Pulse Diagnosis​

Deep Change: Leadership and Education in Chinese Medicine

“Why not go out on a limb? That’s where all the fruit is.” – Will Rogers

I am writing this piece because I believe leadership is not only a key to becoming an effective teacher and practitioner; it also is a key to success in the field of acupuncture and Oriental medicine (AOM). It may be a key to practitioner success and patient access. Ultimately, it affects the ability of Americans to receive the benefits of AOM.

Kouzes and Posner performed extensive research into leadership and the features of successful leaders.3 It seems to me this might be a good place to start this conversation. They identified five essential practices of effective leaders.

Model the Way

Leaders create standards of excellence and then set an example for others to follow.

Inspire a Shared Vision

When I seek passionately to fulfill a vision and believe I can make a difference, people around me respond and I am enthusiastic about life. From this place, I can envision the future, creating an ideal and unique image of what this profession can become.

Challenge the Process

One way to approach this practice is to ask: Are we asking the right questions?5,6 Further, is what we are about to engage upon in alignment with our mission and purpose or our strategic plan? In a sense, it is being hard on the issues – not on the people.

Enable Others to Act

Leaders foster collaboration, build spirited teams and actively involve others. Leaders understand that mutual respect is what sustains extraordinary efforts. They strive to create an atmosphere of trust and human dignity. They strengthen others, making each person feel capable and powerful.

Encourage the Heart

Accomplishing extraordinary things in organizations is hard work. To keep hope and determination alive, leaders recognize contributions that individuals make. In every winning team, the members need to share in the rewards of their efforts, so leaders celebrate accomplishments. They make people feel like heroes.

I would like to take a moment to delve into the concept of challenging the process, with a more detailed exploration of deep change. Luanne Wilkerson, director for Harvard’s New Horizons Medical Education Program, had a significant impact on me as a leader. I met her at the University of Southern California’s Masters of Medical Education Program. During the leadership part of the program, we interviewed influential leaders in the field of medical education. My colleagues and I asked Luanne, “What is the most important thing you learned leading Harvard’s New Horizons program?” Her response can be summed up in a single phrase: “Give away the credit.”

I would like to extend on this thought of giving away credit, which takes a generosity of spirit. Can I take the blame and without attempting to save face, sit with the discomfort of being fully responsible for the shared reality? Without trying to fix it, when I stay present to the pain of disapproval or betrayal and let it soften me, there is a possibility of connecting with the awakened spirit.

However, this is a deep change and it requires letting go of the fear of rejection and fiercely holding myself accountable for the realities that I create. Rather than project the problems onto the people in the environment, I define my circle of influence within myself.1 In other words, in order to potently change my environment, I change myself. From this view, the person I blame for doing or saying anything to me is a part of me. However, I have only so much control over that person and their actions. In the end, my direct sphere of influence is limited to my own thoughts, behaviors and actions.

Deep change involves the surrender of control.2 This is risky business. It doesn’t occur without personal and collective risk. It involves breaking the rules, risking security of the known and “walking naked into the land of uncertainty.”4 Without the fetters of knowledge and competence, this can be a terrifying experience – one that leads to a dark night of the soul. Here are the greatest possibilities.

So often, I seek peace at any price. I sweep the concerns and issues under the rug in an effort to gain temporary comfort in a relationship. I do this, rather than risk my comfort, the relationship and most importantly my well-guarded conception of a good and competent self. However, this structure is so human, vulnerable and fragile. The ego can become delicate such that it is easier to hide and deny wrongdoing than to perform an eloquent mea culpa. This peace leads to a “life of quiet desperation.” This happens with collectives, as well as with individuals. In such a culture, the people are involved in a strategy of peace and pay by avoiding risk, attempting to go unnoticed and remaining politically neutral. Or, they may plan the active exit, which gives a sense of being proactive, but with one foot out the door. This business of slow death is not just an organizational problem. It is a problem that each and every human being faces. Die slowly or face deep change.4

I hope that we as a profession may grow in presence and authority within the Western culture. The examples:

  • aligning actions with shared values;
  • envisioning the future by imagining exciting and ennobling possibilities;
  • enlisting others in a common vision by appealing to shared aspirations;
  • seeking innovative ways to change, grow and improve;
  • taking risks by constantly generating small wins and learning from mistakes;
  • fostering collaboration by promoting cooperative goals and building trust;
  • strengthening others by sharing power and discretion;
  • showing appreciation for the individual’s excellence; and
  • celebrating the values and victories by creating a spirit of community.


  1. Covey SR. Seven Habits of Highly Effective People. New York: Simon & Schuster, 1990.
  2. French JRP, Raven B. The basis of social power. In: Studies in Social Power, Cartwright D, Ed. Ann Arbor, Mich.: University of Michigan Press, 1959.
  3. Kouzes J, Posner B. The Leadership Challenge, 3rd ed. San Francisco: Jossey-Bass, 2002.
  4. Quinn RE. Deep Change: Discovering the Leader Within. San Francisco: Jossey-Bass, 1996.
  5. Torbert WR. Action Inquiry: The Secret of Timely and Transforming Leadership. San Francisco: Berrett-Koehler, 2004.
  6. Torbert WR. The Power of Balance: Transforming Self, Society and Scientific Inquiry. Newbury Park, Calif.: Sage Publications, 1991.

April 2008