In this insightful book, an emergency medicine physician and a horseman, Larry McEvoy, explains what healthcare organizational leadership would look like if leaders adopted the principles of how pathogens cause epidemics. Good infectious diseases epidemiologists and public health professionals have said this about leadership many times over– that we can’t leave anyone behind or else it won’t work. This book discusses how we might create that inclusive and participatory leadership environment where everyone feels that they matter and contributes to the positive epidemic.

I can be called a leadership book junkie – I just love reading them and tinkering with different ideas. The author accurately describes the problems ailing our healthcare systems – by describing his own observations from work as an ED physician and a leader of the division, and later on as a health system CEO. He calls out certain problems boldly, e.g., Chronic Professional Dysphoria – a name he gives to the all too pervasive disengagement and burnout among healthcare professionals. Pathogens perform, learn and adapt and have vitality, qualities that a leader needs in order to survive. He uses phenomena from biology and human physiology to explain how humans communicate with each other in response to a situation, how they self-organize themselves and what makes them respond to each other, and particularly to leaders. Although he doesn’t talk explicitly about direction and purpose of leadership, he talks about how a leader’s work results in followers to self-organize around certain ideas and values, and if those ideas and values are not aligned with what’s important to patients and the clinical team proximate to the patient who ultimately leaders in healthcare are accountable to, then there is leadership failure.

He discusses several leadership hacks, tips and tricks in his book in order to accomplish inclusivity and “infectiousness” which is necessary to scale and sustain. An example is a school in which children are taught that they are humble and obedient, and after a lot of time investment, the teachers are surprised that the children don’t perform. By adding another word to the original two words to how the children describe themselves – humble and obedient and creative, the children go on to create a garden in a stretch of empty land. He starts with creating ideas (pathogens), creating thinking, spatial and physiological conditions, and designing interactions between people, and people and ideas in a way they are contagious, and then use networks to multiply them, and effectively use technology to multiply effects. I liked that he discussed a way to balance homophily that is fundamental to human nature, with support for diversity which affords advantages for survival and thriving as a human species. The book has a lot of novel ideas which are worth reflecting on and adopting in one’s leadership work. Wonderful read!