What makes you stay?

Patrick Ryan, CEO of Press Ganey recently co-wrote an article for the Harvard Business Review with Thomas Lee, the Chief Medical Officer at Press Ganey, entitled "What makes health care workers stay in their jobs?"  It's a timely and relevant article given many of the challenges that health care organizations have faced during the last three or so years.  The opening sentence of the article is perfect - "Ask leaders of health care organizations about their top three challenges for the year ahead, and many answer 'Workforce, workforce, and workforce.'"  

Health care leaders are struggling to recruit and retain providers.  We've heard a lot about the national shortage of nurses, largely driven by an aging population with greater health care needs, increasing nurse burnout (particularly relevant during the COVID-19 pandemic), and a limited number of degree-granting training programs in the United States.  Even before the COVID-19 pandemic, there was a growing gap between the supply and demand for nurses in health care organizations (in the wrong way), which has grown even wider during the pandemic.  In order to meet the demand, health care organizations have traditionally hired temporary nurses from staffing agencies.  Unfortunately, the cost of temporary nurses have skyrocketed, and with the rising supply chain costs, hospital margins have remained negative for the past several months.

While nurses are among the most sought after health care professionals today, they are not the only ones.  Health care organizations are faced with labor shortages across the board.  And since recruiting for all of these positions continues to be a challenge, retaining staff has become an organizational imperative!  Becker's Hospital Review recently reported that the average cost of turnover for one staff RN increased by 13.5 percent from 2021 to 2022 to $52,350.  Each percentage decrease in RN turnover will save the average hospital $380, 600 per year.  The cost of physician turnover is less clear, as it usually depends upon the specialty.  However, most studies estimate that turnover costs are roughly 2-3 times the physician's salary with a range between $88,000 to $1 million per physician.  Lastly, while maybe not as relevant to health care organizations (I would argue that it is relevant), an analysis of financial services companies found that workers promoted internally have significantly better performance for the first two years (the analysis did not extend beyond that time-frame) than workers hired from outside the organization.  Just as important, the external hires costed 18% more than the internal ones.  So not only is it much less expensive to retain employees, but it also is better for organizational performance.

So back to the article from Harvard Business Review - how can health care organizations make sure that they keep their best employees?  Press Ganey analyzed their database of literally hundreds of thousands of employee experience data for physicians, nurses, and allied health providers and found that (1) pride in their work and (2) loyalty to their colleagues were the two strongest drivers of their desire to stay at their current organization.  Ryan and Lee summarized their findings by saying, "While competitive pay and other support options are essential to recruiting caregivers...organizational culture, including a commitment to excellence, is what makes them stay."

The Press Ganey survey asks providers to rate their level of agreement to two highly relevant statements: "I would stay with this organization if offered a similar position elsewhere" and "I would like to be working at this organization three years from now."  They observed a marked decline in both metrics from 2020 to 2022.  However, the pattern of decline was not the same for every organization or every position (physician, nurse, etc).  Their analysis showed greater variation, a "spreading of the pack" if you will, between organizations that were doing well in terms of employee engagement versus those who were not.  

Regardless of job type, the organization's commitment to quality and patient-centered care were among the top drivers of providers' willingness to stay at an organization.  If they rated an organization low on these drivers, providers were six times as likely to say that they were preparing to leave!  For physicians specifically, the top factors that were correlated with their expressed likelihood of staying with the organization were (1) whether they liked their work, (2) whether they felt the organization was making good use of their skills, and (3) organizational culture.  These findings are similar to a study published last November in JAMA Health Forum which found that the "intent to leave" among physicians had increased from 24% in 2019 to more than 40% in 2021.  Again, "feeling valued", "good teamwork", and "having values that are aligned with those of leaders" were the three strongest predictors of staying with the organization.  

These staffing challenges likely won't change, at least in the near term.  Keeping an engaged and productive workforce for the future requires a collective effort.  It will also require leadership.  Health care leaders need to focus on "the 5 R's":

1. Recruit new staff.  Keep in mind though that for all of the reasons discussed above, this shouldn't necessarily be the first priority (retention should be the first priority).

2. Retain staff.  Remember, it is less expensive to replace your experienced providers with new ones, who not only will be more expensive, they may not be as experienced or as productive.

3. Remove waste, particularly the kind of wasted effort that decreases productivity and engagement.

4. Replace non-productive work with productive work (similar to #4 above).

5. Re-allocate staff to areas or jobs where they can work at the top of their license.

Finally, there is an old adage that "Culture eats strategy for lunch", and when it comes to staff engagement, nothing is more important than organizational culture.  As leaders, we need to foster a culture of collaboration, teamwork, and mutual respect, where everyone feels like they are valuable members of the team.  And making staff feel valued starts with gratitude, which I will cover in my next post.

Happy Birthday Marcus!

According to historians, the Roman emperor and Stoic philosopher Marcus Aurelius was born on this day, April 26th in the year 121 CE.  He is often mentioned as one of the "Five Good Emperors of Rome" (the others were Nerva, Trajan, Hadrian, and Antoninus Pius) who ruled in succession from 96 CE to 180 CE.  Most recently, Marcus Aurelius was played by the Irish actor Richard Harris in the 2000 film "The Gladiator" , and his book Meditations is still widely read today.  I just read in the excellent book The River of Doubt by Candice Millard (one of the books that I read on my recent beach vacation) that former U.S. President Theodore Roosevelt carried both Meditations and Discourses by Epictetus (another great Stoic philosopher) with him during his expedition in the Amazon rain forest, an expedition in which he nearly died.  I also know that Marine Corps General James Mattis, who served as our 26th Secretary of the Department of Defense carried a copy of Meditations on every deployment.

The website "Daily Philosophy" had this to say about Marcus Aurelius and Meditations:

The glory of Rome is long gone, and its affairs are not ours. What remains is the diary of a reluctant soldier-king, who’d have preferred to become a scholar, and who was forced by his sense of duty to live a life that he didn’t want.  He left us his notes of this lifelong struggle to do what he thought right in the face of overwhelming odds. His Meditations are today as readable and relevant as they have been all through the past two thousand years – as the testimony of a man who managed to overcome his ego and to teach countless generations the true meaning of wisdom, humility, courage and duty.

Marcus Aurelius never intended for Meditations to be so widely read.  As a matter of fact, he originally wrote the book for his own personal use.  The book was essentially his daily journal.  Here are some of my favorite passages (there are many more) from these reflections, which are now fundamental tenets of the Stoic philosophy:

"You have power over your mind — not outside events. Realize this, and you will find strength."  

In other words, there are things that are under your control and likely many more things that are not under your control.  Focus on those things that are under your control, and don't worry about the ones that are not.

"Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth."

We tend to forget this particular recommendation a lot these days.  Remember, we shouldn't believe everything that we read or hear.  It is our job as citizens of the world to verify the facts and search for the truth.

"Waste no more time arguing about what a good man should be. Be one."

I used to have a magnet with this quote on it hanging in my office at work - it's one of my favorites.  I think there's deeper meaning for this quote in particular.  Again, we tend to forget this one as well.  Rather than arguing about whether "so and so" or "such and such" is a good or bad person, we should focus on being a good person ourselves.

"The best revenge is to be unlike him who performed the injury."

If someone wrongs you, avoid the temptation to seek revenge.  The best response is to "turn the other cheek" and be the better person.

"The soul becomes dyed with the color of its thoughts."

I like this quote too, and I've posted about it in the past.  

There's one final point that I think is very important to keep in mind.  Marcus Aurelius wasn't always a good person.  Remember that he wrote these reflections to help him be a better person and a better leader.  Nobody is perfect - so do not despair if you are not.  Just try to be better in the future.  Happy Birthday Marcus!

"Screen somebody out there!"

I took a break the last couple of weeks and enjoyed some time at the beach.  My wife and I are still training for a marathon that's coming up in a couple of weeks, so it wasn't all rest and relaxation.  However, we definitely needed some time away, and we both had a great time.  Back to writing!

I remember the first time I learned about Coach Bob Knight as if it were only yesterday.  Coach Knight hosted a television show on one of our local television stations (WTTV Channel 4).  He used to wear a plaid blazer (very stylish for the 1970's) during the show, and he would have some of his Indiana University Hoosiers basketball players run through basketball drills to demonstrate some of the fundamentals of basketball, at least according to Coach Knight.  Even though we were a Purdue University family, I was still enthralled!  How could you not be, when Coach brought legendary players like Kent Benson, Quinn Buckner, and Scottie May on the show?  Remember, to this day, IU is the only team to win the NCAA championship and go undefeated the entire season!

Coach Knight won the NCAA championship three times (1976, 1981, and 1987), and at one point had more college Division I basketball wins (902) than any other coach in history (he's currently fifth on the all-time wins list).  Unfortunately, even though he was one heck of a basketball coach, Bob Knight was not a good person.  His history of volatile behavior, which included throwing a chair towards a Purdue player in 1985, as well as allegations (which were true) of physically assaulting one of his players during a basketball practice, eventually led to his firing in the fall of 2000.  He would go on to coach Texas Tech from 2001 to 2008, though he remained somewhat of a pariah at Indiana University until his triumphant return to Indiana University's Assembly Hall in 2020. 

It's unfortunate when you grow up and learn that some of your childhood heroes don't deserve to be called heroes.  So I don't want to make this post about Bob Knight.  I bring all of this up in the context of another basketball legend who I was fortunate enough to see play during my lifetime, Michael Jordan.  At least to me, the arguments about who was the better player, Michael Jordan or LeBron James  are pointless.  I've seen them both play, and I say Jordan was the best that I've ever seen play the game.  One of my favorite Michael Jordan stories actually involves Coach Knight.

Years ago, professional basketball players weren't allowed to play in the Olympic Games.  As a matter of fact, the last amateur team to play in the Olympics for the United States was actually the 1984 team, who were coached by Bob Knight.  The star of that team (in retrospect) was Michael Jordan, then a first team All American who played for the North Carolina Tar Heels and their legendary head coach, Dean Smith.  Bob Knight would say that Michael Jordan was the best basketball player he had ever seen, while Michael Jordan wrote in his memoir The Jordan Rules that "I don't know if I would have done it (played for the U.S. team) if I knew what Knight was going to be like."  

I posted about "team chemistry" and dealing with superstars a few posts back, and here is where things come back full circle.  There is an oft repeated story about the final game in the 1984 Olympics between the United States and Spain.  At half time, Coach Knight went into the locker room wondering what he could say to the team.  They had already breezed through the tournament without losing a single game.  Michael Jordan was on absolute fire, and the U.S. team was winning by 28 points at the half.  Knight would admit, "We played the game about as well as basketball can be played."  However, Coach Knight wondered what he could say to the team to get them play even better during the second half.

He decided that if he criticized the star of the team, the other players would be encouraged to play even harder in the second half.  So Knight immediately started criticizing Jordan, saying "Mike, when in the hell are you going to set a screen? We had four guys out there screening. When the hell are you going to screen somebody, Mike? I mean all you’re doing is rebounding, passing, and scoring. Screen somebody out here."

Okay, I get it.  I guess.  I've been saying that you can't treat the superstars differently from everyone else on the team.  But making up stuff to complain about?  I'm not so sure about that.  Regardless, what did Jordan come back with?  

Jordan responds by saying, "Coach, didn’t I just read last week where you said I may be the quickest player you’ve ever been around?"

Knight comes back with, "What the hell does that have to do with you screening?"

Jordan replies with his signature smile, "Coach, I think I set them quicker than you can see them."

Here's my first point.  Don't place your superstars on a pedestal.  It's important that the rest of the members of the team see that you, as their leader, treat everyone - superstars and role players - equally.  And here is my second point.  Create the kind of psychologically safe environment where one of your players feels completely at ease with responding in the way that Michael Jordan did, "Coach, I think I set them quicker than you can see them."

Hotwash

I've been reading a lot about near-misses and how they can be used to learn and improve.  Most of the studies have found that organizations tend to discount near-misses and focus only upon the failures.  And while learning from failure is a "must do" (remember FAIL is an acronym for "First Attempt In Learning"), organizations can learn just as much from their near-misses.

The U.S. Army uses two similar techniques called that remind me a lot of the Root Cause Analysis process that is used in many healthcare organizations today to analyze safety events.  The first technique is called an "After Action Review" (see my post "The Failure of Foresight" for more information on this technique), which I think is analgous to a Root Cause Analysis.  The second technique is called a "Hotwash" and reminds me more of what is called an Apparent Cause Analysis, which is a more focused and limited version of the Root Cause Analysis.  The term "hotwash" apparently comes from the practice used by some soldiers of using extremely hot water to wash their weapons as a means of removing all the dirt and grit following a combat training (or real) exercise.  While the "hotwash" doesn't eliminate the need to break down the weapon and clean it, it does remove at least some of the residue and makes cleaning later easier.

Similar to the Apparent Cause Analysis, a "hotwash" is more focused, more limited, and more immediate than a Root Cause Analysis (or the analgous "After Action Review" ).  The main purpose of the "hotwash" is to get the team together to quickly discuss what happened, identify any strengths or weaknesses of the team's response, and discuss any "lessons learned".  The "hotwash" usually includes all the individuals who participated in the action or exercise.  Very few, if any, outside experts participate in the "hotwash" (unlike the After Action Review, which may rely heavily upon several subject matter experts from outside the immediate team).  

Next time your team experiences a near-miss event or a failure, consider holding a "hotwash" debrief.  If the "hotwash" suggests that further, more in-depth analysis is required, then proceed with the full "After Action Review".  

Four M's

I spent some time at the 13th Annual Meeting of Becker's Hospital Review conference in Chicago last week.  I was honored to serve on a panel with three other leaders in healthcare quality and safety to talk about some of the challenges of keeping Quality Improvement and Patient Safety top of mind with everything that is going on within the healthcare industry right now.  I mentioned the most recent Hospital Flash Report from the consulting firm Kaufman Hall which showed that hospitals have been struggling with negative operating margins for over a year!  Health care organizations have had to deal with declining reimbursement rates at a time when labor and capital costs have signficantly increased.  And in case you haven't heard it, we are in the midst of a national nursing shortage, which will likely not end for the forseeable future.  In other words, keeping our "eyes on the prize" of quality and safety can be a bit of a challenge.

As I was preparing for the session, I came across an online post that I thought made an important point about something that I had learned a while ago but had apparently forgot.  Lean/Six Sigma manufacturing has something called the "four M's".  The key to ensuring quality in manufacturing starts with achieving optimal conditions with machinery, materials, manpower, and methods (somewhere along the line, someone added two additional M's - measurement and Mother Nature or milieu, but I will stick with the original four).  

The important point here is that the first step in assuring quality is to optimize these four foundational conditions.  Workers (manpower) have to have the right knowledge and skills, as well as the the requisite amount of motivation and morale.  They also have to have the right equipment (machinery) and resources (materials) to be able to do their jobs effectively.  Finally, they have to be using the right processes (methods).  If any of these four areas are not optimized, quality will not be optimized either.

As I thought about this, I can't help to go back to where we are in healthcare today.  Our frontline providers are faced with supply shortages, inadequate staffing, and an exceedingly high level of burnout.  So, right there we are not optimized in at least three of the four M's!  As we think about trying to improve quality and safety in the healthcare setting, we absolutely have to address these issues.  It's clear we have a lot of work ahead of us!

"In search of David Ross"

I want to continue the theme I started last time with "He's the glue...".  There is no question in my mind that all teams, regardless of the industry, need role players ("glue guys" and "glue gals") - someone like Shane Battier.  Or David Ross.  David Ross is currently the Manager of the Chicago Cubs, but he also spent 15 seasons as a player in the Major Leagues, winning the World Series for the Boston Red Sox in 2013 and the Chicago Cubs in 2016.  He has been the Manager for the Cubs since the 2020 season.

On paper, Ross looks like he was an average player.  He was always more of a back-up catcher than a starter, appearing in only 883 games over his 15 year career (that's just over 58 games per 162-game season).  Statistically speaking, his life-time batting average was 0.229, and he hit only 106 home runs and batted in 314 runs.  However, as a teammate, Ross was routinely described as someone who made everyone around him better.  In other words, just like Shane Battier, David Ross was a "glue guy".  

If there is such a thing as "team chemistry" (and I believe that there is - see "Chemistry is Culture", "Superstars and the mess in Cleveland", "That's what being a Boilermaker is all about", "Chemistry Magic", and "There's no 'I' in team"), then the "magic elixir" that produces it has to be having role players like Shane Battier and David Ross on the team.  Unfortunately, the impact that these role players have on "team chemistry" and ultimately on how the team performs can be difficult to quantify.  Scott Brave, R. Andrew Butters, and Kevin Roberts were able to do exactly that (at least for Major League Baseball) in their paper, "In search of David Ross".  They use some fancy analytics and eventually settle on a regression model that uses a well-known baseball statistic called the "wins above replacement" or WAR.  These investigators report that there is on average a 20 percent variance between a team’s actual win total and the cumulative WAR of all the players on that team. Their analysis attributes half of that 20 percent variance to what they call "team chemistry".

If "team chemistry" has been called the "Holy Grail of performance analytics" in sports, imagine how hard it is to develop an objective measure of "team chemistry" in organizations outside sports!  Given the importance of "team chemistry" to an organization's success, coming up with an objective measure of "team chemistry" seems like an incredibly important area for further research.  Until that time, however, we will be stuck with more subjective measures, which will be necessary to build an effective, high performing team.  Remember, we need role players as much as, if not more, than we need superstars.

"He's the glue..."

The NBA's Miami Heat had lofty expectations for success at the start of the 2010 season.  During the off-season, the team added superstar players LeBron James and Chris Bosh to join the superstar they already had in Dywane Wade.  The three superstars were introduced with great fanfare (including fireworks) at a press conference attended by literally thousands of fans.  A journalist asked James how many NBA titles the team was going to win, and he famously replied, "Not two, not three, not four, not five, not six, not seven..."  The crowd loved it.  Unfortunately, the reality was very different.  With James, Bosh, and Wade leading the way, the Heat ended up winning only two titles (2012 and 2013) in their so-called "Big Three Era" from 2010-2014, losing twice in the NBA Finals at the end of the 2011 and 2014 seasons.  Following the 2014 season, LeBron James opted out of the final year of his contract and returned to play for the Cleveland Cavaliers, breaking up the "Big Three" for good.

Why did the "Big Three" fail to meet expectations?  Can you really say that a team "underperformed" if they won their conference four years in a row and played in four consecutive NBA Finals?  Perhaps not, but when you consider LeBron's own prediction of multiple (he didn't stop after saying "seven titles") titles, the team clearly didn't even meet their own expectations for success.  The team famously struggled during their first season together, and while they won their conference, they eventually lost to the Dallas Mavericks in the NBA Finals.  During the off-season following that first "disappointing" year, the Heat added another key component that helped them find success the next two seasons.  Did they go out and sign another superstar free agent?  Not really.

As Adam Grant tells the story in his podcast "The Problem with All-Stars", the Heat went out and signed a solid player who was primarily known as a role player.  As I mentioned in a previous post ("I play not my eleven best, but my best eleven"), most, if not all successful championship caliber teams have a mix of highly talented players and at least one role player.  As one coach put it, "The role player shuns the glory of attention, praise, and impressive statistics for the sake of the team. In doing this, the role player revels in another kind of glory."  The role player's "glory" is the team's success.  

We've often heard the term, "glue guy" (or "glue gal") to describe these role players.  These are the individuals who never put up big stats, and the highest number in their box score is usually "minutes played".  They are the quintessential "team players".  The Miami Heat signed Shane Battier that off-season, and Battier played that important role as a "role player" during the next two seasons when the Heat won back-to-back NBA titles.  Of course, Battier was named the "NBA Teammate of the Year" after the 2013-2014 season.  Michael Lewis wrote a feature on Battier that appeared in The New York Times Magazine that perfectly encapsulates the sentiment here, "The No-Stats All-Star".  The tagline for the article is even better, "His greatness is not marked in box scores or at slam-dunk contests, but on the court Shane Battier makes his team better, often much better, and his opponents worse, often much worse."

As it turns out, the evidence from a number of studies and/or anecdotal experiences in a variety of settings is very conclusive - teams composed principally of superstars almost always fail to meet expectations.  It's often called the "Too Much Talent Effect" and has been observed both in sports and business.  In fact, there's a curvilinear relationship between the number of superstars on a team and performance.  For example, investment firms on Wall Street typically perform better as the number of talented individuals on the team increases, but only up to a point (see "Too Many Cooks Spoil the Broth").  Up to that point the marginal benefit of adding more superstars to the mix actually decreases and then performance falls abruptly.  Similar results have been found both in basketball and football (soccer) - see the graphs below from Adam Grant's blog:

So, what is the "secret sauce" for role players ("glue guys" and "glue gals")?  Again, these individuals understand that their role, whatever it is, is just as important to the overall success of the team, even if it by assuming that role they sacrifice some (or all) of their own personal success.  More simply stated, the "secret sauce" is humility.  As Adam Grant suggests, "Humility isn't having a low opinion of yourself. One of its Latin roots means "from the earth." It's about being grounded. So humility doesn't require you to only do the grunt work. It's about realizing you're not above doing whatever the team needs."  

One of Battier's coaches once called him "the most abnormally unselfish basketball player he has ever seen…helping the team in all sorts of subtle, hard-to-measure ways that appear to violate his own personal interests."  Players like Shane Battier also make everyone else better through a characteristic that psychologists now call moral elevation.  Moral elevation is a positive emotion experienced when witnessing a an act or behavior that improves the welfare and/or wellbeing of others.  On the basketball court, whenever his teammates watched Battier play unselfishly by passing the ball to an open player rather than taking the shot himself, they would model his behavior and play just as unselfishly.  Moral elevation, just like humility, is contagious!

If you don't have at least one Shane Battier type on your team, then you are missing out.  How do you identify these kinds of individuals?  Sara Eshelman, writing for Medium, says that these individuals are, by definition, hard to identify.  However, as a group these individuals are more likely to:

1. Have atypically long tenures

2. Tend to work with and move around with people they know (and who know their value)

3. Have a strikingly positive outlook

4. Hold job descriptions that may seem vague and unremarkable on the surface, but references sing their praises

5. "Just make work better" for everyone around them

6. Have a track record of doing work that is both way above and way below their pay grade, from re-ordering coffee pods to exploring new business opportunities; They just somehow figure it out.

I will end with one of my favorite quotes (which has appeared on this blog before actually).  Legendary Notre Dame football coach Knute Rockne once said, "The secret is to work less as individuals and more as a team.  As a coach, I play not my eleven best, but my best eleven."  Rockne undoubtedly had his share of superstars on his team, but most importantly, he had his "glue guys" too.  

Bill Walton's Haircut

During my residency training, I used to occasionally (very occasionally) go on a run with some of my attendings.  Please remember that I was on active duty in the U.S. Navy during residency training, so my experience was perhaps a little different than most!  The attendings had different names for some of the different routes around the hospital, and one of my favorites was "The Bill Walton", so named because it happened to pass by the Hall of Fame basketball player's house.  It was a beautiful Southern California house with a lot of character!

Bill Walton played college basketball for UCLA's legendary basketball coach John Wooden (see my post "Believe" for more on Coach Wooden).  Walton grew up during the 1960's and played for UCLA during the early 1970's at the height of UCLA's unprecedented run of 88 consecutive victories.  Walton is a self-described hippie and huge fan of the rock-n-roll band the Grateful Dead.  However, his childhood was a little different.  He once said, "I was a skinny, scrawny guy. I stuttered horrendously, couldn't speak at all. I was a very shy, reserved player and a very shy, reserved person. I found a safe place in life in basketball."  During high school, he played basketball with his older brother Bruce, who would later go on to play football for UCLA and the NFL's Dallas Cowboys (Walton says that he and his brother are the only brother combination in history to win both the Super Bowl and the NBA championship).  Whenever Bill was treated roughly during a game, his brother Bruce would return the favor!

Despite dealing with a number of injuries during high school, Walton would lead his school to 49 consecutive victories and two state championships, and for this reason he was heavily recruited by UCLA.  Walton was already a huge fan of UCLA basketball and admitted, "I was John Wooden's easiest recruit. I became his worst nightmare. I drove the poor guy to an early grave when he was 99."  One of my favorite Wooden stories explains some of the difficulties he had when dealing with his superstar player.  It's the time when he told Walton to get a haircut.  

Coach Wooden had a rule that hair could be no longer than 2 inches, and there could be no facial hair.  Walton came to the first practice of his junior year after winning the national championship and being named a first-team All-American as a sophomore (freshmen weren't allowed to play varsity in those days) with long hair and a beard.  Wooden took one look and said, "What's this?  It's unacceptable."  Walton responded by stating emphatically that it was his right to wear his hair long.  Coach Wooden responded, "That's good, Bill.  I admire people who have strong beliefs and stick by them, I really do.  We're going to miss you."  Walton immediately left practice, hopped on his bicycle, and rode to the nearest barbershop for a shave and a haircut.  UCLA would go in another undefeated season and win another national championship.  Incidentally, the winning streak would end during Walton's senior season with a loss to Notre Dame on January 19, 1974.  UCLA's streak of seven consecutive national championships would end that year as well.  Walton would go on to an injury-plagued but still Hall of Fame career in the NBA.

Wooden had his rules, and he expected players - even his superstars (and he coached several) - to follow them.  Regardless of whether you are coaching superstar athletes or managing superstar employees, the leadership lesson is the same.  Treat the superstars the same way as the rest of the members of the team.  The same rules should apply equally across the board.