2019 November

Infinite Mindset

Why leaders need to shift focus to their Just Cause in 2020.

I am departing for Australia this week but wanted to leave you with some thoughts to help you plan for 2020.

Collectively we can have the biggest impact on the health of Americans by shifting our mindset and implementing policies that support all stakeholders – not just shareholders. 

Infinite Mindset

I’ve been reading a new book called the Infinite Mindset that frames the ideas that I’ve shared in earlier articles and posts about ethics, values and trust in relation to capitalism.

Infinite Mindset emphasizes the need for leaders to focus on their Just Cause [aka: vision] and to adopt the policies that promote the trust needed to support collaboration and innovation. 

The most courageous brands that you can think of attract and retain talent because they have a compelling vision for the future. Courageous brands pay employees well, offer meaningful work and training needed for continuous development and promote trust so that employees have the tenacity needed to overcome challenges.

You don’t need Apple’s profit margins to be a courageous brand. Paying your employees a living wage, reduces the cost and negative impact of turnover and enables your company to move forward. The ability to continuously improve and move forward [toward the vision] is how leading edge companies win the long game.

Ethical Fading

I’ve been using the expression “misguided understanding of capitalism” to describe the short sighted business practices that I’ve encountered over the years. Interestingly, there is term for it – Ethical Fading.

A few years ago, I was asked to interview for a CEO position of a company purchased by a Venture Capitalist [VC]. The company was running a strategy the was legal but ethically questionable. I was already familiar with the company and thought that I got the call because they needed my help in transforming the business. I couldn’t have been more wrong. 

The VC was doubling down on the strategy so that they could milk it to the very end. That’s referred to as a Finite Mindset. The meeting didn’t go well because I challenged the ethics of it all. It was so jarring that I debrief needed to debrief with another VC to get his thoughts on the strategy. He agreed with me.

The timeline often reveals the mindset. Activist Investor Starboard Value just took a position in CVS to “unlock shareholder value”. The first question is will they make CVS sell tobacco products again to recover the $2 Billion in annual sales or will they support the company’s Just Cause?

Ethical fading happens when investors and leaders are able to normalize questionable conduct because it’s not illegal. Some experts believe it’s a function of excessive pressure rather than a lapse of individual values and ethics.

Normalizing unethical practices:

Unfortunately when the law is unclear, many leaders implement practices that serve their own interests regardless of the broader impact. That’s when questionable business practices get normalized.

There are three [3] ways unethical practices get normalized:

  1. Leaders disassociate from it. They use language to mask the harmful impact.
  2. Leaders blame the system for their transgressions rather than getting out in front of the issues and working to fix the system. A recent example is the Mylan EpiPen Scandal. They inflated EpiPen prices and then blamed the system for a lack of pricing regulation.
  3. Leaders blame the consumer for not understanding the risks of their products and services. 

Just Cause

Leaders who take responsibility for the broader impact of their business practices consider the ethics of their decisions. They don’t try to hide behind the law, use confusing language or blame the customer.

Leading edge companies are in business for the long term and care more about fulfilling their Just Cause than short term financial gains. That’s the Infinite Mindset.

2020

There is a good article written about prominent economist, Mariana Mazzucato, about fixing capitalism. The article also frames the 2020 Presidential Election issues well.

On a personal note, RUSH is turning 20 next year. I’ll also be taking time to revisit my Just Cause while away. So you likely won’t see another post from me until next year. I look forward to connecting with you then.

Tell me more

Simply saying “tell me more” can transform a conflict into a fresh start.

When speaking with someone you disagree with, the most courageous thing you could do is simply say “tell me more”.

I’ve been thinking about communication skills lately. No matter how suave of a communicator you are there is always room for improvement. With so many polarizing issues making it harder to authentically connect with others, the need for good communication skills is more important than ever.

Conflict

Whether in a workplace or personal relationship, the problem typically starts with conflict over a difference in opinion which gets exasperated by money, power and/or feelings. 

To “keep the peace” people often mind their tongue while in earshot of those with whom they disagree. Anyone who has tried it knows, the whole strategy falls apart in a bad way with a misspoken word, a look or a leak by your confidant.

“A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”

– Tim Ferriss

Use it

There is a better way to manage conflict – use it. Conflict transformation is about active listening which simply means staying present and listening in the same way you want to be heard. If something spoken strikes a nerve with you, say “tell me more” rather than tuning out so that you can plan your response.

Staying present during conflict requires some curiosity to understand how the other person is formulating their ideas and perspectives. Judging is part of the process but rather than judging as right or wrong, listen for the common ground and the insights that may shed light on your own fears and biases. 

Finding common ground and developing a deeper understanding of the other person’s perspectives will help you find new ways to connect and move forward.

Move Forward

No one benefits from staying stuck in the past or holding onto past hurts. Everyone wants to be understood, respected and ideally, accepted for who they are and what they bring to the relationship.

I discovered the book Braving the Wilderness while looking for resources on empathy and highly recommend adding it to your reading list. The stories from the book will help you put some of these concepts into practice.

If you don’t get a chance to read it before the holidays, the questions below provide a good framework for moving your relationships that need a little TLC forward.

1/ Where are we now?

2/ What are we trying to accomplish for the future?

3/ What do we want our relationship to be?

4/ What do we need to create that future?

5/ What do we want for our relationship? 

Reportedly, shifting your focus to the future is the key for creating something new and fresh.

Happy Holidays!

American Thanksgiving for me marks the start of the holiday season. So with that, I wish you peace and happiness this holiday season – and Happy Thanksgiving!

Building Courage

Courage by definition is the willingness to do something that frightens oneself. 

In a business context it usually requires people to do the right thing rather than acting in their own financial interest. Doing the right thing is frightening for those with a lot to loose.

Ethics and compliance with regulations is comparably a low bar for businesses but still a challenging hurtle for companies focused on maximizing returns to shareholders.

Tenet Health

Tenet is a good example of a leading edge company focused on maximizing shareholder returns that has experienced compliance issues.

The company has made early investments in technologies that help them reduce operating costs, streamline revenue cycle processes and accurately report revenue related numbers.

The problem is that some operators put the financial focus ahead of the company’s purpose of providing high quality care to the patients in the communities that they serve. In some instances, patients paid a very high price. 

If you need details, google Tenet’s issues in Redding, California. Nurses at the facility eventually “blew the whistle” but given the company’s focus on financial operations, others likely new something was wrong but they didn’t have the courage to question the physician or Administrators involved.

Cases like Redding create trust issues with payers, partners, employees and healthcare consumers. The company pays a hefty price for years even when corrective actions are taken.

The question that remains to be answered, is it worth it?

CVS

Did you know that CVS stopped selling tobacco products in all of the company’s pharmacies in 2014? Despite the loss of $2 Billion in annual sales, executives decided it was the right thing to do. 

The company couldn’t be an authentic partner to healthcare providers when they were selling a product known to create significant health issues. They put their mission ahead of their financial gain.

Reportedly, the company didn’t suffer because they were able to replace the revenue stream with new and enhanced services that better aligned with their core mission. Apparently, people in communities with a CVS have changed their tobacco consumption habits as a result – not their purchasing habits.

Other pharmacy companies have continued selling tobacco and claiming they are complying with all laws and regulations. Those companies continue to profit from the sale of tobacco and people continue to smoke.

Is compliance enough when we already know the negative impact to the consumer?

Values

Your answers will reflect your belief and values. For companies, the answers need to reflect how they operate in order to operate authentically and to attract the employees, partners and others that align with their beliefs and values.

Healthier Hospitals

A framework for Healthcare Finance 2.0 already exists.

Similar to leading edge retailers, hospital systems participating in the Healthier Hospital Initiative are working to make their organizations healthier and more environmentally friendly. 

I discovered the initiative while researching organizational values of leading healthcare organizations and noticed the reference on the old values page for Tenet Health. Unfortunately, the page is no longer available.

Tenet Health

Tenet’s new values are reflected by the acronym CARE which may make them easier for people to remember. However, what truly makes values memorable is whether they are reinforced every day by the way people work and conduct themselves on the job and in the community.

Change of Values

I started my healthcare career with Tenet Health and the values reflected now are fairly consistent with how the company operated back then with one important exception.

Innovation is no longer on the values list and there is no reference to the Healthier Hospital Initiative in the description. For me and likely many Tenet employees, that change is a big deal.

Innovation

With the number of innovation titles used now within the healthcare industry, you might think innovation has become more of a platitude than a meaningful organizational value. However, the Tenet that I knew was a leader in information technology. It’s how the company was able to develop Broadlane and Conifer and to provide services to other healthcare systems. 

Now it’s something that I have to question because there has also been a change in management. Do they have the internal courage to make the early investments in technology or not?

Healthier Hospital Initiative

The Healthier Hospital Initiative is what hospital systems need to challenge current financial models. When I posed related questions in my Healthcare Finance 2.0 post, some industry leaders dismissed the idea as something hospital providers couldn’t afford to do.

The reaction is to be expected during the innovation process. However, it’s also why we need leading edge organizations that can make those early investments to show other systems that it’s possible and to support others in the transition to greener, healthier organizations.

Risk Is Rewarded

Companies that take risks attract the people with the courage and drive needed to lead meaningful change. The value structure needs to support the courageous few for the organization to realize the benefits of innovation.

Culture

According to the book the Trillion Dollar Coach, good cultures need a healthy blend of ethics, values and trust. 

Tenet should have focused on trust because the company already has a strong framework for ethics and values. Plus trust is essential for moving healthcare organizations forward into value based care arrangements, retaining good employees and maximizing profits.

Courage

I’m reading a new book on developing the organizational courage needed to facilitate innovation and change. I’ll have more thoughts on that for you next week.

[Re]Building Trust

Why healthcare companies should be re[building] trust now.

Trust is more important than many leaders realize. I’ve been thinking about it in light of the 2019 allegations of wrongdoing in healthcare report and corresponding settlements being chalked up to the cost of doing business. 

The impact of wrongdoing whether it’s excessive charges, abusive billing practices and the mistreatment of patients and their data is likely having a much bigger impact than most healthcare executives realize. 

Healthcare Consumers

Healthcare companies undermined the trust Americans have in the system at a time when we are asking for more and need more data and engagement from patients and healthcare consumers. Granted there are other factors that have contributed to the mistrust felt more broadly but healthcare companies will need to rebuild that trust in order to transition into value based care models.

Employees

Employees of these companies are likely impacted too. The wrongdoing is not accidental but rather a function of the business practices that likely don’t align with the company’s stated values

How do employees reconcile what they believe versus what they do? They can’t reconcile it. The wrongdoing is likely contributing to the anxiety felt by the employees working within those companies. The impact of the stress and anxiety will only get worse until there is better alignment in the values and the work performed.

Profits

Did you know that companies with high levels of trust outperform their competitors by as much as three [3] times? Healthcare companies have relied too heavily on having a captive consumer. When people are sick, they surrender to the process to get better and deal with the fallout after the fact. 

That’s not going to work going forward. New approaches to medicine and healthcare services require participation from all consumers – not just patients. How is your company going to convince consumers to trust your organization and the process when there is no immediate need?

Trust

What is trust? The one common theme that I have found to describe trust is that trust happens when you’re willing to accept the risk of vulnerability or in other words, the risk of being harmed in some way. The perceived risk has to be lower than the probability of being harmed.

How do you convince someone to take the risk on your organization or you? Trust is earned by repeating actions that conveys trust. 

The book Trillion Dollar Coach, written about Bill Campbell’s work with leading Silicon Valley companies and executives, identifies five [5] key elements of trust:

  1. Keep your word: The commitment and/or fulfillment of one’s promises. Be accountable for mistakes, apologize and make amends when things go wrong.
  2. Loyalty: A strong feeling of support or allegiance. Establish clear boundaries and when you’re unclear about what’s okay and not okay, ask rather than ask for forgiveness after the fact.
  3. Integrity: The quality of being honest and having strong moral principles. Have the courage to practice your values and do what is right versus what is easy, fast and fun.
  4. Ability: The possession of the means or skill to do something. Avoid overpromising and underdelivering.
  5. Discretion: The quality of behaving or speaking in such a way as to avoid causing offense or revealing private information.

Trust can’t be won with one large gesture. It has to be built over time with actions that are consistent with the key elements of trust. Just remember – trust can be undermined faster than it is earned.

Be generous

Best advice from Dare to Lead for developing trust within an organization is for everyone to extend the most generous interpretation possible to the intentions, words, and actions of others.

Even if you believe that you are trustworthy, most only trust a handful of people. Chances are your assumptions about a situation, interaction or person are wrong. Default to truth but when in doubt, look for the data and trust the facts.