Leadership Archives

Stuart Bradford's Illustration in the NYTTara Parker-Pope, a journalist and blogger for the Well Blog on the New York Times, has been writing post after post this week on the growing recognition of how deep the rift is between doctors and their patients. Every post she writes get upwards of 150 comments. Her article summarizing the problem has attracted over 300 comments since she posted it Monday. There’s so much spleen being vented by readers on the web pages of the Times right now that it brings new meaning to the old joke, “what’s black, white, and red all over?”

Patients are upset, yes,

To the Doctors who say their patients don’t trust their medical knowledge I, as patient, say stop acting like you know everything – you don’t, so admit it and we patients may stop distrusting your quick off the line, glib diagnosis.
— Posted by Tom in California

but not just patients. Tara cites a Reader’s Digest article that excerpts doctors’ comments about dealing with patients. Much of it is poignant or insightful.

Though we don’t cry in front of you, we sometimes do cry about your situation at home.
Pediatrician, Chicago

And there’s impatience with patients as well.

So let me get this straight: You want a referral to three specialists, an MRI, the medication you saw on TV, and an extra hour for this visit. Gotcha. Do you want fries with that?
Douglas Farrago, MD

There’s almost too much to process and comment on. I’ve spent years training doctors and other medical staff to have conversations with patients that are both efficient and empathetic, though, and two things ring out to me, one about the healthcare industry and another about the fundamental nature of this conflict.

First, there’s the insightful comment by Shelley Holloway, a global customer service analyst. “Guess what folks?” she says, ” The medical field is a Customer Service Industry! … When I or my employer pays for a service, I want excellent treatment/response just as I would for any product/service I might buy.”

I think Ms. Holloway is right on. The healthcare industry is a customer service industry. If you need proof, here are just two observations.  According to a 2004 Harris poll, what patients valued most—even more than their doctors’ training and knowledge of new medical treatments—was their interpersonal skills: treating patients with respect, listening  carefully, being easy to talk to, taking patients’ concerns seriously, spending enough time with them, and really caring. (1) And a Harvard study of 44,821 patients found that only 1 of every 5 malpractice suits arise from medical negligence. What drives the majority of law suits, is the way patients are treated. (2)

Yet as important as customer service is in healthcare, medical schools still don’t train staff in service skills. Health systems spend millions on measuring patient satisfaction and then struggle, by and large, with what to do with low scores. Here’s Mary Malone, Executive Director of Consulting Services for Press Ganey, one of the two largest patient satisfaction measurement firms in the industry. “There is a big difference between paying “lip service” to service in a meeting and doing the hard work that’s needed to implement organizational and behavioral change. And I’m still astonished by how many health care professionals fail to make this connection.”(3)

The  healthcare industry will keep building animosity until senior management realizes they are in the business of serving patients and they happen to do it by fixing bodies, and not the other way around.

The second thing to notice, that’s important for those of us who are in relationships with others is the remarkable destructiveness of mutually perceived threat. I conducted a needs analysis years ago for an oncology department in a large hospital that was prestigious for good reason. The core of the analysis was this: your staff feels threatened by your patients and your patients feel threatened by your staff. Not everyone, not all the time, but often enough that you need to take active steps to turn the situation around. Unbeknownst to me, the analysis flew around the hospital. What started as one training turned into 16 throughout the organization. Even though staff in other departments knew the analysis wasn’t written for them, they could feel a tension that they recognized in the document.

There’s a dynamic of domination that comes up seemingly whenever people approach each other across an examination table, or a cash register, or whatever it is in your industry that separates you from those you serve. Your customers have to come to you to get service and they fear you’ll take advantage of them. You have to serve your customers, and you fear that they’ll stomp and shout and demand an unsustainably high level of service. And if you leave those mutual fears unspoken and unexamined, they fester and escalate. Joe Peschi’s famous line, “They @$%> you in the drive through!” morphs into a lawsuit over coffee served too hot.

Tim’s Takeaway:

What’s the tension in your industry with your customers? Are you courageous enough to say it outloud? Or do you assume the conversation would just be too sensitive. If you’re not addressing it openly. It’s not going away.

References:

 1. Humphrey Taylor, Chairman of The Harris Poll, in The Wall Street Journal Online, Health Care Poll, Vol. 3, Iss. 19, October 1, 2004

2. Medical malpractice as an epidemiological problem, Social Science & Medicine, Volume 59, Issue 1, July 2004, Pages 39-46, Michelle M. Mello and David Hemenway

3. Press Ganey, The Satisfaction Monitor, Sept/Oct 2000, Service InSight: Connecting the Dots, Another in the Latest & Greatest Series, Mary P. Malone, MS, JD, Executive Director, Consulting Services

Want to know how important good communication is? Here’s a great example, with a twist.  The original post, Good communication linked to high levels of engagement, appeared today on Business Education Headline News. The one-line synopsis

Research from the U.S. shows that employees who enjoy frequent communication from senior management are more likely to be engaged with their organization.

shows just how a couple of words can change meaning in crucial ways.  The synopsis claims a causal relationship that is absent from the study and from the title of the original article about that study in internalcommshub.com. Here’s what the original study found:

highly engaged employees are much more likely to receive communication from senior managers at least once a month. More than half (56%) of these employees receive communication from senior management at least monthly.

This statistic is clearly different from summary in the blog post. The blog claims that it’s the communication that predisposes employees to be engaged, while the original article claims that the engagement level of employees may make communication from senior management more common.

The real data is likely different yet. Here’s the following statement in the original article reporting on they study:

 In contrast, 42% of low-engaged employees say they receive annual communication or no communication at all.

Given research methodologies, this statement probably more closely reflects the insights the study could glean. I’d guess in the study, employees who were more engaged reported receiving more communication, while those less engaged reported receiving less communication.

That might mean communication will engage your employees, or it might simply affirm your supposition that employees who are more engaged are more attentive to the communications that everyone in the company receives.

Tim’s Takeaway:

Read your research carefully before you base policies on it. And always be suspicious of any human studies that claim to demonstrate causality. You can rarely set up a human study that shows more than relationship and correlation.

We feel fine montageThe image at the right is from the wonderfully revealing “We Feel Fine” project. Scouring the internet for expressions of emotions, It is a project in mass, anonymous,  intimacy. Not only is the site poetically and artistically moving, on a practical level it gives us a sampling of the utterances we scrabble together or craft with exquisite care in an attempt to make our inner experience available to others.

If we look carefully at groups of these utterances, they give us a picture of how we express our emotions around the world, and how the expressions we choose make clear communications so difficult.

The statements the engine finds, as it searches blogs every 10 minutes, are often banal (I feel sooo good), yet sometimes quite touching (i’m alone with you you make me feel like i am clean).

You’ll find a variety of interfaces on the site, including a set of montages of single posts like the one above as well as visual representations of groupings of expressions, like this one to the left.  Tools We feel happy(programming API’s) on the site allow you to collect groups of statements along with images from the blogs and whatever demographic information the engine has been able to find on the sites where the entries are posted. 

Below, you’ll find a list of utterances I collected as they came into the site at about 9:30 p.m. PST last night. Read the rest of this entry

Wall Street Journal Chart on Producing GrowthThis is a great conceptual model. Get used to seeing it. You will more and more.

The chart comes from an article, In Search of Growth Leaders, that appeared in July 7′s Wall Street Journal. Wally Bock features the article in the weekly review section of his Three Star Leadership blog.

The article is ground breaking on it’s own. It’s a report on a study that’s not been done before–identifying leaders of revenue growth from the mid-level in large companies.  The authors detail a host of attributes that mark and enable growth hounds and then sum up their findings with this chart.

The nut of the chart is this: Read the rest of this entry

Influence – Why is it so hard to teach?

I just returned from a big company meeting where I joined a team to train a big group of new hires, nearly four hundred in all. The training went well. And the team of trainers got to talking about recent training sessions that hadn’t gone well. Influence training came up again and again.

There are a host of classes that are relatively likely to get high reviews–sales skills, presentation skills, critical thinking skills. Not that the subjects are necessarily easy to teach, but when the day is done, participants are grateful and it shows in their reviews. This is often not the case with influence. With a lot of workshops on influence, scores are uneven, some high, some very low.

There are two problems with influence workshops as they’re often led, one lies with the leaders and one with the participants. Read the rest of this entry

 Page 2 of 4 « 1  2  3  4 »