The Wisdom Circle

The Wisdom Circle

I have watched brilliant leaders make decisions in isolation that later cost them everything. Not because they lacked intelligence, but because they lacked a circle. Good judgment, I’ve come to believe, is rarely a solitary act. It is built in relationship, tested in trust and sharpened by the courage to be truly seen and truly heard. This is the story of how we discovered that and how Circle changed the way we led, decided and cared for one another.

“Leader isolation silently alters judgment by narrowing perspectives, increasing stress and filtering out candid feedback.” (Think C-suite and the privileged seclusion of the ivory tower.) “Without a sounding board, leaders often make reactive calls, fall into cognitive biases [e.g., confirmation bias*, overconfidence, anchoring] or rely too heavily on intuitive-based judgments over balanced, strategic risk assessment.”¹

Additional barriers to improved judgment include emotional factors (such as stress and fear) and environmental pressures (time constraints, information overload, peer pressure).²

Linking strongly with these barriers is the lack of self-awareness—not having the ability to accurately assess one’s own biases, emotions, shadow, blind spots and other limitations.

Circle Process

In a traditional hierarchy, leaders often hear what people think they want to hear. In a circle, leaders hear what they actually need to hear to improve judgment and make sound decisions.

The circle process improves judgment by replacing isolated perspectives and thinking with collective, empathetic and holistic dialogue. Circle removes hierarchies, requires and cultivates deep active listening, encourages “speaking from the heart” and “listening with discernment,” trains one to witness their own internal state in preparation for looking deeply into their own mirror and honoring candid feedback received, and ensures each viewpoint, each lens, each voice is valued equally.

At the Hygeia Foundation d/b/a True North Health Center, a nonprofit research institute, innovation laboratory and integrated multispecialty group practice, Circle Process became the model of governance. The circle became our culture. We did so based on a combination of the ideas Christina Baldwin presented in her book Calling the Circle, the teachings of Paula Underwood and the guidelines of Relationship-Centered Care by the Fetzer Institute.

Principles of Circle Process at True North

Rotating Leadership

We leveled the playing field. While one person’s title, experience and gifts are as important as another’s, leadership shifts according to the needs of the circle, and deferring to expertise (see High Reliability Organization or HRO principles). We continually found the wisdom and the resources needed to accomplish our goals most efficiently and effectively while engaging and empowering each member of our team in decision-making—embracing diverse perspectives, candid feedback and improving our overall judgment and ability to execute.

Shared Responsibility

Each person asks for what they need and offers what they can, trusting one another’s integrity and believing someone will step forward with sound judgment to meet the circle’s needs, complete the essential task and honor our mission, all while living our values.

Consensus Decision-Making

We made decisions through consensus building (while not succumbing to groupthink—we each spoke our truth with intention). Where all voices are listened to, where each lens of those in the circle was seen through, where all felt heard, respected, cared for. Where it was encouraged to agree to disagree. This led us to far better judgment and far better decisions based on the safety we created, the empathy we developed and the ability for each circle member to share their voice, even if initially it might have been a lone voice.

As the executive director of the Hygeia Foundation (2005–2011), I found that within the circle I shifted from a fixer to a witness as I suspended the urge to react immediately and strictly see through my own lens. I no longer listened to respond or even to understand in an effort to achieve my own goals, but rather I listened because I trusted, I respected, I valued the multiple lenses and I truly cared for each circle member—and thus my judgment became more measured, much more inclusive and far more deeply informed.

Covenants and Agreements

The use of covenants and agreements, such as “We will hold stories or personal material in confidentiality” and “We listen to each other with compassion and curiosity,” positioned all members to have a free and profound exchange, to respect a diversity of views, to enhance one’s judgment and the judgment of the circle, and to share responsibility for the well-being and direction of the group.

Pathways to honor and achieve covenants and agreements were revised in circle by the circle as goals of the circle (and the circle itself) evolved (see PDSA quality improvement methodology). This allowed for better judgment and continuous improvement, as we studied what was working and what was not and sought optimal impact for all those we were blessed to lead and to serve.

Judgment and Decision-Making

60 percent to 90 percent of strategic plans and initiatives fail to reach their intended outcomes primarily due to poor implementation and execution, as per Harvard Business Review. Our decision-making process, while sometimes taking longer than a traditional hierarchical model, always led to greater engagement and buy-in, deep and meaningful discussions, greater multi-lens understanding and improved judgment, enhanced communication pre-, during- and post-decision-making AND an expedient and most effective implementation and execution. All voices were heard, were honored, were understood and were incorporated throughout the process.

Kristen Lombard, Ph.D., PMHCNS-BC (one of the original founders of the Hygeia Foundation), noted the simple guidelines of Circle Process provided a structure that allowed leaders, providers and the entire team to practice how to be more present with themselves and with others and to be more judicious. According to her, “[Circle] increases our confidence, courage, trust and connects us more strongly with a sense of meaning in our work.”

Measurement

Circle Process positioned us to improve our judgment as we moved beyond limited measurement beliefs.

Like many, I was a proponent of the theory “if you can’t measure it, you can’t manage it.” I figured, “If Deming and Drucker (two quality and performance experts) said it, who am I to argue?”

But over time, I learned they actually never said it—and they never believed it.

In health care specifically, we have been wasting resources, wasting people chasing after data that is not helpful, does not improve judgment, does not turn the dial and does not position ourselves, our teams and our organizations to flourish.

Research and Circle

Some years ago, I was blessed to co-chair the Hygeia Foundation Research Circle with Dr. Joe Semmes, hospice and palliative medicine certified, clinical assistant professor of medicine at Tulane University and former physician and research lead for the Hygeia Foundation.

And now as I reflect on the current state of clinical research and its health care implications …

• “Evidence based medicine has been corrupted by corporate interests, failed regulation and commercialization of academia …” — British Medical Journal: “The Illusion of Evidence Based Medicine”
• “Only one in 10 medical treatments [10 percent] are supported by high-quality evidence …” — Journal of Clinical Epidemiology
• “The problem is so widespread that the publication of fraudulent science is outpacing the growth rate of legitimate scientific publications.” — Northwestern University: “Organized scientific fraud is growing at an alarming rate, study uncovers”
• “Only 18 percent of clinical recommendations are evidence-based.” — HealthExec.com: “Actionable Data. Informed Leaders. Optimized Outcomes”

… even more so, I cherish the Research Circle and its integrity and judgment to always ensure that only the highest-quality evidence was put forth and, when/if a study did not lead to the outcomes expected, to transparently and accurately share the outcomes.

The Circle’s Impact

• Circle Process is a tool to re-humanize health care (and business and beyond), build consensus, improve judgment, foster authentic team relationships and expedite goal achievement through improved implementation and execution.
• Circle eliminates executive isolation, encourages integrity and raw truth shared within reverent participatory relationship, exposes leadership blind spots and leads to better judgment.
• Circle provides a structured, iterative method where multidisciplinary teams regularly meet in an egalitarian format to discuss ethical dilemmas.
• Circle slows down reactions, encouraging reflection (see the 7-second pause) as we listen to understand and because we truly care—all while reducing emotional bias as the process allows time for complex multi-angled data (including the measurable and unmeasurable) and additional views to be heard and understood and judgment improved.
• Circle deepens empathy as trust and safety lead to deeper sharing, deeper understanding and caring.
• Circle focuses on underlying root causes, moving teams past surface-level symptoms of a problem to the driver(s) through multivariant lenses.
• Circle secures authentic buy-in, leading to deep understanding, better judgment and ease in execution.
• Circle integrates human values with performance and impact.

At the True North Health Center, Circle Process also helped to heal many of the multidisciplinary wounds we all felt (including moral injury) and nurtured our leaders, our providers and our entire team, personally and professionally—thus best positioning all of us to optimally engage patients and families and one another with good hearts and with good judgment for the betterment of all.

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1. Leadership in Isolation, Publication Workplace Weekly Leadership & Management & Supervision, January 09, 2026
2. How Can Decision Making Be Improved?, Harvard Press Review, 2008

Categories: Business