Over the past 2 years I have traveled the country visiting universities, health systems, and attending conferences in search of those places where leaders are addressing the hard conversations. These conversations center around toxic work cultures, burnout, leadership issues, and failing systems. I have been searching for solutions that create high performing organizations and the tactics healthcare leaders can use to create them. In all these places I have been driving the discussions to encourage present day leaders to push past the current thinking which maintains and fosters the ‘status quo’.