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I have seen the definition of “leadership” in the health and human service field evolve over the years. When I started my career, leadership in the field equaled advocacy. The great leaders were consumer advocates – for children in foster care, for people afflicted with HIV/AIDS, for the poor – and we wanted executives to lead the public dialog.

Then the expectations of leadership in health and human services evolved. We had the Grace Commission (1982), block grants, a wealth of new technology including the World Wide Web (1991), the “contract for America” (1994), and managed care. Health care became “big . . .

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