The Paradox Leader
Fluency in the Impossible Choices of Healthcare and Biotechnology
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The Paradox Leader
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Seven tensions that cannot be solved — only navigated.
Merck's leaders were not venal. They were not stupid. They were first-rate scientists and experienced executives, and for five years they treated a paradox as though it were a problem. The FDA's own safety officer later put the cost, on his central estimate, in the tens of thousands of excess heart attacks.
Speed and safety. Innovation and regulation. Mission and market. By the time a question reaches the top of a hospital system or a biotechnology company, the tractable part has already been solved further down. What is left is two goods in permanent tension, and an analytical mind, trained to resolve, will collapse the tension rather than hold it.
The Paradox Leader is a working handbook for holding them. Across Moderna and Vioxx, Vertex and Theranos, Mayo Clinic, Kaiser Permanente and Genentech, it sets out the five-stage Steering Cycle, the Fluency Ladder, the Paradox Signature, and the structures that let an organisation carry what no individual can. Every chapter closes with a Practice Kit a working leader can run this week.
Paradox fluency is not a temperament. It is a capability, and it can be built.
“Deeply thought-provoking and yet highly practical.” Sir Ian Cheshire, from the Foreword
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