Author Talks: Use your voice

In this edition of Author Talks, McKinsey Global Publishing’s Raju Narisetti chats with Karen S. Lynch, president and CEO of CVS Health, about her book, Taking Up Space: Get Heard, Deliver Results, and Make a Difference (McGraw Hill, Winter 2024). Lynch discusses the benefits of leading with authenticity, overcoming adversity, and drawing on past experiences to reshape the future. An edited version of the conversation follows. You can also watch the full video at the end of the article.

Why did you write this book at this time?

The reason I decided to write this book is that tomorrows are never promised. My husband encouraged me to write the book, and it was a long process. But when we discussed it, we talked about the journey that I’ve been on in my leadership, how I started my life. We both agreed that I had stories and leadership lessons to share. If I just inspired one person who breaks through barriers, dreams big, and doesn’t let their past define their future because of my book, I would feel satisfied.

The book’s title is deeply personal to you.

I chose the title because [of an experience] when I was very young in my career. I’ve lived my entire career with that memory. I walked into a room, and I asked a gentleman where I should sit. He said, “You should sit in the back of the room, because women just take up space in a boardroom.” This was in the ’80s. Clearly there were not a lot of women in leadership positions. I worked in public accounting, and there was one woman senior partner. I could’ve taken that [comment] and turned it into a negative.

Instead, I turned it into an “I’ll show you,” and a very positive mantra around resilience and optimism. I think for every one of us in our career, someone says something that could be a setback. It’s really about how you choose to respond to anything kind of negative that gets put in front of you. I decided to choose a positive perspective, and really used that negative comment to fuel my passion and my commitment to do great things.

When I was deciding the name of the book, we thought this was appropriately fitting, because it’s not just about taking up space. It’s about letting others take up space as well, and using your voice and letting others use their voice. I talk a lot about that in the book. I hope to encourage not just women but everyone to use their voice and take up space as they embark on whatever journey they set forth in their life.

This is a book about life lessons applied to leadership.

No one is perfect in their career journey, and everyone makes mistakes. It’s about how you address those mistakes and how you use those mistakes to learn. One of the things that I hope people take away is that you need to be a constant life learner.

You get to learn from every part of your life. I talk in the book a little bit about a time my husband and I were doing a cattle drive in Montana. I talk about the lesson I learned from that: you don’t cattle drive from the front. You cattle drive from the side and from behind. The best leaders really guide and navigate from the side and let their people shine in front of them. I share those kinds of things so that people can think about their own experiences and gain insights into how they might approach their life and their journeys.

There’s a lot of vulnerability in that book. The first two chapters were incredibly hard to write. I shared painful mistakes I made. But one of the things I want people to really take away is that you don’t have to be special. What you have to be is consistent and disciplined and get up when you get down. People are going to knock you down, and perhaps you’re going to knock yourself down. It’s about how you get up from those [situations], how you take those experiences, and then use them to learn what you want to do next.

You see a clear difference between managing and leading.

Managing is just doing the rote tasks, and leading is establishing where you want to go. But it’s also about looking around the corners through the crisis and when the crisis is over. You can get through the crisis of managing the day-to-day activities. Leading through a crisis means rallying an entire group of people to overcome the crisis and come out even better on the other side.

I’ve managed and led a lot of different crises in my career. Leading is listening to what’s happening on the front lines, not knowing that you think you have all the answers. But it is about getting the organization rallied around a common purpose and getting people excited about the possibilities of the future. Because in many, many instances, no matter what crisis you’re leading, the opportunity is to come out better afterward.

The COVID crisis is a really good example. We came out stronger as an organization after that. But we could’ve just managed vaccines. We looked at how we could be a bigger part of an individual’s healthcare journey. How do we take our learnings, really change and transform healthcare, and use our company to do it?

What drew you to a career in healthcare?

The early interactions with the healthcare system in my life were twofold. I lost my mom to suicide when I was 12, then my aunt, who took in all four of us—I have two sisters and a brother—died when I was in my mid-20s. Both of those experiences had a profound impact on me and on how I interacted with the healthcare system.

I truly learned that people didn’t really combine physical and mental health. I learned that access to mental health isn’t readily available. It wasn’t then, and it still isn't now. We have a long way to go, but we’ve made tremendous strides. I learned sitting at my aunt’s bedside that I didn’t know the answers. I didn’t know what questions to ask.

So I am passionate about giving people choices, giving people education. Those all fuel my passion. But it doesn’t have to just be in the healthcare industry. You could be passionate about anything that you want to do and any career path that you choose—anything that you do—whatever it is in your life that you’re interested in. I think people, when they find that passion, use it to fuel their energy to really make a difference. People often forget that individually, we can make a difference. Collectively, we can make a difference. You asked early on what some of the lessons were. I hope that people take away that as a lesson: one person can make a difference. Use your voice. I talk about this a lot in my book, about using your voice and letting others use theirs. We all have the opportunity to be passionate about what we do and to truly make a difference.

Why is mental health so important?

We’ve done a lot at CVS Health and at Aetna to really improve and broaden access to mental health resources. We’ve enhanced our telehealth capabilities. We’ve put social workers in some of our MinuteClinic locations. We’ve expanded our EAP [employee assistance program] services. I had the opportunity to create impact and use my position to augment CVS. As a result of the pandemic, we saw a huge increase in mental health challenges and a huge issue relative to access. We’ve been working on that for a few years.

More and more children are suffering from mental health issues. We’re seeing increases in suicides across the nation. And we are seeing mental health access challenges across the nation as well. So, as a country, [mental health] is something that has to be top of the agenda for us as we transform healthcare. And I believe that more and more people are focused on it, and more and more people are talking about it than ever.

What are some of the healthcare challenges consumers face in America?

It’s complicated. I talk about how healthcare is hard. We have to make it simpler, and we have to make connections for people. You go to one doctor, and your information is not connected to that next appointment. It’s a confusing system, and it’s an expensive system. What CVS is really embarking on is to connect the dots for people in their healthcare journey so that they have the information available to them when and where they need it.

We can meet you in the communities. We can connect with you digitally. At the same time, as a company, we have the ability to finance your care, to provide pharmacy benefits to you, to provide care in certain situations, and then connect you to your prescriptions and your consumer wellness products, making it much more simplistic and easy to navigate.

Now, are we there? No. We have a journey ahead of us. I firmly believe there are two things that will help healthcare in the future. One will be technology. We’re seeing significant advances in technology to really support the underlying fundamentals of healthcare.

I think value-based care has to play an important role here, because we really need to drive value, versus transactions, in the healthcare system. Then, we have to make sure that we’re having people engage. What we have found is that when people engage in their healthcare, we see better outcomes and improved health for individuals.

How can leaders stay connected to their communities?

It’s important to stay connected with your colleagues. I make it a point to stop in stores and engage in dialogue. I make it a point to pick up the phone and call individuals. Customers email me, and I respond to them. It’s important to keep your pulse on what’s going on in your company. With consumers and with customers, it’s easy not to [do that].

So you have to really stay connected, and you have to make it a point to do that. I have found that I usually get the best information while walking into a store or walking down the hall and having a conversation with colleagues, asking a few questions—and having a genuine interest in what’s going on.

If you meet with me, I usually ask you these questions. One is, how’s a consumer going to interact with us—what’s the impact on the consumer? And how will that impact our colleagues? Those are two fundamental questions that make people really think about the process, the products, the services that you put in place.

What is your approach to coaching and feedback?

We’ve all been on the other side of feedback, when you’re getting all that positive [input]. Then there’s the negative. Our job as managers or leaders is to really coach people to their top performance.

Think about athletes. Athletes have coaches for everything to sharpen their skills. That’s how we have to think about our colleagues. Giving them coaching feedback is really intended to sharpen their skills and make them even better.

It’s not to be hurtful, and it’s not to give negative feedback. It’s really to have them sharpen what they’re trying to do. Now, the flip side, which I also talk about in the book: feedback is a gift. I always tell people that feedback’s a gift; coaching is a gift.

You can choose whatever you want to do with it. Try it on, see if it fits. If it doesn’t, you don’t have to do it. But our job as leaders and managers is to help people achieve their goals, be it the next promotion or being the best individual contributor they can be. And it is their choice on which direction they want to go. Our job is to help coach and guide them to be the best performers they can be.

Why is authentic storytelling so impactful?

I wasn’t good at it at the beginning of my career. I think the point about storytelling is an important one; it needs to come from that genuine, authentic self. I don’t share a lot personally and didn’t share a lot personally. Now, it’s all in a book. But the first time I shared a story was [when] I talked about my mom and how she died.

I hid that my entire life, because I thought people would hold that against me. I was in fear that people would say, “Oh my god, this is what happened to her. She’s not going to be good at anything. And what if she is a problem?”

I remember sharing that story onstage unscripted, unplanned. The feedback was overwhelming. There was one particular woman who reached out to me immediately and said, “My son just died by suicide and I haven’t told a soul. I’ve been suffering from that, and you made it OK.”

You don’t want to share every story and everything. But here I was, standing on stage trying to drive an entire new health strategy connecting emotional well-being with physical well-being. How am I going to get people to lead if I don’t feel whole?

So I took a chance. And what I learned was—and I still learn to this very day—that everyone has a story. It doesn’t have to be that kind of personal story. Once you start talking about it, people are more willing to talk about it. That's a relief to them.

Being authentically you makes you a more authentic leader. Leadership is about followership. Are people willing to follow you? They’re going to follow you when they believe in you and they trust you. That’s where authenticity really matters.

Are men and women leaders perceived differently?

It’s an interesting question, and it’s an interesting standard. I’ll share my experience. I also talk about this in the book. Not that long ago, I sat across a table from people who were evaluating me for a position. The feedback I got was, “Hey, you’ve got great leadership; the numbers are off the charts. But you don’t look the part. You’re not tall enough. You’re petite. Your voice isn’t deep enough. And you wear pink.”

I’m not sure they would say that to a man—maybe they would. But those are experiences where we can be held under a different microscope. I share those experiences so that people know that it isn’t just them. At the end of my book, there’s a website where you can write comments and share your stories. I have been overwhelmed by the stories that people have been sharing with me—both men and women.

I think they feel better when they know that there are more people out there who are having similar experiences. And they know it’s OK to keep fighting the good fight, to stand up when you’re knocked down, and to keep forging ahead to pursue your dreams. I say this all the time: don’t ever let anyone define you. And don’t ever let anyone tell you that you can’t.

How does it feel to be a first-time author?

Writing a book wasn’t on my bucket list. As I said earlier, if it just helps one person aspire to do great things, or it just helps one person get up when knocked down, or if people look at their mistakes and do not let those get in their way, I’m happy.

I am donating all the proceeds of this book to not-for-profit foundations that support mental health and female empowerment. I’m hopeful that people will buy it and read it. Sometimes people come up to me in the oddest places and say they have the book highlighted and it’s on their desks. I’m happy if it helps just one person.

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