Preservation. Destruction. Creation. The keys to transforming an organization—and an industry.

Cynthia LaConteIn 2006, Cynthia LaConte was happily celebrating the 10-year anniversary of DDN, a highly successful pharmaceutical logistics company she had started under the umbrella of Dohmen, her family’s 150-year-old organization, when she received a phone call she never expected.

It was the organization’s board. They wanted LaConte to leave her position as president of DDN and step into the role of CEO for Dohmen. Losses from the company’s wholesale division were threatening to overtake the whole company and the board needed a fresh perspective on how to fix it. The news was a surprise and the request a difficult one. “But I knew I couldn’t sidestep this. I’d been called to solve this problem and, if I didn’t, hundreds of families might be hurt and generations of work might be lost.” She asked for some time to pull a plan together.

An emerging leader finds her grounding concept

In a happy—or perhaps fateful—coincidence, LaConte soon happened upon a framework for transformation that focused on three key steps: preserve, destroy, create. “The concept offered simplicity in the face of so much complexity,” she recalls. “It was conveyed as a recipe for innovation and growth. And the core concept is that, in order to achieve those things, you must go through these three steps on a concurrent and ongoing basis.”

In a nutshell, the concept calls on leaders to:

1)     Preserve the enduring tenets of your business, which is the big core purpose of why you exist.

2)     Destroy, or let go of, the parts of your business that aren’t working well or may no longer have relevance.

3)     Create new products or services by constantly looking at the horizon for changes that are taking place and how you can meet them.


Cynthia LaConte at 2015 ACStep 1: Preserving a company’s core purpose

For LaConte, the first step was to define the vision and values she wanted Dohmen to preserve. She looked to her company’s history for inspiration. Dohmen started in 1858 as a small apothecary in Milwaukee and evolved into a larger pharmacy, then a wholesaler and manufacturer, and finally a provider of benefits management and outsourced services for biopharma. “Along the way, Dohmen has always been willing to change what it does without sacrificing or changing who it is and what it stands for,” says LaConte. “We have always held onto a simple perspective: What’s the right thing to do for our customers and what’s the right thing to do for our employees?” The result has been a long-term, sustainable model that has positively impacted generations of both.

With this perspective as her foundation, LaConte asked herself what felt like the right thing to do for the future and found her answer in committing to making a real impact on the nation’s healthcare problem. “We spend double every other country and yet we consistently rank in the lowest quartile for healthcare outcomes,” she says. “So I put words to that commitment with a vision of creating an efficient, effective and easy-to-use health experience—and then I named the values that had been guiding our organization’s behaviors for decades.”

Once she had achieved clarity around Dohmen’s vision and values, she began to communicate them to others. She and her executive team created a clear and accessible roadmap, developed an award system to recognize employees for exhibiting values, and incorporated a 360-degree feedback loop on values into their performance management process. “Every communication I make, I orient our team to our vision and values. You have to say it, live it, repeat it over and over and over and tie everything you do to it,” she explains. And it worked. Dohmen gained two critical things: a shared perspective and speed.

With everyone operating with a fundamental sense of the “big why,” as LaConte calls it, the leadership team was able to engage more people in the process of finding solutions—exponentially increasing their probability of finding good answers while minimizing the risk of confirmation bias. “Having our vision and values firmly planted and understood throughout the organization allowed us to make good decisions quickly and with confidence,” says LaConte, “from small ones like how to answer a customer call to big ones like what businesses to sell.”

Step 2: Destroying what’s not working

The next step was harder. As LaConte notes, it can be difficult to take on the role of the change agent within an organization, as confirmation bias has often built up around accepted ideas. To counter this, LaConte actively sought out objective advice from outside the company. She participated in executive roundtables with other CEOs and found a mentor from a different country and industry. “My mentor really grounded me. I would present observations and say, ‘This is what I’m seeing. What are you seeing?’” she recalls. “You can get caught up in the ego of things and in the ownership of ideas and that is the worst thing for any business and any industry.”

With a firm grasp on what needed to be done, LaConte set out to let go of the parts of the business that weren’t working: some because they were underperforming, some because they were in conflict with the company’s vision and values, and some because they were simply losing relevance in the future of healthcare. “This was a painful, and at times, lonely process,” she remembers. “It meant exiting a core part of the company’s identity, but it also brought new business opportunities.”

 Step 3: Creating a strong and focused future

The third step is like the light at the end of the tunnel: the exciting part where you get to put your more focused, lean business plan into action. “This is where you imagine where you want to be in five or 10 years and walk backwards from that,” says LaConte. “I was betting on a future of increasingly precise and effective therapies, so we started to create a company that would be well suited to serving small patient populations.” Within seven years, Dohmen had made nine acquisitions, done four divestitures, doubled in size, expanded its footprint to seven states, moved headquarters and launched a new company. “Through this process, we were able to preserve our core purpose while creating a vibrant new biopharma services company and a foundation that has positively impacted the lives of over 123 million people since we started it in 2008.”

And they haven’t stopped there. “It’s never ending,” says LaConte. “As soon as you feel like everyone is speaking the vision, a new person works through the door or you buy a company or a significant event happens and your mettle is tested with something unforeseen. You have to use these concepts like a compass and you have to use them all the time.” Looking forward, she hopes to continue improving the organization’s efforts at quantifying the progress made towards its vision with hard data.

A tested leader offers advice on making an impact in healthcare

The biopharma industry, according to LaConte, is ripe for disruption. She notes that the industry’s current negative reputation is one that has been the result of many individual decisions—and is begging for the restoration of its once noble purpose. She further predicts that the significant efforts and investments being made in health by technological companies will create an emerging type of drug development model that leaves room for nontraditional players to make huge impacts on human health. And she believes that this process of preservation, destruction and creation is just what today’s healthcare leaders need to get us there.

“Change starts with developing a collective consciousness around a core purpose,” explains LaConte. “An understanding of what is the problem we’re all here trying to solve? What are we really trying to get done?” Then, she says, it’s about destroying the greed, profiteering and short-term thinking that often run counter to that purpose. With that accomplished, we can achieve the goal of creating an industry paradigm that prioritizes innovation over incrementalism.

“I think it’s about looking at the landscape and seeing what’s happening out there on the edges and walking backwards from that and saying, ‘How could I apply that thinking in my own organization?’” she advises, noting the companies that are actively working to restore their focus on patient need with real, tangible actions like implementing data transparency initiatives, as well as the emerging models that FDA, patient communities and social businesses are propelling forward that allow companies to think about a different risk/reward ratio and to imagine more discovery and commercialization of products within areas of unmet need. “It’s there,” challenges LaConte. “Do you have the courage and the appetite to respond?”

Gaining this courage starts with going through the preserve, destroy, create process for yourself as an individual. “There is an extraordinary power in taking the time to understand what’s important to you,” says LaConte. She advises leaders at all stages of their careers to take time to write down your personal vision and set of values and then actively look for an organization with a compatible worldview.

Once there, it’s a matter of overlaying your core purpose with that of your organization. “When I became CEO of Dohmen, I viewed myself as having the temporary privilege of stewarding the organization forward,” says LaConte. “So I had to think deeply about what our organization stood for all those many years preceding me and what I wanted it to stand for in the future, and how those two connected.” Then, you must align every activity, goal and metric to that core purpose.

“I think the fact is that people are hungry for a shared sense of purpose,” concludes LaConte. “Leaders who can be clear about why they are in business and the fact that they’re in business first and foremost to improve the health and wellbeing of people, and who can live out that purpose in their daily actions, will succeed.”

This article was inspired by the main stage presentation given by Cynthia at the HBA 2015 Annual Conference.

Written by Danielle Thierry, president and content director, Thierry Writing