Salmom Upstream, LLC

Developing and implementing real-world community solutions.

A Convener of Stature

Governor Leavitt continuously championed collaboration throughout his career, and he authored a book entitled “Finding Allies and Building Alliances.” In the book, he outlines the commonalities of successful alliances from analysis of hundreds of organizations and programs at both the state and federal levels, in government and private sectors, spanning large publicly traded industries and nonprofits. His analysis identified eight elements that are essential for success. Some of these elements are almost obvious, like committed leadership or a common pain point for involved parties, but one in particular is not only critical but is often the most difficult to secure: a “convener of stature.”


A couple of weeks ago I got to listen to a brief lecture by Mike Leavitt, former governor of Utah and Secretary of Health and Human Service under Pres. George W. Bush.

Governor Leavitt continuously championed collaboration throughout his career, and he authored a book entitled “Finding Allies and Building Alliances.” In the book, he outlines the commonalities of successful alliances from analysis of hundreds of organizations and programs at both the state and federal levels, in government and private sectors, spanning large publicly traded industries and nonprofits. His analysis identified eight elements that are essential for success. Some of these elements are almost obvious, like committed leadership or a common pain point for involved parties, but one in particular is not only critical but is often the most difficult to secure: a “convener of stature.”

He defines this as one who commands the respect of everyone involved such that they all are compelled to sit down at the table. The example he used at the time was the writing of the constitution where all (quarrelling) thirteen states needed to come together, and George Washington – despite not being directly involved in the drafting of the document – served as this convener of stature.

Though I had never used the term, I have looked for a convener of stature for the past five years. I was initially convinced it would be Centra Health, and my app was even designed from the outset with their colors in preparation for what I believed was inevitable integration. I have subsequently asked four consecutive CEOs of our health system to enable Centra to fill this role and have never received even a statement of support. My most recent meeting revolved around that fact that the health system wanted to improve transportation, but it was only interested in regard to its own patients getting to its own providers, or its own employees getting to work.

I looked to the city, because transportation is the number one community health need and is critical to our economy. When that didn’t work, I looked to the bus company, and then to the VA Department of Rail and Public Transportation, with the Secretary of Transportation at the time the wife of a Lynchburg physician. At their direction, I applied for what are called Demonstration Grants beginning in 2017 and then annually for the subsequent two years. Lacking city backing – without a convener of stature – I never received any support.

I approached Roche Diagnostics who had a navigation platform called Navify, supposedly with the intent of enabling more patient centric care for cancer patients and for whom transportation is always an issue. I suggested that if they solved the critical problem for the community, cancer patients – and all other patients, honestly – would look to Roche as an essential component to quality care. I was invited to Indianapolis to sit down with their North American CEO, but it turned out that what they really wanted was for me to use my role as lab director to convince the hospital to switch to their instrumentation and get them a valuable reagent sales contract.

I approached Abbott Laboratories because they built a cloud system called AlinIQ that was designed to enable community connectivity similar to what I was working on. I was invited to their headquarters outside Chicago, and this time I met with an entire team that had been assembled to design systems that could build what they termed a “Healthy Community.” This led to a 3-day work session where a team of five including several VPs flew to our little city and met with a variety of stakeholders and community leaders to discuss the possibility of investing significant capital and resources into Lynchburg as a pilot. I was truly disappointed when not a single representative from Centra Health showed up, but in the end it didn’t matter: The meeting was at the close of 2019, and our world was getting ready to change. Even before the shutdowns, Abbott redirected all of its resources to develop Covid testing platforms (and they sold a lot of them) and dissolved the entire community health initiative.

The list of influential stakeholders that I have approached to serve in this role is grows almost continuously. One thing I have learned is how to more effectively weed out those that have an ulterior motive, and also how to tell when an entity will feign interest simply because our mission statements clearly align, and the community expects that they are actually trying to search for effective solutions. Often these groups, despite their apparent goals, do not actually share a common pain point: the bus company does not suffer when they are unable to provide effective transportation for people in the region, as the people who lack this resource become the justification for ongoing federal and state support. If the problem goes away, so does their reason for existence.

The search continues, as does the development of the comprehensive system that we have designed. In the end, the driving force will be the desire of people in the community to live better, and someone of the appropriate stature will ultimately stand up and enable us to work together and reach this goal.