Identifying, attracting, and retaining leaders for hyper-growth environments: An interview with Karishma Patel Buford, chief people officer at Spring Health

In this podcast, Heidrick & Struggles’ Josh Clarke speaks to Karishma Patel Buford, chief people officer at Spring Health, which provides comprehensive mental health solutions for employers and health plans. Buford discusses how the role of an HR leader is evolving as a strategic business partner and how she identifies leaders who can fit into and thrive in a hyper-growth environment, as well as what else leaders should be considering in terms of leadership capabilities for fast-growing companies. She also shares how her team is managing fatigue, what policies she is implementing in order to combat burnout, and how she is working to retain employees.

Some key questions answered in this podcast include:

• (4:18) With the growing importance for CEOs and boards to have the HR function as a strategic partner, and given your experience with chief people officer and talent management roles, what are the most important aspects of how you have seen the role evolve? 
• (7:28) Diving into your experience in the health tech space and the fintech space, how do you identify and attract leaders who fit into and can thrive in a rapidly evolving, hyper-growth environment?
• (12:29) What should leaders at companies that need to scale quickly be considering as they build out their teams? How can they help determine what skills are most needed and which leadership capabilities new executives will need to continue and contribute to growth? 
• (14:55) With the growing focus across the board for employers to support the whole person, how are you internally walking the talk in terms of supporting the mental health and wellness of your own employees? 
• (21:43) Our colleagues in the DE&I practice here at Hedrick recently published an article on LinkedIn discussing the prevalence of fatigue in the workplace and its impact specifically on DE&I efforts. Is that something you’ve faced? And how are you managing it for the company?

Below is a full transcript of the episode, which has been edited for clarity.

Welcome to the Heidrick & Struggles Leadership Podcast. Heidrick is the premier global provider of senior-level executive search and leadership consulting services. Diversity and inclusion, leading through tumultuous times, and building thriving teams and organizations are among the core issues we talk with leaders about every day, including in our podcasts. Thank you for joining the conversation.

Josh Clarke: Hi, I'm Josh Clarke, a partner in Heidrick & Struggles’ Boston office and co-leader of our global health tech practice. Today, I'm thrilled to be joined by Karishma Patel Buford, chief people officer at Spring Health. Spring Health provides comprehensive mental health solutions for employers and health plans. Prior to Spring Health, Karishma was the chief people officer and customer officer at OppFi, a leading fintech platform, and held VP and director talent management roles at Groupon and BAE Systems. Karishma, thank you for joining us today.

Karishma Patel Buford: Thank you, Josh. So excited to be here. 

Josh Clarke: Great. Well, let's jump in. You've held HR leadership roles at both large and small companies, established market leaders and disruptive innovators, and in multiple industries. How have these differentiated experiences helped you develop as a leader? 

Karishma Patel Buford: Thank you so much. Such an important question, and I would add consulting into that experience as well. One of my most pivotal transitions was from consulting to a very large company, BAE Systems—100,000 employees. One of the big lessons that I learned in that transition was how important it is to be practical and pragmatic in the solutions that you recommend to the business. As a consultant, you can sell quite elegant and abstract solutions but, internally, you have to live with them, and you have to execute on them and make them successful and impactful. And I had some very key moments of feedback in that first experience about how to make initiatives more business focused and practical. So that was a very important transition that I experienced, from consulting to a large company and then going from large company to start-up, a scrappier environment, it was really about prioritization and the fact that you really have to hone in on trying to do three or five things exceptionally well versus trying to do 10 things OK.

And so, now and in my last few experiences in the smaller and start-up environment, I've really been pushing my team. The philosophy has been around prioritization and impact in a way that fuels the business versus what you sometimes hear in HR, check the box initiatives and rolling as much as we can. So I think those are my two big lessons in my career through my experiences: pragmatism and prioritization, and impact. 

Josh Clarke: Any surprises as you reflect back on that? Things that translated particularly well or prepared you for these different types of roles that you wouldn't have anticipated would serve you well? 

Karishma Patel Buford: Yeah, the biggest surprise is probably through my global experiences. Both BAE Systems and Groupon were global experiences and global companies. And it was a surprise but enlightening in the sense that it's certainly not one-size-fits-all. So, what could work in the US may or may not work in Asia Pacific, in Europe and Africa, or Latin America. And you have to pivot and try to find what you can do consistently, globally and locally, and that can change based on whether it's talent management or executive coaching or mental health and what you're doing there. And so, you have to be adaptable and you have to be curious and open to what is going to work within a particular culture. And I can't even say my experiences at BAE Systems and Groupon, even though I was working in many of the same countries, was the same, because the situational context and the timing and the market and the product and services were different. So, [those large global companies were] less of a surprise and more of an enlightenment experience.

Josh Clarke: Thank you for that, I appreciate you sharing. With the growing importance for CEOs and boards to have the HR function as a strategic partner, and given your experience with chief people officer and talent management roles, what are the most important aspects of how you have seen the role evolve? 

Karishma Patel Buford: So, the answer, to me, looks very different than it did pre-pandemic. And the reason is that this role has been elevated in an incredible way as a result of the pandemic. I think that, before the pandemic, the HR function was seen as much more operational, much more of a services function versus that strategic partner. And I think that because of the pandemic, the mental health challenges that so many employees experience, the political divisiveness, our social climate, DE&I—and all of those things happening together in remote world, right? The whole remote distribution and workforce was born in this way out of the pandemic—I think CEOs are really seeing the importance of having a strategic partner in a CHRO or a chief people officer. And I think that's the biggest shift. 

To me, strategic partnership looks like being a trusted advisor and coach to the CEO and the board and being able to lead enterprise-level change. How do you win hearts and minds and obtain massive buy-in for the changes that we're facing internally and external? 

Another important criteria and skill set has been around assessing and developing executive talent. So, this is where my background and experience in Korn Ferry and in being a clinical psychologist has really helped me, because getting the right talent at the right time is the make or break for many companies. And so I think the strategic partner view has changed as a result of the pandemic. And I think that the, the skill set that CEOs are looking for is at a much higher level than it was three, or even five years ago. 

Josh Clarke: Looking back, at this point in your career, what advice would you give your younger self as an aspiring HR leader to prepare for the world we're in today? 

Karishma Patel Buford: I love this question. I think it relates to a bit of what we've talked about so far. My advice is put your business hat on first and your HR hat on second. And what I mean by that is always be solving problems in the context of how you can fuel the business engine. That's our purpose. That's how you can be seen as a value-add versus a cost center. And so what that looks like is working back from the business what problems you need to solve, and if those business problems are tied to performance or optimization or attrition or trying to manage supply and demand of talent, work back from what the business problems are that you're solving versus working in your HR vacuum of cut-and-paste programs or what you think the policy or procedure needs to be. So that's what I would tell my younger self to learn early. 

Josh Clarke: That's great. Pivoting here and diving into your experience in the health tech space and the fintech space, how do you identify and attract leaders who fit into and can thrive in a rapidly evolving, hyper-growth environment?

Karishma Patel Buford: Absolutely, and this comes again from my early days at Korn Ferry, where I learned the science of leadership and what really makes the biggest difference. I would start with the idea of balancing IQ and EQ. The cognitive horsepower and really strong judgment and ability to problem solve in complexity and ambiguity is absolutely critical. It's necessary, but not sufficient. And so, I spent a good bit of my time assessing the EQ side. And when I think about EQ, I think about the grit and resilience, passion and perseverance in a high-speed environment that enables someone to connect with people, give tough feedback, manage the pressures and stresses of a hyper-growth environment, and be able to make decisions and get buy-in from people in that environment—that’s especially important.

I also think that, when it comes to enterprise-level change, having humility and vulnerability as a leader is becoming much more important in terms of authentic leadership and being able to, again, as I mentioned before, win the hearts and minds of people. It’s key. One of our Spring Health values is actually around breaking barriers. Of course, our mission is to eliminate every barrier for mental health, and so of course our leadership competency is around breaking barriers, that is, a person's ability to be relentlessly resourceful in breaking those barriers. And that is again, about both the IQ and EQ pieces because it's about identifying those most critical problems, breaking through the noise, and then is bringing people along to actually drive change and meaningful outcomes. So, those are a few areas that I really dive into as we assess people. 

Josh Clarke: That's great. And, of course, identification and attraction are the first part, but then retention comes into play. As you think about your approach to talent retention, I'm curious to hear how you navigate challenging circumstances such as the bumpy equity market we've been dealing with in the last year. How does that influence your approach to talent retention? 

Karishma Patel Buford: So, the way that we think about retention is, of course, that it starts with understanding what the drivers for engagement and retention at our company are, right? Think about engagement, engagement surveys and data. Those are leading indicators for us in terms of future attrition and retention. We have a wealth of engagement data that tells us what the most critical factors to retain our talent are. And based on just my experience over the past several years, there are a few things that really matter to people when it comes to retaining them. They want to have a sense of purpose and feel inspired by the mission. And I have actually never been at a company that has such a powerful mission and purpose that people live every day and feel, and that we see that clearly and even in our most recent engagement survey. So, it's a big reason that people come to Spring Health and stay. So, being inspiring and having a sense of purpose is very important [for retention.]

The other piece that makes people stay in an organization is a sense that they can be with their manager in a psychologically safe, inclusive environment, one in which they can unlock their full potential and develop themselves. And so, the second area that we are investing very heavily in is building excellent managers. Managers who have much of what I've talked about already, who can really support people in driving performance, in helping them achieve their career goals. [People need to] know that there's a path for learning and growth. The way I think about learning and growth is lattice not ladder, right? Up is not the only way. But how do you unlock career paths for people and how do you create an environment where they can have enough autonomy to develop and to innovate and to experiment and also have an opportunity to master a skill that they are feeling really passionate about that will add value to the business? 

As I reflect back on the last 15 years of my career, the biggest lift you can have in retaining talent is to heavily invest in hiring and developing the right leaders. So that is a huge component of our people strategy has been this year and will be moving forward.

Josh Clarke: Great. Expanding on this topic, what should leaders at companies that need to scale quickly be considering as they build out their teams? How can they help determine what skills are most needed and which leadership capabilities new executives will need to continue and contribute to growth? 

Karishma Patel Buford: The one point I would make on that, Josh, is the idea of what got you here won't get you there. So, at different horizons of growth for company, the skill set, that was enough at one time may not be enough in the next horizon of growth. And that's most critical for a company when they go from start-up to more of that growth stage to mature. The skill sets are different and what scale looks like is different. And so, in that sense, while the foundational skills and competencies may be the same, how long-term and strategically the leader has scaled is going to be a critical differentiator.

Josh Clarke: Well said. And I'm curious, having transitioned to the healthcare space with Spring Health, do you find that the makeup of that organization, the team, the diversity of the functions, the backgrounds, and the experiences from technical to commercial to clinical add another layer of complexity compared to other sectors you've worked in in the past?

Karishma Patel Buford: I think that it adds complexity and some tension. We’re a for-profit in a health space, so we have commercial team members and clinical team members, and I think that there's probably a natural level of tension on the fact that we want to first and foremost change millions and millions of lives. But the way that we're doing it takes a commercial approach, right? The commercial approach is to be able to partner with customers who have a large employee base, who we can serve and connect members with care. And that's the clinical side. It's complex and a natural tension to continue to navigate. And the reality is that we want do both really well. Because doing both really well means being able to win customers, which allows us to grow revenue and ultimately profits that we can then feed back into serving more employees and more people in the world from a clinical standpoint. So, there is a flywheel there that is very purposeful, but that's some of the communication and natural tensions to work through in this space.

Josh Clarke: And with the growing focus across the board for employers to support the whole person, how are you internally walking the talk in terms of supporting the mental health and wellness of your own employees? 

Karishma Patel Buford: Absolutely. One of our values is “science will win.” And so, I'm very big on data and, as I mentioned, we use employee data to understand what our team needs. It's not a one-size-fits-all. We can’t take a wellbeing program from another customer and paint it onto us. That is not our approach. My approach to engagement is very much data-driven and customized. One of the main insights I've gained through our most recent employee engagement data is that, as a hyper-growth company, we have grown faster than most every company in our space. And our rate of growth is so aggressive that most people would experience in three years what we experience in one year. And so hyper growth is true and real for us. And with hyper growth, we know that our business has grown faster than our infrastructure. There are processes and systems and tools that we need to continue to invest in that reduce friction for our employees that may be causing exhaustion and burnout.

But when you're growing this fast, you're often thinking about what the next big thing is. And sometimes, the next big thing is doing what you're already doing but doing it much, much better, more effectively, and more efficiently so that people can gain back time. And that's been a big insight—how much we need to invest in that, because that actually is impacting employee wellbeing and creating burnout. So, it's not a traditional wellness program, right? It's actually more of an initiative to really home in on what the root causes are of the burnout and exhaustion that I think are organic to our hyper-growth environment. 

I've been reading a lot about causes of burnout that may seem nontraditional. One other conclusion I've heard based on the research is that in a meeting-heavy culture, which is, quite frankly, most companies, people do not have time for deep work. Deep work is when you need to focus your brain on creative ideas and deep analysis and innovation. This meeting-heavy Zoom culture is exhausting. People don’t have the time to do this deep work and you can't do that 15 minutes here, 15 minutes there. That is exhausting; it just doesn't work like that. So, we implemented what we called calm Fridays earlier this year for people to do deep work. Now what is happening? We're getting busier, we're growing faster, and having more meetings, and another realization that I've had is that we need to reignite calm Fridays around what it means and hold some of that time sacred so that people can do this deep work that they're trying to squeeze in between meetings. And that's a recipe for burnout. So, these are just a few of the ways we're thinking about walking the talk for our employees in nontraditional ways. I mean, we do the resilience training and we're teaching on growth mindset, and that's what I think of as traditional ways. But some of these ideas are the more customized, data-driven ways that work for where we are as a company.

Josh Clarke: Thanks for sharing those examples, Karishma. You've mentioned Spring Internal to me in the past. Can you tell us more about that? 

Karishma Patel Buford: Yes, absolutely. Spring Internal is our Spring Health platform that we sell and position with customers, and for quite a while, our own employees didn’t have access to our complete provider network. Now we have our own employees on our Spring Health platform, and they have access to all of the providers that our customers have access to. And this was a huge win because when I walked into this role, this was absolutely a pain that our employees were not having the same experience from a care standpoint that we were affording our customers.

And so I'm so proud of my team being able to make Spring internal work for us. We started with a target of utilization of 10%—for employees to book at least one appointment. And we are now at over 25%. So, a quarter of our team is connected to care through Spring Internal. So that's one major way that we are supporting our team when it comes to their own wellness and mental health.

Josh Clarke: That's great. I thought it was interesting to learn that the name of the company, Spring Health, came to be because the founders wanted it to be Spring every day, the season of Spring evokes hope, newness, and change. As the chief people officer, how does this purpose attract and engage people? How do you instill that mission internally?

Karishma Patel Buford: That's a great question, Josh, and that's where I've been so amazed at how many people talk about the mission every single day. And it's one of our highest scoring items, again, that people not only feel such an incredible connection but they're clearly able to align their goals to our mission on a day-to-day basis. And that’s very hard to do in most companies. I've seen this be a disconnect, right? Especially for those in more junior roles, and the mission feels big and lofty. It's harder to connect to that, and we're in a unique position compared to what I've ever seen elsewhere. Here, it's very real for people, how we're changing lives and how we're doing that every single day in terms of how many appointments we're booking for every member and converting to patients. We can see it every day, and so that's actually one of our core strengths. The other aspect I would say about the meaning of Spring Health is that it’s about constant renewal, being fresh. And that's another really strong area that we're continuing to build, which is this idea of growth mindset and continuing to assess how are we doing and learning and pivoting and adapting. So, there will be things we will learn that worked, that didn't work, and we need to ask how are we using those lessons to fuel what we do next. So this idea of renewal is also a thread that we've started on and I think we need to build on much more, but it's core to Spring Health. 

Josh Clarke: Great. Our colleagues in the DE&I practice here at Hedrick recently published an article on LinkedIn discussing the prevalence of fatigue in the workplace and its impact specifically on DE&I efforts. Is that something you’ve faced? And how are you managing it for the company? 

Karishma Patel Buford: So, specific to my team, the people team and HR and DE&I team, there is quite a bit of emotional labor and compassion fatigue that comes into play. And on the DE&I front, to your question—I learned this the first time when I took over global DE&I at Groupon—it is a very long game and it is met with barriers and resistance. Just think about it from a hiring perspective: diverse slates and some of what we want to do. It slows you down to do what is right for the long term of the organization and when you are a fast-growing company. That's challenging. And so you have to try to find the win-wins, and there's emotional labor as you're continuing to try to influence. And so much of the role of HR is influencing; influencing through resistance or gaining commitment versus compliance. And then there's the compassion fatigue that I mentioned.

Spring Health just put an article out there around HR leaders and what they're facing, and I think that that's real as well. My team is very much that first line for employees’ frustrations and disappointments and things not going as expected. And so a lot of what my team holds true in models and lives by is being compassionate and empathic to employees. So that's very real. What you hear from your colleagues is a very, very real experience. And making sure that as a team, we're taking care of ourselves so that we can take care of our employees better is incredibly critical. And so I'm continuously ensuring that my team has a sounding board themselves, and has an outlet and an opportunity to make themselves whole and be the best that they can be. And a lot of that is about team support and cohesion and connection and the social support that a team brings. 

Josh Clarke: Great. And Karishma, one final question as we begin to bring this conversation to a close. Looking ahead, what specific leadership skill sets and capabilities will be most important as you help Spring Health meet its strategic goals? 

Karishma Patel Buford: I think this touches on a few of the areas that I've mentioned, but if I were to identify two of the most critical, I would say from a leadership perspective, it's change management—change leadership and authentic, vulnerable leadership. Those are the two areas that I think are so critical. Change is complex. There are hearts and emotions involved. And so being able to bring people along in a way that's inspiring, exciting, and fulfilling is enormously critical and it's hard. What helps fuel that is truly authentic leadership, leadership that's transparent and real and honest and unafraid to share the tough message. Give people a clear understanding of the why and do it in a vulnerable way. Brené Brown talks about this so much, but I think that talking about vulnerable leadership and then becoming a vulnerable leader are two very different things. The more that we can do that, the more the trust in employees can increase and surge so much, and so much of my work as I coach the executive team is around building ourselves in these areas, myself included.

Josh Clarke: Karishma, thank you for taking the time to speak with us today.

Karishma Patel Buford: Thank you, Josh. Really appreciate it.

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About the interviewer

Josh Clarke (jclarke@heidrick.com) is a partner in Heidrick & Struggles’ Boston office and a member of the global Technology Practice, in which he co-leads the global health tech sector.