Leadership Stories

Building Coalitions: Thinking Across Boundaries
An interview with Leticia Paez

Director, Institute for Border Community Health Education
University of Texas at El Paso, Texas Tech University Health Sciences Center, and the County of El Paso

El Paso, Texas

Letty Paez's Creed
The world is made up not of things, but of relationships -- relationships that must be developed and nurtured through constant and consistent demonstration of accountability, responsibility, inclusivity, respect for and valuing diversity, trust, optimism, and creativity.

Asked to name the leadership skills she believes are crucial to building coalitions, Letty Paez pauses thoughtfully -- maybe even tactfully.

"I find I think more in terms of overall style than particular skills," she says after a moment.

"Management books will tell you leadership is team building and communication and conflict resolution. But I find the philosophy you bring to the process is more important than any of those things. It transcends the organizational activities. Building coalitions and leading partnerships is more than managing resources," Paez states. "Coalitions are built through relationships."

Since March of 1994, Leticia Paez has had ample opportunity to test her beliefs about leadership. In her role as director of the Institute for Border Community Health Education in El Paso, Paez has been actively engaged in the challenge of joining academic institutions and community agencies to educate health professions students and provide needed health care services to a community of more than 50,000. The list of the Institute's accomplishments during her tenure is an impressive one:

• 10,000 Colonia residents received high quality community-based primary care services;
• The achievement of an additional $4 million to support provision of health services to the underserved; and
• A growing number of partnerships to sustain the Institute's goals.

The personal recognition accorded Paez is equally prestigious — including two recent gubernatorial appointments and service on numerous boards and commissions addressing health and workforce issues.

But Paez says this is little more than the natural byproduct of a viable process at work.

"If my leadership is effective, it's because I'm creating opportunities for others to grow and succeed. This is a collective agenda developed from a collective mission and vision," she emphasizes.

According to Paez, leading a process is different than other leadership endeavors.

"The agenda changes as the players change — and the politics. It's easy to focus on things — resources, physical possessions. When you begin to build a coalition, people want to know what piece is theirs. But it's what each partner brings to the table that matters.

"It is the relationships people bring and the needs they share that shape the entire agenda," Paez insists. "Players will drop in and out according to their needs. So if you lead through a personal agenda only, you won't be able to build a viable coalition. The agenda is what we're supposed to get done together."

Building a Common Agenda
In her early days as director, Paez experienced firsthand the necessity to develop a common agenda.

"When I first came to the project, we had a collection of players with different understandings of the outcomes the Institute was seeking," Paez explains. "The community thought the purpose was to deliver health care services. Academic partners thought education was the point. Only by taking the time to plan together did we develop the necessary collective perspective and a common mission," she says.

Planning together — designating ample time to explore differing agendas and needs — begins to clarify expectations and address the factors that hamper many coalitions, Paez suggests. For example, diversity of participants is often looked upon as a barrier to coalition building — as though bringing very different groups together with very different expectations is an insurmountable difficulty.

Paez admits that diversity is a factor in coalition building. In fact, she suggests that coalitions seeking to join partners from community and academe address a type of diversity that goes beyond ethnic diversity. Partners from academic settings may speak a different language from that spoken by community providers. Cultural and organizational traditions may highlight differences and spark misunderstandings. But Paez advocates acknowledging diversity and building on, rather than avoiding, it.

"There is diversity of opinion, diversity of agenda, diversity of institutional goals, and diversity of community goals. The concept of diversity cannot be overlooked when you are trying to put a coalition together. That's why inclusivity and negotiation to discuss common ground are an absolute must."

Lack of time is often floated as another barrier to building coalitions.

"But I tell people, 'If you don't have time to do it right, how will you have time to do it over?'" Paez laughs. Committing time is practical, she believes. "Coalitions need to dedicate time. New players need time to catch up. Old players need time to reflect. And all of us need time to celebrate together. We spend time on struggles together. We need to celebrate our accomplishments, too."

At the time of this interview, Paez and her colleagues were in the process of planning an annual celebration. More than 100 project participants and supporters were invited to an hour-long event, many to receive "You Made It Happen," "Thanks For Chipping In," and "We Couldn't Have Done It Without You" awards.

Celebrating and expressing thanks are two dimensions of coalition-building Paez will not neglect.

"We take the time to ask someone to help us, but we seldom take the time to thank them afterwards. It's an important part of dealing with people that cannot be overlooked," she says.

Clearly, Letty Paez's strong beliefs about how to treat people translate into her boundary-spanning leadership.

"You lead by example," she says firmly, "with consistency of purpose. I always say, 'Never promise more than you can deliver and always deliver more than you promise."

Given Paez's track record, that constitutes some sage advice for coalition builders everywhere.