My career has not turned out as I expected.

I planned and trained to be a pediatrician spending my days, as well as some nights and weekends, taking care of children. Instead I have had one experience after another that has expanded my skills, my work, and my life. I have lived all over the country, from Boston to Hawaii and places in between. I have worked in non-profit and for-profit settings; health insurance, hospitals, and medical groups; health policy, regulation, federal grant funding and care delivery. In my current position, I oversee the world’s largest civilian implementation of an electronic health record. No one could have predicted that, including me.

Men and women alike have frequently asked my advice on how to develop a diverse, stimulating career. I always advise them to take the opportunities offered with open arms and an open mind. Some opportunities will be small—a new project, a new department, an additional location. Some opportunities will be large—a new company, a big promotion, a different city or country.

Opportunities come with challenges: new skills, new responsibilities, different cultures and norms. Be ready to ask a lot of questions and ask for help. Find out who you can go to for subject matter expertise, management coaching, and company history and norms. Talk to people deeply involved in your work, customers of your work, and those peripheral who have a broader context. Suspend coming to firm conclusions until you have made your own assessment based on direct experience and results.

It is a leader’s responsibility to create situations so each person can perform at their best. Find the right balance between continuing effective practices, preserving culturally important traditions, and making changes to improve individual and group performance. There is great satisfaction in continually learning and applying new concepts, bringing past experience to bear on new challenges, and producing higher performance than previously thought possible.