“We offer service that is good, fast and inexpensive … but you can only pick two of the three.”

While it’s a popular saying among professional service providers and greasy spoon chefs, it accurately speaks to three elements of service that for many industries simply can’t be executed simultaneously.

A similar theory was discussed during a recent LEAD San Diego IMPACT class that focused on the hot topic of health care.

Tom Gehring, executive director & CEO of San Diego County Medical Society, gave the cohort a heavy dose of reality as it relates to the future of health care and the impact of the Affordable Care Act.

One of his examples related to the “pick two” theory. He explained that improving the cost of care, increasing quality of care and improving patients’ access to care can’t happen simultaneously. You can improve access and quality, but that’s going to increase the price. You can increase access and decrease cost, but quality will suffer.

However, these are three basic elements health care reform set out to improve. How well the Affordable Care Act addresses those issues is still up for debate, but the resounding theme the cohort heard throughout the day, was reform isn’t over. The Affordable Care Act isn’t the magic bullet to solve all our problems.

“Health care needed to be reformed. Health care still needs to be reformed,” said Mike Murphy, president and CEO of Sharp HealthCare. “Health care has not been solved.”

The session’s dialogue was data heavy and covered issues ranging from end of life care and health insurance exchanges to the importance of community health centers and the unsustainable nature of Medicare. Some of the mind-boggling statistics shared by the day’s presenters included:

• 18 percent of the U.S. population doesn’t have health insurance and unemployment contributes to this figure.
• Medicare is projected to be bankrupt in 2024.
• In addition to cutting reimbursements to medical providers, the government will also make cuts on payments to medical schools, meaning there may be less physicians, while the number of patients accessing care will increase.
• On average, today’s Medicare patient contributed $200,000 toward Medicare during their working years, but will consume $350,000 in care.
• 60 to 70 percent of health care costs are spent on roughly 10 percent of the population.
• 45 percent of the U.S. population has a chronic condition.

But Gehring reminded the cohort this session wasn’t all about doom and gloom, but rather awareness. By understanding the implications these decisions have on small businesses, large medical providers and low-income members of our community, we’re better equipped to address the needs of our region.

It’s critical for all of us to stay informed and look at the issue from a variety of viewpoints. Solving the health care conundrum will require not just the focus of the health care community and politicians, but all citizens.

LEAD San Diego Vice President Sherrie-Lyn Thompson started out the recent LEAD IMPACT session acknowledging something we all knew to be true: there is something sensational about going into a high-security detention center, which was on our day’s agenda. The purpose, she assured us, was not entertainment but something much more significant.  By the end of the day, I knew she was right.

It was a glimpse at a life that many people will never see. As we stood in the guard area looking out at the incarcerated men, I overheard someone from the LEAD cohort say he felt strange looking at them “like they are animals.” It was a no doubt an odd experience.

From the safety of the guard’s quarters, we received an explanation of the different colored wristbands worn by inmates. Men who committed among the most disturbing of crimes (sex crimes or crimes committed against children) wore yellow bands.

While many – myself included – may find it difficult to have compassion for the men behind bars, a more thoughtful look would reveal the situations that put many men there are complex and varied. Further, the solutions for what to do with them are far more complicated than what I’ve heard proposed many times: lock ‘em up and throw away the key.  It’s this thinking that has caused many to dub America the “incarceration nation.” And while many people prefer to think of the situation as “not my problem,” the reality is as taxpayers, it is our problem. For some, it’s a fiscal problem; for others, it’s a moral one.

“It’s a sad commentary on our society when people don’t care about what happens to inmates,” said San Diego County Sheriff Bill Gore.

Even if you are among those who “don’t care,” Gore shared with the LEAD cohort a fact that may pique your interest. It’s also one that many people would prefer to ignore: more than 95 percent of inmates are released back into society. Then what? Many are lacking basic skills such as reading and writing.  Many others struggle with addiction. Unfortunately, California has among the highest recidivism rates in the nation, which are estimated by some to be as high as 80 percent in our state.  Without skills for integration with society, many return to their former lives that got them in trouble to begin with.

After touring two detention centers and the San Diego Regional Firearms Training Center, and hearing from several experts in rehabilitation, I left the day still a little unsure of what to think of it all. Later, I realized that in many ways, the people behind bars represented a culmination of societal problems and issues the LEAD cohort had been exposed to in earlier sessions.  The most obvious tie is to our discussion of behavioral health issues, including mental health and substance abuse disorders, which put people at greater risk of ending up behind bars. But ties can also be made to our education session and our discussion of developing 21^st century leadership skills.

The incarceration system has problems with no easy answer, and it’s critical we think beyond simple solutions.  While undoubtedly there are incarcerated men and women who should never be allowed to walk the streets again, there are others who – like it or not – will. These men and women are someone’s child, mother, father, sister, brother, aunt or uncle. As a society, we need to be more compassionate and not take the easy way out by sweeping it all under the rug.

On the day I write this, my colleague’s husband – along with many other husbands, wives, sons, daughters, brothers and sisters – is leaving on a deployment. It reminds me of the recent LEAD San Diego IMPACT seminar in which the cohort learned about the military’s impact in San Diego, home to the largest concentration of military personnel in the world. For the men and women in the armed forces and their families, they know the impact of the military well. For the rest of us, hearing from service men and women, taking a tour of the Naval Base San Diego, and visiting the Naval Medical Center, the LEAD session was a good reminder.

As part of the experience, the IMPACT group also toured the USS Howard, where we were greeted by several sailors who took us on a ship tour.  I was struck by how young our guide looked and thought about my own brother, who is now 15 years old and considering entering the military; it was a thought I kept with me throughout the day.

The most poignant moments came at the Naval Medical Center, where we heard from the San Diego Military Advisory Council (SDMAC), and service men and women from the center. SDMAC told us the facts: the military’s presence in San Diego is responsible for $30.5 billion in economic output, $16.3 billion in household earnings, and 354,627 jobs, or about one out of every four jobs in San Diego.  We then heard about the work done at the medical center and saw a simulation video that moved us all.

It was a training video used to prepare military medical personnel for what they may see in combat. Designed to mirror real life situations, the explosions, injuries and operations were so life like that the video was stopped to make sure everyone in the class was comfortable watching it. Even knowing it was not real, it was hard to sit through.

“When people come back, they are changed. They see things most of us will never see,” said Commander Langlais, who discussed her own experiences serving. The cohort talked about the increasing instances of post-traumatic stress, and how the military is helping men and women cope.

Watching the video, I thought about what it must be like to witness the tragedies of combat in real life. I thought about what this sacrifice means not only to the individuals who serve, but to their friends, families, communities and to us all as Americans. We owe our service men and women a huge debt of gratitude. Langlais summed up well the lesson for the LEAD cohort and those in the San Diego community.

“We expect a lot of them out there, so they should expect a lot of us back here,” said Langlais.

To those not in the armed forces, let us remember the important work of our service men and women and their contributions to the fabric that makes up San Diego. Thank you to all those who serve for your important work on duty and off for our country and for our community.

“I live a charmed life … I try to honor it by reaching out to people who don’t live the life I live,” said Kim Bond, president of Mental Health Systems (MHS), at a recent LEAD San Diego IMPACT session dedicated to health and human services. I reflected back on the LEAD session recently when I received an email from a commercial tenant in my condo complex seeking solutions to the “homeless problems” in the building.

While reading the email – which noted the “problem” erodes our enjoyment of our properties and property value – I couldn’t help but feel compassion for those homeless individuals who end up sleeping in our building’s stairwells or commercial parking spaces. I took off my hat of condo owner and dutiful HOA-dues payer, and instead wore one of concerned community member, and thought back to the discussion recently facilitated through LEAD.

The LEAD session centered mainly around “behavioral health,” a term that, according to MHS, includes both mental illnesses and challenges, and substance abuse disorders – things that are common in our community. Some estimates say as many as one out of every four people suffer from some form of mental illness, which – like substance abuse – can happen on a continuum and includes everything from anxiety and post traumatic stress disorder to depression and schizophrenia.

“What does mental health issues look like?,” said James Lepanto, senor vice president, mental health division of MHS. “Hold up a mirror. That’s what it looks like. We often think of it as ‘other’ people, but it’s not. It’s us. It’s our community.”

The LEAD cohort discussed not only how behavioral health issues affect individuals and families, but also the impact to the workforce, economy and quality of life through problems such as homelessness and strains placed on our health care and incarceration systems.

So what do we do?  LEAD attendees were reminded of the words of Mahatma Gandhi: “Be the change you want to see in the world.”

Ways you can help include:

• Get educated. Aspects of behavioral health issues are preventable and treatable.
• Talk about behavioral health with friends, family, colleagues or others.
• Advocate on behalf of programs that provide solutions and address behavioral health issues head on.
• Be empathetic.
• Volunteer your time and talent.

By doing these things, we are playing a role in the solution, and removing the stigma around mental illness. According to MHS, every day in San Diego someone commits suicide. Others who suffer from behavioral health issues sleep in our public spaces and on our streets. We can’t – and shouldn’t – ignore the issue.

The transformative power of art has long been known to people whose lives have been touched by it, but the ability of arts and culture to transform not only individuals, but communities at large hasn’t been given nearly as much attention.  This was the focus of a recent LEAD San Diego IMPACT session, and Councilman Todd Gloria beautifully captured the theme of the day.

“Art is not elective … it’s essential to a vibrant city,” said Gloria.

Gloria — along with other speakers, many from Balboa Park’s museums and other institutions — spoke about our city’s arts and culture offerings, and about the upcoming 2015 Balboa Park centennial celebration.

With a mission to “Celebrate a ‘year of creativity’ that brings together innovative experiences with art, culture, nature, technology and science,” the celebration is aimed at reinvigorating and elevating the park for San Diegans and visitors alike.  While specifics are under development, enthusiasm for the event is palatable, and you can’t help but feel the celebration will be something big; something defining not only for the park, but also for us as San Diegans.

“2015 is going to be the coming out party for San Diego’s creative class,” said developer David Malmuth, whose vision for arts and culture stems well beyond park boundaries.

In addition to discussing the park, Malmuth spoke to the cohort about his vision of merging art, culture, commerce and place with the I.D.E.A. district, a mixed-use district driven by a Design jobs cluster, nourished by Education, enriched by the Arts and focused on Innovation. In addition to creating “more ideas per square foot,” Malmuth says the district will not only inspire creativity, but spur economic development.

Whether talking about the upcoming Balboa Park centennial, the I.D.E.A. district or a particular museum exhibition, IMPACT attendees couldn’t helped but be moved. After all, being a San Diegan is about more than where we live and work. It’s about where we play and enjoy our lives. It’s about where our interests lie and where our sense of curiosity and wonder can be sparked, and arts and culture make San Diego what it is today.

With this perspective in mind, the message to current and future leaders is clear: advocating for arts and culture shouldn’t be something left to the “arts community” alone, but rather something we all support. And, with 2015 just around the corner, I can’t help but ask, will you join the party?

Creativity, embracing risk, questioning, systems thinking, collaboration, communication and worldview – these are among the skills needed for the 21^st century, according to Grant Lichtman, chief operating officer at the Francis Parker School.

Lichtman – who was a guest speaker at LEAD San Diego’s IMPACT session dedicated to K-12 education – advocated that there is a disconnect between what we teach and what we want students to learn. The day was filled with discussions related to facts and figures on the educational system and potential solutions from various speakers, including Lichtman who says the world is changing at a dramatic rate, yet our educational system is not.

While his presentation was focused mainly on how we develop current and future students into individuals who possess the needed 21^st century skills, I couldn’t help but also think about how we – as business leaders – instill and foster these skill sets among our current workforce.  I viewed the discussion through the eyes of someone who works in a field in which these skills are not only desirable, but necessary to survive.

The industry in which I work – like many other industries – can no longer get by on a set-in-stone knowledge or skill set. We must evolve. We must think critically. We can’t rely upon knowledge “professed” to us in college. We must come up with new solutions – and not be afraid to fail every once in a while. We also need to know not only how to “play nice in the sandbox,” but also how to engage in real collaboration for sustainable solutions to business challenges … and today, that often happens across borders and among different cultures.  It’s from this perspective that innovation and creativity is born.

How we instill these 21^st century skills in children is therefore an important task. Also critical is how we nurture these skill sets for those who are currently in the workforce.  Programs, like those offered through LEAD San Diego, do just that.

At NST, we recently completed our annual retreat in which we reviewed our mission, vision and values and I’m proud to say that we adopted a new value this year, one that – while we’ve been practicing it, we’ve never put it on paper – focuses on the notion that we push ourselves and each other. It’s about not accepting the status quo. It’s about continual learning and exploration. It’s about feeding our sense of curiosity – and to not do it is no longer an option.

Teresa Siles (@tsiles) is vice president and director of social media at Nuffer, Smith, Tucker, a full-service public relations firm in San Diego focused on creating conversations and building relationships to help clients succeed.

“For the past 150 years, we’ve been tinkering with education,” said Scott Himelstein, director of the Center for Education Policy & Law at University of San Diego. “We haven’t evolved … but we’re reaching a tipping point. Things can’t stay the same.”

Education-related issues can spark heated debate – I saw that firsthand at a recent LEAD San Diego IMPACT program in which Himelstein spoke.  The cohort also heard from Sally J. Bennett-Schmidt, director of assessment at the San Diego County Office of Education, who made it clear there is a problem: only 60 percent of students (grades 2-11) are meeting state standards in English and only 56 percent are meeting the standards in mathematics.  Further, barely 40 percent of San Diego County students graduated with the requirements to enter into the University of California or California State University system. These students don’t even have a choice as to whether to go to a UC or CSU school because they don’t meet the requirements. Sixteen percent dropout altogether, and minority populations are at greater risk.

“We are not satisfied with these data,” said Bennett-Schmidt. “Everyone of these students has a face, and their parents are sending them to us with expectations.”

While getting agreement on the causes of our problems in the educational system or  solutions for the future is a daunting task, most people agree that something has to be done.

“At the end of the day, a strong public school system is something just about everybody wants,” said Richard Barrera, board president, San Diego Unified School District.

So how do we get there? What can we – as business men and women, civic-minded individuals, parents, employers and human beings – do? Putting politics aside, there are a few things that are not debated:

• Speak up – don’t let education be somebody else’s problem. This is your education system too.
• Organize with others – parents, teachers, administrators and others should collaborate and work toward solutions. Strong communities make a difference.
• Become involved with your school board – can you name people who sit on your local school board? Most people can’t. Learn about and get involved with your local school board.
• Be accountable – while it’s easy to play the blame game, we all play a role. Do your part to make a difference.
• Invest in our schools – An “investment” doesn’t always mean money. It can also mean investing your time, energy and other resources. For those looking to get involved through volunteerism, the Union-Tribune (client) Volunteer for Education Campaign aims to mobilize, challenge and recruit San Diego County residents to pledge to volunteer in K-12 schools throughout the 2011-12 school year.

Creating an education system that allows our kids and kids’ kids to be successful – regardless of race, background or socio-economic status – is not only the right thing to do, but our future also depends on it.

Teresa Siles (@tsiles) is vice president and director of social media at Nuffer, Smith, Tucker, a full-service public relations firm in San Diego focused on creating conversations and building relationships to help clients succeed.

LEAD President and CEO Vicky Carlson has called the IMPACT program an “MBA in San Diego,” – on Oct. 20 the cohort got its first official course and it was on the green economy.

While we didn’t become experts in one day, we certainly learned a lot about what the “green economy” really means and the role we play in the future of a green San Diego. While many people tie the green economy to global warning, Reo Carr, editor in chief at the San Diego Business Journal, who served as the day’s moderator, challenged this notion.

“Whether global warming exists is irrelevant to our considerations … to link the green economy to global warming is a huge mistake,” said Carr. He argued that being “green” is about much more than global warming. It’s about the impacts on our environment that we see every day. Carr said that people are moved by what they see on a local level.

Things like plastic bottles washed on the shores of our beaches and the San Diego riverbed fouled with pollution are examples of negative impacts on our environment that can’t be ignored. Unlike global warning, you can see these physical manifestations, and they impact what our future looks like.

“The green economy will become as fundamental as any industry we know today,” said Carr.

So what does that mean for me and my IMPACT cohorts? Does that mean we should abandon our fields and jump on the “green” bandwagon? Not so, but there are implications for all of us. In fact, Jim Waring, co-founder of CleanTECH San Diego says every business can be a “green” business.

“I don’t care what you do. It’s about being the best you can be with your resources,” said Waring. “It’s about doing more with less, and it’s in the best interest of the world.”

Some argue that at its most basic level, being “green” is about just that – doing more with less. But in San Diego, we are doing more than the status quo. We are putting our stake in the ground as being a recognized leader in green technology. But are we ready?

“We need to develop our competitiveness,” said Chuck Flack, research director for the San Diego Workforce Partnership. “There is excitement around ‘green,’ but do we have the workforce needed?” The answer isn’t simple. While there are certainly individuals, organizations, educational institutions and businesses dedicated to improving the green skill set of our workforce, there is still work to be done. It’s an evolving process that has no end.

The takeaway for leaders: we all play a role, not only in doing our respective parts to use resources more wisely as individuals and within our respective organizations, but also to ensure the workforce is equipped with the green skill set needed now and in the future.

Teresa Siles (@tsiles) is vice president and director of social media at Nuffer, Smith, Tucker, a full-service public relations firm in San Diego focused on creating conversations and building relationships to help clients succeed.

At one point or another you may have heard someone say, “The problem in San Diego is that we have no leadership.” Do you agree?

For Mary Walshok, associate vice chancellor of extended studies at UCSD,  the answer is a strong “no.” Walshok recently helped welcome LEAD San Diego’s 2012 IMPACT class.  And while her welcome was short and sweet (about 10 minutes), her words were thought provoking, prompting me — and presumably others in the class — to wonder: what is the role of “leaders” today? Further, what does “leadership” in the future look like?

Walshok advocated that when you have diversity, you have multiple centers of leadership.

“The challenge then becomes, mobilizing these multiple centers of leadership around common causes,” said Walshok, who went on to offer three things needed for leadership.

First, people need to know how and where to access knowledge. Secondly, leaders need to network, including bridging the gap between those individuals with a hyper-local focus, i.e. localites and those who are more cosmopolitan, or global. Lastly, Walshok argues that leaders must know how to harvest the skills of others and empower them.

LEAD San Diego seeks to advance the quality of life in San Diego through a growing network of capable and engaged civic leaders. What does being a leader mean to you? And what skills do you think are needed to demonstrate great leadership?

Recently, I was driving home from a meeting in Los Angeles with a colleague, when she asked me (somewhat out of the blue) what I thought her strengths and weaknesses are.  Put on the spot, I considered her question and it struck me that perhaps one of her biggest strengths was the fact that she was asking me this question at all.

Lao Tzu once said: “He who knows others is wise. He who knows himself is enlightened.” The concept of self awareness – and its relationship to great leadership – was the crux of a recent seminar as part of LEAD San Diego’s 2012 IMPACT class.

“Leadership development is a lifelong journey,” said George Reed, University of San Diego professor, who presented to the LEAD cohort of 60 participants.

Reed offered the class tools to help assess their personality and change leadership style, including the Myers-Briggs Type Indicator (MBTI), which measures psychological preferences in how people perceive the world and make decisions, and the Change Style Indicator, which measures preferred styles in approaching and dealing with change.  These are just a few of the tools offered to help leaders become more self aware, and while the results can be interesting, the real value of these tests is not in the results themselves, but in what you do with them.

Reed argues that results shouldn’t be used to describe your personality “type,” but rather results should be used to help guide your actions – even if that makes you uncomfortable.

“Like right-handedness or left-handedness, personality is hard wired … Leaders must work against their preferences all the time,” said Reed.

I walked away knowing that not only am I a “ISTJ” (preferences toward Introversion, Sensing, Thinking and Judging) on the Myers-Briggs scale, but also – and more importantly – I was more self aware and curious about others who I interact with both professionally and personality.  While every assessment and tool has its flaws, each can also provide good insight to help inspire improved leadership, which is a principle at the core of LEAD San Diego.

Updated 10/4.