Happy Doctor's Day!

National Doctor’s Day is celebrated every year on March 30th.  The first Doctor’s Day was observed more than 90 years ago, on March 30, 1933 by the Alliance to the Barrow County Medical Society in Winder, Georgia (a small town located just east of Atlanta).  Members of the Alliance selected the date to honor all physicians on the anniversary of Dr. Crawford W. Long’s first administration of anesthesia in 1842.  Of note, Dr. Long used ether during surgery to remove a tumor from the neck of James Venable.  The first Doctor’s Day was observed by sending cards to all the physicians and their spouses, and a red carnation flower was placed on the graves of deceased doctors.  Through a series of resolutions in the years that followed, Doctor’s Day was widely celebrated throughout the southern United States, with sponsorship by the Southern Medical Association.  Eventually, a resolution was adopted and approved by both the U.S. House of Representatives and the U.S. Senate on October 30, 1990 and signed by President George H.W. Bush, designating March 30 as “National Doctor’s Day."  The red carnation remains as the symbol of Doctor’s Day.

I have never been more proud to be a member of this great profession.  We've all had a difficult past few years with everything that has been going on in our world.  Regardless, physicians have been at the forefront leading societal change during one of the most difficult periods in our history.  Importantly, our influence is due in large measure to the trust and respect that society has for our profession.  Physicians are still one of the most trusted of all professions.  As a matter of fact, we are second only to nurses, who have ranked as the most trusted of all professions for more than a decade.

I can honestly say that if I had the chance to do it all over again, I would still choose medicine as my life's work.  Medicine has been my passion and my calling.  Being a physician has made me a better person, and I am incredibly proud to be a member of this esteemed profession.

To all Doctor's - thank you for what you do, each and every day!

Mandatory Education

"Mandatory" and "education" are probably two words in the English language that, when used together, incite strongly negative emotions in hospital employees everywhere.  What perhaps is less appreciated by those same hospital employees is that virtually every organization in just about every industry requires some kind of annual or semi-annual required training.  Let's be honest, most of us, often begrudgingly (and often while multi-tasking) skim through the required slide-decks or online videos hoping to gather enough information to be able to correctly answer the quiz that invariably comes at the end.  And I won't even begin to argue about whether mandatory training as currently implemented is actually effective or not.  I'd be willing to bet that very little of the information in these modules stays with us for much longer than a few minutes after we receive the certificate of completion.

It is with these thoughts in mind that I read an incredibly thought-provoking article in the most recent issue of Harvard Business Review (see "Does Gamified Training Get Results?" in the March/April 2023 issue).  I've learned through the years that I can be easily manipulated through the technique known as gamification (just see my post "All Things Must Pass"  as an example).  Gamification is defined as the addition of the elements of a game to what are typically non-game activities.  These elements include points, badges, and leaderboards.  So, can gamification make "mandatory education" more fun?  More importantly, does gamification make "mandatory education" more effective?  A new study performed at the global professional services firm KPMG suggests that it can (see the working paper "Learning or Playing?  The Effect of Gamified Training on Performance").

The Harvard Business School investigators, Ryan Buell, Wei Cai, and Tatiana Sandino conducted a natural field experiment (which is an experiment conducted in the field where the subjects are not aware that an experiment is taking place) on the implementation of a gamified training tool for the employees at a professional services firm (de-identified in the working paper but revealed to be KPMG in the HBR article).  KPMG wanted to increase their employees' awareness and understanding of the firm's value proposition in order to attract more customers.  The study was conducted in 24 offices participating in the training, which was rolled out at various times in a randomized fashion to create a natural experimental group and control group.  

The gamified training tool was called "KPMG Globerunner" in which employees designed their own avatars who would "race around the world" and answer questions about the firm's service offerings.  Each correct answer would earn travel points, which would open up new travel opportunities for the avatar.  Wrong answers would be corrected with a brief explanation, but no points were awarded.  Employees could also complete mini-game challenges to earn additional points or unlock new levels.  The tool included a leaderboard that showed each avatar and the number of points earned according to rank.

Participation in the training was optional, and employees could engage in the platform as often or as long as they liked.  The HBS investigators analyzed five performance measures on a monthly basis for over 29 months - fees collected, number of clients served, total business opportunities generated, opportunities generated from existing clients, and opportunities generated for new clients.  They also evaluated how much time employees spent on the platform, as well as the number of questions that each employee answered in the training module.  Finally, the investigators analyzed staff engagement, based upon the percentage of employees in each office who logged on to the tool at least once, as well as leader engagement, which was based on how much the leaders in each office played the game.

Analysis showed that the gamified training tool increased the fees collected by participating offices by more than 25% above baseline, while the number of clients increased by 16%.  The investigators also demonstrated that the more employees played the gamified training tool, the more likely the office was to significantly improve performance.  Similarly, offices with engaged leaders also were more likely to improve performance.  Finally, and perhaps most importantly, the impact of the gamified training was sustained for up to 18 months!

These are incredibly promising results!  The study didn't measure the employees' satisfaction with the gamified training platform, but the fact that higher staff engagement with the tool led to greater success at least suggests that they either enjoyed "playing the game" or enjoyed competing with their fellow employees.  KPMG executives were interviewed in an accompanying article in Harvard Business Review, in which it was revealed that 83% of the employees say that they enjoy playing KPMG Globerunner.  As Christian Gossan, a director at KPMG Australia said, "Rote training is boring - but games are the opposite of boring."  Gossan was asked if any employees played the game so much that their productivity decreased.  He responded, "You do need to monitor for that.  Each year a small number of employees - about 1 in 10,000 - become compulsive users, and for their sake as well as the firm's, we need to intervene."

It would be really interesting to see if gamified "mandatory education" could achieve the same level of results (remember that participation in KPMG Globerunner was optional).  Regardless, there appears to be an opportunity here to make mandatory training and education a lot more fun!  

On Top

 I read a book called The Leadership Moment by the author and Wharton professor, Michael Useem several years ago that I really enjoyed.  The book tells nine true stories of both triumph and disaster, which is right up my alley!  I knew some of the stories, including the tragic story of Wagner Dodge and the Mann Gulch Fire (also told in the book, Young Men and Fire by Norman Maclean) and the famous stand by Colonel Joshua Chamberlain and the 20th Maine on Little Round Top during the Battle of Gettysburg (also told in the Civil War novel The Killer Angels and the movie Gettysburg based on the novel).  However, I also learned some new stories, including the story of Arlene Blum, who led the first successful American ascent of the mountain Annapurna I.  I've been intrigued by that story ever since, and I've been wanting to learn more about it.

Annapurna I has been called "The Deadliest Mountain in the World" due to its highest fatality-to-summit rate among the world's 8,000 meter peaks.  Until 2012, the fatality rate (as a percentage of successful summit attempts) was 32%, but that rate has now fallen to under 20% due to a number of successful attempts in the last few years.  The mountain is still quite dangerous due to the number of avalanches, unpredictable weather, and the technical difficulty of its climbing routes.  It is the 10th highest mountain in the world at just 8,091 meters (26,545 feet) above sea level.  The mountaineer Maurice Herzog led a successful summit by an all-French team in 1950, making Annapurna I the first of the 8,000 meter peaks to be successfully climbed.  The mountain is named after the Hindu goddess of the harvest.

A British team successfully reached the summit in 1970, and the first expedition from the United States to reach the summit was the American Women's Himalayan Expedition, an all female expedition team led by Arlene Blum, in 1978.  Blum was an accomplished mountaineer, but expedition mountaineering at that time was largely a male-dominated sport.  Blum had tried to join an expedition to Afghanistan in 1969 and was told that the presence of a female would undercut the "masculine companionship which is so vital a part of the joy of an expedition."  One year later, she had applied to join an expedition of Alaska's Denali (previously known as Mount McKinley, the highest peak in North America) and was told that if she joined, her duties would be restricted to cooking at base camp.  One of her close male friends told her, "You should not sacrifice life on the same altar of egotism that causes men to join the Marines, shoot buffalo, and drive fast cars."  Blum responded by leading her own, all female team that successfully reached the 20,300 foot summit of Denali in 1970.

Blum's early success opened up new opportunities for her, and she was the first American woman to attempt climbing Mount Everest as part of the American Bicentennial Expedition in 1976.  A chance encounter with legendary Polish climber Wanda Rutkiewicz and British climber Alison Chadwick-Onyszkiewicz on an earlier expedition had led to the concept of an all female attempt at Annapurna I, and after her failed summit attempt of Everest, Blum stopped at the Ministry of Tourism in Kathmandu on the way home for a 1978 permit to climb Annapurna I.

Blum recruited a number of experienced mountaineers for her team.  In order to raise the $80,000 required to finance the expedition, the team sold 15,000 T-shirts with the expedition's slogan, "A Woman's Place Is on Top".  The team encountered a number of issues throughout the expedition (including a temporary strike by their team of Sherpas), all of which demonstrated Blum's exceptional leadership skills, as told in Michael Useem's book as well as Blum's own memoir of the expedition, Annapurna: A Women's Place.  Importantly, as of August 1978, only eight climbers had ever successfully reached the summit, and nine other climbers had died during various attempts.  There were only three "established" routes to climb, and Blum decided to use the route known as "The Dutch Rib", as it seemed to have less avalanches, which were a daily occurrence on the other two routes.  

Blum herself decided not to make an attempt at the summit, as she was not feelin well.  However, she knew that as a the team leader, her ultimate success was for the fellow climbers on her team to reach the summit.  She defined the expedition's success by the team's ultimate success, and not by her own personal success.  The first team composed of two climbers (Irene Beardsley and Vera Komarkova - a third climber, Piro Kramer, an eye surgeon, decided to stop after developing frostbite on her right index finger) and two Sherpas (Mingma Tshering Sherpa and Chewang Rinjing Sherpa) of reached the summit on October 15, 1978.  Unfortunately, a second team, consisting of climbers Alison Chadwick-Onyszkiewicz and Vera Watson was not successful, both of whom died on the mountain. 

While the expedition was still viewed as a success (it was even hailed by The New York Times as an "inspiration to women" everywhere), Blum was still criticized for some of the decisions that she had made.  Moreover, the team continued to encounter male chauvinism.  One letter to National Geographic, which had partially financed the expedition, written by mountaineer Galen Rowell said, "Had the men on Annapurna been Americans instead of Nepalese, no one would have gotten away with a claim that this was an achievement by and for American women."  Regardless, in hindsight (we have that luxury), the American Women's Himalayan Expedition broke down significant barriers and opened up opportunities for women in both the sport of mountaineering and in general.  The successful summit attempt by these Americans was an incredible achievement, and I would highly recommend Blum's book and the account written in The Leadership Moment.

 

"Have you been infected yet?"

Once again, the American author, Stoic philosopher, and bookstore owner Ryan Holiday wrote an excellent post today for his "Daily Stoic" blog, entitled appropriately enough, "Have You Been Infected Yet?"  It's not what you think - he wasn't asking if you've been infected with COVID-19 yet.  What he was doing, I think, was comparing the experiences of the ancient Roman emperor and Stoic philosopher Marcus Aurelius during another pandemic called the Antonine Plague.  The Antonine Plague started around 165 CE and lasted for approximately 15 years.  This ancient pandemic was also caused by a virus, believed by most scholars to be either smallpox or measles, and it is believed to have killed anywhere between 1.5 million to 25 million people in the ancient world.  

Holiday suggests that Meditations, which was written by Marcus Aurelius, was a "pandemic book" since it was at least partially written during the Antonine Plague.  He writes, "Marcus Aurelius wrote that there are two types of pestilence in the midst of an epidemic, or indeed any crisis - there is the one that can destroy your life and there is the one that can destroy your character."

Holiday goes on, "Selfishness. Cruelty. Indifference to the fate of your fellow humans. Cowardice. Desperate panic buying. Paranoia. Crippling anxiety. These were things seen in Marcus’s time just as they were seen the last few years. Same goes for scapegoating, demagoguery, misinformation, and all the other things that crisis can bring out of leaders and populations alike. Perhaps you were infected like this. Or perhaps there was something more personal you caught during the pandemic–bad habits, a relapse, screwed up priorities, skewed values."

I have been fortunate during the COVID-19 pandemic, but others have not been as lucky as me.  As we nudge ever so closer to the end of the COVID-19 pandemic, let's all work together to put an end to the other one that seems to have occured with it.  These last three plus years have been incredibly stressful on everyone, but that doesn't give us the excuse to forget how to be kind and respectful.  As Fred Rogers said, "There are three ways to ultimate success: The first way is to be kind.  The second way is to be kind.  The third way is to be kind."

Scale

Did you know that all animals (from the smallest shrew to the largest blue whale) have about 1.5 billion total heartbeats over the course of their lifetime?  We know that rabbits live approximately 3 years, while elephants whose average lifespan is around 80 years.  How can a rabbit and an elephant have the same number of heartbeats during their vastly different lifespans?  The answer is that rabbits have a much higher resting heart rate compared to elephants.  The same is true for most animals (the smaller the animal, the faster the resting heart rate), and there is almost a fairly predictable decrease in heart rate as the body size of an animal increases.  

As it turns out, this mathematical relationship between heart rate and body mass is not unique.  For example, the Swiss biologist Max Kleiber found in the 1930's that an animal's basal metabolic rate is also mathematically related to body mass.  Specifically, metabolic rate scales to the 3/4 power of an animal's body mass, which is now known as Kleiber's Law.  For example, a cat has 100 times the body mass of a mouse, but uses only 31.6 times the same energy as a mouse (the figure below is from an review of the book Scale by Geoffrey West that appeared in the Wall Street Journal).  

 

If you are mathematically savvy, you will note that the scale for both the x-axis (body mass, in kg) and y-axis (metabolic rate, in watts) are logarithmic!  What is remarkable is that all of these different animals fall almost exactly on this line!  The slope of the line is 3/4, which is the exponent in the equation describing the relationship between body mass and metabolic rate.

These relationships between body size and various physiologic variables are known as allometric laws.  More broadly, these relationships have been observed throughout nature and even in disciplines outside of biology.  Geoffrey West (mentioned above) is a theoretical physicist who is now studying complexity theory at the Santa Fe Institute.  West and his team have described a number of what are now called nonlinear scaling relationships (or scaling laws) when studying the characteristics of cities and even organizations!  

Certain characteristics of modern cities, supply chain networks, and transportation can be described by these scaling laws.  So, for example, the number of gas stations per capita, the number of water pipes, or even the average income can all be described by these nonlinear scaling relationships.  Similarly, the average lifespan of a corporation, as well as its market share, number of policies and regulations, and profits are also related to its size.  West gave a TED talk called "The Surprising Mathematics of Cities and Corporations" that is very interesting.

My argument here is that even though our world is incredibly complex, there is a surprisingly vast amount of order in our world too.  As leaders, we should take some time to understand the relatively new fields of complexity theory, chaos, and network science.  As one of my favorite leaders, Winston Churchill, once said, "Out of intense complexities, intense simplicities emerge."

Herzberg's Two Factor Model

Frederick Herzberg was an American psychologist who is perhaps best known for his theories on job enrichment and motivation in the workforce.  His 1968  article, "One more time: How do you motivate employees?" is a classic in management theory and one of the most frequently requested and downloaded articles from the Harvard Business Review.  The article provides a high-level overview of his Motivator-Hygiene Theory , also known as the Two-factor theory.

Herzberg developed his theory after interviewing over 200 engineers and accountants , primarily in the Pittsburgh area, asking them specifically to describe times in their professional lives when they were happy and unhappy with their work.  He and his colleagues both verified and further corroborated their findings in a number of subsequent studies published in the late 1950's and early 1960's.  The fundamental concept (and I believe the most important one) is that job satisfaction and job dissatisfaction are not opposites of each other.  The opposite of job satisfaction is not job dissatisfaction, but rather no job satisfaction.  Similarly, the opposite of job dissatisfaction is not job satisfaction but no job dissatisfaction (all of this reminds me of the Kano model of customer satisfaction, but that is a topic for another day).

The "two-factor theory" comes from Herzberg's findings that there are two broad categories of job characteristics that are important for job satisfaction.  The first category was associated with "the need for growth or self-actualization" and included achievement, recognition, the work itself, level of responsibility, advancement, and the potential for professional growth and development.  Herzberg called these "motivators" and felt that they were intrinsic to the job itself.  The second category involved "the need to avoid unpleasantness" and included company policies and administration, relationship with supervisors, interpersonal relationships, working conditions, and salary.  Herzberg called this second category "hygiene factors" and felt that they were extrinsic to the job.  

Importantly, "motivators" work to increase job satisfaction, while "hygiene factors" work to reduce job dissatisfaction.  Herzberg described these two factors as follows (see also the diagram below):

"The factors on the right that led to satisfaction (achievement, intrinsic interest in the work, responsibility, and advancement) are mostly unipolar; that is, they contribute very little to job dissatisfaction. Conversely, the dis-satisfiers (company policy and administrative practices, supervision, interpersonal relationships, working conditions, and salary) contribute very little to job satisfaction."

Importantly, the presence of "motivators" can produce job satisfaction, but their absence leads to no job satisfaction and not necessarily job dissatisfaction per se.  Similarly, the presence of "hygiene factors" can reduce job dissatisfaction but cannot cause job satisfaction.  

Herzberg's Two Factor Model certainly builds upon and incorporates some aspects of Maslow's Hierarchy of Needs, which is perhaps better known.  One of the main arguments against the Herzberg model is that it has more to do with job satisfaction (and job dissatisfaction), which is related but not equivalent to motivation.  The word motivation comes from the Latin word movere, which means "to move."  Motivation is thus defined as how to stimulate or drive someone to action, i.e. to move.  Someone can be satisfied with their work and still not be motivated (think of someone who is just "going through the motions" or even "quiet quitting").  Conversely, someone can be quite motivated to do the work, even if it doesn't make them feel happy.  I have previously discussed the differences between intrinsic and extrinsic motivation (see, for example, my post "Holes").  Regardless, I do find that the Herzberg Model is a valuable and important contribution.  Job satisfaction and motivation are both incredibly important and complex topics, which I hope to return to in some future posts.

An Irish Blessing

Sometimes, you just have to get into the spirit!  Here are two of my all-time favorite Irish blessings for you:

"May the road rise up to meet you.  May the wind be always at your back.  May the sun shine warm upon your face.  May the rains fall soft upon your fields.  And, until we meet again, May God hold you in the palm of his hand."

"May there always be work for your hands to do.  May your purse always hold a coin or two.  May the sun always shine on your windowpane.  May a rainbow be certain to follow each rain.  May the hand of a friend always be near you.  May God fill your heart with gladness to cheer you."

Happy St. Patrick's Day!

Synchronicity

One of my favorite albums growing up was Synchronicity, the fifth and final studio album released by the English rock band The Police in 1983.  The album's title (and the two songs on the album with the same name, "Synchronicity I" and "Synchronicity II") were inspired by Arthur Koestler's book The Roots of Coincidence.  Apparently, Sting, the band's lead singer and bass player was an avid fan of Koestler, and he even named an earlier album after yet another book by Koestler, The Ghost in the Machine.  The album's original cover artwork included a photograph of Sting reading the psychologist Carl Jung's book Synchronicity.  Jung's theory has to do with the simultaneous occurrence of events both in one's mind and the outside world that may be completely unrelated to each other, yet have some other unknown connection.  It was all a bit too cerebral for me then (still is!), but I just really liked the music.

And yet, I continue to be fascinated by the concept of synchronicity.  I am talking less about Jung's theory here, and more about the concept that two seemingly unrelated events can occur simultaneously through some as yet unidentified but powerful connection.  Have you ever been in an audience watching a concert or play?  When someone starts clapping their hands, everyone else in the audience starts clapping too, and somehow their clapping is perfectly synchronized!  I realize it's still March right now, but have you ever noticed the fireflies on a summer night?  Even if they are far apart, they somehow time their lights perfectly (here's a video from National Geographic).  The American mathematician and chaos theorist Steven Strogatz wrote a really interesting book on the science of synchronicity, called Sync: How order Emerges from Chaos in the Universe, Nature, and Daily Life.

My mind works in mysterious ways, because whenever I start reading about something having to do with synchronicity, I think about all of these things.  It's a fascinating area of science, and it probably has a lot more to do with leadership than you realize.  For example, how do you motivate individuals from several different backgrounds, all with different interests, different skills, and different goals to achieve a common goal?  We often use the cliché "rowing in the same direction" when talking about teamwork, which comes from the fact that when you are rowing a boat, you have to synchronize your movements near perfectly with the others on the boat in order to keep the boat moving in the same direction.  If everyone's timing is off, the boat not only doesn't move forward, but chances are that the boat tips over.  It's chaos!

When working in a group, the successful coordination of efforts requires cooperation and collaboration.  In other words, cooperation and collaboration lead to synchronicity, and synchronicity leads to success.  But is the reverse also true?  Can synchronous behavior lead to cooperation and collaboration?  Ponder on this for a second.  Why does the military continue to train new recruits to march and drill?  They even train their physicians to march (see my post on my experiences during Officer Indoctrination School during medical school).  The days of marching in step as a combat tactic are long gone.  And yet, the military continues to emphasize marching in time - synchronous movement - during recruit training.

The historian William H. McNeill suggests in his book, Keeping Together in Time that throughout history, armies, churches, and communities have all used synchronicity as a way to build collaboration, cooperation, and cohesion in groups.  Have you ever watched a sporting event at a bar (or even in person at the event itself) when all the fans start chanting in unison?  It feels pretty good, doesn't it?  Why?  The act of doing something together, all at once, builds comradery, doesn't it?

It is exactly this question ("Does synchronous behavior improve cooperation?") that the Stanford psychologists Scott Wiltermuth and Chip Heath studied in their 2009 research report, "Synchrony and Cooperation".  Wiltermuth and Heath conducted three experiments, all of which tested their hypothesis that synchrony improved cooperation, even when such cooperation was costly to the individual (see my post on "free riding" behavior).  They used a technique called the "Weak Link Coordination Exercise", in which all the participants in a group choose a number between 1 and 7 without communicating.  The individual pay-offs depend upon the numbers selected - they increase as a function of the smallest number chosen  and decrease with the distance between the individual's choice of number and the smallest number chosen in the group.  Every participant receives the highest pay-off if all the group members choose 7, but of course if they are worried that another participant will choose a lower number, they may rationally choose a lower number.

In the first two studies, Wiltermuth and Heath used two different methods of synchronous behavior.  Participants in the first study marched together in unison across campus, while another group of participants walked haphazardly.  Participants in the second study waved a cup back-and-forth and sang the Canadian national anthem, "O Canada" in unison, while another group sang haphazardly.  In both studies, synchronicity actually produced greater cooperation in the "Weak Link Coordination Exercise" in that individuals in the synchronous groups received a higher pay-off (and rated their level of cooperation higher).  

In the third study, Wiltermuth and Heath used the "O Canada" synchronous exercise to improve cooperation in a public goods game.  Participants worked together in groups of three.  Each participant had 10 tokens that they could place in a public kitty or keep in their own private kitty during five rounds of play.  At the end of the game, participants received $0.25 for each token in the public kitty versus $0.50 for each token in the private kitty.  The dominant strategy in this particular game is to behave selfishly and place tokens in the private kitty (recall my posts on the "Prisoner's Dilemma" or "The Tragedy of the Commons").  Similar to the results of the first two studies, participants in the synchrony conditions placed more tokens in the public kitty and actually ended up receiving a higher pay-off!  Wiltermuth and Heath concluded that "acting in synchrony with others can lead people to cooperate with group members."

So what does all of this mean?  As I mentioned above, great teams work together through collaboration, cooperation, and coordination.  In other words, great teamwork depends upon synchronicity.  However, just as important, synchronicity itself leads to better collaboration, cooperation, and coordination.  My take-home message here is that great teamwork creates a virtuous cycle of mutually reinforcing synchronous behavior!  Being part of a team that is "rowing in the same boat" and "firing on all cylinders" is an incredible experience that leads to even closer collaboration, cooperation, and coordination of efforts.  Teamwork, as they say, makes the dream work.

Word of the Year

Every year (apparently), a number of dictionaries proclaim "the Word of the Year".  For example, Collins Dictionary named "permacrisis" as its 2022 Word of the Year.  "Permacrisis" is defined as "an extended period of instability and insecurity."  Certainly we can appreciate their sentiment!  It seems that we've been through crisis after crisis these past three years.  Remember the Australian forest fires that were so widespread starting in September 2019 and lasting through January 2020?  from 2019 to 2020?  At the time, many of us thought that would have been the news story of the year, especially in light of the ongoing political arguments over global warming.  But then along came something known as SARS-CoV-2 and COVID-19, which as of today (almost three years to the date when the World Health Organization declared a global pandemic - officially on March 11, 2020) has killed over 6.86 million individuals worldwide.  Many of us in the United States have never experienced a Presidential election year quite as contentious as the one that occurred on November 3, 2020.  And no American has ever witnessed something like the January 6, 2021.  These last couple of years have brought an unprecedented increase in mass shootings, police shootings, and hate crimes.  We've experienced labor shortages.  We've experienced supply chain shortages.  And just this past Friday, two large banks in the U.S. collapsed. We seem to be bouncing from one crisis to the next.  In other words, "permacrisis" seems to be an appropriate "Word of the Year".    

Just as interesting, perhaps, the Oxford English Dictionary named "goblin mode" as its 2022 Word of the Year.  "Goblin mode" is slang term that is defined as "a type of behavior which is unapologetically self-indulgent, lazy, slovenly, or greedy, typically in a way that rejects social norms or expectations."  And similarly, Merriam-Webster's 2022 Word of the Year was "gaslighting", defined as "the act or practice of grossly misleading someone especially for one’s own advantage."  The important point though is this - don't let the "permacrisis" give you an excuse to go into "goblin mode" or "gaslight" someone.  We should all remember to treat others in the way we would want to be treated.  We should all remember to BE KIND.

"Why your critics aren't the ones who count"

Theodore Roosevelt delivered a speech - some would argue that it was his greatest speech - on April 23, 1910, called "Citizenship in a Republic" but more widely known as the "Man in the Arena" speech (see one of my old posts, "In the Arena" for more).  The most famous passage in the speech goes as follows:

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

Absolutely amazing words.  My wife recently sent me a link to a video by the American professor and author Brene Brown in which she talks about being "in the arena."  Brown claims that the passage above changed her life.  She goes on to say that after reading this passage for the first time, "three huge things hit me."  Here they are:

1. The speech is all about vulnerability.  Being a leader - being "in the arena" is all about being vulnerable.  But here is the important point, "It's not about winning.  It's not about losing.  I's about showing up and being seen."

2. "If you are going to show up and be seen, there is only one guarantee, and that is that you will get your ass kicked."  She goes on to say that if you are going to spend any amount of time "in the arena", you will get your ass kicked.  "If courage is a value that you hold, then this is the consequence.  You can't avoid it."

3. "If you're not in the arena also getting your ass kicked, I'm not interested in your feedback.  Period."  She goes on to say that if someone has constructive feedback or new information to offer, leaders in the arena should listen.  However, "if you are not putting yourself out there and standing in the arena, I don't want your criticism about how you could be doing a better job than me."

The video clip came from a speech Brown delivered at the Adobe 99U conference called "Why Your Critics Aren't the Ones Who Count".  It's only about 20 minutes, but it is really a great talk that I highly recommend.  Incidentally, Brene Brown rose to prominence following a 2011 TED talk entitled "The power of vulnerability", which is also excellent!

The difference between management and leadership is...

If I had to come up with my own Mount Rushmore of great leaders, there's a good chance that the British statesman, orator, writer, and world leader Winston Churchill would be on it.  Churchill had his faults, but there's no question that his leadership during World War II saved Great Britain, which likely saved the world. Churchill once said, "The difference between mere management and leadership is communication."

Leadership is all about communication.  As Mike Myatt recently wrote in a Forbes article  ("10 Communication Secrets of Great Leaders"), "It is simply impossible to become a great leader without being a great communicator."  Unfortunately, a recent study appearing in the Academy of Management journal found that leaders do not communicate nearly enough.  As the Irish playwright George Bernard Shaw said, "The single biggest problem in communication is the illusion that it has taken place."

The study investigators analyzed the results of both employee engagement surveys and 360 degree leadership assessments and found that leaders are nearly ten times as likely to be criticized for not communicating enough compared to communicating too much.  Moreover, leaders who don't communicate enough are viewed as less effective and less empathetic.  When leaders don't communicate enough, employees rate them much lower in terms of leadership ability.

Now there is more to communication than just the quantity of communication.  However, what this study shows is that even if leaders communicate well (in terms of the quality of communication), they are probably not communicating enough.  And, even if leaders think that they are communicating enough, they probably aren't meeting the expectations of their employees.

Happy is contagious

If you work in health care, you've probably heard of the famous Framingham Heart Study.  This particular study started way back in 1948 and followed a cohort of 5,209 adults living in Framingham, Massachusetts with the goal of identifying risk factors for cardiovascular disease.  Incredibly, when Congress commissioned the study, they selected the residents of Framingham over the residents of Paintsville, Kentucky, as the Framingham residents were more open to participating in research.  The study is now on its third generation and has produced over 3,000 peer-reviewed scientific publications.  

I recently came across one of these publications which appeared in the British Medical Journal, entitled "Dynamic spread of happiness in a large social network: Longitudinal analysis over 20 years in the Framingham Heart Study".  The study followed 5,124 individuals from the so-called "offspring cohort" (composed of most of the children of the original cohort, as well as their spouses) to evaluate whether happiness can spread from person to person.  In other words, the study investigators wanted to find out if happiness was contagious.

Happiness was measured using a previously validated questionairre.  The investigators used the emerging science of social networks to analyze both the number of connections that the study participants had with family members, friends, coworkers, and neighbors.  There were over 53,000 different social ties within the cohort, with an average of 10.4 ties to family, friends, and coworkers over the course of the study.  

The network map below shows that happy people tend to be connected to each other.  Each dot (called a node) represents an individual in the study (circles are females, squares are males).  The lines between nodes indicate the type of relationship between individuals (black for siblings, red for friends and spouses), while the color of the node indicates the degree of happiness (blue is least happy, yellow is most happy, and green is intermediate).

The clusters of happy and unhappy people are significantly larger than what would be expected based on pure chance.  Further analysis suggests that a person is 15% more likely to be happy if a direct connection is also happy - however, the impact of happiness goes out to three degrees of separation, with these individuals being 6% more likely to be happy.  Importantly, similar findings have been observed for more deleterious characteristics, such as obesity and smoking (i.e., people who are around others who smoke are more likely to smoke and people who are around others who are obese are more likely to be obese).  The investigators conclude that "People's happiness depends on the happiness of others to whom they are connected."

In my mind, these findings are incredibly important.  The more time we spend about people who are happy, the happier we will be!  Conversely, if we are happy, those around us will have a much greater likelihood of being happy too!  I've written about the power of happiness in the past (see "Don't worry, be happy!", "Happiness is the highest form of health", and "The mathematics of happiness").  What's really great about these findings from the Framingham Heart Study cohort is that happiness is contagious!

Will the real Mr. Smith please stand up?

There used to be a show on television (a long time ago actually) that was really popular called "To Tell the Truth".  The show was off and on the air throughout the late 1950's through the 1970's, and there were even a couple of attempts to revive the show in the 1980's.  The basic premise was that four guest celebrity panelists would question three contestants, asking questions to identify the "central character" whose unusual occupation or life experience had been read by the show's moderator/host.  The catch was that while the unknown "central character" had to answer truthfully, the other two impostors could lie.  After a set period of time, the celebrity panelists would guess which one of the contestants was the "central character", and the audience would also get to vote.  Once all the votes were in, the show's moderator/host would say, "Will the real [person's name] please stand up", and the "central character" would reveal him- or herself.  The other two contestants - the impostors - would then leave the stage.

At some point in our lives, we all have probably felt like one of the other two contestants in the television show, "To Tell the Truth".  While we aren't trying to fool the audience, we may feel as though we've fooled everyone else around us (even when we weren't trying to do so).  We feel like impostors (incidentally, impostor and imposter are two different spellings of the same word) or frauds.  We feel like we aren't qualified for the jobs that we have, or we don't deserve all the accolades that come our way.

I have posted about what has come to be called the imposter syndrome in the past (see "Imposters").  Imposter syndrome is defined as the persistent inability to believe that one's success is deserved or has been legitimately achieved as a result of one's own effort and skill.  Psychologists estimate that at least 25-30% of high-achievers suffer from imposter syndrome, and around 70% of adults experience a mild form of it at least once in their lives.

The imposter syndrome was first described in a research study by Pauline Clance and Suzanne Imes in 1978 ("The imposter phenomenon in high-achieving women: Dynamics and therapeutic intervention").  Since that first description, several studies have further characterized imposter syndrome in a variety of settings and contexts.  Imposter syndrome has been linked with a host of negative outcomes, including decreased self-esteem, decreased well-being, and increased burnout.  Whether the negative intrapersonal outcomes lead to lower performance in the workplace, however, is still not known for certain.

Imposter syndrome can, and often does, affect all of us.  I think we would be surprised to learn how prevalent these thoughts of inadequacy really, even among some very accomplished individuals.  The American writer Maya Angelou once wrote, "I have written 11 books but each time I think 'Uh-oh, they're going to find out now.  I've run a game on everybody, and they're going to find me out."  Sheryl Sandberg, who was the Chief Operating Officer at Facebook, tells a similar story in her book, Lean In.  "Every time I was called on in class, I was sure that I was about to embarrass myself.  Every time I took a test, I was sure that it had gone badly.  And every time I didn't embarrass myself - or even excelled - I believed that I had fooled everyone yet again."  The American writer and Nobel Laureate John Steinbeck once said, "I am not a writer.  I've been fooling myself and other people."  

Basima Tewfik published a very interesting study last year in the Academy of Management Journal and found that those who have workplace imposter thoughts actually are viewed in a more positive light.  Contrary to expectation, she found that these individuals are more likely to be seen as more interpersonally effective at work and no less competent than their peers.

Tewfik conducted four small studies that collectively involved just over 3,600 individuals in four different workplace settings.  In the first study, she surveyed 150 employees at an investment advisory firm and matched their subjectively reported feelings of imposter syndrome with their direct supervisors' ratings.  Those employees who reported more frequent imposter thoughts actually scored higher on interpersonal effectiveness!  In the second study, Tewfik surveyed 70 physicians in residency training and again found that those physicians who self-reported imposter thoughts were more likely to adopt an other-focused orientation through eye contact, personal gestures, etc and were thus perceived as having a much better "bedside manner" by their patients.

While the first two studies suggest a relationship between imposter thoughts and better interactions with others, her next two studies established a cause-and-effect relationship.  Specifically, she randomly assigned study subjects to either a control condition or an imposter thoughts condition.  Subjects in the latter group were asked to recall a specific time when they had imposter thoughts at work, after which they were interviewed.  Those subjects in the imposter group were rated higher in interpersonal effectiveness than those in the control group.  Given the prevalence of imposter thoughts (I'm not sure that there are true diagnostic criteria for the syndrome itself) in the workplace, it's reassuring, to me at least, that there appears to be some benefit.  When we feel inadequate to the task at hand, we often interact better with our colleagues, customers, patients, or peers!  

So, there are two important lessons from today's post.  First, at some point in time, most, if not all, of us will question are own abilities, knowledge, skills, or expertise.  Even some of the most accomplished and successful individuals in the world will at one time have feelings of imposter syndrome.  Second, imposter syndrome doesn't necessarily have to be a bad thing.  As a matter of fact, when we feel inadequate or question our own abilities, we are more likely to adopt an outward focus on those around us - we become better friends, colleagues, and teammates.

Reverence vs Respect

As I mentioned a couple of days ago, I am currently watching the MasterClass by Bob Iger, the former (and once again current) CEO at The Walt Disney Company.  I really enjoyed his book on leadership, The Ride of a Lifetime, and so far his MasterClass has been wonderful!  When Iger took over as CEO in 2005, one of his first priorities (remember "Your focus determines your reality") was to revitalize (maybe resuscitate is a better word?) Disney's famed animation studio, which he felt was really the lifeblood of the entire company.  

Iger talks about having to confront the traditionalists who felt that Disney's past was to be revered - in other words, Disney brand should be not be touched.  He argued that there is a big difference between respecting the traditions of an organization versus revering those same traditions.  "If you revere something, you work hard to protect it so that it stays the same.  You may as well place it in a museum case so that it doesn't change."  Respecting a brand, conversely, "considers all the reason why it was so valued in the first place."  By respecting the proud traditions of an organization, Iger would argue that you can still keep it relevant in modern times.  There is no question that what made an organization successful in the past may not work in the present.  By respecting these traditions - not revering them - an organization can maintain the ties to the past, embrace the present, and look forward to a new future.

There is a subtle difference between reverence and respect, but I believe it is an important one.  Take a look at the following quote by Abraham Lincoln.  He said, "Let reverence for the laws be breathed by every American mother to the lisping babe that prattles on her lap - let it be taught in schools, in seminaries, and in colleges; let it be written in primers, spelling books, and in almanacs; let it be preached from the pulpit, proclaimed in legislative halls, and enforced in courts of justice."  Reverence, used in this kind of context, sounds a lot like placing something on a pedestal or in a museum so that it is honored, cherished, idolized, and most importantly, not changed.  

Albert Einstein said, "Everyone should be respected as an individual, but no one idolized."  The definition of the word respect says it all.  Respect is defined as a feeling of deep admiration for someone or something elicited by their abilities, qualities, or achievements.  We can respect what an organization has accomplished in the past by remembering and holding a deep admiration for it, but we don't have to idolize it to the point where we ignore the need to change it.  As I stated previously in an older post, "The need for change is not an indictment of the past."

So how did the Disney brand evolve under Iger's leadership?  During his tenure as CEO, Disney acquired Pixar, Marvel Entertainment, Lucasfilm, and 21st Century Fox and increased its market capitalization fivefold.  Disney once again was the entertainment leader.  Iger changed the brand to make it more modern, while simultaneously respecting the proud traditions of the past.