Seth Kahan on Big Change

This week, I am facilitating the American Association of Physicists in Medicine’s summit, Empowering Medicine through Physics. It is more than a convening. It is a signal. Medicine is at an inflection point. Artificial intelligence is accelerating discovery. Workforce strain is real. Regulatory pressures are mounting. Data is exploding. And yet the promise of precision,

Pictured: me at the World Bank, where I lived through two change initiatives in the mid-1990s, both called Knowledge Management. Same organization. Same label. Completely different outcomes. The first effort looked unstoppable. A small group of world-class thinkers. A dedicated budget. Closed meetings. Impressive technology demos. After a year, almost nothing had reached the organization.

When a challenge depends on actors you do not control, incentives you cannot align internally, and commitments that must be made across institutional boundaries, treating it as organizational work becomes counterproductive. An iceberg is a useful metaphor here. From the surface, an iceberg looks manageable. Its visible mass suggests scale, effort, and risk. But what

Many organizations are still staffed for the world that made them successful, not the one they are navigating now. As technology, AI, and business models shift, leadership requires a different way of thinking about roles, risk, and growth. Here are six truths I see again and again in organizations that are getting this right. Hat

Most leadership teams respond to stubborn problems the same way. They sharpen the strategy, clarify accountabilities, add metrics, and launch another initiative. When that fails, they work harder. But some problems do not fail because strategy is weak. They fail because strategy is no longer sufficient. These challenges live between organizations, professions, incentives, and identities.

Successful change ultimately rests on the support of the people who are responsible for implementing it. Without their buy-in, even the most promising initiative will stall. This is why leaders must be strategic in how they communicate and introduce new ideas. One of the most common mistakes I see is trying to convince everyone at

In this episode, I sit down with Joe Feldman, founder and CEO of Cover My Mental Health. His website, CoverMyMentalHealth.org, is filled with free resources—including helpful instructions and templates—designed to empower families and clinicians. Joe’s journey began when his child was denied essential mental health care—sparking a federal lawsuit and igniting his passion for advocacy.

In this episode, I talk with filmmaker and mental health advocate Max Blaska, whose short film Last Rung on the Ladder—an adaptation of a Stephen King story—became both a tribute to his late aunt and a lifeline in his own battle with anxiety and depression. Max shares how the project nearly fell apart amid a