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.

 

Unflattering Trait ≠ Unprofessional

People are sometimes described as unprofessional by their colleagues or associates when they have a trait or characteristic that stands out—-typically in an unflattering way.  Consider:

***the woman with the shrill laugh who seemingly thinks everything is funny (her colleagues initially found this trait to be cute, but over time became repelled by it)   

***the man who is naturally inquisitive and incessantly asks questions. (his peers quickly found this to be aggravating)  

***the supervisor (someone who happened to have a hearing disability) that speaks especially loudly—even when having one-on-one conversations in close quarters. ( even understanding his condition, the staff never quite got used to this and too often felt like they were being yelled at—inappropriately so)

If asked, how would you describe these individuals?  Or what if you were an executive recruiter and one of these people becomes a serious candidate for a position you’re attempting to fill.  As a professional, how do describe (objectively so) the individual to your hiring manager client?  After all, what you say holds sway with the hiring manager.  Say something inappropriate (or misleading) and you could torpedo the candidate. 

Sometimes we’re inclined to describe these types of individuals as unprofessional.  And that inclination is often fueled from our own emotional reaction to them (the importance of mind-set six, once again, raises its head).  From my point of view, when someone has a trait or characteristic that stands out in an unflattering way, it doesn’t make them unprofessional.  ‘Un’ means without or the opposite of.  In effect, in describing someone as unprofessional it suggests that the person has virtually no professionalism.  It would be a rare circumstance in which that would be true.   

Plus, when you suggest someone is unprofessional it suggests that you can’t trust them—whether it be their competence, their judgment, or their character (for more on this see Chapter Four in The Power of Professionalism).  Having a defining personal trait (however annoying) typically doesn’t have much to do with their professionalism and, by default, their trustworthiness.  Simply said, transposing someone’s personality with their character does that person a disservice—and does not reflect well on us as a professional.         

When describing someone who has a trait or characteristic that is unflattering, consider describing  them as a bit unpolished, needing greater refinement, or something analogous which is appropriate to the situation.

Take first impressions.  It’s true that when someone ‘shows up’ disheveled (think: unkept appearance) it invariably creates the wrong impression.  Many will be put off by it. Certainly people don’t initially associate ‘professional’ with that person.  Yet, it’s important to resist the urge to refer to them as unprofessional—for many of the reasons previously stated.    

The point here is not to generalize.  As professionals, it’s important for all of us to be objective. Recall  the woman with the shrill laugh.  Annoying? Sure. Unprofessional? No.

Character: An Important Lesson From Peyton Manning

Yesterday’s Super Bowl was, arguably, anti-climatic—given all the pre-game hype.  Yet there’s a wonderful post-script to the game—the post-game reaction of Peyton Manning.

No doubt Manning was crushed (emotionally) after he and his team failed to match the skill and intensity of the Seahawks on football’s biggest stage.  Yet, he took the high road.

Manning has a well- deserved reputation of being a class act—win or lose. Yesterday was no exception.

Said another way, Manning is a real ‘pro’—defined primarily by how he conducts himself, not because of his skill on the football field. He’s a professional worth emulating.

Here’s an article that gives an insightful first-hand account of Peyton’s post-game activities.

How many mind-sets do you see in action?

The (Sometimes Maddening) Need For Precision

A manager is presenting in an important meeting.  He is in the process of making a critical point, yet goes blank as he has forgotten the date he last met with the Chief Marketing Officer (CMO).  The CMO is someone who had played an integral role in the breakthrough the manager is reporting on.  “Let’s see I think I met with the CMO last Wednesday”.  Backpedaling, he painstakingly recants, “no it was Thursday”.   After confusion ensues amongst the group, he changes course once again.  “Wait, it was probably Tuesday”.

The manager has taken nearly a minute attempting to sort this out. That’s an eternity for someone who has been allocated only 15 minutes on the agenda—with five of those minutes committed to Q&A.  The manager seems oblivious to the side-show he has created.  Yet he’s especially pleased with himself when he finally figures out that it was indeed Wednesday when he met with the CMO.  He’s a man who has a high need for precision–someone who (among other things) prides themselves in getting the facts 100% right every time.  To him it’s a badge of honor.

Here’s the problem with people’s need for precision: too often in group settings (think: meetings, teachers instructing, etc) it detracts more than it helps.  This gentleman, for example, ultimately got his fact right but in the process lost his audience.  Plus, the group ultimately lost its momentum after the manager had trouble regaining his mojo.

The irony is that the meeting date with the CMO was inconsequential to the point the manager was attempting to make.  It simply didn’t matter.  Yet the manager seemingly had more invested energy in identifying that arcane fact than his all-important proposition.  The manager got lost in the weeds.  The culprit?  His own need for precision.

Precision, as important as it is, is essential only when it has direct bearing on a desired outcome you’re trying to achieve.  Otherwise, it’s noise.  There are exceptions, but not many.

The opposite also occurs.  How frequently do you see this happen?

A manager is attempting to share an inspiring story about Judy —the company’s promising new COO.  Early on in the manager’s comments to the assembled group of front-line supervisors the manager says,  “Judy was a supervising engineer for only two years before she was promoted to Director.”   Dan, a seasoned front-line supervisor, interrupts, “…actually, it was three years.”

Turns out, Dan was right—but his point added no value to the manager’s insightful perspective about Judy.

A human resources director is reporting on the results from the annual employee satisfaction survey to the company’s top officers.  She is pointing out the implications from the unmistakable downward trend in employee confidence across the entire enterprise.  Arthur, the company’s newest officer, unexpectedly chimes in.  “Yes, but look at the high level of confidence amongst the officer corps.”

Turns out, Arthur was right—but the high level of confidence amongst the officers was clearly an anomaly when contrasted against each and every other group in the company.  Arthur’s comment unfortunately distracted his fellow officer’s focus away from the all-important need for them to understand the dramatic decline in employee confidence.

Brett, a twenty nine year old chemist, makes a recommendation to his GM about how to remove the unwelcome deposits on the company’s boiler tubes. Betty, a twenty four year veteran of the steam generation department, asks Brett during an important group meeting: “what makes you think, after a short six months with this company, that you are in a position to recommend on such an important  issue?”

Turns out Betty was right—Brett was a short-timer, someone who was seemingly ill-equipped to make  such a recommendation.  But Brett had experience.  Turns out, he had helped solve a very similar problem with his last employer.

Each of these latter three examples are variations on people’s need for precision: the first is always representing the facts correctly, the second is never letting an exception go unnoticed, and the third is being unforgiving to those attempting to lead (i.e. expecting perfection).

All three of these are admirable and (usually) well-intended. Yet, it’s not helpful for the group when someone shares an arcane fact that adds no value.  It’s not helpful for the group when someone’s clever observation (think: exception) sidetracks the group from weightier matters.  And it’s especially not helpful for the group when those that attempt lead it come under constant cross-examination as a means of passing someone’s self-appointed credibility test.

Precision is a good thing—it enabled Man to send astronauts to the Moon and return them safely.  Yet, precision isn’t always our friend…no more so than when it becomes maddening to our colleagues!

 

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.

Part Two—Is A Moral Compass A Prerequisite To Being A Leader?

Consider:

***the director of an after- school program (think:  Boys and Girls Clubs) is consistently losing kids to a new, increasingly popular, gang in town.

***the senior executive whose ‘killer’ proposal for the company’s strategic direction loses favor amongst her colleagues to a peer whose own proposal is blatantly self-serving

***the forthright and well-intended politician consistently loses ground to a charismatic, but unprincipled, opponent whose policies will (among other things) break the bank

What’s common amongst these three examples?

1)      each leader had a compelling message

2)      each leader was losing ground to an arguably inferior ‘competitor’ and was surprised by it

3)      each leader had become dismissive of their counterpart

4)      each leader assumed that the ‘moral high ground’ they believed they held would count for more than it eventually did

5)      each leader failed to acknowledge their counterpart as a leader

The director, the executive, and the politician each saw their counterpart as unworthy—at least compared to themselves.  By default, none of their counterparts could measure up to the lofty standards they associated with being a leader.  Each leader felt contempt towards their counterpart.  They were dismissive of them—all the while feeling a little victimized.

Of course, all of this is misplaced energy.  Most importantly, each made the classic mistake of disrespecting a worthy opponent.  They didn’t make any of this of this public.  Rather, each kept their feelings and impressions private.

Each of these three were less diligent in advancing their point of view than they should have been. They didn’t work as hard as they needed to.  They assumed (among other things) that the moral high-ground they represented would be a great equalizer. Unfortunately for them, it didn’t work out that way.

The truth is, each leader was facing a formidable opponent—a formidable leader if you will. Their counterparts were people that were creating a new status quo; people who had influenced others thinking.  Yes their counterparts were indeed leaders—even though these people may have had a malfunctioning moral compass.

Being dismissive of one’s opponents (as leaders) because one considers them ‘unworthy’ is a mistake. It  sets in motion a set of psychological conditions that prove to be self-defeating.  For each of these three leaders, their counterparts were leaders –they just weren’t ones that these three had much respect for.

Making a judgment is one thing, but developing a sense of moral superiority is quite another.  And it was largely that sense of moral superiority that undermined these three leaders.  As we mentioned in Part One, leadership is an equal opportunity aspiration for saints and scoundrels alike.

An Agonizing Situation Made Almost Pleasurable

Many years ago, while still in the corporate world, I was hiring for a key position within my department from a pool of internal candidates.  Two finalists emerged.   One was an up-and-comer; the other was seasoned.  Both had unique strengths.

I hired the up-and-comer. …but it wasn’t without a lot of consternation.

Turns out, the seasoned candidate (let’s call him Rory) had lost his former position as a result of a downsizing. Rory could post for any internal position he wished, but was given a time limit to make his transition.  If, after a pre-determined number of months, Rory failed to land a job—he’d be let go.

It was the 11th hour when Rory interviewed with me.  Rory wanted to be hired on merit, although we both knew that if I didn’t hire him his stellar career with that company would be over.

Naturally, I was torn.  It wasn’t a decision I took lightly.  In the end, I didn’t hire Rory–as the other candidate was a better fit for our department’s needs at the time.  Even though I felt good about doing what I thought was the right thing for the organization, I agonized over making that phone call to Rory.

Despite being disappointed about not being chosen, Rory was gracious beyond words.  A normally tension-filled call was made almost pleasurable by how he conducted himself.  To say I was impressed is an understatement.  A year after leaving the company, Rory called me to re-connect. He had made a successful transition to another organization—one he was flourishing in. We have subsequently stayed in touch.

How many times have you heard about these types of situations going ‘south’?  I know I’ve heard of far too many!  Given the stakes involved, it’s no wonder why.

It was Rory’s professionalism that helped turn a potentially contentious situation into a really positive one.  He really stood out.  In that situation, Rory demonstrated mastery of his emotions. Plus, he didn’t let his ego undermine him in a highly stressful situation.  Of course, all of this is consistent with mind-set #6—a mind-set that most people struggle with.

Think about the people you consider to be a consummate professional.   I’ll bet they rate high on mind-set #6. They’re likely to take a measured approach to stressful situations; and not be prone to uncontrolled emotional outbursts.  The types of professionals remain in control, never letting their ‘lizard brain’ take charge.  When they do express deep emotion, it’s a conscious choice—not a shrill, often automatic response, that they might regret later.

In many ways, mind-set #six is a hallmark of the consummate professional. It’s precisely why I admire Rory so much.

 

Can We Tolerate Working With You?

In 1999 Whirlpool began a quest to go from one-product, one-customer manufacturer of washing machines to being the global leader of marketing and manufacturing major household appliances, with revenues over $10 billion. Today the Whirlpool brand is the top-selling appliance brand in the world.

Many contributed to Whirlpool’s remarkable success story—but arguably none more than Chief Innovative Officer—Nancy Snyder.   Nancy was the chief architect of this remarkable transformation.  She tells the complete story in her 2009 book Unleashing Innovation.

Nancy would be the first to tell you that there was an endless array of people who deserve credit for this remarkable transformation.  That said, amongst those that were closest to the work itself, there’s an especially important group.  Nancy calls them iHeros.   Without the efforts of the iHeros many of the remarkable commercial innovation successes would have never come to fruition.  In addition, these people were the catalysts that enabled the organization to institutionalize (culturally) innovation at Whirlpool.

These are people who took out-of-the-ordinary personal risks, made personal sacrifices, and constantly ‘took one for the team’.  In the end, their ‘reputational capital’ was off-the-charts. It goes without saying that they were respected—but people also liked them.  They were iHeros because their peers recognized them as such—not because the organization issued them an award.

There were those within Whirlpool that were almost singularly responsible for some remarkable commercial innovation successes at Whirlpool.  Yet, they weren’t recognized as iHeros by their peers. Why?  Because they were perceived to be more about ‘me’ than ‘we’.

Whereas iHeros weren’t self-glorifying, these individuals tended to be. General Richard Myers once told me that self-aggrandizement was just about the worst character trait one could have in the military.  Turns out, it’s one of the worst at Whirlpool too—although fortunately they don’t seem to have much of it!

Recall in The Power of Professionalism I advocated that professionals are defined by how, not by what they do.  Here’s yet another example of that at Whirlpool.    

‘Can we tolerate working with you?” This is one of only three key questions that several respected executive recruiters tell us need be asked in hiring interviews.  (The other two are:  ‘can you do the job?’ and ‘will you love the job?’)  While it’s more important to be respected than liked, the Whirlpool experience reinforces how important it is to be liked as well.  Ask yourself, everything else being equal, who would I rather work with—someone I like or someone I just tolerate?   Kind of a no-brainer, huh?

Good Meeting? Bad Meeting? Look In The Mirror!

Have you ever been in a meeting when:

***the group’s enthusiasm gets squashed due to a few individuals negativity?

***the group gets stuck in the weeds

***constructive discussion turns into contention as people’s passion spills over

***the group’s energy gets drained upon the announcement of an unpopular decision

***apathy prevails when a less-popular colleague leads the meeting

***a normally rock-solid colleague uncharacteristically belly-flops on a vital presentation

Because negative energy feeds on itself, it’s easy to get sucked into a downward spiral in these types of situations.  Meetings of this sort are painful, often becoming the grist for Dilbert’s mill.  That’s why MS #6 (getting a hold of your emotions) is all-important here.

It’s almost guaranteed that, absent an intervention, the meeting will be a negative experience. For the professional, it’s recovery time. As easy as it might be to join the majority who enjoy whining about the meeting, the professional is unwilling to settle.  The professional asks themselves, “what can I do to help get this meeting back on track?” (consistent with MS #1…’having a bias for results’)

Thus, in responding to the situations above:

***the professional offers a contrarian point of view—one that offers a healthy dose of optimism

***the professional interjects a question or comment that gets the meeting re-focused.

***the professional points out that the meeting has become unproductive and asks the group, “Given  our situation, what do we need to do as professionals to get this meeting back on track?”

***the professional reminds the group of a similar situation years earlier—one in which people’s fears were never realized.

***the professional tactfully points out the group’s dysfunction, reminds them of the big picture, and challenges them to do better.

***the professional who draws the group’s focus to themselves—stalling for time—all the while enabling their flustered colleague to compose themselves and ultimately recover.

To be clear, the professional isn’t being a ‘yes man’, isn’t being pollyannish about issues of substance,  isn’t playing politics.  Rather, they are attempting to make the best out of a sometimes poor situation—in an objective, yet optimistic way. Professionals know that a good meeting—first and foremost–starts with them.

 

 

 

The Dreaded Heart-To-Heart Conversation With A Beleaguered Colleague

A colleague of yours (let’s call her Janet) isn’t meeting expectations—neither performance targets nor cultural norms.   You know it…everyone else does too.  What Janet is doing (or not doing) threatens the organization’s results.  That means a lot of people (you included) will likely get hurt if her shenanigans continues.

Your gut screams for you to have a heart-to-heart with Janet—you know, peer-to-peer.   What do you do?

It’s interesting the things we tell ourselves when faced with a situation like this:

*** ”If I speak up, our relationship will never be the same.”

*** “It’s not appropriate for me to speak up. This is a job for the boss…that’s why they get paid the big bucks.”

*** “I don’t have the communication skills to pull this off.”

*** “Surely, Janet will be offended if I speak up.”

*** “It isn’t my place to judge.”

I’m confident you can think of plenty of additional examples.  Notice what great lengths we will go to in justifying not speaking up.  Certainly, the situation with Janet requires good judgment and a great deal of decorum, but rest assured that many of us are masters at finding ‘cause’ for not speaking up. (And, yes, an organization’s culture can be an impediment to not speaking up.)

Yet, part of the motivation underlying our unwillingness to speak up (e.g. to be direct with people) is often our own desire to be liked—to be thought of well by others.  When that occurs, it becomes all  about us.

Admittedly, this is one of the most difficult things to get people to do in organizations.  Let’s face it…it’s   risky.  Yet it happens.  You see it in team sports, in the for-profit world, etc. The degree to which an organization’s colleagues (as opposed to just the boss) hold each other accountable is often an indicator as to how well the organization performs.

People’s willingness to speaking up to one of their colleagues is also a reflection as to how committed people are to the organization’s results…..in other words, the degree to which they hold MS #1—having a bias for results.  The commitment to the result becomes a lynchpin in helping us overcome our own human tendencies not to act.

Other MS’s help people in speaking up too; namely all the rest— MS #2- MS #7.  That’s unusual, but it just goes to show how it really takes a professional who is secure in their own skin to speak up in an admittedly uncomfortable situation like this one with Janet.

In spite of all the reasons one might conjure up to avoid approaching Janet, the professional speaks up.    The reason is simple—they’re committed to the result (MS #1).  They know it’s not about them (MS #2) and they know that they need to rise above the fray (MS #4).  Ultimately, they commit to do what they know is right (MS #5).  It’s rarely easy, it’s never fun—but, in the end, they do it.

It’s what professionals do.