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Art of Leading

Sonia Millsom

You Have to Have Different Skills And Backgrounds At The Table

October 16, 2023

Sonia Millsom, CEO of Oxeon, a healthcare firm, shares her key leadership insights in this “Art of Leading” interview. 

Q:  How would you describe your approach to leadership?

A: There are four things that are particularly important to me. The first is building trust and respect with people by really understanding where they are coming from. The second is diversity of perspectives—it is incredibly important to have different skills and backgrounds around the table. That leads to better solutions overall.

The third is that I like to have data to inform decisions. Sometimes you won’t have all the data, but at least you can ground your decision-making process in the data you have. The last one is the concept of outside-in. Some companies just get so deep into what they’re doing every day, and if you don’t pick up your head and think about the voice of your customer as well as the external market trends that have to inform your business, then it’s very difficult to be successful over the long-term.

Q: I’m guessing there’s a story about how you learned that last lesson.

A: Yes. I was at a company that provided disease-management services. It was led by brilliant individuals, and they believed that the findings from their research alone would build the business. But they completely missed what the market actually wanted and needed. They were tone deaf. It was a huge lesson about the importance of being externally focused.

Q. This is your first CEO role. Was there anything about the reality of the job that was different from what you expected?

A. The reality of being a CEO for the first time is that it’s a little lonely. I am very used to collaborating directly with people and having them feel the psychological safety to tell me things. When you get into the CEO role, people are a little bit more hesitant to tell you what’s happening.

So I’ve had to adapt my style to encourage people to tell me what’s going on, because I don’t want them thinking they are going to be fired if they did something wrong. So if something happens, I will ask them questions like, “What did we learn from that?”

We also do a lot of work with both private equity and venture capital, which are still very much white male worlds. It’s been really eye-opening to understand how much of that business takes place on the golf course or on fishing trips. My parents immigrated to this country. I was born in Hell’s Kitchen in New York. This is not a world I grew up with or understood. So now I am focusing more on building those relationships one by one.

Q. Can you talk more about those early years, and what shaped you from a young age?

A. I think immigrants are the ultimate entrepreneurs. There’s no playbook or safety net, and you have to figure things out. We moved every year from the time I was born until fourth grade. My father was a physician, and he had to go to different places to do his residency. There were some places where he was not welcome because of his skin color, or the hospital was reluctant to put foreign doctors into leadership positions.

My parents had three daughters, and none of us are physicians. He said, “You can do whatever you want.” That gave us a lot of freedom and flexibility.

Q. Where does your drive come from?

A. I’ve always been pretty driven. I like to put myself in uncomfortable situations. Right after college, I joined the Peace Corps, and I was a maternal child health volunteer living in Morocco for two and a half years in a rural village with no running water or electricity. I grew so much through that experience.

Q. What do you think is the hardest part of leadership?

A: It’s the balance of building trust with your team, but then also having to make difficult decisions for the betterment of the business. And how do you do that in a way that still allows people to feel psychologically safe, but then also continues to drive you through to that North Star that you’re aiming toward?

Q. One of the realities of leadership, particularly when you are the CEO, is that you have to have a lot of difficult conversations. How do you approach those?

A. Because I’ve worked in a variety of organizations, including large public companies, I got very comfortable with the fact that businesses have to evolve and change in order to meet their goals.

It is more difficult in smaller organizations, because you sometimes have single points of failure, or the company gets to a certain phase and then you need to move people out to get to the next phase or they have to level up. If I do have to let people go, I try to do it in a way that’s authentic, aligned with our cultural values, and in the best interests of the business.

Q. I’m sure you’ve done a lot of coaching and mentoring of senior leaders over the years. What do you see as their most common blind spot?

A. One pattern I’ve seen often is that people are afraid to hire somebody they think might be better than them. Perhaps it’s because of insecurity, but they might hire a junior person so they can tell them what to do, rather than trying to bring in a real thought partner that allows them to level up quicker and move the business forward.

Q. What’s the best lesson you’ve learned from your worst manager over your career?

A. It goes back to the idea of insecurity. I once worked for someone who was deeply insecure. Every time I had to present to the board or to our most senior leaders, this manager wanted to see my talking points ahead of time. She was so nervous about how it was going to reflect on her or that I was going to say something wrong. It made me completely shut down.

It’s a much more productive approach, of course, to be thinking instead about trying to figure out how to leverage someone’s strengths to help build the organization. I’m not a micromanager by nature, and I learned first-hand how that approach can make people shut down.

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