Growth Through Collaboration: John Abele’s Vision

John Abele has always been fascinated by the impact of collaboration. Much of his obsession stems from a long battle with a debilitating childhood staph infection called osteomyelitis. He spent most of his time between the ages of 5 and 8 in a full body cast in the hospital, undergoing three surgeries and 1,200 injections. Doctors weren’t sure he would survive. Spending countless hours alone staring at the ceiling and inventing ways to entertain himself, Abele, now 76, longed to play with other children. Having lost his father during World War II (see “The Search for the Grunion,” page 44), Abele, with two supportive older brothers, learned at an early age the nature of self-reliance coupled with the influence of trusted peers.

As cofounder of Boston Scientific, the medical devices giant, Abele helped pioneer and foster the concept of minimally invasive surgery. Along the way, while building his company and becoming a billionaire, he regularly encountered accomplished inventors who relied on the collaboration of a host of often-disparate groups within the medical community. Great ideas didn’t become innovations without the foresight and acceptance of key constituents. In the medical world, acceptance of a new paradigm was dependent on unrelated groups of participants, most of whom had no desire or reason to collaborate. A leader who can harness talent and drive collaboration in such an environment is rare.

Having helped generate the growth at Boston Scientific, from its founding into a $7 billion firm, Abele believes collaboration made all the difference. In the case of Boston Scientific, which was producing innovative technology in a field where many didn’t embrace change, gaining collaborative favor among physicians was crucial to the company’s expansion. Getting a special group of risk-takers to collaborate led to innovation. The net result was not just growth for Boston Scientific but for the entire industry.

“Growth in a collaborative organization doesn’t have to be any different than a non-collaborative organization, except that with a non-collaborative organization there is likely to be more turnover,” Abele said. “And turnover costs money, it costs reputation and so on. So finding the right balance is the key.”

Abele, who retired from Boston Scientific’s board in 2011 to practice “venture philanthropy,” majored in physics and philosophy at Amherst College and has been fixated on technology and organizational behavior ever since. This atypical mix of right- and left-brain prowess makes Abele ever curious and insightful about the future of collaboration. “I’ve always been fascinated with what makes people tick,” Abele said.

That fascination figured in his decision to buy the Kingbridge Conference Centre just north of Toronto in 2001.

“I bought Kingbridge because I wanted to explore the idea of an experimental place where people could learn to communicate in a way that harnesses collective intelligence,” Abele said. “And the biggest barrier to doing that is frequently pride, ego and sometimes fundamental conflict of interest.” In the medical field, where competition is intense and breakthrough ideas are guarded with ferocity, collaboration is often anathema. Yet Abele’s success at Boston Scientific was built upon his ability to bring together extremely competitive intellects and create an environment where participants could meet and be candid about what they were working on, including the new techniques, the risks, the benefits and the strategies they employed.

“It was about really sharing what they were learning rather than lecturing about what they were teaching,” Abele said. “That was powerful because it really accelerated the development of these new technologies in health care—such as revolutionary steerable catheters—and I believed there must be more opportunities to apply this collaboration in a lot of different areas.”

To that end, Abele has spent much of his post-Boston Scientific time hosting salons, conducting brainstorming sessions at places like M.I.T., holding weekend retreats at his Vermont estate on Lake Champlain and bringing curious minds to Kingbridge.

The motto at Kingbridge is “Place Matters” and the facility’s unusual design, welcoming light, superior acoustics and layout create a relaxing environment. First built as a health and wellness center, and later a leadership-training institute, Kingbridge is a Petri dish for Abele’s efforts to understand corporate and individual behavior, shining a light on ways to shift that behavior toward collaborative outcomes.

At a recent gathering of York region representatives at an afternoon planning session, consultants, academics, corporate executives and meeting facilitators sat around a conference table to prepare for a late-September meeting about helping Ontario communities work together to foster innovation. Abele steered the conversation.

Karen Dubeau, vice president of the Newmarket Chamber of Commerce, set the agenda.

“How do you build collaboration ecosystems?” Dubeau asked. “We talk about collaboration, but how do you actually make that work between organizations especially that are not like each other? A hospital, a local utility, towns in the region, the chamber and the library, these are very different organizations culturally in their governance, in their budgeting, in their project priorities. How do you pull that together in a new model, a new leadership framework to advance initiatives that actually benefit all of the parties?”

Abele responded. “My experience with collaboration is that breakthroughs came, not from within the system, but by having non-establishment parties run the show. So they didn’t have the bias of whatever establishment they came from. Their focus was to create the environment where all views were presented. They chose a panel of experts who were all contrary to each other. Their job was to critique, but because they were together with experts in other fields, they were not incented to sink the boat. They were incented to demonstrate that they had reasonableness, insight and creativity. And that was a spirit that lasted.”

“John seems to appreciate the human alchemy of getting the right mix of questioners and wise men and troublemakers and jokers in a room to answer and frame a question in a non-obvious way,” said Kenneth Zolot, who teaches entrepreneurism at M.I.T.’s School of Engineering. “He knows that sometimes you need to look at just one side of a star to see it properly rather than stare right at it.”

LIGHT THE WORLD

While Abele was in college, his older brother landed him a summer job at Simonds Saw and Steel, a maker of cutting tools in Fitchburg, Mass., where Abele got his first taste of the way organizations worked. Low on the totem pole, he worked as an assistant to some of the company’s engineers. “Being a college student, I knew this wasn’t a life, it was an experiment,” Abele said. “I was always interested in quantitative things, including trying to quantitatively explain human behavior. And I was constantly rebuffed.”

But at Simonds, he made friends with some of the line workers, and one of them had devised a technique for grinding a saw blade on both sides of the blade at the same time. Though the idea made sense and produced a more efficient and cost-effective way to make the blade, nobody would listen to this man’s proposal. Abele offered to write up the idea and give it to his boss on behalf of the worker.

The process worked and saved the company hundreds of thousands of dollars, “and they gave me the credit,” Abele said. “I was embarrassed because I was just passing the idea along. But it was a wonderful exercise in organizational dynamics. My direct boss figured if he gave me the credit, it would reflect well on him.”

Eschewing graduate school—one of only about 10 in his Amherst graduating class to do so—Abele went into sales, selling light bulbs. (“I took the Amherst motto ‘Terras Irradient’—Light the World, literally,” he said smiling.) Among his customers was a small medical technology firm, Advanced Instruments. The company made analytical equipment used in hospitals, which presented a problem for Abele. After his nightmarish experience as a child, he never wanted to go near a hospital or medical equipment again.

“I had so much ether for the many operations I had that if I heard the sounds I heard when I was going under, I would literally collapse, just fall unconscious,” he said.

Nonetheless, in 1960, Abele joined Advanced Instruments, which made an osmometer that measured particle concentration in solutions and a flame photometer that measured ions in a solution. Both instruments were new to the market, and they sparked a fascination with innovative medical devices.While selling for Advanced Instruments he met Jack Whitehead, who would later found the Whitehead Institute for Biomedical Research in Cambridge, Mass. In the early 1960’s, Whitehead was running a small medical firm called Technicon. Abele met Whitehead at a booth at a conference and learned about Whitehead’s skill at selling and his unique ideas about collaboration.

Whitehead, in an attempt to grow his company, bought an innovative device that automated the process of analyzing chemicals for lab tests. Though it was breakthrough technology, the inventor couldn’t get any of the big laboratory supply companies to buy it. In those days, ’physicians seldom ordered lab tests. (Today, laboratory testing is a multibillion-dollar industry.) Whitehead bought the patents and set out to persuade the world to buy this machine.

In his Harvard Business Review article “Bringing Minds Together” (July-August 2011), Abele described Whitehead’s sales technique.

Whitehead, he said, told interested buyers “they’d have to spend a week at his factory learning about (the machine)—and that payment was required in advance. The training would cover how the instrument worked, what might go wrong, how to fix it, how to use it for different applications and how to develop new applications. Customers even had to put their own machines together.”

This approach was like catnip to the early adopters. At the factory, an air of collaboration emerged, the participants feeling less like customers and more like partners. The group worked hard during the day and partied hard together in the evening. “They got to know one another very well,” Abele wrote. “They became a kind of family. When the week ended, those relationships endured, and a vibrant community began to emerge around the innovation.”

The impact on Abele was profound. “Most of my colleagues saw what Jack was doing as creative marketing and aggressive business strategy,” Abele said. “But I saw it differently, and by now I know that something much bigger was actually going on. He was launching a new field that could be created only by collaboration—and collaboration among people who had previously seen no need to work together. Thanks to Jack’s efforts, a group of scientist-customers self-organized to do something he never could have done on his own: advance the responsible development of automated chemical analysis.”

Abele eventually rose through the ranks to run Advanced Instruments, but it was a family-owned business—the owner had three sons— and Abele realized that he didn’t just want to run a company, he wanted to own a piece of the rock. When Abele left Advanced Instruments in 1965, he set out to find a company to buy. During the two years of searching, Abele stayed busy exploring the dynamics of the medical devices industry and the ways in which collaboration and communication across professions and industries would have a profound impact. He went so far as to found the Association for the Advancement of Medical Instrumentation (AAMI), a society “that challenged doctors, engineers and manufacturers to develop standards, improve communication and organize education.”

In 1969, when Abele bought a tiny medical device company called Medi-Tech (which eventually became Boston Scientific), he had a new appreciation for collaborative methods and the type of personality required to spawn such teamwork.

Medi-Tech was founded by a Czech inventor named Itzak Bentov, an iconoclast who spoke 11 languages. Bentov’s innovative steerable catheter intrigued Abele. He envisioned an array of potential uses for the device and believed he could build a company upon its promise.

In his new situation, Abele constantly reached out to the leading lights in their respective fields, men like Ken Olsen at Digital Equipment Corporation, Alex d’Arbeloff at Teradyne, and prominent physicians like Dwight Harken, father of cardiac surgery, at the Brigham and Women’s Hospital in Boston.

“I always wanted to understand where character comes from,” Abele said. “How do you get a Yoda?” Abele is fond of identifying types within organizations who fill key roles. There is the court jester, the fool who can speak truth to power without losing his head; the flamethrower, who can make creative trouble within an organization; and the Yoda, a corporate guru who is not in the chain of command but whose wisdom is invaluable.

In the early 1970’s, Abele and the medical world met a charismatic Yoda named Andreas Gruentzig, a German physician working in Switzerland. Gruentzig was intrigued by the steerable catheter concept and foresaw a way to use a balloon catheter to clear arterial blockages, specifically in the case of heart disease. Balloon catheters had been used as far back as the 1800’s for urological cases, and practitioners had improved the devices over the years. But Gruentzig felt it was crude and nowhere near as effective as it might be. So he invented his own device with a sausage-shaped inflatable segment that would not get misshapen and fail to open a blockage. A careful and thorough researcher, he experimented first on dogs and human cadavers and eventually on the legs of human patients.

Seeking help in the design, Gruentzig reached out to Medi-Tech and struck up a relationship with Abele. In 1975, Abele visited Gruentzig in Zurich and watched, intrigued, as the inventor made his devices by hand at his kitchen table.

But what made Gruentzig so effective was his innate understanding of human nature and the power of collaboration. A confident physician, Gruentzig “was a phenomenal presenter and he knew how to present to a hostile audience,” Abele said. “He was very understated, which was unusual for someone who is passionate about a cause.” Mostly, Gruentzig, instead of proclaiming that he knew all the answers, presented his findings in a way that attracted other great thinkers and innovators to him.

It helped that early on, a number of the doctors who were interested in the technique were “non-establishment.” The idea of putting a balloon in an artery and expanding it strained credibility. How would it not damage the artery or loosen debris that would move downstream in the circulatory system and cause havoc?

With careful experimentation and help from a chemist who showed him how to develop strong, efficient polymers, Gruentzig found answers before the questions were even asked. Abele became an adviser on strategy for introducing new medical devices. In 1976, Abele invited Gruentzig to present at the annual American Heart Association conference. The meeting was full of leading cardiologists and surgeons. Most ignored the balloon catheter, but a small cadre paid attention. Abele introduced them to Gruentzig, who turned the tables and asked questions of his questioners. “He was setting the stage,” Abele said. “He was an absolute master.”

By listening to his audience, as much to get in their good graces as to tap their knowledge, Gruentzig gained credibility. Over time, he hosted surgeons, radiologists, cardiologists and others. “He was an outsider,” Abele said. “And one of my conclusions is that if you really want to change a culture, you can’t change it from the inside. You need somebody who is very talented but also a non-establishment type, someone who is politically incorrect, to guide and lead. They can then become truly objective in the process.”

Using Gruentzig as his muse, Abele established an inviting culture at Boston Scientific. Slowly but surely, he created a community around the nascent company’s products. The company became known for its collaborative methods and for being trustworthy innovators. “We wanted those physicians to be partners with us, but we also wanted a larger group to make sure that whatever we were going to come up with would work for a variety of different backgrounds and mindsets,” Abele said.

To fuel growth, Abele had to understand the many aspects of collaboration. “Growth might be sales,” he said. “Or growth might be due to the impact of a certain activity that doesn’t require enlargement of the organization. You can have different types of collaboration in any environment. You can have adversarial collaboration, or hierarchical collaboration. And then you can have more, an egalitarian collaboration where you bring a group of independent professionals together to work for the purpose of enlarging the pie.”

The company created criteria to screen potential collaborators, no small amount of hubris for a small player in a big field. Physicians were asked to rate themselves on those criteria by answering survey questions: Do you do a lot of research writing? Do you write articles? Do you give talks? How are you viewed by your colleagues? Are you respected? Are you collaborative?

“It was fascinating,” Abele said. “There were so many politically incorrect questions, but we were sending a message saying, ‘There are rules for participating in this, that in order to advance the technology we have to prevent any single individual from running away with it.’ ”

To his surprise, doctors loved the aggressive tactics. They were trendsetters who wanted to be challenged. “That was the purpose of those questions,” Abele said. “To say, ‘Hey, we can come out of left field here and change the world.’ ”

Bigger competitors tried to lure the industry’s opinion makers to their doors, but as Abele said, “The opinion makers took us out to dinner.”

Eventually, Gruentzig came to the United States to visit Medi-Tech’s offices in Watertown, Mass., and the two men formed a strong bond. Abele even taught Gruentzig how to windsurf on Cape Cod during his visit. By 1978, the first balloon angioplasties were performed in the U.S. and the momentum for less invasive surgery grew stronger. Though it has struggled in recent years to regain its past glory, Boston Scientific embodied Abele’s notions about collaboration.

INNOVATION WITHOUT BOUNDARIES

The art on the walls at Kingbridge is designed to provoke thoughtful dialogue or quiet contemplation. Escher prints, a favorite of Abele’s, are prevalent. In a quiet library, the world’s largest Klein bottle is housed in a glass case. The Klein bottle is a four-dimensional mathematical construct of a continuous glass surface with only one side. What looks like a bottle folded in on itself represents essentially no inside or outside but rather one boundless structure. For Abele, it represents not only the Kingbridge philosophy but a metaphor for perfect collaboration. Collaboration requires the elimination of boundaries, artificial and real.

“To me, the purpose of achieving a good collaborative environment is to harness collective intelligence,” Abele said, sitting in his spacious Kingbridge office. “We are taught to be cautious and a bit paranoid from a young age. When your teacher in grade school asked if anyone did not understand a concept, if you raised your hand, you were dead in the water. That passes on to adulthood, and the academic system makes it worse. The business world doesn’t do collaboration all that well, but it continues to pursue collaborative success.”

Having retired from active leadership at Boston Scientific, Abele has devoted his time to the endless search for creative collaboration opportunities. He has been an active board member and supporter of the FIRST Robotics competition, an international high school science and engineering contest that emphasizes collaboration. He is at work on a book about his collaboration theories and is a devoted student of behavioral economics. Being a big fan of Malcolm Gladwell (author of “The Tipping Point” and “Outliers”), Abele is a believer in the impact of indirect learning.

“John gets past the myth of collaboration where we are all sitting around a campfire holding hands,” Zolot said. “Collaboration to him is really understanding how to align the interests of various stakeholders, some of whom may be bitter enemies and competitors.”

If his vision emerges, Kingbridge will continue to grow as a destination for like-minded thinkers intent on embracing the promise of collaborative innovation. “Collaboration is about relationships. It is about trust and always looking for the boundary and recognizing that the boundaries are going to change for a variety of reasons,” Abele said. “They will certainly change technologically and culturally in terms of what is politically acceptable. The key is trying to understand to what extent you can influence those boundaries.”