The Most Valuable Exercise I’ve Done As CEO

By Mark Arnoldy

When I decided to write Possible’s For-Impact Culture Code I was in my pajamas, isolated in a cabin overlooking the White Mountains in New Hampshire. I hadn’t seen or talked to another human in four days.

I was in the middle of the most valuable exercise I’ve done as CEO.

Part of what I did that week was review a survey I’d asked our leaders to complete. One of the questions was: “How would you describe our work culture to a friend?”

Here is the full, unedited response I wrote to my own question for our team.

“We are getting there. Building a ‘good’ culture is easy. Building a remarkable culture is what only a few organizations ever accomplish. It’s especially hard in our category of work because almost everything we’ve been taught about being a nonprofit is wrong and thus most potential team members come seeking something we don’t really believe in. So we are unlearning that while also trying to understand the value of something foreign and new. I love our team. We have extraordinary potential. And we are going to do great things as long as we treat time as scarce, maximize our learning, and keep focused on punching above our weight class. Growth will be the ultimate arbiter of whether our culture is good or remarkable.”

In writing that response, the idea for our For-Impact Culture Code was hatched. Why?

First, I was frustrated and tired of defining ourselves by what we aren’t. I think it’s sad the nonprofit sector is the only sector labeled that way. Those of us in this sector don’t wake up and pursue this work to “not make a profit.” We wake up to make an impact, change lives, and bend the arc of the universe towards justice. Nonprofit is honestly a pathetic and uninspiring term. That’s why one of the first slides in our For-Impact Culture Code says this:

“Non-profit” is a legal structure, not a way of doing things.
And we don’t believe we should define ourselves in the negative.

Second, when I held our work next to the work of great companies like Netflix and HubSpot that had built transformative culture codes, I realized culture was equally important. Our team is taking on the challenge of making healthcare possible in the world’s most impossible places.

Without building extreme clarity around our principles and arguing why they are essential to get remarkable results for our patients, we would risk attracting the wrong talent, the wrong partners, and diluting the culture of excellence our work demands.

Hence, we created a culture code that drives our work.


Our For-Impact Culture Code

Why For-Impact?

“Non-profit” is a legal structure, not a way of doing things. And we don’t believe we should define ourselves in the negative.

Instead, we exist to create impact.

In everything we do, we believe in proving it’s possible to deliver high-quality, low-cost healthcare to the world’s poor.

Proving possibility requires results.

The driving force behind our for-impact culture is to get
remarkable results for our patients.

Why care about culture?

“Culture IS strategy.” — Jim Collins

Great teams bring the same entrepreneurial energy to improving their culture as they do to improving their product.

We want to build the best global health organization in the world. To do that, we need a culture where remarkable people produce remarkable results.

People and results: That’s what makes a great organization people love and invest in.

Here are the 10 principles that drive our for-impact culture.

1. We put our patients first.

Our #1 rule: solve for the patient.

In every patient, we aim to see the possibilities we see in those we love.

The dignity and
opportunity of our
patients are far more
important than our own
egos or who gets credit.

Favor the patient’s
interest above the team’s.

Favor the team’s interest
above your own.

2. We embrace challenge with grit.

“We are obligated to the battle, but not entitled to its fruits.” — Bhagavad Gita

If building effective healthcare systems for the poor were easy, everyone
would do it. We do this work precisely because it is labeled as “impossible” by many.

We expect failure and tremendous degrees of adversity. Grit is what we deploy to get remarkable results anyway.

“The only thing that I see that is distinctly different about me is I’m not afraid to die on a treadmill. I will not be outworked, period. You might have more talent than me, you might be smarter than me, you might be sexier than me, you might be all of those things—you got it on me in nine categories. But if we get on the treadmill together, there’s two things: You’re getting off first, or I’m going to die. It’s really that simple.” — Will Smith

We seek out people with grit because we are building a
formidable team.

3. We treat efficiency as a moral must.

When your outcome is impact, time is a terrible thing to waste. And when you’re working in the world’s most challenging environments under constant uncertainty, the way to maximize learning is to minimize the
time to try things.

It’s everyone’s job to turn time into resources and possibility for our patients.

We are obsessed with using simple tools to shrink the time we spend on “work about work.” There is a critical and constant push towards making our individual and team workflows as efficient as possible.

4. We think big.

Lions can catch, kill, and eat mice, but they will die doing so because it’s a calorie negative endeavor. So instead they hunt antelopes.

Like lions, we can’t afford to hunt mice.

Nearly 1 billion people around the world lack access to high-quality healthcare.

Thinking big is balanced by focused execution. Spreading resources thin to appear big is enticing and common in impact work. But it’s dishonest and leads to low-quality impact.

Instead, we set goals that are big enough to matter and small enough to achieve.

5. We build simple.

Complexity is easy. Simplicity is hard. People ignore complexity. People enjoy simplicity. Complexity makes work feel like a burden. Simplicity makes work feel like progress.

Our goal is to minimize complexity as we grow.

That is really hard to do.

But otherwise, complexity and bureaucracy flourish, great people leave, and
results suffer.

6. We challenge conventional thinking.

Most conventional “wisdom” says the poor can’t have high-quality, low-cost healthcare. When confronted with that “wisdom,” we should always ask:

“Is this the beginning of a conversation about getting healthcare to the poor or the end of one?” — Dr. Paul Farmer

When challenging convention: Don’t be angry. Don’t be arrogant.
Do demand data to justify conventional wisdom.

If data doesn’t exist, solve for the patient and prove possibility with data. It’s our job to solve for the patient and win debates with data — not create enemies based on opinion.

7. We realize great design creates dignity.

Everything we build, from a hospital to a business card, has real implications for the dignity of our patients and the effectiveness of our impact.

Great design isn’t a luxury — it’s a powerful and real priority in everything we do.

“Design isn’t just the way something looks. It’s the whole thing, the way something actually works, on so many different levels. Ultimately, of course, design defines so much of our experience. I think there’s a profound and enduring beauty in simplicity, in clarity, in efficiency. It’s about bringing order to complexity.” — Jonathan Ives

8. We are transparent until it hurts.

At the core, we believe in
transparency because it’s
an accountability guarantee against our own human frailties.

We believe it’s most important to be transparent about our impact
data, finances and failures. We also work to build in transparency as a default state in our systems.

A few examples:

  • We publish quarterly impact reports openly covering all areas of the organization.
  • We use Asana so team members can see everything happening across the organization.
  • Our strategy, areas of responsibility, milestones, and board minutes are open within the team.

9. We balance professional intensity with personal support.

“We’re a team, not a family. We hire, develop and cut smartly so we have stars in every position.”— Netflix

Solving one of the world’s most challenging problems requires intense commitment. We are supportive and intense.

But when push comes to shove, we are intense.

Yet our leaders constantly remind themselves to be professionally uncompromising and personally supportive. We only select leaders who are “givers” — people who are always looking to add value to their teammates’ lives.

A few ways we are personally supportive:

  • We use our networks to find world-class mentors for team members.
  • We use a reciprocity listserve so anyone can ask for support inside or outside of work.
  • We let people own their 1 on 1 meetings with their managers so they can cover their needs.

10. We believe everything is impossible, until it isn’t.

We go to work every day determined to create a better world — to expand humanity’s belief about what’s possible.

“Hope is the belief in the plausibility of the possible as opposed to the necessity of the probable.”— Maimonides

In our team, hope isn’t a fluffy, soft, or naïve concept. We believe in a hard edged hope — one created when possibility is earned through execution against all odds.

Do we sound like your kind of people? Then prove possibility.