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Big dreams stall when willpower wears thin. The Persistence Factor shows you how to keep going-smartly, sustainably, and together. Physician-executive Dr Kevin Fickenscher distills forty-plus years of leading rural clinics, Fortune-500 C-suites, and national policy tables into one repeatable blueprint: the Persistence Cycle of Purpose ¿ Consider ¿ Commit ¿ Focus ¿ Assess ¿ Integrate - and then repeat until the breakthrough sticks . Packed with field stories that range from transforming prairie health systems to advising Congress on digital medicine, the book reveals why long-game change hinges less on heroic stamina than on disciplined reflection and adaptive iteration. Inside you'll discoverThe FAIR-CTI ethos-Fairness, Attitude, Integrity, Respect, Consistency, Transparency, and Inclusion-that turns trust into the "mortar" holding teams together through stormy seasons A Confidence Loop to convert criticism into renewed momentum without losing sight of your purpose Failure as Strategic Fuel-how to mine setbacks for data, allies, and narrative power The Leader's Self-Retreat-a step-by-step reset that clarifies values, reallocates energy, and prevents burnout Whether you're launching a social-impact start-up, re-architecting healthcare, or rallying a community around bold policy, The Persistence Factor hands you the compass and the toolkit. Dr Fickenscher's warm storytelling voice makes complex strategy feel like a fireside chat, while ready-to-use worksheets and reflection prompts turn insight into immediate action.