Donato J. Tramuto is widely recognized for his commitment to social change and transformational leadership in healthcare innovation that led The New York Times to deem him “a global health activist.” He is the former CEO of Tivity Health®, Inc. (NASDAQ: TVTY) where he served as a Board Member, Chairman of the Board, and later as CEO. He led a turnaround that moved the company toward profitability.

He is an entrepreneur, innovator and passionate champion of cutting-edge approaches to healthcare access, drug safety, and addressing the social determinants of health (SDOH), defined by the World Health Organization as the conditions in which people are born, grow, live, work and age. Tramuto is also the founder and chair of The TramutoPorter Foundation which advances people’s rights to education, healthcare access, and combats human right violations.

Tramuto currently serves as a member of the Board of Directors of Robert F. Kennedy Human Rights and is Chairman of its Leadership Council where in 2018, his foundation committed to funding a three-year, $1 million grant to address workplace bullying, leading a national initiative to address workplace dignity and inclusion in the U.S. and Europe.

He is a regular speaker on topics of workplace dignity, social justice, healthcare access, and value-based leadership. He has frequently appeared in the media in outlets such as The New York Times, CNBC, Fox News with Neil Cavuto, Bloomberg News, The Boston Globe, and The Wall Street Journal. His book, The Double Bottom Line: How Compassionate Leaders Captivate Hearts and Deliver Results, written with Tami Booth Corwin, was published by Fast Company Press (April 2022).

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Before discussing The Double Bottom Line, here are a few general questions. First, was there a turning point (if not an epiphany) years ago that set you on the career course you continue to follow? Please explain.

Yes. September 11, 2001 was a turning point for many people and for me – this day changed my life. I was scheduled to be on United Flight 175. However, the day before, I had a toothache and decided to see my dentist in Boston whose office was three minutes from the Boston Logan Airport. Then, after my 1:00 PM dental appointment, I decided to change my flight to leave on September 10th. Because I was already in Boston, it did not make sense to go back to my home in Maine and leave for LA on September 11th. That decision saved my life!

Unfortunately, and for my two friends and their 3-year-old son who were visiting my partner and me at our summer home in Maine, they boarded the flight and lost their lives when United Flight 175 hit the south tower. Rather than have hatred and anger in my heart, I launched the TramutoPorter Foundation and Health eVillages channeling the hurt and pain from 9/11 into something good. This experience also taught me that the life we live is temporal and the greatest responsibility we have is to be kind and compassionate and to express our love to all people. I moved away from hiding who I am with my employees to sharing my beliefs and total persona and accepted the notion that being vulnerable is actually a very positive attribute to have in business.

Who and/or what have had the greatest impact on the development of your thoughts about compassionate leadership? How so?

Pope John Paul II. John Paul II often asked for people to show compassion and in an extraordinary personal example, he proved he was able to give it. In May 1981, when he went out to meet the people, as he so often did, he was shot in St. Peter’s Square and then later displayed unmatched compassion to his assassin by visiting him in prison two years later forgiving him for the assassination attempt. Agca was later pardoned by the Italian president at the Pope’s request. Some people would say this was a display of weak leadership and I disagree. Agca served his time in prison and later communicated publicly his apology asking for forgiveness. Pope John Paul could have ignored the pleas and rather he went to visit him sending a message to the entire world that leaders must walk the talk, and this is an important quality of Compassionate Leadership. Namely, empathy in action and by example!

Here are several of my favorite quotations to which I ask you to respond. First, from Lao-tse’s Tao Te Ching:

“Learn from the people
Plan with the people
Begin with what they have
Build on what they know
Of the best leaders
When the task is accomplished
The people will remark
We have done it ourselves.”

This quote aligns so well with our message in the book as well as with the survey we did among 1500 people across the United States, as well as 40+ one-on-one interviews. Namely, when asked this question:  “Do your leaders seek input and support from employees to promote a compassionate workplace?” 85% of the senior leaders agreed. 75% of middle managers agreed yet only 59% of the lowest-evel employees agreed. Messages are getting lost as they travel from top to bottom and if this quote is to have its full meaning in an organization, leaders must recognize if your messages are not getting across or if your employees hear but don’t believe you, you risk losing trust. If you say you care, but you don’t pair your words with actions, you will come across as inauthentic and risk losing others’ trust and respect.

From William L. McKnight: “If you put fences around people, you get sheep. Tear down the fences!”

I love this quote and although it was introduced nearly 100 years ago the words have such great meaning today. Compassionate Leadership is about cultivating trust which then leads to full empowerment of your people. Nothing can get done in any organization without people and the sooner leaders recognize that it should make difference the age of the employee, each person has a talent – a skill – a need to contribute and setting your employees free and letting them lead will drive higher growth and greater productivity in your business. Today’s leaders must move away from thinking that establishing a culture/mission is the number one priority of a new leader and rather establishing “trust” needs to take top priority followed by the mission/vision statement. If you do not have the trust from most of your employees, nothing else will matter.

From Margaret Mead: “Always remember that you are absolutely unique. Just like everyone else.”

Today we are faced with a new chronic condition of the 21st century called loneliness which is shocking to many when you think about technology claims of advancing a very connected world. While many experts in the Public Health field have associated loneliness with a variety of causes, the one area that my own research has unveiled is the relationship of social isolation and loneliness to one’s sense of a decline in their own overall relevancy. People are feeling a loss sense of purpose – value – and sense of connection to others and the compassionate leadership movement is about “consistency” and “commitment” in taking the time- every single day – to stop and enter a deep listening mode to truly understand the stories of people you meet and in doing so, we have validated to that person how relevant they are.

Unfortunately, what we do today is we “listen to reply” rather than listen to understand and the recent pandemic has only exacerbated this sense of loss of connectivity to others. This is why I used the concept of the three T’s in my approach to leadership and that is – take time to show Tenderness (learn about the person) which will lead to the 2nd T of gaining Trust and then you can implement the 3rd T = embrace Toughness. Too many leaders begin with using the 3rd T as their first approach and then they wonder why they are going around with a pooper scooper to secure the Trust. Take time to listen to the stories of other people – I call this “story health” and you will be surprised how much you will learn about that person.

From Maya Angelou: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

This is by far one of my favorite quotes and I often use it in many of my speeches. It captured my attention many years ago following decades of a hearing loss and the recognition that while I am unable to hear all the words that might be coming my way, I, as well as others, do have the quintessential ability to use other senses to connect to people. Taking the time to convey a smile, a nod recognizing you understand what was said, taking the time to send a thank you card (by the way, I have sent many thousands of cards to people in my lifetime) after you have met with someone, picking up the phone to reach out to someone you have not spoken to in a long time, etc are all gestures that have the power to make someone feel great. I always approach each day with the notion that the people I will meet during the day most likely are having a more difficult time than I may be experiencing and by adopting this philosophy, I then have a unique opportunity to show compassion and kindness and help make the day better for that person. I never leave any conversation – either live or via a written correspondence – with have a nice day. Rather, I use “make it a nice day” because I believe it is in our power to help make the day great!

In your opinion, what are the defining characteristics of a workplace culture within which personal growth and professional development are most likely to thrive?

For me, it begins by establishing Trust before you address the development of a workplace culture/vision/mission. Think about it for a moment as it applies to personal relationships. No one talks about marriage and children on their first date and rather the first, second and perhaps a few more dates are all directed toward listening and connecting to the other person to establish Trust. It is only after that stage when you feel connected and safe that you can move onward and develop your personal journey for how you will live together. This is no different in an organization.

So, take time to get to know your people – your customers – your Board members – your colleagues and together – and I emphasize – together – you can then create the vision, mission and the agreed upon expectations for the organization. Front and center to all of this is to have a communication plan that provides multiple venues around how you will communicate and if you have the Trust in place and you reinforce it through a very comprehensive communication plan whereby you are comfortable with any questions at any time, you then by default create a culture where everyone will feel empowered, respected, and where their individual contribution is valued.

Looking ahead (let’s say) 3-5 years, what do you think will be the greatest challenge that CEOs will face? Any advice?

Prior to the COVID-19 pandemic, we observed negative trends in the workplace that included lower satisfaction and engagement, rising dissatisfaction with leadership, even bullying in the workplace. The pandemic and social and political upheaval that started before it led to widespread disruption and epidemic levels of loneliness, anxiety, and depression at home and at work. The workplace has also changed because of a new generation of workers – with different priorities, values, and workstyles – entering the workplace in greater numbers. These younger workers are still being led primarily by a less diverse set of senior leaders trained under traditional leadership models. Technology advancements have also been driving a need for a different type of employee – one with more developed “human’ qualities and “soft skills” creativity, adaptability, and workplaces still focus on productivity, profitability, and technology. The confluence of events and trends has resulted in a seismic shift in the workplace that has left many leaders ill-equipped for the workplace of today and that of the future. There will be a need for a different model of leadership – one that is more aligned with its workplace and current trends, an approach to leadership that is a people-focused and it is results-focused. My belief is that the new approach to leading will be about delivering on a double bottom line where bettering conditions for people and delivering strong performance or profits. In fact, they not only can coexist. A better focus on people leads to better results.

Now please shift your attention to The Double Bottom Line. For those who have not as yet read it, hopefully your responses to these questions will stimulate their interest and, better yet, encourage them to purchase a copy and read the book ASAP. First, when and why did you decide to write it?

I decided to write the book following my experience as CEO of a Public Company. During my first 18 months in that role, I pushed the notion with my leaders around the importance of compassionate leadership yet when I randomly surveyed the employee population, I uncovered more than 20% of the workforce felt bullied despite our having communicated the value around leading with compassion. Since then, I’ve continued to see a decline in worker engagement, continued lack of diversity, inclusion, respect – and a lack of empathy that prohibits us from understanding each other. I still see too many ‘old school’ leaders who don’t know how to manage new generations of workers. We’re seeing demands from workers, stakeholders, and consumers for a kinder, more conscious workplace and world.

Today’s leaders need to adapt to the new world they’re in. They need the skills and mindset to manage the double bottom line of better conditions for people and better business results in order for their companies to survive and thrive, and for them to succeed in their roles as leaders.

There is also a need among aspiring leaders to understand how important compassion and related skills will be in the future. There is a growing need for skills like communication, adaptability, the ability to understand others’ needs and this is just as true in a tech company as it is in a hospital or a school.

This book is a guidebook for a new model of leadership that fits the demands of today’s workforce and world. Drawn from original research and interviews with 40 compassionate leaders, The Double Bottom Line shares real-world examples and actionable advice from leaders who have proven this leadership approach works.

Were there any head-snapping revelations while writing it? Please explain.

There were too many to highlight here, however, we interviewed 40 leaders including Fortune 50 public company CEOs, political leaders, non-profit founders, actors and journalists, doctors who ran COVID wards, a nun who was honored in Time magazine’s “Most Interesting People” list for her fierce advocacy for the homeless, and many more.

There were many commonalities among those we interviewed. One they all shared was how they defined compassion — as a combination of empathy and action. There is a misperception that compassion and empathy are interchangeable, but they’re not. Empathy is more correlated with emotion whereas compassion is about action. Empathy is feeling, compassion is doing.

These leaders were inspiring examples of how strong and tough compassionate leaders are. There is another myth that suggests that compassionate leaders are weak, too nice, will get walked all over. This could not be further from the truth. Compassionate leaders are driven by a strong desire to uphold high standards, to deliver on a mission, to stand up for what’s right. All of these initiatives require courage.

We wrote the Double Bottom Line because understanding how you can be both tough and compassionate is something many naturally compassionate leaders need help with. Compassionate leadership involves much more than being nice or having empathy.

There is also a need among aspiring leaders to understand how important compassion and related skills will be in the future. There is a growing need for skills like communication, adaptability, the ability to understand other’s needs and this is just as true in a tech company as it is in a hospital or a school. This book is a great primer that will help prepare our future leaders.
We also found in our own original research that there is a big disconnect between how senior leaders see themselves in terms of how compassionate they are, and what workers think. We want to help close that gap.

Compassionate leadership isn’t as about just being nice or showing empathy. There are specific things to keep in mind and pitfalls to watch out for. That’s why we pulled together the advice, case studies and examples that will help leaders do this effectively.

To what extent (if any) does the book in final form differ significantly from what you originally envisioned?

In the first thought process of writing the book, I did not envision more than 10 one-on-one interviews and the survey of 1500 people was not in the mix. To have limited this project to just a few interviews would have missed the mark with regard to what we now have in terms of compelling facts supported by the data. There is no doubt in my mind whatsoever that every person whether they are in the business arena – not for profit – education – or trying to improve on their personal and professional relationships – will take from this book some tangible leadership nuggets so that they can implement in their day-to-day interactions with other people to improve their overall approach to leading with compassion.

What are the defining characteristics of a compassionate leader?

To deliver on the compassionate leadership mantra of “empathy in action”, our survey of 1500 people ranked commitment, communication, and consistency as key characteristics of a compassionate leader.

Of all those characteristics, which seems to have the greatest impact on the given organization? Please explain.

I like to stress the consistency aspect because practicing compassionate leadership is not an occasional skill nor is it for a few (commitment) and the constant training and check-in points (communication) when linked together establishes the kind of trust you want in today’s organization

For those who have not as yet read your brilliant book, please explain the concept of an organization’s “double bottom line.”

Employees, consumers, and other stakeholders are demanding that companies today take care of their people, their communities, and the planet while at the same time companies must deliver profitable financial results to create sustainable businesses. We’re seeing employees leave their jobs when they’re not feeling engaged or respected, and that’s why we’re suffering through a talent shortage. It’s imperative that companies focus on their people as much as their bottom line. That’s double bottom line leadership. Leading with compassion is no longer a “nice to do” — it’s a MUST-DO.

We know it’s possible for leaders to deliver on both the human level and the financial level if they take a compassionate, people-focused approach, and importantly – if they do it effectively. Taking care of your people leads to stronger results. This leadership strategy allows leaders to deliver on both at the same time — that’s the “Double Bottom Line.”

We make the case that capitalism and compassion are perfectly compatible!

And by the way, leading with compassion is more satisfying for the leader who embraces it. Science has shown that compassion increases, indeed enriches well-being.

In this context, years ago, Southwest Airlines’s then chairman and CEO, Herb Kelleher, was asked how his airline was ten times more profitable than any of its nine competitors and worth more than all of them combined. He replied, “We take great care of our people, they take great care of our customers, and our customers take great care of our shareholders.”

Here’s my next question: Which misconception about compassionate leadership is most widespread and problematic?

That being compassionate cannot be taught. Either you have it or you don’t.

This was one of the major issues we addressed as we began to work on the book. We asked every leader if they were born compassionate or learned it along the way. We concluded that yes, compassion can be taught. Perhaps the most powerful way is by example. That’s why it’s so important for more and more people to adopt this leadership approach — compassionate leaders today have the power to affect so many more future leaders.

Which question had you hoped to be asked during this interview – but weren’t – and what is your response to it?

Here are a few questions I’ve recently been asked:

“In an increasingly tech- and data-driven world, does developing compassion really matter?”

It’s true that technological change continues to accelerate and it’s changing the nature of the skills we need in the workplace – but not necessarily in all the ways you might think. We don’t just need technically savvy workers; we need people with finely tuned human skills and leaders who understand how to cultivate these competencies in the proper proportions. In a Future of Work report from McKinsey, they modeled what the workforce needs would be by 2030 and they reached some interesting conclusions such as increasing need for social and emotional skills, skills that are a long way from machines mastering in this age of AI. These also include empathy, more finely tuned communication skills, compassion, creativity and even courage. These are all optimized with a compassionate, double-bottom-line leadership approach.

“When you say empathy isn’t enough, what do you mean? What’s the difference between empathy and compassion?”

Empathy has been a leadership buzzword, particularly during COVID, and it is often confused with compassion. A lack of empathy prohibits you from understanding others’ perspectives and that keeps you within your own closed-circuit domain. That’s not a powerful place to lead from. Empathy is truly an essential element in human relationships. Compassionate leadership needs to go a step further. Compassionate leadership isn’t about just being nice or feeling empathy only. It is also about respnding to another person’s need for help. There are specific issues to keep in mind and pitfalls to avoid when doing That’s why we pulled together the advice, case studies, and examples that will help those who read our book to embrace this form of leadership with skill and effectiveness.

“Some leaders will assume that you expect them to coddle or indulge their workers and try to meet every demand at a cost to their business. Can you comment on that?”

It’s true, many leaders have concerns about where to draw the line between supporting workers and indulging them. Many leaders have stereotyped particularly those in younger generations as entitled or lazy. Acknowledging these concerns makes it more imperative than ever for leaders to understand that this form of double bottom line leadership I’m making the case for does not mean indulging employees at a cost to your business.

One critical piece of this equation is gaining a better understanding of younger generations (and for younger generations to increase their understanding of older generations) through empathy and efforts to identify their unconscious biases. The other critical piece is setting very clear expectations of your employees, communicating with them often to assess how they’re doing, and determining if they need support or mentoring to reinforce what their company needs from them in their jobs.

Managing for the Double Bottom Line means that you treat your employees with respect, communicate with them, care for them but also hold them to the high standard you set for everyone as well as for yoursellf. Being a compassionate leader also means that if an employee is still not meeting their goals after multiple discussions, you may need to let them go — and in that event,  do it with respect and honesty so that they can learn from it.

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Donato cordially invites you to check out the resources at these websites:

Donato Tramuto Official Website link

Order The Double Bottom Line link

The Tramuto Porter Foundation link

Health eVillages link