Bred To Lead | With Dr. Jake Tayler Jacobs
Who Says Elephants Can't Dance? IBM’s Comeback and the Healthcare Lesson
15 Jan 2026
Chapter 1: What were the challenges IBM faced in 1993?
In 1993, IBM was dying. $8 billion in losses, the largest in American corporate history. Analysts said, break it up. Sell it for parts. The talent is gone. The culture is toxic. The elephant is too big, too slow, too stuck to survive. They were wrong. One man walked into that disaster and saw something no one else could see. He didn't fire everyone. He didn't blow it up.
He kept most of the same managers who presided over the collapse and turned them into the leaders of one of the greatest corporate turnarounds in the history of America. How? He changed the system, not the people, the system. And that lesson, the lesson that IBM taught the business world 30 years ago is the exact same lesson the healthcare industry today is in dire need of.
Welcome back to Bread to Lead.
I'm excited to see you.
Chapter 2: How did Lou Gerstner approach the turnaround at IBM?
And in this episode, things may be a little bit different. We're going to try for the rest of this season, rather long season, for full video. If you want to see the full actual video of the podcast or class, as we call it, you can go to our YouTube at Dr. Jake Taylor Jacobs on YouTube.
And we're excited to show more of a visual aspect of the show in my office at our research and training institute, our headquarters here. Dallas. So let's get to it. Welcome back Bridge Builders to Bred to Lead, the podcast built to build the greatest leaders of our next generation. I'm your host, Dr. Jake Taylor Jacobson. If you're new here, welcome to the family.
If you've been rocking with us since season one, I appreciate you holding it down. This is episode 35, season three. In this season, we're doing something different. I just released my newest book, Operational Blindness, why healthcare leaders can't see what's costing them millions and how to finally fix it. I'm excited about this book.
And instead of telling you to go and buy it and figure it out for yourself, I'm going to bring you inside. Every episode for the remainder of this season, I'm going to read directly from the book. Word for word.
Chapter 3: What is the concept of operational blindness?
And then I'm going to break it down, teach it, expand on it, give you the stories, the context and the application that didn't make it to the pages or else this book would have been a thousand pages. Think of it like a masterclass, which is what Bread to Lead is. You get the content, then you get the commentary.
Now, if you want the full book, it will be available on Amazon soon and on our site everywhere that the book can be sold online.
Chapter 4: How can operational blindness affect healthcare organizations?
If you want a free copy of this book and you are an executive at a hospital, assume the qualifications, you have to be an executive at a hospital.
We will be having very soon, potentially by episode 36 or 37, we will have very soon the operational blindness assessment that any leader running any organization can take it to see if you are indeed operationally blind and how we can help you fix that. So I'm excited about this. But if you don't ever go get it, the book.
You're going to walk away from every episode this season with something you can use. So let's jump right into it. Today's topic is actually called the elephant everyone forgot. I'm starting here for a reason. Because before I can teach you what operational blindness is, before I can show you what it's costing your organization, I need to reframe how you think about organizational failure.
Because here's what most leaders do. When something isn't working, they look for someone to blame. The department is underperforming. Fire the director. Metrics aren't hitting. Replace the manager. The complaints keep coming. It must be a people problem. And look, sometimes it very much is a people problem. I'm not naive.
But more often than not, you got talented people just trapped in broken, old, antiquated systems. And this is what's causing the demise of so many organizations. Doesn't matter how many heads you swap out, the result will stay the same. And Lou Gertzner figured this out at IBM.
And if you're a health care executive who's been cycling through SPD directors every two years wondering why nothing ever changes, you need to hear what he discovered. Now, before I get into reading a section of the book, Let me tell you something. If the concept is hitting you, it's hitting home for you.
If you're already thinking about your own organization and wondering how deep this goes, I put together a resource specifically for leaders who want to dive deeper and go deeper. It's called the operational blindness white paper. It's a comprehensive breakdown of what the condition is, how to identify it and what it actually is costing health care organizations.
And we're talking millions and hitting costs that never show up on a standard P&L. The beautiful thing about the white paper is regardless of the industry that you're in, I know that we have several bridge builders that are from different industries that listen to this podcast.
You still can take so many isms because the problems that health care are dealing with today are the same problems that every industry and every business, every market deals with. And the white paper is free. You can download it right now at SipsHealthcare.com. And if you go to blog on our page, you'll be able to see the white paper. You don't have to put any information in. It's absolutely free.
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Chapter 5: What beliefs hinder organizational success?
I hear this constantly all over the country. That's just the nature of the work. Instruments come in, you process them, fires happen, you put them out, that's the job. But it's not true. Proactive SPD operations are possible. We've done it. We run them. They're just rare because most organizations have never seen them and can't imagine them. SPD is a call center, not a strategic asset.
This belief determines everything. How much attention SPD gets, how much investment, how much respect. But think about it. SPD directly enables surgical revenue. It's not opinion. It's a fact. Every case delay, every frustrated surgeon, every quality event has a financial impact. The department isn't just a cost. It's a constraint on your most profitable service line.
The OR will never be satisfied. And this one poisons the relationship between SPD and surgical services. It creates an adversary adversarial dynamic where both sides stop trying because they've decided the problems are unsolvable. But the OR is dissatisfaction is a signal, not a character flaw. It's telling you something is broken, dismissing it as inevitable guarantees it will never be fixed.
And what Gertzner did. And what you need to do, Gertzner didn't fire everyone. He didn't bring in an army of outsiders. He kept most of the existing management team, but he changed the system that they operated in. He challenged the beliefs. He changed the measurements. He restructured the organization. He created new accountability mechanisms. He made the systems the target, not the people.
That's what's key. And here's what happened. Many of the same managers who had presided over IBM's decline became leaders of its turnaround. Talking all across the world today about their involvement in this historic turnaround. Their capabilities hadn't changed. Their circumstances had. And let me say that again, because this is the whole point.
The same people who looked incompetent in the broken system looked excellent in the fixed system. The people didn't change. The system changed. Your application. So here's what I want you to take for this. Your application. What do I want you to take from this? Your application. If you're an executive, stop looking for people to blame. Start looking for systems to fix.
The next time your SPD is underperforming, before you fire the director, ask yourself, does this person have visibility into their real impact? Do they have the resources to succeed? Is the measurement system showing them what actually matters? If the answer to any of these things are no, you don't have a people problem. You have a system problem.
If you're an SPD leader, this should be liberated. The dysfunction you've been drowning in is not your fault. You've been operating in a system designed to fail. Anyone in your position would struggle, but in this is important. Liberation is not the same as Once you understand it's a system problem, you have a responsibility to advocate for a system change.
You can't just throw up your hands and say, hey, it's the system while continuing to operate the same. If you are in surgical services, your frustration is valid, but your SPD colleagues aren't your enemies. They're trapped in the same broken system that you are. The question isn't why can't SPD get it together? The question is what system is preventing all of us from succeeding together?
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