Burwell, former director of the Office of Management and Budget (2013-2014), spent the 10 years before that in the field of philanthropy—first at the Bill & Melinda Gates Foundation, then at the Walmart Foundation. She developed her concept of “the boss” soon after starting work at Gates, when she received a snapshot from a grantee.
In the picture, a little Senagalese toddler happily bathed, without a care. In that moment, it was clear to Burwell who she and the entire organization answered to. From then on, she said, “I gave a copy of the photo to each person who joined the global development team, with a note that said, ‘I’m looking forward to your work and delivering impact for the boss.’ So the idea is that you would have a picture at your desk every day that would help you focus on who it is you’re trying to serve and that you would focus on the actual impact. I hope as you all come in to work each day, you focus on who is my boss and how am I going to deliver impact this day. I believe that’s one of the fundamentals of high-performance organizations and fulfills the passion many of us have for why we’re here and why we do this kind of work. ”
Before taking the stage, Burwell had toured the CC’s surgical oncology outpatient clinic, where NCI’s Dr. Marston Linehan had introduced her to another boss—a 66-year-old outpatient who embodies the success NIH has had in precision medicine. President Obama announced the Precision Medicine Initiative in his State of the Union address on Jan. 20, and formally launched PMI on Jan. 30.
NIH director Dr. Francis Collins and Burwell share light moments during a town hall meeting.
|NCI Urologic Oncology Branch patient Donald Dean (r) discusses precision medicine with Burwell as Dr. Ram Srinivasan (l) of the branch and CC director Dr. John Gallin look on.
The secretary had also met with several institute and center directors and top NIH scientific leaders, familiarizing herself with NIH’s research portfolio and learning more about advances in the BRAIN Initiative, Ebola vaccine development and a potential universal flu vaccine.
In brief remarks before taking questions, Burwell acknowledged that transitions in leadership often can be rough. As someone who’s held 4 jobs in the last 5 years, she said she’s found two fundamental concepts that make changes go smoothly—strategy and execution.
At some places, she noted, she’s observed one of those ideas being emphasized over the other. “One thing I’ve seen across all of those organizations where I’ve worked is [that] it’s important to do both. You actually have to have quality ability in both.”
During Q&As, which were pre-submitted electronically by staff, NIH director Dr. Francis Collins moderated as the two sat on chairs on the Masur stage.
What are Burwell’s three greatest challenges as secretary? he asked.
From the moment she was sworn in as department secretary, she replied, the first great hurdle has been negotiating “the unpredictable incoming”—those unforeseen crises that arise suddenly and have to be handled right away. An example would be the 57,000 unaccompanied children who crossed U.S. borders and whose well-being almost immediately became HHS’s responsibility. Nearer to NIH’s heart, the Ebola outbreak in West Africa, too, emerged as a major public health issue shortly after Burwell took leadership of the department.
Burwell (seated, c) meets in the NIH Library with a small group of employees representing a cross-section of NIH, following her town hall in Masur.
Photos: Ernie Branson
“This is one secretary who really had to hit the ground running,” Collins said in introducing Burwell.
The secretary said big challenge number two is shortness of time. Offering insights about her leadership style, Burwell confirmed that she feels a sense of urgency, which she wants to convey to all 77,000 employees of HHS. That’s also why she emphasizes the importance of setting priorities and staying focused.
“We [in President Obama’s administration] don’t have a lot of time left to get things done,” she said, adding that she views her job in constant countdown mode. “It’s less than 2 years now and we’ve got a lot to do. I’m excited and we’re going to get it done.”
The third tough challenge is “lack of proximity to substance,” Burwell said, alluding to the often-difficult political climate. “Getting people to connect to the substance [is crucial]. I’m fine with disagreeing with someone in a debate on points of substance. That’s okay. I am not fine with not having the substantive debate [at all], and not allowing the American people to know what the substantive debate is.”
She also tackled questions on HHS’s role in global health, NIH’s prospects in the current budget climate and her own strategies for balancing an intense job and her family life.
After the town hall, Burwell held a small group session in the NIH Library with 13 employees representing a cross-section of staff—diverse jobs, career lengths and levels of seniority.
|Burwell chats with (from l) NCI director Dr. Harold Varmus, Urologic Oncology Branch chief Dr. Marston Linehan and Srinivasan.
“The secretary talked about transparency and how important it is for all of us in our jobs,” said Mike Alexander, who works at the welcome desk in the CC hospitality department and was in the session. “I’m the first person you meet when you come into the Clinical Center. What I do is already pretty transparent. She also talked about her 8 years at OMB in the Clinton administration, and how much technology and things in government have changed over the years, what with social media and the Internet. It was really short, but also really interesting.”
The final question that Collins posed during the town meeting sparked chuckles around the auditorium, “Does the President love us?”
Joining in the humor, Burwell smiled broadly before answering, “Two things I think will help you in your daily work: First, the precision medicine thing? That’s all him. It’s a presidential priority. The amount of time the President spends on this is incredible. This is personal for him. He believes so much that this is about our nation’s innovation in science. He believes this is about our economy. He believes this is about the health and welfare of our people. So precision medicine gives you a view into his thinking about the work you do every day.
“The second thing is that the President is very interested in the quality management of government,” she concluded. “His deep interest in making sure that we as the caretakers of the taxpayers’ money are doing that well and right is something he is personally invested in.”
Burwell’s town hall is archived online at http://videocast.nih.gov/summary.asp?Live=15633&bhcp=1.