Category Archives: Change

Burn Out: Don’t Judge

When was the last time that something in your life became so overwhelming that you simply ignored it? What are you ignoring right now that will likely cause you to experience pain or discomfort in the future? What is stopping you from doing something about it?

There are plenty of things that I would love to ignore right now: a major job transition, selling my house, and preparing to move with my family to Colorado, to name a few. The good news is that these are all time-limited events, and I will push through them. The exciting opportunities on the other side of these changes will re-energize me.

What about challenges not of our choosing, and not of short duration?

I’ve read for months about the struggles of other diabetics for managing their chronic disease over a lifetime. My response had honestly been a helping of empathy, mixed in with a small dose of, “Suck it up.” I had managed my blood sugars through a strict diet, vigorous exercise, and extreme focus. If I could do it, anybody should.

The Rate of Change

One of the principles of the Adaptive Leadership theory is this: leaders should introduce organizational change at a rate that people can tolerate. The acceptable change rate is not the same for everybody, and it is the work of leaders to monitor this tolerance, and to make adjustments accordingly. In other words, we are all capable of adapting to change as long as the rate of change is not faster than what we are capable of managing.

I wonder how this concept applies to our personal choices? Are we capable of managing and maintaining lifestyle and behavioral changes? How do we know when it is too much?

A Dose of Humility

I spent fourteen consecutive months managing diet and exercise changes through focus and discipline. It was a pretty good run, and I’m proud of the substantive changes that it had on my health and my diabetes – my blood sugars were virtually perfect. The problem now is that I need to begin again.

Fourteen months with no donuts (that’s hard for an ex-cop), virtually no beer, a fast-food hiatus, and 20-plus running miles a week came to a screeching halt about 6 weeks ago. It’s not that I had a couple of bad meals, and missed a long run; I jumped into the fast-food express lane, riding my Lazy-Boy, and inhaled a doughnut (or maybe two) for the first time in more than a year. I’ve completely abandoned my approach to managing diabetes. The result: I once again have erratic blood sugars, and feel like crap, all the time.

Tolerance

While living with such discipline is hard – sometimes really hard – I can’t say that the lifestyle changes (diet and exercise) alone led to burn out. I’m wondering if it has more to do with the significant life changes (i.e., a new job and preparing to move my family 1,000 miles) that have pushed me past my point of change tolerance? My reaction to more change has been to focus on that which is most immediate, and most pressing, seemingly at the expense of that which is not. The time-limited, high-energy events have gotten all of my attention while the long-term health events have been ignored.

How true is this of our professional work? When we get overwhelmed, we move into firefighting mode and deal with those things that are most urgent, rather than what is more important. The long term consequence is burn out.

What has caused you to experience burn out in your job or your life? How have you overcome it?

Healthcare Reform: Culture and People

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I love to talk about organization culture and leadership. What I like even more than talking about it is working on it. In my experience, they are inseparable. You cannot change one without simultaneously working on the other. What happens when we are talking about changing the culture of an entire industry?

Healthcare Finance Management Association (HFMA)

One of the best conversations I’ve had in a long time about culture and leadership took place last week. I was interviewed by researchers from HFMA and McManis Consulting about the Value Project.

HFMA is in its second phase of an ambitious effort to help healthcare organizations prepare for the monumental changes that are occurring in (or, “to”) the industry. The result of this research will be a series of recommendations and road maps to help healthcare organizations navigate the structure, reimbursement, and organizational changes that will be required as a result of healthcare reform. In the end, healthcare organizations are going to have to change, and deliver more value to their patients and their communities.

What I found interesting is that I was one of few Chief HR Officers to be interviewed in this project to date. I’m glad that I was given the opportunity, and I had a few suggestions and opinions to share regarding the project’s focus on “Culture and People.”

Managing Conflict

After a robust, high-energy, and 75-minute conversation, one of the researchers summed up my “radical” rant like this: ”Building the culture to drive this change must include building the leadership capacity to manage conflict.” My response was, “Yes!” I’ll take it one step further: this work is going to require healthcare leaders who thrive in a world of continuous conflict.

Change is Not a Program

One mistake that we often make in leadership and organization development is that we try to reduce the change work that we need to accomplish into neatly defined programs and initiatives. We develop strategies, timelines, and metrics to fit into our strategic plans and organization dashboards. Trying to codify change elements into concrete business deliverables sometimes comes at the cost of really understanding the human side of change. It is difficult to plot the steps of behavioral evolution onto Gantt charts.

Radical change will always be rooted in messy and emotional people issues. Conflict is inherent in change work. But, it is in this conflict where human innovation, strength, and diversity lie. The answers to our problems will be found in the conflict and debate that hasn’t yet occurred. Leadership is about creating this conflict where it doesn’t exist, and effectively leading people to contribute where it does. Change is not a program, it is a set of relationships and social structures. Changing an organization, or an industry is a contact sport.

Back to Reality

As much as I like to debate theoretical constructs, it still comes down to the day-to-day actions of leaders to move their organizations (or industry) through change. Here were a couple of my recommendations about the Value Project:

Involve more CHROs in the research. There are some smart, radical, and strategic thinkers in the HR profession and the industry;
Do not underestimate the importance of organization development and social science research on change. The real work of healthcare reform lies with the people who are providing care to our communities; and,
Challenge traditional business logic and assumptions. As one of my colleagues often says, “Rearranging the deck chairs on the Titanic will not change the outcome.” Focusing exclusively on re-aligning the financial incentives and payment systems will not in itself drive the behavioral changes necessary to create value in our country’s healthcare system.

What are your thoughts about healthcare reform, and the people side of the change necessary to address it?

Candor with Respect

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News Flash: My wife recently called me fat. Well, not exactly fat. After work one recent afternoon, I changed into a form-fitted athletic shirt and a pair of shorts prior to going for a run. My wife was leaving the house, and I needed to ask her a question. I caught her as she was backing down the driveway. She stopped and rolled down the window.

When the real purpose of our exchange was completed, she volunteered an additional, unsolicited observation. ”Wow,” she said, “I haven’t seen that little jelly roll on you in some time.” She smiled and drove away.

At first I was indignant. No, I was offended. Then I looked down and confirmed that my well-known, half-hearted muffin top had indeed reared its ugly pudge once once again. Damn. After a year of a flat stomach, someone had obviously managed to slap a baby roll of belly fat on me when I wasn’t looking. I hadn’t noticed. She was correct.

Love and Respect

The exchange and my reaction to it got me thinking about why my wife can deliver such a personal and candid observation when very few other people would have the courage or the leeway to do the same. The answer is simple: because I know that she loves me, and always has my best interest in mind. I am open to her feedback, even when it is critical, and even when I don’t like what I hear.

Candor with Respect

My organization’s leaders have been working to improve what we call candor with respect. I work with a group of great people, and we know that we need to get even better. We need to become more open, honest, and direct in our interactions with each other because that is now required of healthcare leaders in this time of industry tumult and uncertainty. We no longer have the luxury of time for organizational politics. The healthcare reform train is headed down the tracks, and it is going to cause all kinds of collateral damage to the healthcare system the we currently know – that is not necessarily a bad thing.

I find it far more challenging to be so open to honest criticism in the workplace. Ego, positional authority, credibility, and personal insecurities prompt us to create barriers against anything that might be harmful. We don’t always assume that our colleagues have our best interest in mind, and when we do actually get candid feedback of a critical nature, we often assume that the bearer of candid criticism has bad intentions. Because we question their purpose for pointing out our shortcomings, we sometimes assume that it comes from a lack of respect.

But, when such feedback is authentic and sincere, and we are able to set our egos aside, it is not that difficult to see that such candor actually comes from a profound sense of respect.

How do we know the difference? I think it comes down to relationships.

Now, I’m off to change my shirt and do some crunches. What do you think about candor and respect in the workplace?

Mistaking Strategy for Purpose

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One of the highlights of my job is the opportunity to facilitate courses on Crucial Conversations. If you’re not familiar with this material (based on a best-selling book), it provides skills for identifying where we are stuck in our work, our relationships, and our lives, and teaches us how to identify and handle the crucial conversations that are at the root of our frustrations. If I had to name one training program that has helped me more than any other in my career – or my life – this is the ONE.

Purpose versus Strategy

One of the principles of Crucial Conversations is the importance of seeking mutual purpose when we find ourselves at an impasse with others. The reason we have conflict is often our mistaking strategies for purpose. In other words, you and I may both want the same outcome (purpose), but when we attach emotions to our conflict, we tend to argue for our strategies and lose sight of our purpose (this is pride). The key to getting unstuck is often a commitment to seeking a mutual purpose.

A Crucial Conversation with Myself

I recently had a crucial conversation with myself. No, this is not part of the course materials, and may be an indication that a mental health intervention is warranted. I had mistaken my own strategy for purpose. This resulted in stress, and a high degree of frustration.

After I was diagnosed with diabetes in March, I made a commitment to change my lifestyle. This meant a strict diet, regularly checking my blood sugars, and making exercise a priority in my life. To facilitate the exercise commitment, I signed up for the Disney World half-marathon in January 2012.

My on-and-off, love-hate relationship with running has transformed into an obsession. The purpose of running was to lose weight and to help regulate my blood sugars. After the first couple of months of running very consistently, I transitioned from someone who ran periodically because I knew I should, to having to run because it felt great. In the long run (pun intended), this is a great place to be.

The problem started when my strategy shifted from a regular running schedule to specific goals related to my upcoming race. I was getting faster (by my standards), running a lot longer, and I set specific targets and expectations for my first half-marathon time. Yes, I do have a tendency to fixate on goals.

Reality Check

I couple of weeks ago I was 8 miles into a run when I suffered a deep muscle cramp in my calf. Not a big deal, I used to get them all the time when I was much younger. I was 3 miles away from home, and rather than call my wife for a ride (that would be too logical), I stretched it out and finished the run that was in my schedule.

That was a stupid decision. The deep muscle bruising has taken my off of my training schedule entirely. I’ve been angry about my inability to train at a critical time, which directly threatened the goal time that I had established.

Then I noticed that my blood sugars were getting higher, more inconsistent, and eventually out of control. My purpose for running is to control diabetes. My strategy for staying motivated to run was a half-marathon. My highly-competitive nature intervened and caused me to mistake my strategy for purpose.

Back on Track

I was able to do an easy 4 miles on the treadmill without pain. I know that I already have the endurance to complete 13.1 miles next month in a respectable time. I am now able to get back to regularly exercising for the sake of getting my blood sugars back under control. I have committed to reconnecting with my purpose, and have reset my strategy for getting there.

What About Leadership Strategies

All of this has caused me to think about how my work strategies (and goals) might also be interfering with my leadership purpose. That one is a little harder to digest right now.

How have you mistaken strategy for purpose?