Pluck: Lessons We Learned for Improving Healthcare and the World
by Alfred Sadler and Blair Sadler

Pluck is for anyone who aspires to help improve the world around them
As a doctor and lawyer, and identical twin brothers with a history of collaborative teamwork, Alfred and Blair Sadler wrote Pluck to share some of the most important lessons they learned on their journey, which began more than fifty years ago, helping to make major decisions that have had a multigenerational impact on healthcare in the United States.
Pluck brings together the spirit of courage, taking of roads-less-traveled, and living with a mindset focused on possibility that we can all call upon to improve everyday life. It inspires hope and collaboration, as well as meaningful change and action.
Alfred Sadler and Blair Sadler, a doctor and a lawyer, who are also twin brothers, worked together on the early laws concerning organ donation and the first heart transplants, the emergence of the physician assistant profession, the birth of bioethics, and the creation of emergency medicine. In this compelling and stirring book, they take us on a fascinating journey through the National Institutes of Health, Yale University Medical School, The Hastings Center on Bioethics, and the Robert Wood Johnson Foundation.
In Pluck, the Sadlers recall being in rooms where major changes occurred that have had multi-generational and lifesaving impacts on our country’s healthcare. They describe their roles in helping to lead and accelerate the pace and scale of needed change. The lessons they learned are enduring and relevant today.
Whether you are interested in healthcare, environmental activism, criminal justice reform, economic and racial equity, or education, transformation is possible with the help of the authors’ 15 lessons for catalyzing change that conclude their enriching book.
What people say about it
The behind-the-scenes story of how twin brothers—doctor and lawyer—collaborated with scores of unsung heroes to modernize emergency medical services, help create the physician assistant profession, help write the model law for organ donation and develop other programs that save thousands of lives a year. Pluck is an inspiring model for how to lead major change—a great read, couldn’t put it down.
—James A. Guest, Past President and CEO of Consumer Reports
They reverse engineer their effectiveness…in a series of lessons learned offering guidance for the leadership of change, always emphasizing initiative, optimism, resilience, and above all, cooperation…. No matter which of their several quests they describe, Blair and Fred also reveal a level of agility and creativity that marks the best leaders. They always seem to find a pathway out of paralysis and conflict into shared possibility.
—Donald M. Berwick, M.D. President Emeritus and Senior Fellow Institute for Healthcare Improvement
About the Authors
Alfred Sadler, M.D.
Alfred Sadler, M.D. ScD (Hon) FACP. He is Co-Founder of the Physician Assistant Program at California State University Monterey Bay in 2015 and is President of the Cypress Foundation – dedicated to improving physician and PA workforce in the tri county area where he lives. He was trained in Surgery at the Hospital of the University of Pennsylvania and in internal medicine at the Harvard Medical School and the Massachusetts General Hospital. He practiced primary care in Monterey County for nearly forty years with emphasis on underserved populations. He is a member of Alpha Omega Alpha and in 2018 was recognized as “Physician of the Year” by the Monterey County Medical Society. He is a coauthor of The Physician Assistant: An Illustrated History in 2013. He lives in Carmel, California.


Blair Sadler, J.D.
Blair Sadler, J.D. is a senior fellow at the Institute for Healthcare Improvement (IHI), and a member of the faculty at the University of California San Diego’s Rady School of Management. Through teaching and presentations, he remains a strong advocate for evidence-based architectural design, healing arts in health care, transforming health care’s environmental impact, and leading with transparency and empathy in times of crisis. A graduate of Amherst College and the University of Pennsylvania Law School, he was a law clerk for the Superior Court of Pennsylvania. From 1980 to 2006, he was the president and CEO of the Rady Children’s Hospital in San Diego. He has served on the board of the Hastings Center for 12 years and is a member of the board of Health Care without Harm, an environmental health advocacy organization. He chairs the Board of Access Youth Academy, a San Diego nonprofit devoted to transforming the lives of underserved youth. He lives in La Jolla, California.