Leadership Stories

Finding and Cultivating Other Leaders:
An interview with David Gamez, RN, MA

President and CEO, Health Delivery, Inc.
Saginaw, Michigan

Sitting around a campfire with a group of GM executives, David Gamez recalls being asked, "Who were your mentors?" and "Are your mentors the same as they were at 18, 19, or 20?" Gamez takes that question very seriously — not only because of the young man he was, but because of the men and women he works with as President and CEO of Health Delivery, Inc.

"Finding someone with confidence in you, someone who helps you along is a big part of who you become in life. We need to ask, 'What can we pass on? How can I try to find the one who was me when I was that age?'

"When I got out of the service, I went through a transformation," Gamez says. Most young men in his community looked no farther than a high school diploma and a job at the plant. But Gamez found himself on a different path, in part because of the people who took an interest in him and encouraged him to pursue a career in health care. "I went to work at the hospital as an orderly and that shaped my view of what I could become."

Today, Gamez sees all people — young, old, and in-between — as individuals with leadership potential. And the people he has believed in over the years have helped Health Delivery, Inc., grow from its modest beginnings in the late 1960s to a health care provider serving 12,000 seasonal workers and underserved families in 14 counties in Michigan. Health Delivery offers comprehensive health care in urban and rural areas and features a bilingual staff with roots in the community.

"In our organization, we find people and give them the encouragement they need to grow," explains Gamez. " I like to look for potential in everybody. Everybody can excel, but they have to be challenged."

Leaders in Every Layer of an Organization's Work
Once you decide to foster the development of new leaders, according to Gamez, people emerge as valuable resources for organizations and communities. The staff of Health Delivery, Inc., is witness to many such examples, he says with pride.

"A dentist working with our organization began as an outreach worker. The person who runs our migrant program began with a summer job when he was in college."

Drawing young people into Health Delivery's work is one important layer of Gamez's approach to leadership development.

"For many health professions students and student volunteers, working in our program is a first exposure to underserved populations," Gamez emphasizes. "We see dental hygiene students, nursing and social work students. You can tell if someone has the heart, the desire to give."

But Gamez sees students and individuals outside the organization as only one source of potential leaders. The people already working within the organization need to be cultivated and nurtured as leaders, too.

"Employees at every level and in every profession need encounters and opportunities to increase their dedication," Gamez believes.

Involving staff throughout the system in the issues, decisions, and future plans of the organizations they serve contributes to the growth and capacity of both employees and the health delivery organization.

"We need to let all employees know what we're doing, to engage them in aspects of the work that they may not usually be involved in. It's a process we can repeat and pass on," states Gamez. "Any job can become comfortable, but we need to stretch ourselves."

Cultivating leaders among community members is the third crucial dimension of a health care organization's growth and potential. Community members ground the organization's work in the real needs and issues of the people targeted by services. But drawing community people into health services delivery and decision making can be a challenge. Says Gamez:

"At least half of our Board members are from the community -- patients or representatives of migrant farm workers. We strive to make Board meetings as understandable as possible -- to draw on the skills people bring and involve every member of the Board in decision making."

The language of health care systems stymies many community people. And among Health Delivery's Board members, this and other language barriers have the potential to limit participation. But Gamez feels his role is to overcome these obstacles and keep all Board members involved in the process.

"I may restate something in Spanish or ask a member who has been quiet, 'What do you think?' As Director, you have to have the pulse of the meeting — to have a feeling for how it's going. That's where your ability to lead comes into play. You must have the pulse of the group and read it to exert your leadership."

Cultivating Leaders, Credibility and Sustainability

Gamez credits the W.K. Kellogg Foundation's support in leadership development as an important element of his own thinking and growth.

"The leadership training I received through the Kellogg Foundation made a real difference in my view of leadership and my role in Health Delivery. Leadership starts at the top. Directors must look for and train others to become leaders."

But Gamez remembers a time when he did not always feel quite so committed to developing the leadership potential of others.

"I went through a phase when I wanted participatory management," he recalls. "I wanted the executives in our organization to meet with me so we could make decisions collectively. Now I know to let our managers manage. These individuals understand the mission and make decisions accordingly. You need to give up some control -- to give up the power to make decisions and act on those decisions to the people around you.

"I had a hard time with that idea when I first heard it," Gamez admits. "But now I know that it works. The real problem is the uncertainty that comes with it. In health care you feel the stakes are too high. If one person complains, six may walk away. It's still a struggle. But trust is crucial. You earn their trust, they earn yours -- it works both ways."

And Gamez sees tangible advantages for health care organizations that cultivate leaders within their ranks and in the community.

"This approach is a plus for an organization like ours. Cultivating leaders increases our credibility. Many hospitals and health care organizations are merging. Leaders are looking at Health Delivery to see how we're doing in this new environment. But we've been there and the collaborative approach we use produces results."

At all times, Gamez believes that health care organizations need to view the work they do in terms of sustainability and long-term support.

"Managed care has changed things. We are constantly asking, 'How can we do it better?' I've seen the transition from fee-for-service to HMOs to managed care. In health care, there's always a new ball game. I've learned that you don't burn bridges."

In addition to the organizational benefits, Gamez knows the personal benefits make finding and cultivating new leaders well worth the time and energy.

"I feel a great sense of satisfaction when I see a person grow and change through the work we do -- particularly when the person is Hispanic. You hear a lot about how the Hispanic population will increase in the next century. But we still have communities where less than 50 percent of Hispanic students graduate high school. We have a long way to go," he admits.

But over time, Gamez hopes finding and tapping the leadership potential in others will change statistics like these for the better. And through Health Delivery, Inc., he is working at it one person at a time.