Professional Values Under Attack–A Sobering Look At Healthcare

Why Doctors Are Sick of Their Profession is an article that ran recently in the Wall Street Journal.  It’s a sobering look at the human side of the current dysfunction we call healthcare.

The article’s author Sandeep Jauhar MD makes the point that he and many of his physician colleagues are ‘struggling with the loss of their professional values’.  He suggests that in many ways he has become the doctor he never thought he would be: impatient, occasionally indifferent, at times dismissive or paternalistic.  Whether he’s being too hard on himself, I don’t pretend to know.

The causes for the trend are varied and, in many cases, deeply rooted within an industry in need of reform. In many ways the system has beaten down the doctors—imparting cynicism in place of their once noble aspirations.

The doctors are largely part of a system they can’t beat and many don’t want to be a part of.  This article is instructive in two important ways:

***First: it demonstrates how important professionals really are—healthcare just happens to be today’s example.  Absent professional values, things ‘go south’ fast for all stakeholders.  As Jauhar points out, naturally the patient’s experience is negatively impacted when the doctor’s professional values slip.

***Second: to me the answer to having a system ‘beat you down’  is (in part) to remember why you entered the profession in the first place.  In other words, never forget what your purpose is.  Tattoo it on your forehead if you must.  For one’s own mental health, a compelling purpose (on most days) will typically trump a bad system.

It’s interesting to note, from a systemic point of view, that the author suggests emphasizing professional values in the next generation.  That means ‘instilling professional values early on’ in medical school. Couldn’t agree more.  That’s precisely what we’ve helped do at the West Coast Ultrasound Institute. The results are exciting.

Professional values: without them, eventually we’ll all be sick. With them, we’ve got an invaluable  formula for health.

 

Leadership Development – Grading a 14 Billion Dollar Investment

Many of you have heard me rail against so-called training methods that prove ineffective. Long story short, lots of training is a waste of time and money. At least that’s the way I see it.

The January 2014 issue of the McKinsey Quarterly contains an article that echos that sentiment. The article—“Why Leadership Development Programs Fail”— outlines four common mistakes that contribute to the leadership development failure.

One of the four mistakes referenced in the article has to do with ineffectively addressing an individual’s mind-set. In other words, most leadership development programs don’t deal with the root cause of behavior—namely the individual’s mind-set.

While the authors have a slightly different view of ‘mind-set’ than I do….the gist of our views is common enough not to quibble with.

In writing The Power of Professionalism I made a commitment to deal with the root causes of behavior—namely to identify the mind-sets held by trusted professionals. Get the focus on the right mind-sets and a lot of things (behaviorally, for the student) naturally takes care of itself. Get the focus on the right mind-sets and now you’re (managerially speaking) leveraging your training investment.

Apparently one of the world’s premier consultancies now sees it that way too!

Identity As A Predictor of Behavior

We humans incessantly want to know ‘why’.  Children especially.

Why did so-and-so do such-and-such is an especially popular ‘why’ question centered around human behavior.  Given all the seemingly unexplainable things we humans do, it’s certainly a natural.

In The Power of Professionalism I suggested that an especially helpful way to better understand a person’s behavior is to understand how they view themselves. Said another way, understand the identity the individual has assigned to themselves.

It wasn’t until the mega-talented All-Star outfielder Jose Canseco revealed to baseball manager Tony LaRussa that he saw himself as an entertainer (think: identity) that LaRussa finally understood his flamboyant, and often maddening, outfielder (source: full story page 56, The Power of Professionalism). It wasn’t until that acknowledgement on Canseco’s part that LaRussa truly understand why Jose did what he did.

Fast-forward to last Saturday March 8th. A San Francisco Giants beat writer was being interviewed by Marty Lurie.  Marty hosts the Giants pre and post game radio program show on the weekends in the Bay Area.  The subject shifted to steroids and, naturally, Barry Bonds.

Did he or didn’t he?  And if he did use steroids, why? To be clear, Bonds has never  acknowledged he used steroids, although most believe he likely did.  The ‘did he use’ question was also focus of a protracted federal court case.

The beat writer goes on to share an experience he had with Barry (and his entourage) very late in his playing career.  Barry was ‘holding court’ with this tight-knit group out of ear shot of others. It was Barry ‘unplugged’.  He was authentic and unabashedly forthright as he spoke about his career, his reputation, and his station in baseball history.

During the session Barry never acknowledged that he had used steroids but spoke ‘as if’ he had. After all, he reflected, wouldn’t a player get contact lenses if it enhanced their  performance?, wouldn’t a player doctor the ball if it enhanced their performance?  wouldn’t a player use steroids if it enhanced their performance?

Bonds went on to say that he considered himself an entertainer (think: identity)…just as Canseco did!

What’s the principal thing entertainers are expected to do?  Perform!

Did Barry Bonds use steroids?  I don’t know.  But if he (the entertainer) did, now you know why.

 

 

 

 

 

 

 

 

 

Don’t Let A New Organizational Structure Become the Grist For Employee’s Cynicism Mill

Here’s an interesting question, “Of all the organizational structures out there (i.e. matrix, self-management, traditional hierarchy, etc) is there one you recommend that will best leverage a culture centered around professional values?”

I get this question occasionally. The short answer is ‘no’…’no’ I don’t advocate one organizational structure over another.

People get pretty enamored with organizational structure. Some see it as a silver bullet.  Some unknowingly (and sometimes unconsciously) view it as a substitute for good management.

Long story short: an organization with an unhealthy culture that adopts a new organizational structure will likely remain an unhealthy organization.  Structure is not a substitute for good management.

People make the difference, structure is merely a tool. There are many examples of organizations with admirable cultures that happen to have unique organizational structures. Yet, look deeper…what typically makes these organizations ‘tick’ is the way their people think. Their people think like professionals.

Note: let’s acknowledge that structure can indeed influence thinking. The difference between the winners and the losers is the depth of thinking (and commitment). Organizational structure should never be a substitute for things like organizational purpose, jointly-held values, engagement, etc.

I’ve seen organizations with the most convoluted organizational structures (one that seemingly wouldn’t work) that shine.  The reason it works is because of their people.     In other words, the professionals overcame the arcane structure.

Bottom line: professional values can add value to virtually any organizational structure.  The most important part is the professionals, not the structure.

What prompted this post was an article about Zappos eliminating their managers—adopting a vastly different organizational structure. I suspect it will help Zappos…as their culture is admirable, their management committed. Yet, too often a new organizational structure (which can, to a lessor degree, also include shifting the boxes on the org chart) ultimately becomes grist for employee’s cynicism mill. 

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A Well-Intended, Yet Misguided, Question Professionals Should Stop Asking

You’ve heard it on Oprah, you expect it from psychologists, emphatic managers are sometimes encouraged to ask it.

“How does that make you feel?” It’s an oh-so-common question.  On the surface, the question seems innocuous–even well intended.  Someone has a ‘bad’ experience; empathy gets marched out as an anti-dote.   On the surface, it all makes sense.

But it’s a question that makes my head explode.

Why? Because the implication is that the person has no control over how they feel.  That’s just wrong.  Taken to its logical conclusion, it enables people to abdicate responsibility.  It breeds victimhood.

Events trigger emotions. This is an automatic reaction—or that’s what most people believe. But that’s not really the way it works. Rather, emotions are determined by what we think about the event, not by the event itself. In other words, our interpretation of an event ultimately becomes the precursor to the emotion we experience.

For instance, the mandatory overtime Saturday work-day unexpectedly gets canceled by management. Tom is thrilled (he gets to play golf); while Mary is bummed (she needs the extra money).   Same event— two completely different emotions.  The event/circumstance didn’t make either one of them feel anything.   It was Tom and Mary’s interpretation of the event that ultimately produced the emotion they assigned to it.

Don’t misunderstand, empathy is a very good thing. By all means ask folks how they feel….that will help them.  Just don’t ask them how an event or circumstance made them feel.  Good intent, bad question.

NOTE: this topic is covered in greater detail in chapter eleven of The Power of Professionalism and in chapter six in The Big AHA.  Both reference the terrific work of Professor Seymour Epstein at the University of Massachusetts.

Is Your College Going Out of Business?

Today college students are asking themselves a lot of questions many of us once thought unimaginable. Mark Cuban asks ‘Is Your College Going Out of Business?‘. Check out his article, it’s really thought provoking.

I relate to Mark’s message. When my kids were in the process of choosing colleges, I drilled home to them the importance of coming out of school with as little debt as possible. (they each paid part of the freight)  Two of my three college kids came out of school with zero debt. The third had less than $10,000 in debt.

Being wise stewards of money (largely by being smart consumers of educational services) is one of the most important things my children learned as a result of attending college. I’m proud of each for having the discipline to make the tough choices that enabled them to come out of school with little or no debt.

I wish Mark hadn’t used some of the language he did towards the end of the article, but it is what it is.  Consider yourself forewarned.

What Each Of Us Can Learn From Lance’s Disclosure

Full disclosure: I didn’t watch Oprah’s interview with Lance Armstrong, nor did I seek out articles regarding such.  My exposure to the subject was limited to one article I accidentally happened on through my ISP.

This article points out that Armstrong finally comes clean with his oldest son Luke about his indiscretions after he witnessed his son defending him in front of others.  In other words, Armstrong made an arguably tough decision after seeing the adverse impact on Luke.

As we’ve learned through Stanford Professor James March’s research on decision making, these types of tough choices are most strongly influenced by either one of two factors: 1) the consequences one is subject to—what I get versus what it costs OR  2) the choice is influenced by an especially important aspect of one’s identity.   The former is quite calculated, the latter is quite intuitive.

In Armstrong’s case it appears he finally fessed up to Luke because of the  identity he held of himself as Dad.   As the article points out, Armstrong became the most emotional when the subject of his son came up….this contrasted against the subject of all the sponsorships (and money) he had lost.

In his role as Dad, Armstrong no doubt had certain expectations of himself—to do right by his kids, to protect them, to teach them properly, etc. For those of us who are parents, our identity of ourselves (as either mom or dad) is one our most powerful.  Thus, we shouldn’t find it too surprising that Armstrong told Luke after he saw the damage the situation was having on him.

That’s the power that identity had on Armstrong—as it does for each of us. Our best decisions–especially the tough ones–are by-products of situations when we’ve been willing to be influenced by our identity.

Is it any wonder then that within The Power of Professionalism  we put such emphasis on being a professional—the ultimate workplace identity?