivity and to lower costs by taking them “outside.”

Rewards and Incentives:

Make productivity improvement a worthwhile activity to everyone, especially all levels of management. “What’s In It For Me (WIIFM) is the name of the game. Make it fun. Have competitions, give spot awards, regularly recognize achievements, and spotlight stellar players and managers who are fully engaged.

Ask the employees what THEY want. You will be surprised and in most cases, if that is what they want, set it up so they can earn it.

And the rewards have to be linked to productivity improvement: People either met the criteria for reward, or did not. Only those that clearly did meet the criteria get the rewards and recognition.  No promotions, rewards or perks for those that did not.

Monitor Progress:

Throughout the organization, management must be consistent, firm and fair. If executive management is not fully engaged, the lower and middle management will hold back so it is critical that they be seen as the change leaders.

Establish by-name responsibilities for productivity improvement and tie those directly into your performance management system. It puts productivity improvement as an official part of their jobs. This is critical and will be the area of most resistance in that managers generally will shy away from “being on the blame line” by name and in writing.

Change Agents:

Call them what you will, like project managers, but skill-up your best people to do the work of the productivity initiatives WITH, not FOR their managers.

The managers are ultimately responsible for success, so hold them to it.

By giving them power house agents, project managers, you are enabling your management to succeed, rather than leave them to figure it out themselves. And, giving managers additional assets echeloned to handle the initiatives allows those managers to focus on their functional areas and keep the business running.

Management must be visibly and directly involved in making productivity THE priority.


And this is just the beginning. So, be clear as to what it is that you want your organization to achieve by articulating the desired state along with the specific metrics that describe success.  Involve everyone. Clean up the organization by structuring your productivity efforts with dedicated, skilled-up change agents and committed management. Take a hard look at how you do your work and who is delivering value. Re-engineer and/or outsource processes and functions.

And have fun doing it.

What you Want is Commitment — But What is it?

  • March 11, 2010
  • Change Management
  • Comments Off on What you Want is Commitment — But What is it?

When Daryl Conner put together his Managing Organizational Change (MOC) methodology he included discussion on commitment, since commitment to change is what is absolutely necessary to move from the status quo or present state to a desired future state.  Later, when we put together Managing at the Speed of Change we included the commitment curve and an explanation as to how to use it in consulting work.

A comment on Managing at the Speed of Change:  Is remains an outstanding primer for those wanting to know the basics of organizational change.  Many other books and articles have since been published, but Managing at the Speed of Change should be on every manager’s and every consultant’s bookshelf.

In managing change it is essential to not only describe desired state which could be a vision, an end state, a future state or simply a description as where the organization needs to go.  The more detail, the less resistance to change and the greater the ease of building commitment to get there.  That said, a description of the desired state is not enough. (See an earlier post: You Can’t Just Say ‘Fix It’ )

Since people and organizations are always in some form of status quo or present state, we have to make the case for change in order to get their commitment to leave or change the status quo and venture through a process to get to the desired state.  In the beginning of any change effort people are more committed to the present than they are to the future.  Why?  Because even if the present state is dysfunctional or uncomfortable, they are comfortable with it because they know how to operate within it.  Even though change might be desirable, there is a danger is leaving the security of what is known into some desired state that is more unknown than known.

The consultant or manager needs to sell the desired state while simultaneously de-selling the status quo: Why do we have to change?  What are the benefits?  What if we don’t change…what is the cost versus what it will cost to change?  Making the case for change is an art form which will be covered in another posting, but for now we will look at commitment to change.

The commitment process is also a sales process.  Looking at the commitment curve we start with making contact.  If that contact is successful we achieve awareness.  If we do not, we keep contacting until we do.

Contacting is best done in as many ways as possible:  email, posters, announcements, all-hands meetings, celebrations…any means to bring attention that something is going to happen is the goal.

Once you have awareness, you can begin to give more and more information to develop understanding.  To be successful in gaining commitment, that understanding needs to become positive understanding of the change and the need to make it happen.  If it is negative understanding you need to continue to provide more and more information and to engage with the people or constituencies to help them understand and see the change as a positive and necessary thing to do.

Once you have achieved positive understanding you have not gained commitment.  This is the first big mistake leaders and managers make:  taking positive understanding for commitment.  Until you ask them to do something you have not crosses the commitment threshold and have not been successful in getting them involved.

There are four levels of commitment with only three applicable to organizational change:

  • Installation
  • Adoption
  • Institutionalization
  • Internalization


This is the lowest form of commitment as you are only asking your target to try something.  Try this to see if it will work.  If it does not work, we will try something else.  I call this a fill or kill option.  Commitment is easy since you are only asking for a trial.

Take the case of new software.  You have a handful of programs and ask the IT department to see which ones will work on your system.  Nothing more, for now.  They boot them up and you now know which ones have potential.


Higher than installation, at this level you are not only asking your target to try something to see if it will work, but to live with it for a period of time to determine if it will do what we want it to do.

Continuing with the software analogy, you ask the IT department to use the programs that will work on your system to determine which ones work best for the work at-hand.  This will require more time, will disrupt their current work and the IT department will owe you an analysis on their findings.

You are asking for a higher level of commitment and need to make the case as to why you need this work done and what it might be leading to as well as contributing to the organization.


Both installation and adoption have reversibility:  you are not stuck with the results.  The work are trials, tests to see what might work, not work or be worth using in the organization.

Institutionalization is commitment into an area or enterprise that is not reversible.  Bringing  in enterprise systems such as SAP or Baan cannot be done on a trial basis.  Once you commit to it, you have to live with it and make it work.  These enterprise systems are highly impactful, influencing just about every way that work is done thereby affecting people and processes.  Try it?  No.  You can go to like organizations to see how it is working with them, but you need to develop this high commitment without return or retreat to bring it in and make it work.


This is the highest level of commitment and is not practical to ask for or demand this level within an organization.  Internalization is a commitment whereby people believe that this is the best option and that they will live with it forever.

We do ask for commitment in interpersonal relationships and in religions, but this level is not practical for organizations, although there will be people who do have internalized commitments to aspects of the status quo.  These are people deeply committed to the way things are and their entrenchment to the present state will require a very pointed and intense effort to get them to commit to change.

So as managers, leaders and consultants, look at what level of commitment you want from key players, key constituencies, people and organizational parts.  Those that are most impacted by the change will need to be more highly committed than those who are not.  Human Resources is not heavily impacted by an enterprise system coming into the organization unless a people package is included in it.  But IT and procurement are target center, having to make huge adjustments to such a system.

So given the different levels of desired and required commitment, communications, frequency of contact, details of the change and inclusion are all tailored to people and organizational entities.

Just as another example, take these stages of building commitment and think about dating and seeking a partner, buying an automobile or getting a pet.  Think about how businesses and sales people use these stages in getting you to make an institutionalized level of commitment.

And you be successful applying this model.

How to Get Smart about Change Management

  • March 8, 2010
  • Change Management
  • Comments Off on How to Get Smart about Change Management
Mitch Kotula offers training, seminars and consulting in Change Management.  I stand uniquely as one who has worked in this field since 1982 in a wide variety of organizations both internationally and domestically.
  • I offer a comprehensive two- and three-day Change Planning Seminars whereby participants bring change projects or change teams together to actively learn and plan for implementation.  Tools are provided to measure risk areas of sponsorship, resistance and culture along with supporting material so the process can be replicated within the organization.  Although excellent for education in change management, these seminars are designed to specifically plan for real changes.
  • Executive overviews from a few hours to one full day are available, tailored to your needs.  Short overviews suitable for dinner speaking occasions or conferences can be tailored from 30 minutes to over one hour of duration.
  • Consulting interventions can be arranged where my associates and I work within your organization to plan for and implement a wide array of changes to include but are not limited to mergers and acquisitions, introduction of technology, realignments, strategic planning, scenario planning, personnel adjustments and problem solving.
  • I have been conducting a Facilitating Organizational Change seminar as a contractor for the American Society for Training and Development (ASTD) that provides concepts, skills, techniques as well as a methodology to become literate in change management and to enable participants to undertake a change management engagement.  This two-day program is conducted through public sessions and can be brought inside organizations for delivery.

Those in-house programs are discounted from the public offering price and, most importantly, can be tailored to the specific needs of the hosting organization and the participants.

In 2010 I am currently set to deliver a Facilitating Organizational Change public session in Houston, TX, 14 – 15 October.  More will be scheduled in 2010 by ASTD.

You can contact ASTD through their web site:, through Courtney Kriebs at 708-838-5847, email or Amanda Miller at, 703-683-9215.  Ask for Mitch Kotulaas the facilitator, especially if you want to conduct a tailored in-house session.

Follow this link for a detailed description of this program, course outline and learning objectives and a personal taped description of this program by Mitch Kotula:

“But this is OLD stuff!”

At a recent seminar I passed out material on organizational models from the late 1970s and early 1980s.  One of the participants exclaimed, “This is so old,” as if she was being cheated.  In the ensuing discussion it became clear to me that some of the seminar attendees were there for “the latest and greatest” information, concepts, tools and technique, ready to disregard or devalue earlier works.

I could not disagree more.  Some work is timeless.  The works of  Kast & Rosenwig, Wil Schutz, Hersey & Blanchard and many others are as applicable today as they were when they came about in the early stages of the organizational development field.  Being old is not necessarily bad.

It seems like there is a desire to keep developing newer things, and that is taking place to the point that there are, for instance, loads of change management methodologies, but when you look at them you find that they are simply versions of the same themes and components:  sponsorship, resistance, culture, assessing, planning, implementing, evaluating, etc.  In many cases “new” is simply a re-hashing or re-naming of “old”.

I have been handling this by showing application and relevance to their work situations and even comparing the old material with other newer versions.

Anybody out there experiencing this reaction when working with organizations and/or skilling up people?

Discussion is welcome.

Why a book? The Art of Aggression

I have been a leader all my life:  Eagle Scout, state champion newspaper carrier, student body officer, club and social group officer, homeowner association president.  Even when attending the 1960 Boy Scout International Jamboree at Colorado Springs, CO I was elected the Senior Patrol Leader of the Hawaii contingent.

Leadership was my fate as much as felt obligation when with a group or organization that lacked leadership.  If no one stepped forward or the current leadership was ineffective, I would step into the breach.  Although usually rewarding, leadership was a lot of work and frustration, principally from dealing with people, their idiosyncrasies’’, their diverse opinions and many times divergent desires.

I knew nothing of leadership, per se, simply watching others who were successful, seeking and accepting advice from others and intuitively leading.  Overall, I have been a successful and respected leader.

Now, as a young senior, I have been conducting seminars on managing change and consultant skills, both forms of leadership.  The seminars and I have been well-received and I feel good in that I am passing on knowledge and skills to others in order to make them successful as leaders.  It is a good feeling and a corollary of “giving back,” although those that directly helped me are now few.

I decided to put it down on paper.  I began to write.

The first of two leadership books, Art of Aggression: Leadership Skills from a Year of War begins to describe my early life journey as a leader, in particular my combat experience as an infantry lieutenant platoon leader and as a captain rifle company commander.  One can’t get more “nitty gritty” than leading and caring for soldiers who, by choice or chance are facing an armed enemy.  Poor leadership would, not could, get people killed and injured.

I found that in relating my combat experience that there were many lessons I learned in the process.  These lessons not only held true during my Army career, but when I went in to corporate consulting those same leadership lessons had direct value to me in my work, but also to the managers and leaders with whom I worked.

The follow-on book to Art of Aggression will take in my corporate consulting experiences, my work with many leaders in not-for-profit, Fortune 1000, governments at state, local and federal levels and social action movements.  I found that any organization, even those in benevolent pursuits, were in a “war” of sorts, competing for funding, recognition, good people and opportunities to “do their thing.”

My hope is that through books, articles that my efforts to help others, to better enable leaders to lead their organizations and causes to success and to “pay back” will be fruitful.

Micro-Managing Ain’t Leading!

Amongst the many lessons brought forth in The Art Of Aggression are three related to managing and developing subordinates, especially subordinate leaders.  The net of these is that micro managing, and micro managers do more damage than good in organizations.

  • If you are shooting, you probably are not leading.
  • Understand the skills and depth of experience of your subordinates, and then get out of their way.
  • Listen and be appreciative for any help you are offered.  If you don’t, you will be left to figure things out on your own.

Let’s look at all three of these lessons one at a time.

If you are shooting, you probably are not leading.

In combat, leaders are, certainly, armed as like their soldiers.  Everyone carries a “basic load” of stuff.  But their role is not to be shooters, but to lead and direct.  Their real weapon is the radio, so that you can bring in support.  The leaders are there to give direction and guidance and to insure control so that the troops are doing what they should.  I rarely ever fired my weapon in combat, because it wasn’t my job, it was theirs.  And I was pretty busy and distracted dealing with the entire unit, versus my individual situation.

So this lesson is one of knowing your place and your role as a leader.  It is not your job to pull the switches or move the materiel, rather, your job is to insure that the organizations management understand where the organization is going and what it is trying to accomplish and to use your positional power to resource and support those efforts.  Micro-managing leaders regularly interfere with the effective operation of the organization, undercut subordinate leaders and managers and lose the respect of the workers.

Understand the skills and depth of experience of your subordinates, and then get out of their way.

The worse sin that any leader can commit is to micro-manage their subordinate leaders.  It does not matter if you are a general officer, a lieutenant, a senior NCO or an acting sergeant. This is the most critical part of leadership, especially in the less disciplined environments of the non-military workplace.

There is rank in civilian life: the sergeants of your organizations being the front line supervisors, the foremen and other lower management positions, and some non-management positions that are primarily focused on the “doing” tasks:  production, quality control, logistics, warehousing, and other downstream functions, usually away from the administrative headquarters.  Your sergeants are “on the line”, having risen to their positions from entry level jobs, mostly in their particular skill areas.  As such, they know the business from that level.  They know how to get things done, particularly what you want done for the organization.

If you do micromanage, your subordinate leaders will simply do as you say and you will be truly on your own.  Most likely you will drive yourself crazy being so busy doing everyone’s job for them and you, in turn, will most likely not be making the best decisions without their input.

You cannot develop leadership without allowing leaders to lead and consequently to learn from their successes along with their mistakes.  Coaching and mentoring accomplish the grooming needed to grow.  So give your subordinate leaders the opportunity to fail, so that they will learn.  Now I am not recommending that you give a rookie manager unsupervised control of a nuclear power plant, but use a variety of correctable situations as vehicles for learning and developing.

Good leaders respect these people along with what they do.  Include them when problem-solving or trying to determine the best way to manage any particular change or problem.  In my many years of consulting I have found that the answers to most of the problems vexing management are right there, on the line.

Involving them with management helps to educate them as to where the organization is going and what the organization is trying to achieve.  It also helps to develop them further in their career progression, especially as the organization needs to replace or increase the number of managers and senior officers over time.  Dipping into an experienced workforce is a good start, as they already know the organization and are known by their employees.

Listen and be appreciative for any help you are offered.  If you don’t, you will be left to figure things out on your own.

Leaders who collaborate at all levels are far more successful than those who are intimately involved at the nuts and bolts level.  Think about it:  If I am doing everything for the sergeants, why do I need the sergeants?  Or, if they are so ineffective in their work, perhaps they need to be replaced?

All work is worthy of respect, so show that respect through collaboration, personal contacts and giving over to them the control as to how they get the job done.

Tradition is important and teaching the beliefs and behaviors inherent therein falls squarely on the shoulders of senior leaders and managers.  And when it comes to junior leaders the secondary duty of all more senior leaders is to acculturate and groom them.  So be happy when you receive a little lecture that might sound like an ass-chewing.  The leader might be frustrated with you, but is, in reality, helping you to be a competent professional.

No leader wants to be 100% alone, not getting any input or advice that could help them make better decisions.  Most organizations have value sets, rites and rituals and codes of dress and conduct.  All together, these define the culture of the organization and can be identified through observed behaviors.  Ideally, the behaviors are being driven by the organization’s values.

Therefore, corporate officers, leaders and managers at all levels are entrusted as keepers of the core values which drive the culture.  As such, a part of their duties is to insure that newcomers and new leaders know how to behave consistently within the values and behaviors.  Reluctance to engage, on either side of this leader-employee relationship, will result in an inconsistent culture and a wide range of behaviors, which could be disruptive to production and damaging to the organization.

Regular management conferences and leadership forums are an important investment in reinforcing the culture and passing on the traditions and heritage of the organization.  New employee orientations perform the same function, making the newcomers proud of the organization that they have joined while teaching them appropriate behaviors.

This is an on-going aspect of good leadership in all organizations.

Be conscious of, respect and support your subordinate leaders and managers. Direct the work that needs to be done, fix responsibilities, provide guidance and get out of the way.  Allow them their work.

You won’t be around forever and the best legacy that a leader can leave is a competently run organization, the leaders of which acknowledge you with respect because you enabled them to be successful.

Using Surveys: Smart or Dumb Move?

At a recent seminar we were discussion various ways of determining readiness for change, commitment of key managers and how resistance would be manifested.  I have always been a fan of asking key individuals and constituencies, especially those that will be most impacted by changes, to get a “feel” for these critical risk areas.

In small organizations one-on-one discussions and focus groups work well and are pretty efficient.  In larger, geographically diverse organizations surveys are very helpful in gathering lots of information.

And there are sources available that have excellent “canned” surveys in a number of areas, such as employee satisfaction, and offer easy to construct and deliver tailored surveys for a reasonable price.   There are a lot of sources for surveys, so, do an internet search for “on line surveys”.  For organizational development, change management and general organizational consulting work take a look at:

Doing your own survey is certainly another option, but you will be swimming in quick sand and not know it until deep into your engagement.  There is an art form in asking a question so as to get an answer that you are looking for…and I don’t mean agree or disagree with you, but that show you what is going on in the organization.  If you do decide to go this not recommended route, you can engage a professional survey maker to craft survey questions.

That said, you will be much happier and less frazzled by using on-line services.

A popular myth is that “organizations are surveyed to death,” so doing surveys is a bad data gathering idea.  I disagree and found support for surveys in an article from Smart Manager, dated September 22, 2008, titled “Why Use Employee Surveys.”  In essence, managers might be over-frequently surveyed, but employees like to be asked their opinion, thoughts and feedback.  Also, employees tend to take surveys seriously, since they believe that their ideas have value and they appreciate the fact that they were asked.

So, in your data gathering, don’t hesitate to use surveys.  You can gather larger numbers and slice and dice the data so as to get a “representative sample” of the organization.  The bottom line is that you want as much input, from as many people from multiple functional areas and levels as you can get.  So as far as time, resources and people permit, supplement your data gathering by also using interviews, focus groups, records and reports, informal discussions, other consultants who have worked with your client, annual reports, the Internet and even competitors.

In the end, you want the clearest picture possible of the organization so that you can craft relevant and effective interventions.  Limiting yourself to just one or two methods of date gathering will hobble you in your work.  Surveys are well received, are inexpensive and bring in a lot of data in a short period of time.

Use this article to fend off the myth of “we are surveyed to death.”  If you need link, shoot me a an email

You Just Can’t Say “Fix It!”

  • March 5, 2010
  • Leadership
  • Comments Off on You Just Can’t Say “Fix It!”

But unfortunately that is just what happened when President Obama handed over the fixing of the nation’s healthcare system to Congress soon after his inauguration.

Executives need to direct and guide their organizations, political parties and operations.  Identifying problems is a good start, but without at least the outline of a general solution, problem identification is more the purview of the non-manager.

As a leader myself, as an organizational consultant working in the planning and implementation of change and as a student of leadership I have been thinking about the healthcare fiasco and further thought to share my thinking with  anyone who will listen.  Not to criticize what did or did not take place, but to illustrate an example that might be helpful to other leaders.

So what could Mr. Obama have done?

He beautifully articulated and campaigned for healthcare reform so well that he won the presidency.  But he could have done a bit more other than just turning the problem over to Congress to fix.

Executives need to clarify the desired state…just what would it look like, in general terms, when it was done?  What would be the main components of a healthcare reform effort?  What would be the essential elements that the president wanted included and what would be the no-go elements that he absolutely did not want.  In change management parlance, he could have articulated a more clear vision of the future state.

Given that, he could have then met with the Congressional leaders of both parties, or, given his super majority, maybe just with his team.  And in those meetings he would “sell” his vision, making the case for each of the essential elements.  The ensuing discussion could have generated more detail as to the vision as well as additional components of it.

In change management parlance, he would be establishing sponsorship for the initiative.

That initial sponsorship now armed with the case for change and an ability to articulate that vision would further expand the sponsorship, cascading responsibility and enlisting commitment throughout the various constituencies necessary to develop a healthcare fix and to further sell others on the need to act.

Once this infrastructure of sponsorship was established, the next step would be to get away from emotion and opinion by mandating a needs assessment or comprehensive study.  What is going well, not so well, what are the major issues, who are the major players in the healthcare arena?  Further, what are specific things that should be started, stopped or left alone?

From this needs assessment would flow numerous study groups, action teams, call-them-what-you-like teams, that would generate solutions and recommendations…all within the context set by the president.

We are witnessing what happens when Congress is given free rein to fix anything, so in the future, the president, or any executive, must lead by giving direction, a vision of a future state, gaining the commitment of key sponsors and widely engaging others, as inclusively as possible, in the generation of solutions.

Don’t just say,”Fix it!”