What Alicia Boler Davis had to ‘unlearn’ from Jeff Bezos and Amazon to lead digital pharmacy Alto 

Hello and welcome to Modern CEO! I’m Stephanie Mehta, CEO and chief content officer of Mansueto Ventures. Each week this newsletter explores inclusive approaches to leadership drawn from conversations with executives and entrepreneurs, and from the pages of Inc. and Fast Company. If you received this newsletter from a friend, you can sign up to get it yourself every Monday morning.  Those of us who track the moves of prominent women in business were surprised when Alicia Boler Davis left Amazon in 2022 to become CEO of Alto, a digital pharmacy with approximately $1 billion annual revenue. Boler Davis, who spent nearly 25 years at General Motors before joining Amazon in 2019, was the first Black executive to join the e-commerce company’s senior leadership team, also known as the S-team. When she was elevated to the S-team in 2020, members included then-CEO Jeff Bezos and current CEO Andy Jassy, who led Amazon Web Services at the time. A high-profile corporate CEO gig seemed like a natural next step for Boler Davis.  Building a better pharmacy solution But Boler Davis says the leap to startup Alto, founded in 2015, was a great fit for her skills and aspirations. “Obviously I can lead and scale organizations,” she says. “Pharmacy is so antiquated, and there’s so much opportunity in this space. I felt that I could have an impact. I could make a difference. That resonated with what I wanted to do at this point in my career.” She adds: “I’m a builder at heart.”  Indeed, hints of Boler Davis’s ambition for Alto are starting to emerge. Last month the company launched Alto Technologies, an enterprise platform that provides services to drugmakers, provider networks, hubs—specialists that work with patients on access to medication—and payors. The platform aims to use artificial intelligence (AI) and automation to expedite the delivery of medicine to consumers. In one example Boler Davis cited, Alto’s software cut the “speed to fill” of one time-sensitive, specialty medication in half.   Alto’s effort to connect stakeholders in the pharmacy industry and accelerate processes reflects Boler Davis’s professional experiences. At GM she rose to executive vice president of global manufacturing and labor relations, and at Amazon she was senior vice president of global customer fulfillment and was also in charge of customer service, robotics, and product assurance, among other responsibilities.   ‘Unlearning’ early lessons But not all of Boler Davis’s experiences at Amazon translated at Alto. I asked her what she had to “unlearn” from her days at one of the world’s largest companies in order to succeed at Alto. She noted that Amazon has to innovate for a mass audience, while Alto needs to think smaller for now. “We have to be nimble, we have to be fast, we have to be creative,” she says. “The first solution isn’t being built for a million people—you have to demonstrate that you have a product that works before you can scale it.”   As she reflected on the differences between startup life and the corporate world, Boler Davis invoked one of Amazon’s famous leadership tools—the concept of one-way and two-way doors. Amazon defines one-way-door decisions as “significant,” with major financial consequences, such as building one of the fulfillment centers that Boler Davis used to oversee. A two-way-door decision can be more easily reversed. The decision-maker can walk back through the door in which they came and pick another door.  At Alto, products may need to evolve and change. Even after launching Alto Technologies, Boler Davis says the platform must continue to pursue new configurations and different offerings for customers. She says: “Here at the startup we are running through two-way doors constantly.”   The value of unlearning At a time when companies extol the virtues of the growth mindset or seek to become “learning organizations,” it might be worth celebrating the value of unlearning. “Unlearning is not about forgetting. It’s about the ability to choose an alternative mental model or paradigm,” leadership expert Mark Bonchek wrote in Harvard Business Review. “When we learn, we add new skills or knowledge to what we already know. When we unlearn, we step outside the mental model in order to choose a different one.”  What skills, traits, or habits have you unlearned when changing jobs, careers, or even when trying to learn a new discipline? Send your experiences to me at stephaniemehta@mansueto.com. I’d love to publish the best examples in a future newsletter.   And as a reminder, I’m soliciting nominations for Modern CEO of the Year. Any chief executive officer—your company can be based anywhere in the world and be any size—is eligible. You may submit your nominations via this form. The deadline for submissions is November 22.   Read more: Beyond big tech  Meet the rebounder founders   Former Microsoft CEO Steve Ballmer has cracked the code on second acts  Inside Reed Ha