Yesterday (the Monday after the final game of the NFL season) marked a sort of annual tradition when different NFL team owners and general managers get together and decide whether or not to fire their head coach ("Black Monday"). At least by my count, 4 coaches were fired (though 2 of these were fired mid-season and there is at least one more coach, Jason Garrett of the Dallas Cowboys, who may not make it through the end of the week). The two question on everyone's minds (at least the fans of the four teams that lost their head coach) today are:
1. Who can these teams get for their new head coach?
2. Will a new head coach make a difference?
I've talked about this issue before in the past (see "Lovable Losers" once more... and "You're fired!"). At least to answer the second question, most of the time, changing a head coach doesn't really help a team start to win (at least if they are losing, and I would assume that is the case for most teams that fire their head coach). In other words, changing the coach is not the answer.
Case in point - just take a look at the Cleveland Browns, who fired their head coach, Freddie Kitchens after just one season (in which their win-loss record was 6-10). If you are about my age, you will remember the last time that the Cleveland Browns were winning was when Marty Schottenheimer was their head coach from 1984 to 1988 (the overall record during that stretch was 44-27-0). Since the 1988 season, the Cleveland Browns have had 14 head coaches with an overall record of 149-297-2 (winning percentage of 0.498). Now, during this same period of time, the Browns moved to Baltimore and became the Baltimore Ravens, and then a few years later a new franchise was created for Cleveland with the original name.
One could certainly ask whether the Browns are just incredibly unlucky with their head coaching hires. Until my next point. Most of you may not remember, but Bill Belichick, who will likely go down in history as one of the greatest (if not THE greatest) head coaches in NFL history, served as head coach of the Browns from 1991-1995 with an overall record of 36-44. Recall that Belichick's overall win-loss record as head coach of the New England Patriots is 237-83 with six Super Bowl victories (he's also lost the Super Bowl three times). So, either Belichick learned from his mistakes in Cleveland or there's something else different about the Browns versus the Patriots. I would argue (see my previous posts on this topic, "The Patriot Way", "The Patriot Way Redux", and "That makes it twice...") that it has more to do with the latter than the former - the culture throughout the Cleveland Browns organization is just not a winning culture.
Clearly then, changing your head coach doesn't help if the rest of the organization is terribly run. And I would also argue that firing your head coach is not always the best answer. Case in point - just take a look at the University of Virginia men's basketball team. After the 2018 season, the UVa Cavaliers were the number one ranked team in the country and the number one overall seed in the NCAA tournament. Many experts thought that 2018 was their year to win it all. As the top-ranked seed in their region, they were scheduled to play the team that was the number 16 (last) seed, the University of Maryland-Baltimore County Retrievers team.
What happened? The UMBC team beat the UVa team! For the first time in the 880 year history of the NCAA men's college basketball tournament, a number 16 seed beat a number 1 seed in the first round. At least one sports journalist compared the magnitude of this upset to the famous defeat of the Spanish Armada in 1588! He went on to say that UVa's head coach, Tony Bennett "will be remembered in years, perhaps decades, to come, for becoming the first No. 1 seed... to lose to a No. 16 seed. That stain does not easily, if ever, wash away." The same journalist didn't call for Coach Bennett to be fired, but he did say that "Something is missing. Something has to change. An answer must be found."
What did Coach Bennett have to say after the loss? During the postgame press conference he explained his philosophy, "That's life. We talk about it all the time...If you play this game, and you step into the arena, this stuff can happen...And all those who compete take that on. And so we'll accept it."
In other words, take the loss and learn from it. As Ryan Holiday wrote in a recent post on his "Daily Stoic" blog, "What matters is what you do next." He goes on to talk about what the ancient Roman emperor and Stoic philosopher, Marcus Aurelius, would say, "If you accept this obstacle and work with what you're given, an alternative will present itself - another piece of what you're trying to assemble." In other words, learn and move on.
What happened next? The University of Virginia won the NCAA basketball tournament the very next year to become the 2019 National Champions! Again, Coach Bennett said, "All of the ridicule, all of the criticism, all the humility, all the things that happened, at that moment, it was crystal clear that it was all worth it...If you learn to use failure, suffering, adversity right, it will buy you a ticket to a place you couldn't have gone any other way."
That is how you build a winning culture folks! You don't need to fire your coach, or for that matter, your CEO, if you build the right culture around that individual. I would bet that the next head coach of the Cleveland Browns will last a couple of years and get fired for yet another losing record. We won't know for sure until the next "Black Monday" in 2020 (or the one after that), but I think we can almost guarantee it will happen, unless something drastically changes in the Browns organization.
Life is all about metaphors and personal stories. I wanted a place to collect random thoughts, musings, and stories about leadership in general and more specifically on leadership and management in health care.
Tuesday, December 31, 2019
Sunday, December 29, 2019
Survival of the fittest?
This is an update and correction of the previous post.
The English naturalist, Charles Darwin first published his theory of evolution in 1859 in his classic book, On the Origin of the Species. In his book, which was based upon evidence gathered during his voyages on the HMS Beagle, Darwin proposed that populations evolve, or change over time, through a process of natural selection, commonly referred to as the "survival of the fittest". "The use of the phrase, "survival of the fittest" is perhaps an oversimplification, for Darwin also reportedly said, "It is not the strongest species that survives, nor the most intelligent, but the one most ready for change." In other words, the species that do ultimately survive are the ones that adapt. Evolution then, is about perpetual change.
What's good for biological species is also good for organizations. To paraphrase Darwin, "It is not the biggest or richest organizations, nor the ones with the most talented leaders that survive, but rather the ones that are most ready to change." Change is good. Overreliance on your past successes is not.
If you need evidence, look no further than how the companies that comprise the Dow Jones Industrial Average have changed over time. Since its inception on May 26, 1896, the companies that have comprised this overall barometer for the New York Stock Exchange have changed 54 times. That doesn't sound like all that much until you consider that these companies are considered some of the most stable performers over time (which is one of the reasons why they are included in the DJIA metric). Just take a look at some of the companies that have been recently dropped from the DJIA - General Electric, AT&T, Alcoa, Bank of America, Hewlett-Packard, Kraft Foods, Citigroup, and General Motors - and that's just in the last decade!
Do you need more evidence? Just read any of the books by the management guru, Jim Collins. I think his book, "How the Mighty Fall" is particularly relevant to the present topic of discussion. We'll talk more about this book later in another post, but the overall message from all of Collins' books is that companies that fail to change with the times don't last for very long.
If you are still not convinced that change is important, consider the case of the retail chain, Kmart. Kmart was one of those companies that I grew up with - we used to shop there all the time. Kmart sold just about everything - clothes, home appliances, automotive parts, shoes, and electronics. I remember that we even bought our first home computer (a Texas Instruments personal computer) there! Kmart even had an in-store cafeteria.
Kmart was founded by S.S. Kresge and was first incorporated in 1899 as the S.S. Kresge Corporation. The company was renamed the Kmart Corporation in 1977. Throughout the 1980's and 1990's, Kmart was one of the largest discount retail chains in the United States. At its peak in 1994, Kmart operated over 2,400 stores around the world.
Kmart was known for its "Blue Light Special", an in store promotion in which a rotating blue light (similar to the ones found on the tops of police cars, fire trucks, and ambulances at the time) was placed for a short period of time (usually only a few hours) near special on sale items that were significantly discounted. The sales promotion was announced throughout the store over the public address system with the phrase, "Attention Kmart shoppers..."
I can still remember when Kmart sponsored the Newman/Haas Racing Indy Car racing team (co-owned by the actor, Paul Newman and former race car driver, Carl Haas). Kmart's drivers included Nigell Mansell (who won the overall championship for Kmart in 1991 and 1993) and one of my favorite drivers, Mario Andretti.
Unfortunately, Kmart failed to change with the times. Kmart's brand became synonymous with poor quality. As a result, Kmart lost customers to other department stores, such as Walmart and Target. The company tried (unsuccessfully) to rebrand its image by offering exclusive merchandise lines by Martha Stewart, Kathy Ireland, and Jaclyn Smith. Kmart even changed its logo, but it was too late. Kmart's profitability and sales peaked in 1992 and continued to decline and never recovered. Kmart filed for Chapter 11 bankruptcy on January 22, 2002.
Kmart continued to close stores in order to cut costs. The company re-structured and emerged from bankruptcy a year later, at which time the new management announced a decision to purchase Sears for $11 billion (more about Sears later). The merger of two failing department stores, at least in this case, only made things worse. The new company continued to close stores at a number of locations throughout the U.S., eventually declaring bankruptcy again in 2018. More stores are scheduled to be closed, and by 2020 (assuming Kmart is still around), the number of stores will be reduced to only 54 locations in the United States.
Kmart failed to adapt its business model to compete with other stores, such as Walmart and Target. Kmart couldn't convince consumers that cheap prices didn't mean cheap quality. Later on, Kmart failed to change its business model as consumers shifted preferences away from brick-and-mortar stores to online shopping.
Companies and organizations "die" because they fail to recognize when it's time to change. Perpetual change. Continuous improvement. "Skating to where the puck is going to be". Call it whatever you want. The survivors are the ones most ready to change.
The English naturalist, Charles Darwin first published his theory of evolution in 1859 in his classic book, On the Origin of the Species. In his book, which was based upon evidence gathered during his voyages on the HMS Beagle, Darwin proposed that populations evolve, or change over time, through a process of natural selection, commonly referred to as the "survival of the fittest". "The use of the phrase, "survival of the fittest" is perhaps an oversimplification, for Darwin also reportedly said, "It is not the strongest species that survives, nor the most intelligent, but the one most ready for change." In other words, the species that do ultimately survive are the ones that adapt. Evolution then, is about perpetual change.
What's good for biological species is also good for organizations. To paraphrase Darwin, "It is not the biggest or richest organizations, nor the ones with the most talented leaders that survive, but rather the ones that are most ready to change." Change is good. Overreliance on your past successes is not.
If you need evidence, look no further than how the companies that comprise the Dow Jones Industrial Average have changed over time. Since its inception on May 26, 1896, the companies that have comprised this overall barometer for the New York Stock Exchange have changed 54 times. That doesn't sound like all that much until you consider that these companies are considered some of the most stable performers over time (which is one of the reasons why they are included in the DJIA metric). Just take a look at some of the companies that have been recently dropped from the DJIA - General Electric, AT&T, Alcoa, Bank of America, Hewlett-Packard, Kraft Foods, Citigroup, and General Motors - and that's just in the last decade!
Do you need more evidence? Just read any of the books by the management guru, Jim Collins. I think his book, "How the Mighty Fall" is particularly relevant to the present topic of discussion. We'll talk more about this book later in another post, but the overall message from all of Collins' books is that companies that fail to change with the times don't last for very long.
If you are still not convinced that change is important, consider the case of the retail chain, Kmart. Kmart was one of those companies that I grew up with - we used to shop there all the time. Kmart sold just about everything - clothes, home appliances, automotive parts, shoes, and electronics. I remember that we even bought our first home computer (a Texas Instruments personal computer) there! Kmart even had an in-store cafeteria.
Kmart was founded by S.S. Kresge and was first incorporated in 1899 as the S.S. Kresge Corporation. The company was renamed the Kmart Corporation in 1977. Throughout the 1980's and 1990's, Kmart was one of the largest discount retail chains in the United States. At its peak in 1994, Kmart operated over 2,400 stores around the world.
Kmart was known for its "Blue Light Special", an in store promotion in which a rotating blue light (similar to the ones found on the tops of police cars, fire trucks, and ambulances at the time) was placed for a short period of time (usually only a few hours) near special on sale items that were significantly discounted. The sales promotion was announced throughout the store over the public address system with the phrase, "Attention Kmart shoppers..."
I can still remember when Kmart sponsored the Newman/Haas Racing Indy Car racing team (co-owned by the actor, Paul Newman and former race car driver, Carl Haas). Kmart's drivers included Nigell Mansell (who won the overall championship for Kmart in 1991 and 1993) and one of my favorite drivers, Mario Andretti.
Unfortunately, Kmart failed to change with the times. Kmart's brand became synonymous with poor quality. As a result, Kmart lost customers to other department stores, such as Walmart and Target. The company tried (unsuccessfully) to rebrand its image by offering exclusive merchandise lines by Martha Stewart, Kathy Ireland, and Jaclyn Smith. Kmart even changed its logo, but it was too late. Kmart's profitability and sales peaked in 1992 and continued to decline and never recovered. Kmart filed for Chapter 11 bankruptcy on January 22, 2002.
Kmart continued to close stores in order to cut costs. The company re-structured and emerged from bankruptcy a year later, at which time the new management announced a decision to purchase Sears for $11 billion (more about Sears later). The merger of two failing department stores, at least in this case, only made things worse. The new company continued to close stores at a number of locations throughout the U.S., eventually declaring bankruptcy again in 2018. More stores are scheduled to be closed, and by 2020 (assuming Kmart is still around), the number of stores will be reduced to only 54 locations in the United States.
Kmart failed to adapt its business model to compete with other stores, such as Walmart and Target. Kmart couldn't convince consumers that cheap prices didn't mean cheap quality. Later on, Kmart failed to change its business model as consumers shifted preferences away from brick-and-mortar stores to online shopping.
Companies and organizations "die" because they fail to recognize when it's time to change. Perpetual change. Continuous improvement. "Skating to where the puck is going to be". Call it whatever you want. The survivors are the ones most ready to change.
Monday, December 23, 2019
"Prescription for the Future"
Ezekiel Emanuel is an oncologist, bioethicist, and health policy researcher who currently serves as the Vice Provost for Global Initiatives and Chair, Department of Medical Ethics and Health Policy at the University of Pennsylvania. Dr. Emanuel has written extensively about our U.S. health care system, and he served as one of former President Barack Obama's chief advisors and architects of the Affordable Care Act in 2010. Incidentally, he is also the older brother of Rahm Emanuel, President Obama's Chief of Staff from 2009 to 2010 and former mayor of the city of Chicago. This past year, I read his most recent book, Prescription for the Future, in which he lays out twelve key practices that he believes will transform health care for the future.
Dr. Emanuel starts off his introduction with the prophetic statement, "With the electoral victory of President Donald Trump, it seems reasonable to ask whether this book is still relevant. Have current events overtaken a book advocating reform and transformation of the American healthcare system?" His answer is a resounding no. He goes on to say, "Improving the American healthcare system is something every patient, every small business owner, every corporate executive, every physician, nurse, and other practitioner, every politician and policy-maker should care about. The system desperately needs to be fixed."
He starts off by suggesting that there are six essential elements that will be necessary for the successful transformation of our healthcare system:
1. Catalyzing crisis - According to Newton's First Law of Motion, a body at rest will remain at rest unless acted upon by some external force. Similarly, there has to be what John Kotter calls "a sense of urgency" for people (and organizations) to change. Without some external force applied to healthcare, there will simply be no change for the better.
2. Leadership - Again, take one look at Kotter's classic 8-step change model and it is clear that without someone serving as the driving force (the catalyst above necessary to overcome inertia) to create the "sense of urgency", "build a guiding coalition," and "form a strategic vision", it will be next to impossible to change the healthcare system for the better.
3. Culture, Governance, and Physician Engagement - You have probably heard the old adage, "Culture eats strategy for lunch." It's absolutely true - without the proper culture, change will be next to impossible. Similarly, having physicians engaged with any change initiative will be absolutely essential.
4. Data - Dr. Emanuel suggests that at least 5 types of data will be necessary for healthcare organizations to successfully implement his 12 transformational practices (1) claims data, (2) laboratory data, (3) imaging data, (4) pharmacy data, and (5) clinical data. Clearly, having the right data will be necessary to identify quality gaps and drive improvement. Having the right data analytics is even more important - data scientists should be involved at the beginning of any change initiative to help design valid, reproducible, and measurable metrics for improvement.
5. Physician management/alignment - I have argued this point as well - having physicians aligned with management, or in many cases, serving as management, will be a key aspect of the drive to change the American healthcare system. Several organizations have adopted the concept of leadership dyads and triads (physicians leaders, nurse leaders, and administrators work together to create the necessary alignment and collaboration for change).
6. Financial Risk and Incentives - If the financial incentives to change the system aren't there, change will never happen. If health insurance companies aren't "all in" with creating the necessary incentives for organizations to change, transformation will be dead in the water.
Dr. Emanuel then follows these six essential elements with 12 transformational practices that he has observed in highly successful healthcare organizations and which he believes will be necessary to transform the U.S. healthcare system. Importantly, he doesn't provide any significant description on (1) how to implement these practices or (2) how to pay for them, but I do think these practices represent a reasonable starting point for change:
1. Scheduling - Particularly with respect to clinic visits, open access to scheduling (where the patient can go online and schedule his or her appointment) has decreased utilization of high-cost sites of care, such as the Emergency Department (with subsequent decreases in cost) and dramatically improved the patient experience.
2. Registration and Rooming - Improve the efficiency of the patient registration process (if you've ever been to a doctor's office or required admission to the hospital, you know exactly what this process entails) and have medical assistants rather than nurses room patients (bring the patient back to the clinic office).
3. Performance Measurement and Reporting - establish key metrics - preferably ones based on outcomes and cost of care - to drive improvement. Link these metrics with performance evaluations and reimbursement.
4. Standardization of Care - Standardization of care is not "cookbook medicine" - it improves the efficiency and cost of care, as well as both the provider's and patient's experience with care.
5. Chronic Care Coordination - We need to shift from an Acute Care-based model to one that emphasizes care management of chronic diseases, which disproportionately determine the overall cost of care in the United States.
6. Shared decisionmaking - Patients should be involved in making the decisions about what care they receive and how that care is delivered.
7. Site of Service - Patients should receive care at the right place and the right time. As one example, the emergency department should not be used for routine or non-emergent conditions.
8. De-institutionalization - Again, we need to shift from an acute care-based system to one focusing on health and prevention.
9. Behavioral Health Interventions - Mental health has been neglected for far too long - we need to make the right investments to improve the overall physical, spiritual, and mental health and wellbeing of our patients.
10. Palliative Care - We need to invest in palliative care, so that patients who are in the final stages of their life can be cared for at home, if they choose, rather than in the hospital setting.
11. Community Interventions - Health care organizations should start focusing on the health of their local populations.
12. Lifestyle Interventions - Again, addressing the social determinants of health with a renewed and re-energized focus on lifestyle factors (exercise, diet, tobacco use, etc) will be necessary to drive improvements in key health metrics such as life expectancy and infant mortality, among many others.
Overall, I really enjoyed Dr. Emanuel's book. I do think his recommendations make a lot of sense. He focuses mostly on the "what" and perhaps falls a little short on the "how", but the book is definitely worth a read.
Dr. Emanuel starts off his introduction with the prophetic statement, "With the electoral victory of President Donald Trump, it seems reasonable to ask whether this book is still relevant. Have current events overtaken a book advocating reform and transformation of the American healthcare system?" His answer is a resounding no. He goes on to say, "Improving the American healthcare system is something every patient, every small business owner, every corporate executive, every physician, nurse, and other practitioner, every politician and policy-maker should care about. The system desperately needs to be fixed."
He starts off by suggesting that there are six essential elements that will be necessary for the successful transformation of our healthcare system:
1. Catalyzing crisis - According to Newton's First Law of Motion, a body at rest will remain at rest unless acted upon by some external force. Similarly, there has to be what John Kotter calls "a sense of urgency" for people (and organizations) to change. Without some external force applied to healthcare, there will simply be no change for the better.
2. Leadership - Again, take one look at Kotter's classic 8-step change model and it is clear that without someone serving as the driving force (the catalyst above necessary to overcome inertia) to create the "sense of urgency", "build a guiding coalition," and "form a strategic vision", it will be next to impossible to change the healthcare system for the better.
3. Culture, Governance, and Physician Engagement - You have probably heard the old adage, "Culture eats strategy for lunch." It's absolutely true - without the proper culture, change will be next to impossible. Similarly, having physicians engaged with any change initiative will be absolutely essential.
4. Data - Dr. Emanuel suggests that at least 5 types of data will be necessary for healthcare organizations to successfully implement his 12 transformational practices (1) claims data, (2) laboratory data, (3) imaging data, (4) pharmacy data, and (5) clinical data. Clearly, having the right data will be necessary to identify quality gaps and drive improvement. Having the right data analytics is even more important - data scientists should be involved at the beginning of any change initiative to help design valid, reproducible, and measurable metrics for improvement.
5. Physician management/alignment - I have argued this point as well - having physicians aligned with management, or in many cases, serving as management, will be a key aspect of the drive to change the American healthcare system. Several organizations have adopted the concept of leadership dyads and triads (physicians leaders, nurse leaders, and administrators work together to create the necessary alignment and collaboration for change).
6. Financial Risk and Incentives - If the financial incentives to change the system aren't there, change will never happen. If health insurance companies aren't "all in" with creating the necessary incentives for organizations to change, transformation will be dead in the water.
Dr. Emanuel then follows these six essential elements with 12 transformational practices that he has observed in highly successful healthcare organizations and which he believes will be necessary to transform the U.S. healthcare system. Importantly, he doesn't provide any significant description on (1) how to implement these practices or (2) how to pay for them, but I do think these practices represent a reasonable starting point for change:
1. Scheduling - Particularly with respect to clinic visits, open access to scheduling (where the patient can go online and schedule his or her appointment) has decreased utilization of high-cost sites of care, such as the Emergency Department (with subsequent decreases in cost) and dramatically improved the patient experience.
2. Registration and Rooming - Improve the efficiency of the patient registration process (if you've ever been to a doctor's office or required admission to the hospital, you know exactly what this process entails) and have medical assistants rather than nurses room patients (bring the patient back to the clinic office).
3. Performance Measurement and Reporting - establish key metrics - preferably ones based on outcomes and cost of care - to drive improvement. Link these metrics with performance evaluations and reimbursement.
4. Standardization of Care - Standardization of care is not "cookbook medicine" - it improves the efficiency and cost of care, as well as both the provider's and patient's experience with care.
5. Chronic Care Coordination - We need to shift from an Acute Care-based model to one that emphasizes care management of chronic diseases, which disproportionately determine the overall cost of care in the United States.
6. Shared decisionmaking - Patients should be involved in making the decisions about what care they receive and how that care is delivered.
7. Site of Service - Patients should receive care at the right place and the right time. As one example, the emergency department should not be used for routine or non-emergent conditions.
8. De-institutionalization - Again, we need to shift from an acute care-based system to one focusing on health and prevention.
9. Behavioral Health Interventions - Mental health has been neglected for far too long - we need to make the right investments to improve the overall physical, spiritual, and mental health and wellbeing of our patients.
10. Palliative Care - We need to invest in palliative care, so that patients who are in the final stages of their life can be cared for at home, if they choose, rather than in the hospital setting.
11. Community Interventions - Health care organizations should start focusing on the health of their local populations.
12. Lifestyle Interventions - Again, addressing the social determinants of health with a renewed and re-energized focus on lifestyle factors (exercise, diet, tobacco use, etc) will be necessary to drive improvements in key health metrics such as life expectancy and infant mortality, among many others.
Overall, I really enjoyed Dr. Emanuel's book. I do think his recommendations make a lot of sense. He focuses mostly on the "what" and perhaps falls a little short on the "how", but the book is definitely worth a read.
Thursday, December 19, 2019
Top 10 Leadership Reverie Blog Posts for 2019
It seems that there are a lot of "Top 10" or "Top 100" lists that come out this time of year. So, just like I did last year, I wanted to provide you with a recap of the "Top 10" Leadership Reverie blog posts for 2019 (there was a tie for 10th place):
1. He had no shoes! 1/31/2019
2. Two sisters and an orange 2/27/2019
3. "Do we need a National Women Physician's Day" - one year later 2/3/2019
4. If you want to improve safety, take a FOD walk 2/12/2019
5. "All along the watchtower..." 2/17/2019
6. Word choice matters 7/31/2019
7. The Periodic Table of Leadership 3/3/2019
8. "Dad is hangry again!" 3/10/2019
9. Invest your money wisely... 3/22/2019
10. The Alabama Paradox 1/16/2019
"You're not you when you're hungry..." 6/5/2019
I really enjoy writing this blog. As it says in the tagline, I wanted a place to collect random thoughts and stories about leadership. The fact that a few individuals read these random thoughts and stories makes it all the more worthwhile. So, thank you to all of you for your interest!
Stay tuned for a new list of some of my favorite "leadership books" in 2020, listed on the right-hand side of the blog's web page.
As some of you may already know, 2020 is going to bring a lot of changes for me, both personally and professionally. After spending the past 15 years at a children's hospital in Cincinnati, Ohio, I will be moving to a new position in Chicago, Illinois! I will still plan on posting at least twice a week, even with the new job!
Finally, as the year 2019 comes to a close, I want to leave you all with a couple of quotes to welcome in the new year:
"Write it on your heart that every day is the best day in the year."
Ralph Waldo Emerson
"Your success and happiness lies in you. Resolve to keep happy, and your joy and you shall form an invincible host against difficulties."
Helen Keller
"Be at war with your vices, at peace with your neighbors, and let every new year find you a better man."
Benjamin Franklin
1. He had no shoes! 1/31/2019
2. Two sisters and an orange 2/27/2019
3. "Do we need a National Women Physician's Day" - one year later 2/3/2019
4. If you want to improve safety, take a FOD walk 2/12/2019
5. "All along the watchtower..." 2/17/2019
6. Word choice matters 7/31/2019
7. The Periodic Table of Leadership 3/3/2019
8. "Dad is hangry again!" 3/10/2019
9. Invest your money wisely... 3/22/2019
10. The Alabama Paradox 1/16/2019
"You're not you when you're hungry..." 6/5/2019
I really enjoy writing this blog. As it says in the tagline, I wanted a place to collect random thoughts and stories about leadership. The fact that a few individuals read these random thoughts and stories makes it all the more worthwhile. So, thank you to all of you for your interest!
Stay tuned for a new list of some of my favorite "leadership books" in 2020, listed on the right-hand side of the blog's web page.
As some of you may already know, 2020 is going to bring a lot of changes for me, both personally and professionally. After spending the past 15 years at a children's hospital in Cincinnati, Ohio, I will be moving to a new position in Chicago, Illinois! I will still plan on posting at least twice a week, even with the new job!
Finally, as the year 2019 comes to a close, I want to leave you all with a couple of quotes to welcome in the new year:
"Write it on your heart that every day is the best day in the year."
Ralph Waldo Emerson
"Your success and happiness lies in you. Resolve to keep happy, and your joy and you shall form an invincible host against difficulties."
Helen Keller
"Be at war with your vices, at peace with your neighbors, and let every new year find you a better man."
Benjamin Franklin
Wednesday, December 18, 2019
"If people are good only because they fear punishment and hope for reward, then we are a sorry lot indeed."
I've previously posted about the famous The Tale of the Five Monkeys and "The Way We Do Things 'Round Here" Syndrome (an experiment that probably never actually happened in exactly the way it has been portrayed all over the Internet). As it turns out, the psychologist Harry Harlow conducted several experiments with monkeys (unfortunately, he violated a number of modern-day ethical principles for animal research in the process) and came up with the novel (at that time) theory of intrinsic motivation.
Basically, Harlow placed puzzles in the monkeys' cages and was surprised to discover that the monkeys solved the puzzles on their own. They didn't receive any rewards for doing so, nor did they avoid any punishments because they solved the puzzles. The monkeys solved the puzzles merely for the pleasure of completing a difficult task. The personal satisfaction that they achieved by solving the puzzles was its own reward - hence, intrinsic motivation. He later found that offering external rewards did not lead to improved performance. As a matter of fact, offering rewards actually disrupted the completion of the task.
Harlow therefore identified three levels of human motivation:
1. The first level of motivation is for survival. We do things to assure our survival.
2. The second level of motivation is to seek rewards and avoid punishment.
3. The third (and perhaps more important than the second) level of motivation is intrinsic - we do things to achieve internal satisfaction.
The management guru, W. Edwards Deming had this to say about how managers try to motivate their employees to do a good job:
Our prevailing system of management has destroyed our people. People are born with intrinsic motivation, self-respect, dignity, curiosity to learn, joy in learning. The forces of destruction begin with toddlers - a prize for the best Halloween costume, grades in school, gold stars - and on up through the university. On the job people, teams, and divisions are ranked, reward for the top, punishment for the bottom. Management by Objectives, quotas, incentive pay, business plans, put together separately, division by division, cause further loss, unknown and unknowable.
Albert Einstein also believed in the theory of intrinsic motivation:
Economists and workplace consultants regard it as almost unquestioned dogma that people are motivated by rewards, so they don't feel the need to test this. It has the status more of religious truth than scientific hypothesis. The facts are absolutely clear. There is no question that in virtually all circumstances in which people are doing things in order to get rewards, extrinsic tangible rewards undermine intrinsic motivation.
He goes on to say, "If people are good only because they fear punishment and hope for reward, then we are a sorry lot indeed."
So, the question to consider then, is how can leaders and managers motivate their teams without using rewards or punishments? In other words, how can we as leaders leverage intrinsic motivation? Here are some suggestions:
1. Provide challenging assignments - most of us like a challenge and will have a desire to "step up" to the challenge.
2. Offer a choice - individuals have different skills and values, so why not leverage this fact by giving them an opportunity to choose the assignments that are best matched to their skill set and personal preferences?
3. Provide a clear path to advancement - promotion is certainly a form of reward, but it is also important to make sure that individuals always have an opportunity to advance and see a clear path forward.
4. Provide regular feedback - giving regular, constructive feedback is one of the best ways to promote intrinsic motivation, as it allows individuals to feel as though they have some degree of control over their personal success and professional development.
5. Allow individuals to participate in decision-making - individuals who participate in decisions will feel a sense of camaraderie as key stakeholders in the success of the organization.
Basically, Harlow placed puzzles in the monkeys' cages and was surprised to discover that the monkeys solved the puzzles on their own. They didn't receive any rewards for doing so, nor did they avoid any punishments because they solved the puzzles. The monkeys solved the puzzles merely for the pleasure of completing a difficult task. The personal satisfaction that they achieved by solving the puzzles was its own reward - hence, intrinsic motivation. He later found that offering external rewards did not lead to improved performance. As a matter of fact, offering rewards actually disrupted the completion of the task.
Harlow therefore identified three levels of human motivation:
1. The first level of motivation is for survival. We do things to assure our survival.
2. The second level of motivation is to seek rewards and avoid punishment.
3. The third (and perhaps more important than the second) level of motivation is intrinsic - we do things to achieve internal satisfaction.
The management guru, W. Edwards Deming had this to say about how managers try to motivate their employees to do a good job:
Our prevailing system of management has destroyed our people. People are born with intrinsic motivation, self-respect, dignity, curiosity to learn, joy in learning. The forces of destruction begin with toddlers - a prize for the best Halloween costume, grades in school, gold stars - and on up through the university. On the job people, teams, and divisions are ranked, reward for the top, punishment for the bottom. Management by Objectives, quotas, incentive pay, business plans, put together separately, division by division, cause further loss, unknown and unknowable.
Albert Einstein also believed in the theory of intrinsic motivation:
Economists and workplace consultants regard it as almost unquestioned dogma that people are motivated by rewards, so they don't feel the need to test this. It has the status more of religious truth than scientific hypothesis. The facts are absolutely clear. There is no question that in virtually all circumstances in which people are doing things in order to get rewards, extrinsic tangible rewards undermine intrinsic motivation.
He goes on to say, "If people are good only because they fear punishment and hope for reward, then we are a sorry lot indeed."
So, the question to consider then, is how can leaders and managers motivate their teams without using rewards or punishments? In other words, how can we as leaders leverage intrinsic motivation? Here are some suggestions:
1. Provide challenging assignments - most of us like a challenge and will have a desire to "step up" to the challenge.
2. Offer a choice - individuals have different skills and values, so why not leverage this fact by giving them an opportunity to choose the assignments that are best matched to their skill set and personal preferences?
3. Provide a clear path to advancement - promotion is certainly a form of reward, but it is also important to make sure that individuals always have an opportunity to advance and see a clear path forward.
4. Provide regular feedback - giving regular, constructive feedback is one of the best ways to promote intrinsic motivation, as it allows individuals to feel as though they have some degree of control over their personal success and professional development.
5. Allow individuals to participate in decision-making - individuals who participate in decisions will feel a sense of camaraderie as key stakeholders in the success of the organization.
Monday, December 16, 2019
Rivals
Imagine if President-elect Donald Trump had asked John Kasich to be his Secretary of State, Marco Rubio to be his Secretary of Treasury, Jeb Bush to be his Secretary of Navy, Chris Christie to be his Attorney General, and Ted Cruz to be his Secretary of War. All of these men were his political rivals during the 2016 Republican Party presidential primaries - at times he threw both political criticism and personal insults their way (as is his way, he picked out childish nicknames for each one, "Lying Ted", "Low Energy Jeb", and "Little Marco" - there's even a Wikipedia site of all the nicknames he has used for both colleagues and rivals here). Trump is one individual who needs his ego stroked as often as possible, so he would never do it.
It's not always a great idea to build the team that is supposed to support you and assist you in executing your vision with individuals who've been your political opponents. But that is exactly what President Abraham Lincoln, arguably our nation's greatest President, did shortly after he was elected President of the United States in 1860. Nearly all of the individuals that President Lincoln asked to serve in his cabinet were political rivals, many of whom he had defeated at the 1860 Republican National Convention.
Senator William Seward of New York had been the frontrunner up until the time that the nominating convention was held, although Lincoln, Governor Salmon Chase of Ohio, former Representative Edward Bates of Missouri, and Senator Simon Cameron of Pennsylvania had strong support from a large number of delegates to the convention too. There were no primaries back then, so the nominating conventions were really where all the action occurred. Senator Seward led after the first ballot, but he didn't have enough votes to have a majority, which was required to win the nomination. Lincoln was a very close second. Senator Cameron's delegates shifted over to Lincoln on the second ballot, resulting in a tie between Seward and Lincoln. Finally, on the third ballot, Lincoln secured the nomination by winning a majority of the delegates' votes.
Once Lincoln took office in 1861, he appointed four of his opponents (Seward, Chase, Bates, and Cameron) to his cabinet. William Seward became his Secretary of State. Salmon Chase became the Secretary of Treasury. Simon Cameron became the Secretary of War, and Edward Bates became the Attorney General. What Lincoln did was unprecedented - not since the early days in the history of the United States, when the Vice President was the individual who got second place in the Presidential election, had something like this occurred. And we will probably never see something like this ever again.
What Lincoln did was even more impressive when you consider the political times. The country was divided over the issue of slavery, and the crisis had built up over many, many years to the point where the 1860 election really was the moment that the proverbial powder keg blew. During a crisis, a leader generally prefers to have a team of individuals who he or she can trust and lean on for support. Lincoln chose the opposite course, and that is the subject of the book, Team of Rivals: The Political Genius of Abraham Lincoln by the Pullitzer Prize-winning author, Doris Kearns Goodwin.
Here is what Larry Sabato had to say about the book in his review:
When he became president in 1861, Lincoln had few strong allies in Washington; he was mainly a stranger to the ways of this most political of cities, and he faced the dissolution of the Union in a matter of weeks. Even more than most chief executives, he needed all the help he could get. So Lincoln made a strategic decision to include his major Republican party rivals in his Cabinet: Salmon P. Chase as secretary of the treasury, William H. Seward as secretary of state, Edwin M. Stanton as secretary of war and Edward Bates as attorney general. Chase, Seward and Bates had been competitors for the GOP presidential nomination, and all of them, especially Chase and Seward, had a shockingly low regard for Lincoln’s abilities and promise. In short, this was not a Cabinet made in compatibility heaven.
As Sabato suggests later in his review, Lincoln applied the old adage "keep your friends close and your enemies closer" when he selected his cabinet. And, as history would attest, Lincoln's gamble worked. As he writes further:
As ambitious men almost always do, Chase, Seward, Stanton and Bates were easily induced to accept their high-status posts, and they wanted to keep them, which meant that they could only go so far in opposing the president’s policies. In fact, for the most part the four Cabinet members raised remarkably few strong objections even in private discussions with the president, while fulminating from time to time about Lincoln’s alleged high-handedness. More significant, Lincoln gradually won over Seward, Stanton and Bates as they came to appreciate the homespun leader’s keen intellect and skillful sense of politics. Lincoln was not at all what they had once thought.
"Team of Rivals" is really an incredible book - it's become one of my favorite books about personally my favorite President. Steven Spielberg directed and produced the 2012 film Lincoln, starring Daniel Day-Lewis as President Lincoln (he won his third Academy Award for his performance), based loosely on the book. The movie is superb, but don't think that you can truly get the gist of the book by watching the movie in this case. Read the book!
It's not always a great idea to build the team that is supposed to support you and assist you in executing your vision with individuals who've been your political opponents. But that is exactly what President Abraham Lincoln, arguably our nation's greatest President, did shortly after he was elected President of the United States in 1860. Nearly all of the individuals that President Lincoln asked to serve in his cabinet were political rivals, many of whom he had defeated at the 1860 Republican National Convention.
Senator William Seward of New York had been the frontrunner up until the time that the nominating convention was held, although Lincoln, Governor Salmon Chase of Ohio, former Representative Edward Bates of Missouri, and Senator Simon Cameron of Pennsylvania had strong support from a large number of delegates to the convention too. There were no primaries back then, so the nominating conventions were really where all the action occurred. Senator Seward led after the first ballot, but he didn't have enough votes to have a majority, which was required to win the nomination. Lincoln was a very close second. Senator Cameron's delegates shifted over to Lincoln on the second ballot, resulting in a tie between Seward and Lincoln. Finally, on the third ballot, Lincoln secured the nomination by winning a majority of the delegates' votes.
Once Lincoln took office in 1861, he appointed four of his opponents (Seward, Chase, Bates, and Cameron) to his cabinet. William Seward became his Secretary of State. Salmon Chase became the Secretary of Treasury. Simon Cameron became the Secretary of War, and Edward Bates became the Attorney General. What Lincoln did was unprecedented - not since the early days in the history of the United States, when the Vice President was the individual who got second place in the Presidential election, had something like this occurred. And we will probably never see something like this ever again.
What Lincoln did was even more impressive when you consider the political times. The country was divided over the issue of slavery, and the crisis had built up over many, many years to the point where the 1860 election really was the moment that the proverbial powder keg blew. During a crisis, a leader generally prefers to have a team of individuals who he or she can trust and lean on for support. Lincoln chose the opposite course, and that is the subject of the book, Team of Rivals: The Political Genius of Abraham Lincoln by the Pullitzer Prize-winning author, Doris Kearns Goodwin.
Here is what Larry Sabato had to say about the book in his review:
When he became president in 1861, Lincoln had few strong allies in Washington; he was mainly a stranger to the ways of this most political of cities, and he faced the dissolution of the Union in a matter of weeks. Even more than most chief executives, he needed all the help he could get. So Lincoln made a strategic decision to include his major Republican party rivals in his Cabinet: Salmon P. Chase as secretary of the treasury, William H. Seward as secretary of state, Edwin M. Stanton as secretary of war and Edward Bates as attorney general. Chase, Seward and Bates had been competitors for the GOP presidential nomination, and all of them, especially Chase and Seward, had a shockingly low regard for Lincoln’s abilities and promise. In short, this was not a Cabinet made in compatibility heaven.
As Sabato suggests later in his review, Lincoln applied the old adage "keep your friends close and your enemies closer" when he selected his cabinet. And, as history would attest, Lincoln's gamble worked. As he writes further:
As ambitious men almost always do, Chase, Seward, Stanton and Bates were easily induced to accept their high-status posts, and they wanted to keep them, which meant that they could only go so far in opposing the president’s policies. In fact, for the most part the four Cabinet members raised remarkably few strong objections even in private discussions with the president, while fulminating from time to time about Lincoln’s alleged high-handedness. More significant, Lincoln gradually won over Seward, Stanton and Bates as they came to appreciate the homespun leader’s keen intellect and skillful sense of politics. Lincoln was not at all what they had once thought.
"Team of Rivals" is really an incredible book - it's become one of my favorite books about personally my favorite President. Steven Spielberg directed and produced the 2012 film Lincoln, starring Daniel Day-Lewis as President Lincoln (he won his third Academy Award for his performance), based loosely on the book. The movie is superb, but don't think that you can truly get the gist of the book by watching the movie in this case. Read the book!
Sunday, December 15, 2019
"It's in the roots, not the branches, that a tree's greatest strengths lie..."
When I was in 8th grade, my parents took my sister and I on a vacation to California. There were several things that I wanted to see on our trip. Alcatraz was one of them, but that's a story for another post. I also remember wanting to see the famous redwood trees that you can drive a car through, and while there are several such trees (there's even a park called "Drive-Thru Tree Park" in Leggett, California), the most famous one is called the Chandelier Tree.
Here's the thing though - there are actually two different species of these sequoia redwood trees in California. The giant sequoia (Sequoiadendron giganteum) is also called the "Sierra redwood" and grows to an average height of 165 to 280 feet and diameters ranging from 20 to 26 feet. The "California coast redwood" (Sequoia sempervirens) can grow to as high as 370 feet (in fact, the world's first-, second-, third-, and sixth-tallest trees are redwoods) and are more slender than the sequoias.
There is an old saying that says, "A small tree with strong roots will outlive a big tree with weak ones." And what truly sets the giant sequoias and redwoods apart from all other trees is not their size, it's their root system. Their roots are remarkably shallow (you would think that a really tall tree would have really deep roots) and only go about 6 to 12 feet into the ground. The roots of several redwoods are intertwined with each other to form a tight chain-like network so that individual trees share nutrients with each other and depend upon one another for strength.
There's another tree that has a similar root system called the Pando. "Pando" is Latin for "I spread out." The Pando is actually a clonal colony of an individual male quaking aspen (Populis tremuloides) which has been determined to be a single living organism. It is, in fact, an entire group of "trees" that are growing from a common root system covering just over 100 acres of land in the Fishlake National Forest of southern Utah. The root system is thought to be over 80,000 years old (though some scientists estimate that the age is closer to 1 million years) and has over 40,000 stems ("trees") which die individually and are replaced by new stems growing from the root system.
There is a beautiful metaphor here. Nature has found "strength in numbers" to be an incredibly stable, long-lasting model for these trees. We could learn a lot from Earth's co-inhabitants it seems. First, building a strong root system - say, core values, morals, and beliefs - is just as important for individuals and organizations as it for the giant sequoias and redwoods of California. Without a strong root system, we just don't last. Second, we can go much farther together than we can do so alone. Imagine what we could accomplish if a group of like-minded individuals with the same set of core values, morals, and beliefs locked hands together and set out to change the world. Just imagine.
Here's the thing though - there are actually two different species of these sequoia redwood trees in California. The giant sequoia (Sequoiadendron giganteum) is also called the "Sierra redwood" and grows to an average height of 165 to 280 feet and diameters ranging from 20 to 26 feet. The "California coast redwood" (Sequoia sempervirens) can grow to as high as 370 feet (in fact, the world's first-, second-, third-, and sixth-tallest trees are redwoods) and are more slender than the sequoias.
There is an old saying that says, "A small tree with strong roots will outlive a big tree with weak ones." And what truly sets the giant sequoias and redwoods apart from all other trees is not their size, it's their root system. Their roots are remarkably shallow (you would think that a really tall tree would have really deep roots) and only go about 6 to 12 feet into the ground. The roots of several redwoods are intertwined with each other to form a tight chain-like network so that individual trees share nutrients with each other and depend upon one another for strength.
There's another tree that has a similar root system called the Pando. "Pando" is Latin for "I spread out." The Pando is actually a clonal colony of an individual male quaking aspen (Populis tremuloides) which has been determined to be a single living organism. It is, in fact, an entire group of "trees" that are growing from a common root system covering just over 100 acres of land in the Fishlake National Forest of southern Utah. The root system is thought to be over 80,000 years old (though some scientists estimate that the age is closer to 1 million years) and has over 40,000 stems ("trees") which die individually and are replaced by new stems growing from the root system.
There is a beautiful metaphor here. Nature has found "strength in numbers" to be an incredibly stable, long-lasting model for these trees. We could learn a lot from Earth's co-inhabitants it seems. First, building a strong root system - say, core values, morals, and beliefs - is just as important for individuals and organizations as it for the giant sequoias and redwoods of California. Without a strong root system, we just don't last. Second, we can go much farther together than we can do so alone. Imagine what we could accomplish if a group of like-minded individuals with the same set of core values, morals, and beliefs locked hands together and set out to change the world. Just imagine.
Wednesday, December 11, 2019
California Dreaming
Someone once asked me, "If you could live anywhere in the United States, where would you choose?" The individual was completely assuming that close proximity to friends, family, and current job wasn't a factor. I thought it over for a minute and responded, "San Diego, California." I get it, the cost of living in California is extremely high. And there's always that fear that the entire state will break off and fall into the Pacific Ocean. Beyond all that, though, it's a pretty great place to call home!
Does living in California make people happy? As it turns out, a couple of investigators researched this exact question in the late 1990's (one of the investigators happens to be the Nobel Prize-winning economist, Daniel Kahneman, who wrote a best-selling book, Thinking Fast and Slow in 2011 that summarized decades of his research in the fields of cognitive psychology and behavioral economics). The results were published in the journal, Psychological Science, under the title, "Does Living in California Make People Happy?" The results might surprise you. There appears to be a cultural stereotype that people are happier in California, and individuals in the study rated overall life satisfaction for their peers as higher in California than in the Midwest. However, self-reported overall life satisfaction was the same between people living in California and people living in the Midwest. In other words, everyone believes that people who live in California are happier, mostly due to the fact that the climate is far better in sunny California compared to the gloomy Midwest. But when you ask individuals to rate their own satisfaction with life in general, people in California aren't any better than those of us who live in the Midwest!
Kahneman believed that we fall prey to something that he called a focusing illusion. As he wrote, "When a judgment about an entire object or category is made with attention focused on a subset of that category, a focusing illusion is likely to occur, whereby the attended subset is overweighted relative to the unattended subset." In other words, if we want to look at the degree of happiness of everyone living in the United States, we will overweight the degree of happiness higher if we focus on just one region, i.e. California.
Let me provide a different example, which may help explain the concept of a focusing illusion further. In a 1996 study by Schwarz and colleagues, college students were asked two questions: "How happy are you?" and "How many dates did you have last month?" The correlation between these two questions depended upon the order in which they were asked. Ask the first question ("How happy are you?") first, the correlation was 0.12 (which is low - perfect correlation would be 1.0), suggesting that the number of dates a college student had in the last month had no bearing on his or her overall happiness. However, ask the second question first ("How many dates did you have last month?" and the correlation between the two increased to 0.66 (which is actually pretty high). Focus on the number of dates a college student had in the last month and you overweight the impact of dating on overall happiness.
There is another famous study ("Lottery winners and accident victims: Is happiness relative?") that found very little difference in overall life satisfaction between paraplegic accident victims and otherwise healthy control subjects - again, the implication here is that a focusing illusion has occurred that causes us to believe that paraplegics are not happy. Similarly, there was no difference in overall life satisfaction between people who win the lottery and those who do not (the focusing illusion would cause us to believe that lottery winners are happier than the rest of us).
The bottom line lesson here? The grass is certainly not always greener on the other side. We tend to look at other people and think that their lives are better. "People who work at that job are happier than me, so if I could only have that job, I would be happier." Or, "people in California are happier than me, so if I could just move to California, I would be happier too." It's just not true, folks. It's a focusing illusion. Be careful that you don't fall prey to it, lest you think that the grass is actually greener on the other side of the fence.
Does living in California make people happy? As it turns out, a couple of investigators researched this exact question in the late 1990's (one of the investigators happens to be the Nobel Prize-winning economist, Daniel Kahneman, who wrote a best-selling book, Thinking Fast and Slow in 2011 that summarized decades of his research in the fields of cognitive psychology and behavioral economics). The results were published in the journal, Psychological Science, under the title, "Does Living in California Make People Happy?" The results might surprise you. There appears to be a cultural stereotype that people are happier in California, and individuals in the study rated overall life satisfaction for their peers as higher in California than in the Midwest. However, self-reported overall life satisfaction was the same between people living in California and people living in the Midwest. In other words, everyone believes that people who live in California are happier, mostly due to the fact that the climate is far better in sunny California compared to the gloomy Midwest. But when you ask individuals to rate their own satisfaction with life in general, people in California aren't any better than those of us who live in the Midwest!
Kahneman believed that we fall prey to something that he called a focusing illusion. As he wrote, "When a judgment about an entire object or category is made with attention focused on a subset of that category, a focusing illusion is likely to occur, whereby the attended subset is overweighted relative to the unattended subset." In other words, if we want to look at the degree of happiness of everyone living in the United States, we will overweight the degree of happiness higher if we focus on just one region, i.e. California.
Let me provide a different example, which may help explain the concept of a focusing illusion further. In a 1996 study by Schwarz and colleagues, college students were asked two questions: "How happy are you?" and "How many dates did you have last month?" The correlation between these two questions depended upon the order in which they were asked. Ask the first question ("How happy are you?") first, the correlation was 0.12 (which is low - perfect correlation would be 1.0), suggesting that the number of dates a college student had in the last month had no bearing on his or her overall happiness. However, ask the second question first ("How many dates did you have last month?" and the correlation between the two increased to 0.66 (which is actually pretty high). Focus on the number of dates a college student had in the last month and you overweight the impact of dating on overall happiness.
There is another famous study ("Lottery winners and accident victims: Is happiness relative?") that found very little difference in overall life satisfaction between paraplegic accident victims and otherwise healthy control subjects - again, the implication here is that a focusing illusion has occurred that causes us to believe that paraplegics are not happy. Similarly, there was no difference in overall life satisfaction between people who win the lottery and those who do not (the focusing illusion would cause us to believe that lottery winners are happier than the rest of us).
The bottom line lesson here? The grass is certainly not always greener on the other side. We tend to look at other people and think that their lives are better. "People who work at that job are happier than me, so if I could only have that job, I would be happier." Or, "people in California are happier than me, so if I could just move to California, I would be happier too." It's just not true, folks. It's a focusing illusion. Be careful that you don't fall prey to it, lest you think that the grass is actually greener on the other side of the fence.
Sunday, December 8, 2019
"Sometimes, we are blind to what is going on around us..."
Let's start out this post with an experiment from a classic paper by two cognitive psychologists - Dan Simons and Christopher Chabris while they were at Harvard University and for which they won the Ig Nobel Prize (the "Ig" stands for "ignoble" and the prize is a awarded annually to "honor achievements that first make people laugh, and then make them think"). If you haven't seen the video before, please do me a favor and don't ruin it for anyone else.
While you watch the video, I want you to pay close attention to the individuals wearing white shirts in the video and count the number of time"s that they pass the basketball. Watch the video here. So, how many passes did the "white shirts" make?
Now, here's the more important question. Did you see the gorilla? If not, go back and watch the video again. There's a good chance that you've seen this video before - the video was used in a study("Gorillas in our midst: Sustained inattentional blindness for dynamic events") that was subsequently published in the journal, Perception, in 1999 and was the subject of the book, The Invisible Gorilla by the two investigators. Don't feel bad if you missed the gorilla - in the original study, slightly less than half (46%) of all the participants in the study completely missed it. I have shown this video to various groups in various settings for the past few years, and about half of the individuals in these groups consistently miss the gorilla.
Most of us greatly overestimate our ability to multi-task - in fact, most of the studies that have been performed in this area suggest that the term, "multi-tasking" is a misnomer. For example, according to statistics from the National Safety Council, there 1 out of every 4 automobile accidents in the U.S. are caused by individuals who are texting and driving at the same time. The facts prove, time and time again, that we can't multi-task. As a matter of record, only about 2% of individuals can successfully focus on more than one task at the same time.
There's another famous study on so-called "inattentional blindness" (sometimes called "change blindness") called the "Door study" by these same two investigators. Basically, individuals (who were part of the study team) walked up to random individuals (who were the subjects of the study) on the street to ask for directions. While the study subjects were explaining the directions, two other individuals (also part of the study team) who were carrying a door walked between them. The first individual who had asked for directions exchanged places with one of the two individuals carrying the door. Fifty percent of the study subjects never even caught that the individual that they finished giving directions to was completely different than the individual who first asked for assistance!
Bottom line. Task fixation is great, as long as we are focusing on just one task. That's why there are so many initiatives that have forced individuals to avoid distractions and focus on one task at a time. If you happen to be a pilot, you are probably familiar with the concept known as the "sterile cockpit" - there's no small talk during take-off and landing. We've adopted this approach in the hospital setting - no one talks to a pharmacist while he or she is preparing medications for administration to patients. Similarly, no one is talking during the crucial pre-surgery "time-out".
If you ever find yourself in a situation where you are trying to multi-task, please remember that there are gorillas in our midst!
While you watch the video, I want you to pay close attention to the individuals wearing white shirts in the video and count the number of time"s that they pass the basketball. Watch the video here. So, how many passes did the "white shirts" make?
Now, here's the more important question. Did you see the gorilla? If not, go back and watch the video again. There's a good chance that you've seen this video before - the video was used in a study("Gorillas in our midst: Sustained inattentional blindness for dynamic events") that was subsequently published in the journal, Perception, in 1999 and was the subject of the book, The Invisible Gorilla by the two investigators. Don't feel bad if you missed the gorilla - in the original study, slightly less than half (46%) of all the participants in the study completely missed it. I have shown this video to various groups in various settings for the past few years, and about half of the individuals in these groups consistently miss the gorilla.
Most of us greatly overestimate our ability to multi-task - in fact, most of the studies that have been performed in this area suggest that the term, "multi-tasking" is a misnomer. For example, according to statistics from the National Safety Council, there 1 out of every 4 automobile accidents in the U.S. are caused by individuals who are texting and driving at the same time. The facts prove, time and time again, that we can't multi-task. As a matter of record, only about 2% of individuals can successfully focus on more than one task at the same time.
There's another famous study on so-called "inattentional blindness" (sometimes called "change blindness") called the "Door study" by these same two investigators. Basically, individuals (who were part of the study team) walked up to random individuals (who were the subjects of the study) on the street to ask for directions. While the study subjects were explaining the directions, two other individuals (also part of the study team) who were carrying a door walked between them. The first individual who had asked for directions exchanged places with one of the two individuals carrying the door. Fifty percent of the study subjects never even caught that the individual that they finished giving directions to was completely different than the individual who first asked for assistance!
Bottom line. Task fixation is great, as long as we are focusing on just one task. That's why there are so many initiatives that have forced individuals to avoid distractions and focus on one task at a time. If you happen to be a pilot, you are probably familiar with the concept known as the "sterile cockpit" - there's no small talk during take-off and landing. We've adopted this approach in the hospital setting - no one talks to a pharmacist while he or she is preparing medications for administration to patients. Similarly, no one is talking during the crucial pre-surgery "time-out".
If you ever find yourself in a situation where you are trying to multi-task, please remember that there are gorillas in our midst!
Wednesday, December 4, 2019
The hardest song in the world to sing
Super Bowl XXV was held in Tampa, Florida on January 27, 1991, only 10 days after the start of the Persian Gulf War (codenamed Operation Desert Storm). The legendary recording artist Whitney Houston sang the national anthem, "The Star Spangled Banner""The Star Spangled Banner" during the pregame ceremonies. Houston's performance is considered one of the greatest renditions of the U.S. national anthem of all time. The recording was subsequently released as a hit single, which peaked at #20 on the Billboard "Hot 100" singles chart, and it was re-released shortly after the events of September 11, 2001 and peaked at #6 on the "Hot 100", making it Houston's last top 10 hit before she died tragically in 2012.
The song is notoriously difficult to sing. The humorist Richard Armour once quipped:
In an attempt to take Baltimore, the British attacked Fort McHenry, which protected the harbor. Bombs were soon bursting in air, rockets were glaring, and all in all it was a moment of great historical interest. During the bombardment, a young lawyer named Francis Off Key [sic] wrote "The Star-Spangled Banner", and when, by the dawn's early light, the British heard it sung, they fled in terror.
Not everyone has Whitney Houston's five octave vocal range - not even close! As a matter of record then, there are several well-known disastrous performances of the national anthem (for example, see Billboard's top 10 worst performances of all time here). Both professional and amateur singers struggle with the song's vocal range and have been known to forget the lyrics.
Take a look at this video of a woman who starts to sing the national anthem before an NHL hockey game. She appears to forget the words, abruptly stops and turns around to go back and grab a lyric sheet, and returns a few seconds later. While walking back onto the ice, she slips and falls, as the audience cheers and jeers in the background. Now ask yourself, what would you have done if you had been there? Would you have jeered or even booed at the woman? Admittedly, I can totally see myself reacting in that fashion in a similar circumstance. And I am not proud to admit that.
Now, check out this video of a similar circumstance. In this case, a young singer was invited to sing the national anthem before an NBA basketball game between the Portland Trailblazers and Oklahoma City Thunder on April 25, 2003. The singer was a 13 year-old 8th grade student who had been selected by the fans in a promotional contest. As luck would have it, she woke up that morning with a case of the flu and felt awful as she walked out in front of 20,000 plus fans.
The young girl started singing, but when she got to the phrase, "What so proudly we hailed," she stumbled over the words. She stopped - complete mind block. She started looking around for her father for help. At first, the audience tried to encourage her to continue, but the longer her uncomfortable pause lasted, some of the cheers turn to jeers. Suddenly, one of the Oklahoma City assistant coaches, Hall of Fame basketball player Maurice "Mo" Cheeks, walks up behind the girl, put his arm around her, and started singing with her. He coached her through the next few words of the song (and if you pay close attention to the video, he actually gets some of the words wrong too!). The audience's jeers and boos turn to cheers, as they collectively finish the song together. The girl would go on to say, “It was like a guardian angel had come and put his arm around my shoulder and helped me get through one of the most difficult experiences I've ever had."
Which situation would you rather be in when you make a mistake - having people make fun of you or celebrate your failure, like the first video, or have someone support you and coach you through the difficult times, like in the second? Now, ask yourself my earlier question again. The next time you see someone struggle, will you be like the hockey fans in the first video or like Coach Cheeks in the second?
You don't have to be an NBA Hall of Famer to be a leader. At times, leadership is defined as being directive but calm under pressure. At other times, leadership requires patience and humility. I want to leave you with one last video - this time, it has nothing to do with the Star Spangled Banner. During a recent NCAA basketball game between the University of Michigan and Iowa State, Michigan's head coach (and former "Fab Five" and NBA superstar), Juwan Howard, took a moment during a time-out to help mop up sweat from the floor. He apparently did it as a player too (see here). How many times do you see a head coach doing that? Leadership.
The song is notoriously difficult to sing. The humorist Richard Armour once quipped:
In an attempt to take Baltimore, the British attacked Fort McHenry, which protected the harbor. Bombs were soon bursting in air, rockets were glaring, and all in all it was a moment of great historical interest. During the bombardment, a young lawyer named Francis Off Key [sic] wrote "The Star-Spangled Banner", and when, by the dawn's early light, the British heard it sung, they fled in terror.
Not everyone has Whitney Houston's five octave vocal range - not even close! As a matter of record then, there are several well-known disastrous performances of the national anthem (for example, see Billboard's top 10 worst performances of all time here). Both professional and amateur singers struggle with the song's vocal range and have been known to forget the lyrics.
Take a look at this video of a woman who starts to sing the national anthem before an NHL hockey game. She appears to forget the words, abruptly stops and turns around to go back and grab a lyric sheet, and returns a few seconds later. While walking back onto the ice, she slips and falls, as the audience cheers and jeers in the background. Now ask yourself, what would you have done if you had been there? Would you have jeered or even booed at the woman? Admittedly, I can totally see myself reacting in that fashion in a similar circumstance. And I am not proud to admit that.
Now, check out this video of a similar circumstance. In this case, a young singer was invited to sing the national anthem before an NBA basketball game between the Portland Trailblazers and Oklahoma City Thunder on April 25, 2003. The singer was a 13 year-old 8th grade student who had been selected by the fans in a promotional contest. As luck would have it, she woke up that morning with a case of the flu and felt awful as she walked out in front of 20,000 plus fans.
The young girl started singing, but when she got to the phrase, "What so proudly we hailed," she stumbled over the words. She stopped - complete mind block. She started looking around for her father for help. At first, the audience tried to encourage her to continue, but the longer her uncomfortable pause lasted, some of the cheers turn to jeers. Suddenly, one of the Oklahoma City assistant coaches, Hall of Fame basketball player Maurice "Mo" Cheeks, walks up behind the girl, put his arm around her, and started singing with her. He coached her through the next few words of the song (and if you pay close attention to the video, he actually gets some of the words wrong too!). The audience's jeers and boos turn to cheers, as they collectively finish the song together. The girl would go on to say, “It was like a guardian angel had come and put his arm around my shoulder and helped me get through one of the most difficult experiences I've ever had."
Which situation would you rather be in when you make a mistake - having people make fun of you or celebrate your failure, like the first video, or have someone support you and coach you through the difficult times, like in the second? Now, ask yourself my earlier question again. The next time you see someone struggle, will you be like the hockey fans in the first video or like Coach Cheeks in the second?
You don't have to be an NBA Hall of Famer to be a leader. At times, leadership is defined as being directive but calm under pressure. At other times, leadership requires patience and humility. I want to leave you with one last video - this time, it has nothing to do with the Star Spangled Banner. During a recent NCAA basketball game between the University of Michigan and Iowa State, Michigan's head coach (and former "Fab Five" and NBA superstar), Juwan Howard, took a moment during a time-out to help mop up sweat from the floor. He apparently did it as a player too (see here). How many times do you see a head coach doing that? Leadership.
Monday, December 2, 2019
Do the Cleveland Browns have a "trust" issue?
I often listen to ESPN Radio on my morning and evening commutes to and from work. Tonight, I was listening to The Will Cain Show. Before going any further, I should tell you that Will Cain is a die-hard Dallas Cowboys fan and thinks Dak Prescott is the next NFL Hall of Fame quarterback. He may be right. He may be wrong. I don't know. I actually don't really care. I am telling you all of this because this evening's show was heavy on a dose of criticism for the Cleveland Browns.
The Cleveland Browns lost yesterday to the Pittsburgh Steelers to drop their season record to 5-7. After several years of mediocrity (I am being generous), the Browns finished the season last year at just below 0.500 with a record of 7-8-1. They loaded up with talent in the offseason and were predicted to finish near the top of their Division this year. Unfortunately, their season has fallen short of these lofty expectations.
Will Cain argued on his show this evening that the problem with the Browns involved a "trust issue" versus a talent issue. As evidence, he cited a popular online video of the author, motivational speaker, and leadership consultant Simon Sinek, whose bestselling books include Start With Why, Leaders Eat Last, and his latest, The Infinite Game. Don't worry, this is not another book review! In his latest offering, Sinek talks about one of the ways that the U.S. Navy SEALs look for in their prospective recruits. He talks in particular about how SEALs are chosen to be part of SEAL Team 6, which is arguably one of the most elite military commando units in the world. The SEALs look for so-called "high-trust" individuals.
Sinek constructs a graph with "performance" on the y-axis and "trust" on the x-axis (see his video here). He argues that just about every industry knows to select the individuals with a high degree of trust and performance (those individuals in the top-right quadrant of his graph). Here, performance essentially refers to how an individual performs on the job (for the SEALs, performance is how well a sailor does on executing the mission). Conversely, trust refers to personal integrity and character. In other words, can you count on an individual to "have your back" and be there when needed. High-trust individuals exhibit humility, empathy, patience, and resilience. It really doesn't matter what industry you work in, the top right quadrant is where you will find the best individuals.
On the other hand, every industry also knows to avoid hiring or selecting those individuals with both low-trust and low-performance (the bottom left quadrant). Everything makes sense so far, right? Both the low-trust/low-performance and high-trust/high-performance individuals are easy to spot. Unfortunately, the high-trust/high-performance individuals are a rare find.
What about the rest? Would you rather have a low-trust/high-performance individual (top left quadrant) or a high-trust/low-performance individual (bottom right quadrant)? The Navy SEALs (at least according to Simon Sinek) generally avoid the low-trust/high-performance individuals - they call them "toxic team members." They would rather have someone with high-trust and average or even low-performance instead.
So, back to Will Cain's argument. Cain claims that the Cleveland Browns, or at least the 2019 version of the Browns, are mostly low-trust/high-performance individuals. They are extremely talented, but not very reliable in other words. Conversely, the team that won the game yesterday, the Pittsburgh Steelers, are mostly on the high-trust/medium-to-low performance side of the spectrum. As proof, the Steelers used a 3rd string quarterback for the entire game and still won!
There are countless examples of professional sports teams (or even college teams for that matter) that were loaded with talent, yet failed to perform to their expectations. On the other hand, there are perhaps just as many examples of sports teams that seemed to play beyond their level of talent and find a way to win. Just look at this year's Washington Nationals baseball team that won the World Series. Now, which would you rather be - the Cleveland Browns or the Washington Nationals? Which would you rather be a part of in your professional life, a team with average talent and a high-trust factor or a team with toxic talent and low-trust? It's a fairly easy question to answer when you come right down to it...
The Cleveland Browns lost yesterday to the Pittsburgh Steelers to drop their season record to 5-7. After several years of mediocrity (I am being generous), the Browns finished the season last year at just below 0.500 with a record of 7-8-1. They loaded up with talent in the offseason and were predicted to finish near the top of their Division this year. Unfortunately, their season has fallen short of these lofty expectations.
Will Cain argued on his show this evening that the problem with the Browns involved a "trust issue" versus a talent issue. As evidence, he cited a popular online video of the author, motivational speaker, and leadership consultant Simon Sinek, whose bestselling books include Start With Why, Leaders Eat Last, and his latest, The Infinite Game. Don't worry, this is not another book review! In his latest offering, Sinek talks about one of the ways that the U.S. Navy SEALs look for in their prospective recruits. He talks in particular about how SEALs are chosen to be part of SEAL Team 6, which is arguably one of the most elite military commando units in the world. The SEALs look for so-called "high-trust" individuals.
Sinek constructs a graph with "performance" on the y-axis and "trust" on the x-axis (see his video here). He argues that just about every industry knows to select the individuals with a high degree of trust and performance (those individuals in the top-right quadrant of his graph). Here, performance essentially refers to how an individual performs on the job (for the SEALs, performance is how well a sailor does on executing the mission). Conversely, trust refers to personal integrity and character. In other words, can you count on an individual to "have your back" and be there when needed. High-trust individuals exhibit humility, empathy, patience, and resilience. It really doesn't matter what industry you work in, the top right quadrant is where you will find the best individuals.
On the other hand, every industry also knows to avoid hiring or selecting those individuals with both low-trust and low-performance (the bottom left quadrant). Everything makes sense so far, right? Both the low-trust/low-performance and high-trust/high-performance individuals are easy to spot. Unfortunately, the high-trust/high-performance individuals are a rare find.
What about the rest? Would you rather have a low-trust/high-performance individual (top left quadrant) or a high-trust/low-performance individual (bottom right quadrant)? The Navy SEALs (at least according to Simon Sinek) generally avoid the low-trust/high-performance individuals - they call them "toxic team members." They would rather have someone with high-trust and average or even low-performance instead.
So, back to Will Cain's argument. Cain claims that the Cleveland Browns, or at least the 2019 version of the Browns, are mostly low-trust/high-performance individuals. They are extremely talented, but not very reliable in other words. Conversely, the team that won the game yesterday, the Pittsburgh Steelers, are mostly on the high-trust/medium-to-low performance side of the spectrum. As proof, the Steelers used a 3rd string quarterback for the entire game and still won!
There are countless examples of professional sports teams (or even college teams for that matter) that were loaded with talent, yet failed to perform to their expectations. On the other hand, there are perhaps just as many examples of sports teams that seemed to play beyond their level of talent and find a way to win. Just look at this year's Washington Nationals baseball team that won the World Series. Now, which would you rather be - the Cleveland Browns or the Washington Nationals? Which would you rather be a part of in your professional life, a team with average talent and a high-trust factor or a team with toxic talent and low-trust? It's a fairly easy question to answer when you come right down to it...
Sunday, December 1, 2019
"Risky Business"
If you were living in the 1980's, or even shortly thereafter, chances are that when you hear the phrase Risky Business, you think about the 1983 hit movie starring Tom Cruise and Rebecca De Mornay. You probably also think of the iconic scene of Tom Cruise, as a young actor, dancing in his underwear and shades singing Bob Seger's song, "Old Time Rock-n-Roll."
Well, when I think of the phrase Risky Business, I think of...okay, I think of the Tom Cruise movie too. But I also think of something completely different than 1980's pop culture. I think of the Risky Business conferences, a series of conferences whose sole purpose are to share experiences and ideas from different high-risk industries, all with the goal of improving safety and outcomes in the health care industry. The conferences were started by two pediatric critical care specialists named Allan Goldman and Peter Laussen and a British Airways pilot named Guy Hirst. Many of these conferences are held in London, England. I had the distinct pleasure of attending one of these conferences a few years ago. It was truly one of the highlights of my career up to that point - as one of the invited speakers at a joint pediatric patient safety conference held at the same time, I was able to attend the Ceremony of the Keys at the Tower of London. Every night for the past several centuries, the Chief Yeoman Warder of the Queen's Royal Guard by soldiers as he locks up the fortress. It was simply amazing!
One of the featured speakers at the conference that I attended was a West Point graduate, Army veteran, and Harvard Business School professor named Scott Snook. Dr. Snook conducted a half-day session that was essentially a detailed After Action Review of a friendly fire incident involving U.S. military forces during Operation Provide Comfort in Northern Iraq on April 14, 1994. I believe Professor Snook used the case as his doctoral thesis and later wrote about the incident in an excellent book, called Friendly Fire. I simply can't recommend the book enough! Dr. Snook's talk was mesmerizing (I've since tried to get him to come to my institution to present an abbreviated version, but for a number of reasons we've not been able to arrange it), and his book was just as great!
Basically, two U.S. Air Force F-15 fighter jets accidentally shot down two U.S. Army Black Hawk helicopters, killing all 26 peacekeepers aboard. Dr. Snook used his experience as a former U.S. Army officer (who incidentally was a victim of a friendly fire incident himself) and leading authority on organizational behavior to analyze the incident from an individual, group, and organizational level. Clearly the lack of coordination between two different military services helped create the conditions that led to the incident. However, Dr. Snook also found widespread evidence of something he calls "practical drift", the slow, steady uncoupling of practice from written procedure. His conclusions were both mindboggling and disturbing. The incident itself was an example of what we have come to call a "normal accident" occurring in a high reliability organization.
The parallels in health care are easy to recognize. If you don't believe me, just ask any patient who has ever been in the hospital and has had more than one subspecialty participating in his or her care. Hospitals today are great examples of fragmented, uncoordinated care. "Practical drift" is more than just a theory in health care, it is one of the most common phenomena that you will see. "Friendly Fire" is really a fabulous book. If the purpose of the Risky Business conferences are to share experiences and learning from other industries outside health care, then I would say, "Mission Accomplished." Read the book. And if you ever get the opportunity to attend a Risky Business conference, do it!
Well, when I think of the phrase Risky Business, I think of...okay, I think of the Tom Cruise movie too. But I also think of something completely different than 1980's pop culture. I think of the Risky Business conferences, a series of conferences whose sole purpose are to share experiences and ideas from different high-risk industries, all with the goal of improving safety and outcomes in the health care industry. The conferences were started by two pediatric critical care specialists named Allan Goldman and Peter Laussen and a British Airways pilot named Guy Hirst. Many of these conferences are held in London, England. I had the distinct pleasure of attending one of these conferences a few years ago. It was truly one of the highlights of my career up to that point - as one of the invited speakers at a joint pediatric patient safety conference held at the same time, I was able to attend the Ceremony of the Keys at the Tower of London. Every night for the past several centuries, the Chief Yeoman Warder of the Queen's Royal Guard by soldiers as he locks up the fortress. It was simply amazing!
One of the featured speakers at the conference that I attended was a West Point graduate, Army veteran, and Harvard Business School professor named Scott Snook. Dr. Snook conducted a half-day session that was essentially a detailed After Action Review of a friendly fire incident involving U.S. military forces during Operation Provide Comfort in Northern Iraq on April 14, 1994. I believe Professor Snook used the case as his doctoral thesis and later wrote about the incident in an excellent book, called Friendly Fire. I simply can't recommend the book enough! Dr. Snook's talk was mesmerizing (I've since tried to get him to come to my institution to present an abbreviated version, but for a number of reasons we've not been able to arrange it), and his book was just as great!
Basically, two U.S. Air Force F-15 fighter jets accidentally shot down two U.S. Army Black Hawk helicopters, killing all 26 peacekeepers aboard. Dr. Snook used his experience as a former U.S. Army officer (who incidentally was a victim of a friendly fire incident himself) and leading authority on organizational behavior to analyze the incident from an individual, group, and organizational level. Clearly the lack of coordination between two different military services helped create the conditions that led to the incident. However, Dr. Snook also found widespread evidence of something he calls "practical drift", the slow, steady uncoupling of practice from written procedure. His conclusions were both mindboggling and disturbing. The incident itself was an example of what we have come to call a "normal accident" occurring in a high reliability organization.
The parallels in health care are easy to recognize. If you don't believe me, just ask any patient who has ever been in the hospital and has had more than one subspecialty participating in his or her care. Hospitals today are great examples of fragmented, uncoordinated care. "Practical drift" is more than just a theory in health care, it is one of the most common phenomena that you will see. "Friendly Fire" is really a fabulous book. If the purpose of the Risky Business conferences are to share experiences and learning from other industries outside health care, then I would say, "Mission Accomplished." Read the book. And if you ever get the opportunity to attend a Risky Business conference, do it!