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BY CHRIS CORWIN | NOV 4, 2020 | CAREER, HEALTHCARE, LEADERS IN TRANSITION, LEADERSHIP 

IMPORTANCE OF INVOLVING PHYSICIANS IN TRANSFORMATIONAL CHANGE. THE NEED TO REDOUBLE EFFORTS TO SUPPORT PHYSICIANS, ELEVATE PHYSICIAN LEADERS, AND KEEP PHYSICIANS AT THE FOREFRONT OF MAJOR INITIATIVES.  

There must be a commitment in the C-Suite to create an environment and culture where physicians can thrive. For decades, we’ve been talking about the need to improve physician-hospital relationships. While discussion is a step in the right direction, the truth is that we, as an industry, should have made more progress by now.  There’s room for finger-pointing on both sides, but it’s way past time to move on from that. The C-suite needs to take a hard look at what’s within control to change, where they can have the greatest impact, and where the best chance for executing change exists. 

Many of the changes needed to work more effectively with physicians are tied to culture. The “culture eats strategy for lunch” thought bubble instantly appears for most of us when the culture topic surfaces. That’s because it rings true in most situations. The good news about cultural change is that it is often low cost or free. Instead of a financial commitment, it requires us to be better leaders. It requires that we slow down and listen, put ourselves in someone else’s shoes, and model the change we want to see.  

Working well with physicians is a skill. One area to focus is engaging physicians in what THEY care about. For example, an improvement project enthusiastically crafted behind the scenes is presented to physicians and receives a neutral or negative reaction. The oversimplified conclusion is that physicians don’t care about improvement. But when the layers are stripped back, that’s usually not the case. 

The key to physician engagement is identifying and understanding what they care about. That means frequent open and honest dialogue, especially about improvement initiatives. That means involving physicians early and often, not presenting them with a fully baked initiative and then asking for input. That also means being clear about the why. Physicians want to understand the purpose and strategy behind change initiatives and the benefit their patients will experience because of those changes.   

If opportunities to provide better patient care are lost in talk about cost benefits and the importance of standardization, physician engagement will take a hit. Physicians also want data. Anecdotal observations about what physicians should do differently won’t suffice. Executives must know the data and be ready for questions.  

Beyond nurturing physician engagement, leaders must do so much more.  Hire the best and get out of the way. Devote the time to recruiting a strong and diverse team of department chairs and physician leaders. Then, let them do the work they were recruited to do. That means giving them space to be creative and find areas where there was need and opportunity to grow. Let them recruit the right people to drive growth, and then help ensure those physicians are given opportunities to put their imprint on something. Find the early adopters and physicians who are highly regarded by their peers absent age and experience. Then get out of their way! 

Provide opportunities for physicians to learn. By the time most administrative leaders make it to the C-suite, they have participated in or led quality improvement initiatives. Not so for physicians, whose careers may have bypassed involvement in quality efforts. With learning opportunities and coaching, physicians can become engaged change agents. Physicians who learn how to improve the care they provide and influence the environment they work in often find they are able to reconnect with why they became physicians. To accomplish that, executives can’t overlook or dismiss the need for educational programs.

 Create room to fail. True change is not enacted without some level of failure, especially when change is fast paced and transformational. The key is to create space for a soft landing when physician initiatives falter, assess the failure, and then move on to new solutions without excessive ruminating.  

Grow from difficulties. Challenges or crises can break organizations or galvanize them. Without swift action to promote healing, damage can spread quickly. If we are engaged as leaders, as we expect our physicians to be, we will get in front of difficulties, learn from them, and use them to build organizational resilience. 

Part ways when necessary. There are circumstances where parting ways with physicians is the right choice. If physicians refuse to engage on key quality and efficiency initiatives or sabotage these efforts to preserve the status quo, their interests cannot be prioritized over the greater good being pursued by a group of physicians working on behalf of their patients. 

Deliver on your promises. Promises of leadership support, resources, accessibility, and other things of value put your credibility and reputation on the line. As executives, we should know to not make promises lightly, but reminders may be needed to not cavalierly throw around commitments we cannot or should not keep. People will remember your words and only trust you once they see action. 

C-suite colleagues –  can we recommit to creating organizations where physicians can thrive?

BY CHRIS CORWIN | JUL 20, 2020 | CAREER, LEADERSHIP DEVELOPMENT, ORGANIZATIONAL STRATEGY

CREATING AN INCLUSIVE CULTURE AND PHILOSOPHY OF BUSINESS IS CRUCIAL TO SUCCESS TODAY AND INTO THE FUTURE.

When organizations are truly inclusive, combined perspectives become a strategic advantage. Based on what everyone sees, from every possible vantage point, organizations more clearly see the reality of today. Then, based on that reality, organizations become much better at anticipation—predicting what lies ahead.

Here are some thoughts on how to get there:

It takes everyone. The leader must ponder the enormity of leading people on the journey —physically moving them from here to there. The leader must keep everyone motivated and aligned as they leave the familiar for the unknown, losing some people and gaining others on a journey that takes years. People will not follow blindly. They need to see the True North of an embodying purpose—the “why” of the journey. There could be any number of “whys”—to build a team, to challenge themselves, to support a cause, to make a difference. On every leadership journey, the specific “why” will be unique to each organization and its desired destination. What is universal to all is the importance that everyone understands that specific “why.” Where there is purpose, there is hope—even exceeding what anyone thought possible. But it takes everyone—encouraging, supporting, and journeying together.

The language of inclusion. The secret of success on the journey is fostering a culture of inclusion. To create that environment, we need to speak the language. Research indicates inclusion is a behavior. Inclusion values and fully leverages different perspectives and backgrounds to drive results. Diversity is a fact. Differences make each person unique. Engagement is an emotion. The emotional connection leaders have with their team determines the discretionary energy. Leaders who are fluent in the language of inclusion become culturally agile. They fully embrace and leverage the vast diversity of today’s workforces. When this happens, empowerment becomes purposeful power.

Inclusion makes anticipation a team sport. When an organization is truly inclusive, everyone’s perspective and input matters. People know it’s safe to speak “their truth.” Conflict about what people perceive isn’t discouraged—that’s how collective genius is born. People are empowered to ask not just why, but also why not. When inclusion exists, anticipation can truly become a team sport as everyone at every level of the organization becomes a world-class observer. This requires more than just encouraging a behavior—it must be a cultural muscle that gets exercised. When inclusion and anticipation come together, there’s no question: everyone will reach the other side.

Inclusion fuels passion. When an inclusive leader seeks feedback from everyone, people feel seen and heard. These are powerful intrinsic motivators—tapping people’s deep-seated desire to know that they belong, make a difference, and are part of something bigger than themselves. Motivated by purpose and energized by passion, they are more likely to commit to the journey. And, when people are committed to each other, they transform self-interest into shared interest.

Finally, the destination is reached: As satisfying as the end goal is, it’s only one moment out of many. Indeed, every journey is an accumulation of many moments. The moments are what truly matter most—moments of journeying with others!

• How inclusive are you? Here are some questions to help increase self-awareness.

• How does your unconscious bias influence your behavior?

• How often do you take the initiative to seek out different viewpoints when making decisions?

• Do you catch yourself in moments when you make assumptions about others?

• Do you recognize the value of diversity in achieving results?

• Do you actively listen in all conversations, no matter who is speaking?

• When you put together teams, do you purposefully include members with a broad range of perspectives and backgrounds?

• In times of change like these, do you show greater interest in your difficulty or the difficulties of others?

BY CHRIS CORWIN | NOV 4, 2020 | CAREER, HEALTHCARE, LEADERS IN TRANSITION, LEADERSHIP DEVELOPMENT

During this time, it’s important to acknowledge every small step along the way. More than ever, we need to remember: It’s the journey not the destination. Here are some thoughts:

Celebrate—and Notice—Everything. To celebrate the small stuff, you need to notice. Everything. This leadership skill was brought home to me years ago on a visit to a billionaire who, at the time, was the world’s wealthiest person. The day before our meeting, a colleague and I were traveling through a very remote airport. As we passed a boot shop, I noticed these incredibly loud red cowboy boots on the top shelf. “Those are the bomb,” I said, half joking. Later, on the plane, my colleague brought out a box—yep, the cowboy boots. The next day, as I got ready for a speech before hundreds of business leaders and then our meeting with the billionaire, I decided to wear those boots. Not my usual business attire, but I knew my friend and colleague would be so pleased. When we walked into the billionaire’s office, there were stacks of papers and books everywhere. Sitting at his desk, going over a thick report, our host was clearly distracted and did not seem to pay much attention to us as we sat down. Then, at the end of our two-hour meeting, he gave me a sly smile and said, “So, where’s the horse?” We all laughed. What was truly amazing, though, was that this billionaire, who appeared unaware of anything except the papers in front of his nose, had noticed. Nothing was beyond his line of sight.

It’s not numbers, it’s the people. What gets measured, doesn’t just get managed, as the well-known saying goes. It also gets celebrated! Without measuring, you’re only practicing—as if it doesn’t matter how much progress is made. Once goals are set, leaders need to make sure they’re monitored in ways that are relevant and contribute directly to achieving them. It takes more than one metric to measure progress—a dashboard of data that reveals a more complete picture. But it’s not just about data. Even more important are the people. Listen for the stories of what went into those incremental achievements. The team that went the extra mile. The colleagues who spontaneously worked together to solve a problem. Share the data and the story behind the story. Progress inspires!

Catch people doing things right. It used to be everyone waited until the big milestone was reached. When asked, “Now that you’ve won [fill in the blank], what are you going to do?” the answer was, “We’re going to Disneyland!” Times have changed, in so many ways. The journey we’re on today has no parallel—we’re really headed into an unknown. And yet, as we accelerate through the crisis curve toward waves of recovery—whatever and whenever that is—there will be abundant opportunities. They will no doubt involve change—in products, processes, or both. Given the enormity of this journey, leaders can’t afford to hold off celebrating until some end point. If they do, they will likely find that they are traveling alone. Find any reason to celebrate. During this crisis, I’ve been reaching out to at least 50 people a day. Sometimes my messages are very simple: Thank you. I appreciate what you’re doing. I know this is a hard time. In the words of leadership guru Ken Blanchard, “Catch people doing things right.”

For love or for money. You can never say “I believe in you” too often. Many times during the crisis I have asked my team, “What do you recommend?” After asking a couple more questions, I told them, “OK, I trust you.” These subtle, but powerful, motivators are like tossing a pebble in a pond. The leader’s words and actions will ripple throughout the organization. It all comes down to two motivators: for love or for money. Let’s be honest here: in these times, celebrating and rewarding are not going to be about money. Intrinsic motivators are more important than ever. Love wins out every time. People want to be loved and they want to belong. They want to know that they matter, that they make a difference. In recognizing each person, the leader melds self-interest into shared interest—a kinetic, moving force for good to pursue the overarching goals of the organization. Shared purpose creates shared urgency. 

Celebration is motivation. When we acknowledge and celebrate how far we’ve come, we become even more motivated for what undoubtedly will be a long road ahead. It’s a journey that must be successful. The stakes are too high. The only choices are positivity or negativity, construct or criticize. Give energy, don’t consume it. Just the other day, I was about to go on a global town hall videoconference to discuss some serious matters when I passed the room where my college-age daughter Emily was standing on her desk and singing (screaming) Beyoncé into her hairbrush/microphone. Seeing her just reset the context for me. It made me laugh—and I went on that call with high energy and appreciation that even amid difficult times there are still reasons to smile. It was a reminder: create a culture of celebration.

Navigating the crisis curve is not a journey measured in months and miles, but rather in milestones. Turning discouragement into encouragement will elevate the mundane into the miraculous. And that’s a real reason to celebrate.

Excerpts from HBR Article – Business Leaders Taking Meaningful Steps Against Racism – June 2020

No matter your racial, political, or other identity, recent events are almost impossible to escape. In particular, millions of Black people and their allies are hurting. And these issues are not ones that organizations or their leaders — from CEOs at the top of the hierarchy to team managers on the frontline — can ignore.

While conventional diversity, equity, and inclusion initiatives focus on employee engagement and belonging, today’s challenges reach far beyond marginalization in the workplace. We now see and hear Black people who are suffering from the weight of dehumanizing injustice and the open wound of racism that has been festering for centuries.

The psychological impact of these public events — and the way it carries over into the workplace — cannot be overstated. Research shows that how organizations respond to large-scale, diversity-related events that receive significant media attention can either help employees feel psychologically safe or contribute to racial identity threat and mistrust of institutions of authority. Without adequate support, minority employees are likely to perceive their environments as more interpersonally and institutionally biased against them. Leaders seeking to create an inclusive environment for everyone must find ways to address these topics.

Avoiding Missteps

Three common missteps to avoid.

Keeping silent. For people not directly impacted by these events, the default response is often silence. Many Whites avoid talking about race because they fear being seen as prejudiced, so they adopt strategic colorblindness instead. We know that many managers also think they lack the skills to have difficult conversations around differences.

But no one has the perfect words to address atrocities in our society. It is the leader’s responsibility to try, conveying care and concern for all employees but especially targeted groups. As Desmond Tutu once said, “If you are neutral in the situations of injustice, you have chosen the side of the oppressor.” You might be tempted to rest on the laurels of your organizations’ diversity statements and active employee resource groups. But that is not enough. The words of Dr. Martin Luther King remind us: “In the end, we will remember not the words of our enemies, but the silence of our friends.”

Becoming overly defensive. Another common misstep when approaching uncomfortable conversations about racial injustice is to react defensively, especially when our world views, positions, or advantages are questioned or challenged. For instance, when learning about police brutality against unarmed Black people, one reaction might be to search for evidence about what the victim did to deserve abuse, rather than demonstrating compassion and empathy. Another example is diminishing protesters by focusing on and judging those who engaged in looting instead of discussing the unjust act that drove people to the streets. Leaders must resist such reactions because they do not allow for constructive engagement. Instead, they make members of targeted groups feel even more alienated. Remember that comments on systemic inequalities are not personal attacks.

Overgeneralizing. When triggering events occur, there is a tendency to make sweeping generalizations about groups of people involved in the public conflict. Though individuals of the same race, gender or other identity often have shared experiences, there is diversity within groups that should be recognized. Instead of presuming that all members of your in-group or out-group think and feel similarly and talking about what “everybody knows,” how “all of us feel,” and what “none of us would ever do,” leave room for dissenting points of view. When in doubt, ask employees about their individual experiences to honor their uniqueness. Think about how you can allow your employees to discuss what’s happening without putting them on the spot or asking them to speak for everyone in their identity group.

Taking Meaningful Action

Next, we’d like to provide a framework for meaningful action. Leaders must not only offer physical and psychological safety. They also have the power and platform to lead change. Statements from the top are valuable, but they are just a start. Anyone, at any level of the organization, can take small steps to exercise greater compassion and initiate action that provides needed support and promotes racial justice for Black workers as well as others who are marginalized. Managers have a particularly important role in connecting with their employees on these issues.  Here’s how:

Acknowledge. It’s important to acknowledge any harm that your Black and brown coworkers have endured. This means committing to lifelong learning about racism. Seek the facts about racist events, as well as the aggressions and microagressions that your minority coworkers have most likely faced inside and outside of your organization.  We suggest the following steps:

Do the research to fully understand events, using data from reliable sources. Take the initiative to search beyond social media.

Do give your Black and brown employees the space to be angry, afraid, disenchanted, or even disengaged from work.

Do seek out support from your human resources team or office of diversity and inclusion. Books and articles can also be good resources. Three recommended are: Race, Work and Leadership: New Perspectives on the Black Experience series “Toward a Racially Just Workplace”; “The Person You Mean to Be” by Dolly Chugh, and “How to Be Anti-Racist” by Ibram X. Kendi. There are also free resources such as the “Talking about Race” web portal from the Smithsonian National Museum of African American History and Culture.

Do not rely on Black and brown people to educate you about what happened in order to justify their hurt and outrage or counter “colorblind” rhetoric.

Do not ask your Black and brown leaders or employees to comfort or advocate for colleagues or justice initiatives.

In the organizational setting, you have the power to step up.

Affirm. People are looking for leaders to affirm their right to safety and personhood and help them feel protected. When presidents, governors, mayors and sheriffs aren’t doing so, corporate, university, and non-profit leaders can. This means offering continued opportunities for reaction, reflection, conversation, growth, development, impact, and advancement. Affirmation can start with creating a space for employees to share. For example, when asked, “How are you today?” many people of color respond in a scripted manner, instead of answering honestly. Instead, use more thoughtful prompts and questions.

You might say something like this: “I’ve been thinking about the harm of racism in our country, especially considering recent events.” Next, describe your personal reaction and concerns, then make a commitment. “I’d like to help in promoting equity, so here’s one thing I plan to do to help prevent future tragedies like these.” Explain those intentions. Then, offer to engage. “Please let me know if there’s anything else I can do to be supportive, even if you just want to talk about what’s happening. I understand if you don’t, and I won’t be offended. But I just want you to know that the door is open, and that I care.” The last line is important. Not everyone will be interested in or comfortable with discussing racism at work, especially if they haven’t built a solid foundation of trust.

Act. Think critically about how you can use your power to effect change. Employees value words of understanding and encouragement, but leaders’ and organizations’ actions have a more lasting impact.

What can you and your organization do in your community? What would promote equity and justice and activate meaningful change?  Whether you are a senior or junior leader, how can you advocate for such action?

Racism isn’t just Black people’s problem; it’s everyone’s problem because it erodes the fabric of society. Leaders at every level must use their power, platforms, and resources to help employees and communities overcome these challenges and build a better world for us all.

The Facts:

• Burnout costs the U.S. health care industry an estimated $4.6 billion every year. 

• Experts say there is an immediate ROI for CEOs when trying to solve this problem. 

• Burnout impacts nearly half of all physicians, especially those mid-career.  

Clinician burnout, in many ways, is a costly problem for CEOs. It takes a mental toll on your physicians, nurses and other practitioners. It is undoubtedly the reason some of the most talented people in your organization will leave the job. It is a culture killer. Studies have shown that burnout among clinicians has led to decreased productivity, lower quality of care, as well as reduced patient satisfaction and, perhaps most important, safety.  

 For all these reasons and more there is an actual business cost to burnout. Yes, a cost that can be calculated. 

A survey conducted in 2018  estimated burnout costs the U.S. health care industry $4.6 billion every year — a conservative estimate, according to survey authors Christine Sinsky, MD, Vice President of Professional Satisfaction for the American Medical Association, Stanford University’s Tait Shanafelt, MD and Harvard Business School’s Joel Goh.  

While not every physician leaves a job because of burnout, research suggests burned out physicians are twice as likely to turn over. Researchers have found there is significant cost savings for installing an intervention that helps reduce burnout.  

“As a CEO, you’re already investing considerable financial resources every year on physician burnout … you just may not recognize it. If your organization has 1000 physicians, experiencing average rates of turnover and factoring in very conservative rates of the cost to replace one physician, you’re already investing $10 million per year on burnout. You’re just investing it at the sharp end of the stick, on replacing physicians who leave because of burnout rather than on prevention,” says Sinsky.  

While there are obvious moral and ethical reasons to address burnout, it has also become a legitimate business imperative.  

Dan Shapiro,  Vice Dean for Faculty and Administrative Affairs at the Penn State College of Medicine, who has written books on physician burnout, says there is an immediate ROI in trying to solve this problem. He and colleagues developed a five-tier hierarchy to help CEOs and other administrators prioritize burnout interventions.  

Interventions and other solutions not named yoga 

The five-tier intervention, Shapiro says, is comparative to how pilots use a systematic approach when responding to a warning light in their cockpit. The intervention starts with 

Physiological wellness. Are your employees hungry? Are they sleep-deprived? The first tier also touches upon behavioral health and their mental wellbeing. Up from there, it goes to…

Safety and security. Shapiro says one institution found that 58 percent of nurses had been struck, bitten, spit upon or kicked in the last year. “That makes it a more dangerous profession, in some ways, than law enforcement,” Shapiro says. This can also come in other forms (Is my job secure? Am I being threatened?)

Respect.  Am I respected by the people and things I interact with every day? This could mean the obvious examples of respect (a culture of accountability and communication) and the less obvious (is the EHR optimized? Are their dead spots where pagers don’t work?).  

Connected and appreciated by colleagues. Shapiro says that isolated health professionals burn out in higher numbers and leave in higher numbers. 

Making an impact. The highest level of this five-tiered intervention is whether or not the clinician feels they are making an impact. “If you clear up a lot of details lower on the hierarchy, you get to a place where physicians and nurses feel they are making an impact,” Shapiro says.

Other advice to CEOs: 

The most successful approach is by identifying and understanding the drivers of burnout within your organization and tackling them head on. 

Health care CEOs often miss the mark on clinician burnout because they don’t understand what their day-to-day is like. Everyone in the hospital should have to do patient care for a day. They should have to spend regular time with patients. If you have an MD or RN degree, then do patient care. If you don’t have one of those degrees, work at the front desk. See what it’s like. See how the system impedes your ability to do a good job.