Episode 74

Inside Operation Warp Speed

with Paul D. Mango, MBA

July 28, 2022

Paul D. Mango, MBA
Former Deputy Chief of Staff for Policy, U.S. Department of Health and Human Services (HHS)

Paul Mango is the former Deputy Chief of Staff for Policy at Health and Human Services and was part of the leadership for Operation Warp Speed. He is the author of “Warp Speed: Inside the Operation That Beat COVID, the Critics, and the Odds.” Previously, he was the Chief Principal Deputy Administrator and Chief of Staff at Centers for Medicare and Medicaid Services. Paul received a Bachelor’s in Engineering from the U.S. Military Academy at West Point and an MBA from Harvard Business School.

Leadership is not about being on top. It's about being out in front.



[00:01:24] Gary Bisbee, Ph.D.: Well, good morning, Paul and welcome.

[00:01:27] Paul Mango: Thanks for having me, Gary, it’s really a pleasure to be with you.

[00:01:29] Dr. Gary Bisbee: We’re pleased to have you at this microphone, as we’ve discussed, this show is about leadership, and you’ve been a distinguished leader throughout your career. Most recently as the operational lead for Operation Warp Speed that we’ll get into in a moment, but we like to get to know our guests a bit more. What was your life like growing up, Paul?

[00:01:54] Paul Mango: Well, Gary, I think it was very typical of what I would call a lower middle-class family in the 1960s and 1970s. Italian, Irish, Catholic offspring, basically five children all went to public schools. But I have to say never felt unsafe, always felt loved. And it was just a great family environment and a great time to grow up. I played sports in middle school and high school, eventually in college, but that was a big part of my life. I have to say academics weren’t a big part of my life probably until I got to college. But just a very warm safe and enabling environment.

[00:02:32] Dr. Gary Bisbee: What did the young Paul think about leadership?

[00:02:35] Paul Mango: Oh, goodness. Well, I had it along a number of dimensions. I had obviously my parents. I had coaches, as I mentioned, I played like little league baseball and basketball, and I remember my coaches were great mentors and great leaders. My teachers in school, I can still remember all the names of my kindergartens from fifth grade teachers. And the church, I mean, the priests, the nuns. I used to go to catechism every Monday night, and the nuns were very inspirational, let’s say. So, I had a lot of different types of leaders in my childhood. And I looked up to them, and I’m very fortunate now looking in retrospect to have had those experiences.

[00:03:15] Dr. Gary Bisbee: Sure. Well, you mentioned your parents. Do you think they influence your leadership style? Paul?

[00:03:22] Paul Mango: You know, I think very much in my mom and dad were very different persons. My dad was kind of the quiet, confident type who would say, “You’ll never be judged by your words. You’ll always be judged by your deeds.” And that’s kind of the way he was. He didn’t say much but did a lot. And my mother was quite the opposite. She was the big optimist cheerleader in the family. And basically, she instilled in us the belief, and I believe it that, in America, if you’re not successful, there’s only one person to blame and that person’s in the mirror. So, she said take advantage of this opportunity, cuz you’re really blessed with it.

[00:03:55] Dr. Gary Bisbee: Yeah. I mean, that is so true. What was the decision points to your attending West Point?

[00:04:02] Paul Mango: Yeah. You know, it, those things happen over time. But Gary, my dad was an officer in the National Guard the whole time I was growing up. And I remember in 1966, I was seven years old, he was 36, I think. He went off to airborne school. He was assigned to a special forces unit, and he came home and had his green beret and his jump boots, all shiny in his uniform. And I’m sure that had a big influence on me, but I also as I was playing sports in high school, I had some older classmates who went to West Point and asked me to come down and visit. And I did, and I didn’t really know what I was getting into, but basically, I thought it was a pretty interesting place. And for whatever reason, I felt at that point in my life that I probably needed some structure and discipline to continue to advance. And so, it’s the only school I applied to. And this was in 1976 when I was applying. I entered in 1977, and I was fortunate because, one in seven applicants got in back then, now it’s like one in 22, so it was post-Vietnam. And there weren’t as many folks applying. So, I was very fortunate to have matriculated.

[00:05:08] Dr. Gary Bisbee: Timing is always important. Looking at your career. It seems like you’ve had an interest in policy and politics even. Where did that interest develop, Paul?

[00:05:20] Paul Mango: Yeah, it’s a good question again. I think it’s one of those things, Gary, that happens over time. But I remember the first campaign I was ever involved with. It was Lynn Swan’s gubernatorial campaign here in Pennsylvania in 2006. And my eldest daughter was on the campaign team as a volunteer. And, you know, we went to a number of events. I found that to be very interesting. Some of my colleagues from McKinsey, Tom Cotton, left McKinsey and went into politics, and I’ve been close to him for a decade now. Ben Sasse was one of my colleagues at McKinsey, and he went in and now he’s a Senator. So those folks were all, you know, I looked up to them as very bright folks who wanted to serve the country. And I think that’s how I got interested in the first place. So, you know, when Secretary Alex Azar called and asked if I’d come and be part of his staff in 2018, it was an opportunity I jumped at.

[00:06:13] Dr. Gary Bisbee: By the way I interviewed Lynn Swan multiple years ago. And tremendously interesting guy. Great sense of humor. One of the better interviews. Well, to fast forward, you became first the us head of healthcare for McKinsey and then global head of healthcare for McKinsey. How did you become interested in healthcare, Paul?

[00:06:33] Paul Mango: Yeah. You know, it was completely serendipitous, like a lot of other things in our lives. And we were retained by a big corporation that had nothing to do with healthcare but wanted to get into healthcare supply chain management. And they actually, this large corporation actually, approached HCA in Nashville. This was in the mid-1990s. Rick Scott was the CEO at the time. That’s how long ago it

[00:06:58] Dr. Gary Bisbee: Yep.

[00:06:59] Paul Mango: And they paid for us. This large company paid for us to do a supply chain management engagement with HCA. I’d never done anything like that before. And you know, once we got into it, it was a fascinating sector, obviously of the economy and very interesting and kind of took off from there. But again, it was not intentional. It was very serendipitous as I said.

[00:07:24] Dr. Gary Bisbee: All of us in healthcare like it when you refer to it as fascinating Paul. But, after spending some time in healthcare, what takeaways did you have comparing healthcare, let’s say to other sectors of the economy?

[00:07:38] Paul Mango: Yeah, well, most, as you know, most of the healthcare sector is not-for-profit. And I think on the outside, a lot of folks believe that means it’s less demanding. It’s less complex. But it’s actually the opposite in many ways. And I think about boards of directors of large not-for-profit health systems and health insurers, they actually have a tougher because if you are a for-profit company, you have hundreds of analysts and shareholders and everyone else examining everything you’re doing. And if something’s not going right, they let you know very quickly. But if you’re in the not-for-profit realm and you don’t have that, the board role is actually much more important because they have to be the fiduciary that makes sure that there’s not, you know, funds being squandered or strategies being pursued that aren’t correct or, you know, appropriate. So, it’s actually more complex. And of course, this, you know, socioeconomic aspects of it and all types of community issues that maybe large corporations that are publicly traded don’t have to face. So, I think it’s more complex and more demanding than a lot of the publicly traded parts of the sector.

[00:08:44] Dr. Gary Bisbee: Given your experience with the leaders of in healthcare particularly not for profit healthcare. What special characteristics do they need, as leaders let’s say CEOs of large health systems?

[00:08:58] Paul Mango: Yeah, I think, Gary, and I know you studied this pretty closely as well. I think today it’s a lot different than it was even 10 years ago. And I think one is just, if you think about all of the different stakeholders that affect a large health system, if you think about all of the communications demands that puts on a CEO. You know, you have your employees, obviously you have your physicians who may not be employees. You have your patients, you have the broader community, you have regulators at the state and the federal level. And so, I think one of the characteristics of today’s strongest leaders of just being great communicators. I think as well, given the diversity of the workforce today that they have to be able to play up and down the line, talk to the most sophisticated heart surgeons in the world, but also understand the needs and the emotions of the, you know, the housekeepers for instance. So, I think it’s really a demanding role. I think it’s probably a very fulfilling role, but one where communications and people skills are probably the two most prominent that I would call out.

[00:10:13] Dr. Gary Bisbee: Well, you were in the middle of the COVID crisis with your role in Operation Warp Speed. Thinking again about the leaders of the healthcare institutions, what special characteristics does a leader need in a crisis like COVID?

[00:10:29] Paul Mango: Yeah, well, again, I’ll come back to communications and by the way, I talk about this in the book, I think we could have done that differently and better than we did. It’s a 20-20 hindsight observation, but I’m not sure we communicated as well with the American people as we should have, but more important, I think, it’s remaining calm and staying focused on the task at hand, which for us was the mission. And the mission was very clear, have at least one safe and effective vaccine manufactured at scale and effective in those over age 65 before the end of the year. Everyone knew exactly what that objective was and staying focused on that and having leaders and we were really blessed with some great leaders from Alex Azar to Gus Perna and Moncef Slaoui. None of them was emotional, so to speak in terms of getting concerned if we had a bad day or whatever. They just continued to support the team, and we drove on and got it done. So, I think, remaining calm, realistically calm, but calm and confident is very important, especially in a crisis.

[00:11:33] Dr. Gary Bisbee: Well, back to your point about communication. You do make the point in the book that I found very interesting, one, about using behavioral scientists to think about how to communicate with the public. Another point was the use of social media, and the government is perhaps somewhat behind other industries. Are those the two things you were thinking about primarily in terms of communicating with the American people?

[00:11:58] Paul Mango: Yeah. And on the first one, as, you know, again, maybe it’s 20-20 hindsight, we had the best epidemiologist and virologist in the world on our team. And when I say team, this goes beyond Warp Speed. It’s the broader COVID Response Team. But we didn’t have a single behavioral scientist as I call out. And if you think about the response to COVID, it was really about behavior change. Do you wear a mask, or do you not wear a mask? Do you socially isolate or do you not? Do you get your vaccine or do you not? And behavioral science is a science. That’s why they call it behavioral science. I was part of what’s called the Center for Health Incentive and Behavioral Economics at U Penn. And there’s a number of techniques that people use to alter behavior very effectively. We drew upon none of that. So that’s why I thought that was an important thing to note. And on social media, it’s obviously bilateral. It’s how you get messages out, but it’s also listening to what others are communicating on social media and the chatter, so to speak that people engage in, and we weren’t good at that. And the government just doesn’t have a strong social media presence. And I think that has to change over time, particularly if we’re gonna ever have to face another pandemic.

[00:13:13] Dr. Gary Bisbee: Yeah, well, let’s dig into operation, well, the book is called Warp Speed, and it’s about the kind of history and story of Operation Warp Speed. Nicely written by the way. And for anybody who’s interested in this incredible American experience, please get the book. You won’t be dissatisfied at all with it. Where did the vision for Operation Warp Speed originate, Paul?

[00:13:41] Paul Mango: Yeah, I think a hundred percent of the credit has to go to Secretary Alex Azar. As you can imagine, in the early days of the pandemic, basically all hell was breaking loose, as you can imagine. We were dealing with, you know, 20 different priorities a day, everything from repatriating Americans who were stuck in China or on a pleasure boat in the middle of the ocean to standing up a laboratory diagnostic that could test for COVID to trying to get a handle on the characteristics of the virus. I mean, how deadly was it? How did it affect persons differently? How transmissible was it? All of those things were happening, and the gears of government were already in motion on developing a vaccine. It actually started on January 10th when the sequence, the DNA sequence of the virus, was posted publicly for the whole world to see. By January 20th, we had a good vaccine, believe it or not, because the NIH was working with Moderna at the time on cancer treatments and cancer vaccines, and they pivoted very quickly. And they developed a COVID vaccine. We didn’t know it was a good vaccine at that time, but we had one. So, all of this was going on. We were making investments, and one day we got a call from someone who I know very well, Alex Gorski Johnson and Johnson. And he called into the office and wanted to speak with the secretary. So, one of the assistants handed a note to me and informed me this. I was in the secretary’s conference room, because we were with him most of the day. And so, we patched in Alex Gorski, and he wanted to thank the secretary for the $450 million grant that Johnson and Johnson got from HHS, a part of HHS called Barta, earlier that day. And neither Alex Azar nor I knew about this at all. And so, we called in the Barta team afterwards and said, what’s going on? What’d we get for our 450 million dollars, and it didn’t sound like we got much that was different than business as usual. That’s when Alex Azar went into motion and said, we have to change the way we’re approaching this whole thing. And this was in March of 2020. And one of the things he recognized at that point was we didn’t have all the talent we needed inside of HHS. And that’s when we went out and got Moncef Slaoui and Carlo de Notaristefani, and Gus Perna, and formed the team along development, manufacturing, and distribution lines. That’s the way we organized ourselves to get this done. So Secretary Azar was the progenitor, if you will, of the Operation War Speed strategy and architecture.

[00:16:18] Dr. Gary Bisbee: Well, the financing of it is another whole interesting story. Can you Share that with us, Paul?

[00:16:25] Paul Mango: Yeah, well, we eventually spent 30 billion to get this done. And in the Fall of 2020, we didn’t have that money readily available. And the backdrop to this, I talk about it in the book, was a negotiation between generally Mark Meadows and Russ Vought, who was the head of OMB, on our side, and then Nancy Pelosi on the other side. And obviously we were in the middle of a presidential campaign, and she didn’t want to supplement, if you will, the original legislation with more money until after the election. But we needed the money before the election so we could keep everything moving. And so, we met with some very creative folks over at OMB. And we met in Mark Meadow’s office and decided we could pull money from, legally of course, but from a number of other accounts and kind of borrow that money. And we did that in, I think it was August of. 2020. And that got us through to the end of the year. But it did take some level of creativity and gotta give the folks at OMB and chief of staff, Mark Meadows, a lot of credit for helping us out there.

[00:17:28] Dr. Gary Bisbee: What about the Defense Production Act? Where did that fit in?

[00:17:32] Paul Mango: Yeah, well, it fit in a number of different ways. There’s different titles underneath the Defense Production Act. There’s Title III, which is given a priority rating for raw materials, and we use that, I think, about a dozen times to realign the supply chain’s priorities to those companies who were supporting the manufacturer of vaccines, and that could have been filters for the plants that are manufacturing them. It could have been raw materials and even labor. We had to use the Defense Production Act to secure 60 electricians in Houston right down in Texas at one of the facilities to outfit it so that we could manufacture these vaccines. But there’s also a part of the Defense Production Act called Title VII, which is permitting basically competitors to collaborate. And there was a mismatch between who was manufacturing vaccines and who had excess manufacturing capacity, for instance. So we had to get various manufacturers together and to permit them to share capacity. And that took Title VII. So we used it. We wound up using it 18 times during our you know, seven or eight months of Operation Warp Speed, and it really helped.

[00:18:45] Dr. Gary Bisbee: Paul, on page 29 in your book, I reference the page number because it really stuck out in kind of made it such an impression on me. There’s an organizational chart of all of the various people and agencies and departments that were involved. And you were the operational coordinator for all of this stuff. I mean, do you have any idea how many people actually were working on this or how many different agencies or departments were working on this?

[00:19:16] Paul Mango: Yeah we tallied that at one time, and it was somewhere between 6 and 700 folks throughout the departments and you know, of course this was a joint venture between Health and Human Services and Department of Defense. And the DOD folks were spectacular. And Mark Esper, who’s a fellow West Pointer, by the way, was the Secretary of Defense was just 1000% supportive and collaborative and gave us all the resources we needed. We didn’t have even the contracting capacity to engage in all these, you know, multibillion dollar contracts, which have to be written under government rules and everything else. The DOD did all of that for us. They gave us legal support, and they gave us logistical support. And what you see on the page 29 is really just the operating org chart. There was no real hierarchy. It was one of the best team experiences I’ve ever had, because it was a very flat organization where anyone who could be helpful played a significant role. As you pointed out, my role was simply to enable the team to be successful. Give them the resources, give them the space give them air cover. So I used to go over to the White House every day, so that to keep them off our backs, so to speak, cause they were eager to understand what was happening and, but we didn’t want them to bother the team, because the team had to stay focused on the job. And then we had to bring in a lot of HHS support functions. We had, as I said legal. We had finance. We had legislative affairs. We had public affairs. And I had to just coordinate all of them to make sure that their priority was Operation Warp Speed. And that’s how we got things done so quickly.

[00:20:51] Dr. Gary Bisbee: I mean, did you generally find people eager to participate or how did they view this? It was such a unique situation. I don’t think anybody, probably in the government or the private sector, had been involved in anything this grand in terms of magnitude.

[00:21:07] Paul Mango: Yeah. It was really a patriotic group in terms of wanting to have impact. And we didn’t have any trouble getting people interested in participating. And it was a very demanding. It was 16 hours a day, seven days a week. Right in the acknowledgement of the book, I think I went 14 weeks at one stretch without seeing my wife and daughter, you know, and that was just, that’s with everyone, it wasn’t just me. That’s what everyone on the team was going through, but they were so committed to solving this problem. There were hundreds of Americans at the time dying every day of COVID, and that kept people focused. But we had no trouble. In fact, I think it was the opposite , as we were getting closer and closer to success, a lot of people wanted to join the team. And, you know, at that point we didn’t really need them. So it was a good, it was a good group for sure.

[00:21:57] Dr. Gary Bisbee: You outlined in the book Five Keys to Success. Each one of them is unique and almost improbable the way that you did this, but could you just quickly go through, Paul, for us, those five keys and maybe pull out what stands out to you and each of them in terms of challenge and so on.

[00:22:17] Paul Mango: Yeah. The first one was really just the development of the mRNA technology, which had been going on for over a decade. And we were huge beneficiaries of that platform, if you will, technology platform for developing vaccines. As I said, we had a good vaccine within 10 days. That’s never been done before, but the science was actually the easy part. But we wouldn’t have been able to do it without the investments that have been made over a decade. I think the second one was just again, Secretary Azar’s understanding of the pharmaceutical industry, where he had spent 10 years. Let’s do everything that used to be done in series. Let’s do it in parallel. Let’s start manufacturing vaccines before we even know whether we have a good vaccine. So that on Day One, when the FDA approves it, we can ship millions of vaccines, which is what we did. The third one was really a function of Moncef Slaoui, and we call it a venture capital mindset, but his strategy to invest in six different vaccines across three different technology platforms, knowing that we only needed one to win. Five could be losers. We only needed one to win and the return on that investment was and is spectacular. So, that was very important because there were some internal struggles as to which ones we should invest in. But Moncef was pretty firm in his belief, and we supported him. The fourth one was just bypassing the bureaucracy. So the Operation Warp Speed team had a very small board, co-led by Mark Esper and Alex Azar, you know, the joint venture between DOD and HHS reporting directly to the Oval Office. So whenever we needed something, and we needed a breakthrough, literally I would call Jared Kushner within hours. In most cases, we’d get into the Oval Office. The President would make a decision, and we’d move on very, very important. And then the fifth one was really a philosophy about what the government should engage in and what the government shouldn’t engage in. And we had a principal that said, never permit the federal government to do anything that the private sector can do better. And that was a guiding principle for us. And that’s why I mentioned this in the book, Gary, but not a single federal government employee touches a dose of vaccine from factory all the way to administration before Americans get injected with it. It’s really quite a fascinating use of the private sector and limitation of the federal government’s role.

[00:24:37] Dr. Gary Bisbee: Yeah the roles of the private sector and public sector really fascinating. We don’t have time today to go into that, but I’d love to have another interview later to talk just about that. It seemed like the government took risks. They took financial risks clearly. You mentioned 30 billion but I’m sure there are a variety of other risks of failure and so on. How did you orchestrate that, so that the private sector felt comfortable, that they could go ahead and not bear more risk than they might be able to?

[00:25:07] Paul Mango: Yeah, generally, Gary, we did it through the contracting process. And there were two types of risks that we’ve mitigated. One was, as you mentioned, the financial risk, and we pre-purchased doses from Pfizer from Moderna, so, you know, a hundred million doses guaranteed purchase and options to buy 3 or 400 million more. And that gave them the confidence to manufacture this, even if they weren’t gonna be successful. But we also gave them and mitigated their risks through Liability Protection. So there is a very important aspect during a public health emergency that the government can grant to these pharmaceutical companies that says, hey, listen, if we granted Emergency Use Authorization for your vaccine, and it happens to have adverse effects on the American people, you will not be held liable. So that was very important to them as well. Cause you know, there’s a lot of lawsuits that are brought against pharmaceutical companies. So we helped them in those two ways, and that gave them the confidence to make the investments they needed to make to be successful.

[00:26:13] Dr. Gary Bisbee: Yes, this unfolded, you mentioned as you kind of were getting closer to the end ,and it appeared that success was coming. But in the early days it wasn’t clear. It was just a huge project. Did you have to think about keeping the morale of the team up, or were they all pumped up just to have the opportunity to work on this?

[00:26:32] Paul Mango: They were pretty pumped up as you say, but what we focused on and what we did on a couple of occasions was, because this was during COVID and people were spread out, we had the CDC folks who were supporting us were in Atlanta, and different parts of the government, even within the HHS, even within Health and Human Services, you have the NIH, which is out in one part of Maryland, and you have the FDA at a different part of Maryland, and CMS and so forth. So one of the things we were very deliberate about and conscious about was bringing people together. And we did have within the context of our own group and team, we got them together within our building for some social events, so they could talk to each other in person, which is very important when a team is coming together and they don’t know each other, they haven’t worked with each other before. And it was very helpful because once people meet in person and talk for five or 10 minutes, that just lubricates, if you will, their ability to interact remotely after that. So, we were very conscious about that, but morale was never really an issue. This was so fast moving. There weren’t really any dead periods, right. And we were fortunate. There was good news, you know, we’d get Phase II Clinical Trial results. Good news Phase III Enrollment of Clinical Trials was going well. We had a couple of setbacks I talk about in the book with minority enrollment, and we had to take special action there, but people just dug right in and morale was never an issue.

[00:28:02] Dr. Gary Bisbee: So at the beginning, you’ve probably in your mind at least had some hurdles that you figured you’d have to go through to, to succeed. Looking back on it. Were there any hurdles that came up that you weren’t expecting?

[00:28:17] Paul Mango: Um, Probably not. We had some, you know, Moncef Slaoui came and when we interviewed him in April, and then in the first week he was on the team. I remember him saying several times, we’re gonna have a good vaccine. I’m really worried about manufacturing. That’s what he was worried about. And he knew from his 30 years in the industry, that manufacturing is a very, he called that temperamental activity when it comes to vaccines, and you can manufacture something and have it be a very high quality product at five liters, but at 2000 liters, it just doesn’t happen. And so we did have some setbacks in manufacturing. We had a lot of failures, and I talk in the book about Carlo de Notaristefani. He was probably the leading manufacturing expert of pharmaceuticals in the world. And he had a very interesting philosophy. I think this is a lesson for our viewers and listeners. He said, fail fast. He said, I’ve never encountered bringing a pharmaceutical to market where manufacturing has not failed. Let’s fail fast and figure out where our issues are. Fix them. And that’s what we did, but you know, it wasn’t if you say, were there unanticipated barriers or issues there really weren’t and I think that’s because we had a team, logistical experts, manufacturing experts, and vaccine development experts who had so much experience under their belts. They had encountered so many failures in the past, that they developed contingencies for all of them. I think I mentioned just this short anecdote, Gus Perna, when we were putting together the kits that would go with the vaccines, these were syringes, needles, swabs, everything that one would need to actually vaccinate someone beyond the vaccine itself, Gus went to McKesson and said I want you to put 10% more in every box. And you know, that’s a classic, I think, senior army officer learned from experience type of directive, because he knew someone out there at a CBS or a Walgreens or a Walmart was gonna drop a needle or drop a syringe. And we didn’t want the vaccines to expire because they didn’t have enough needles and syringes. So these were leaders who had been through a lot in their lives. And I think they did a great job of anticipating what could have been problems, but turned out not to be problems and barriers.

[00:30:37] Dr. Gary Bisbee: Yeah, well said you made reference to lessons learned earlier. Let’s build on that. The book you actually identified, Five Lessons Learned. Can you review those for us, Paul?

[00:30:49] Paul Mango: Yeah, and these will be, I think, very familiar to healthcare leaders, but maybe just to reiterate them. One is, you have to have the right horses in the race, right? You have to have the right talent. And when Alex Azar said in, at the end of March of 2020, we don’t have the talent inside of HHS that we’re gonna need to get this done. And he went out and personally secured these unbelievable experts. That was key to our success. There’s no doubt about it. I think the second one is really around setting a very clear objective. Every one of those 6 or 700 persons I talked to, you could have asked them the question at any time during Warp Speed to say what are we trying to do here? And they would’ve recited the goal of having at least one safe and effective vaccine manufactured at scale before the end of the year. So that was also just a very important aspect. We talked before about bypassing the bureaucracy and setting up a governance structure that permitted decisions to be made quickly. And yeah, maybe a couple of those were suboptimal. But the speed was so important to our success that it’s a good trade off to make. And I think for CEOs that are going through transformations in their own organizations, quick decision making is, even if it’s only 90% correct, is probably better than slow decision making that’s a 100% correct. And then I also talk about if you’re gonna create a skunk work, you know, let the skunks do their thing. And that’s a nice way of saying don’t micromanage a team that you’ve put together and given them the accountability and the authority, if you will, to get something done. And I think I give a lot of credit on this dimension to President Trump and to Secretary Azar, because neither of them was a micromanager. They could have been. I’m sure they were following this. I know they were following this very closely. They were very interested in it. They never meddled with the team. And I think that was very important as well. So those are just you know, a number of things that in retrospect were very crucial to the ultimate outcome of our effort.

[00:32:59] Dr. Gary Bisbee: Paul, we appreciate your being with us today. The book is called Warp Speed, and it’s the story of Operation Warp Speed, written by Paul Mango. It’s a good one. You should definitely get it. Paul, one last question, given all of your management experience and leadership experience through the years we have a number of up and coming leaders in this audience. What advice do you have for up and coming leaders in healthcare?

[00:33:23] Paul Mango: Yeah, a couple of things, Gary, and thanks for that question. I always use this metaphor that I learned a long time ago. And that is leadership’s not about being on top. It’s about being out in front. And if you just think about that, the image of that, it’s very important. What does that mean to a healthcare leader? I think what it means is you have to look ahead a period of time, I’ll define it as 18 to 24 months, and you have to understand how the world is changing so that you can adapt your organization rapidly enough so that it thrives and survives. And I think that’s the CEO’s role and it’s not about being an authoritarian. It’s about having a point of view in developing a set of followers who are willing to subscribe to that point of view that really distinguishes, I think, the good leaders from the bad leaders. I think second and I put this in the book, the value of team is always greater than the value of any individual. And I think a lot of young leaders hesitate to take action on folks who are disruptive in their organizations, and they wait too long. And I think, they wish they would’ve acted sooner on folks who are just truly disruptive to the team. And then lastly, I think I would say, I know this sounds a little bit strange, but don’t compromise your personal health. If you’re a 35 year old leader, the next subsequent 20 years goes by quickly, you don’t wanna wake up at age 55 with, you know, heart problems and being overweight and that type of thing. And I think if you invest just, you know, a relatively short period of time every morning and staying healthy, you’ll be a better leader. As you age, those years can get by you very quickly.

[00:34:59] Dr. Gary Bisbee: Paul. Excellent advice. Thank you very much. And thank you for being with us today. We also thank you for your service. What a story. Thank you again, Paul.

[00:35:10] Paul Mango: Thanks for having me, Gary. It’s been a real pleasure to be with you.

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