Dr. Marcia Anderson DeCoteau
Strong Principled Leadership

Values and Principles

that which guides me

Relationship Building

The core business of health care is relationships: between physicians and patients; among members of inter-professional health care teams; between physicians and learners; and between health service providers, administrators, governments, and communities. I believe in building relationships that are respectful, truthful, and that value the perspectives, contributions and needs of each party. Without strong relationships we will not be able to address the complex challenges of health care.


Our first accountability is to ourselves: to keep our whole selves well by knowing when to push, when to advance, and when to retreat and rest. When we do this, we are best able to honestly and authentically make commitments and follow through on them. I believe in following through and doing the things that I say I will do, and that in doing this I am honouring the gifts that I have been given.


At its heart, courage is about revealing yourself without knowing what the outcome will be. It is sharing uncomfortable and sometimes unpopular truths as a key step in creating platforms for change. It is necessary for being willing to try out new solutions to current challenges, and for setting goals and following through. I believe in leadership that stands firm and faces adversity head on.


To me humility means being yourself without thinking you are better or worse than anyone else, and that you treat all others as you would your relatives. It is staying willing to learn, and recognizing that everyone has something that they can teach. In a leader, I believe humility is recognizing that others have supported your leadership development and achievements, that you still need to rely on others for guidance and insight, and that you are accountable to the mistakes that you will inevitably make.

Equity and Justice

It is a fundamental right of all humans to have the equal opportunity to be healthy, and to have access to the conditions like shelter, security, and an adequate income necessary for health. The current gaps in health for Indigenous people, and other people impacted by structural disadvantage are unjust and unfair. I believe all health system and policy innovations should be viewed critically with respect to how they will impact these gaps in health, and that promotion of health equity should be a requirement for implementation.

Power and Love

My current favourite leadership book is Adam Kahane’s “Power and Love: A Theory and Practice of Social Change.” In it he describes power as the single-minded desire to achieve one’s solitary purpose, and love as the drive towards unity. He quotes Martin Luther King Jr, “Power without love is reckless and abusive, and love without power is sentimental and anemic.” I believe that in addressing health care’s complex challenges we do need to leverage influence and resources- two key components of power- but we need to balance that with moving in love, which can also be described as recognizing the humanity in others as equal to our own. Particularly when it comes to the anti-racism and Indigenous rights based work I have been involved in I find paying careful attention to both the most successful approach.

Creativity and Innovation

In today’s healthcare and fiscal environment, we are required to find ways to responds to the population’s healthcare needs that are growing at a greater pace than the resources are. In addition, there are pockets of the population, such as Indigenous people, who are not receiving equitable care. In Alaska, Southcentral Foundation has developed a very high-performing primary care system serving Alaska Natives where creativity and innovation are emphasized and strongly supported throughout the organization. I believe we need to have environments where people feel safe to propose and try innovative solutions, and that we need to have the ability to scale up innovative solutions that promote higher quality, more equitable health care.


I believe in ensuring the sustainability of the publicly funded health care system. This will require being strategic with the resources available, reducing waste, and taking the long view on investments in the upstream determinants of health, public health and comprehensive primary health care. I believe our goal should be to sustain a system that provides high quality, equitable health care according to need, and that an inequitable system cannot be sustained.


I believe that part of sustaining energy in complex, difficult work is in celebrating the accomplishments, big and small, of ourselves and our teams. Paying specific attention to being grateful allows us time to honour the processes of our failures and success and to learn from them. I believe that the practice of gratitude reminds us to believe in abundance, which is a necessary counterpoint to the more dominant attitude of scarcity in health care.