Monthly Archives: June 2012

Can Health Care Leadership Discover the Path to Positive Evolution?

There was a rather startling report that recently aired on Rock Center with Brian Williams.  The report exposed the practice of hospitals attempting to collect co-pays at the bedside of emergency room patients.  The story focused on Fairview Health, a Minnesota-based hospital and clinic chain that is now facing legal action from the Attorney General of Minnesota.  Hospitals in the U.S. absorb $40 billion in unrecovered revenue for services rendered each year, so this is not an inconsequential issue that effects all of us.  But is coercing a patient that may be experiencing a myocardial infarction for their credit card the way to go about enhancing revenue?

I wrote a blog a while back that explored the peculiar relationship between health care providers and their customers.  That’s right, customers.  Patients are customers, yet there seems to be a disconnect between what is the natural state of relationships between customers and suppliers from every other industry except health care.  In normal economic exchanges, the customer has the advantage and the supplier will work diligently to maximize the experience, value and benefit they deliver to their customer.  In health care, the relationship is skewed.  The customer is physically and emotionally vulnerable and in need of help and the clinician is the expert that dictates the framework of the relationship.  Be sure to follow doctor’s orders!  The power is reversed in the relationship of economic exchange.

Because of this cultural artifact, health care evolved under an entirely different set of relational circumstances that have brought it to the place it is in today.  The industry operated under a set of drivers that are unique unto itself.  Every other industry has evolved under what we would consider normal, competitive pressures and customer demands.  This forced efficiencies to be uncovered and leveraged to the benefit of the buyer.  No such force ever emerged in health care.

In the report, it was revealed that Fairview had hired a management consulting firm called Accretive Health to help them manage what Accretive calls “end-to-end revenue cycle services to improve your bottom line”. It also revealed the training documents and scripts Accretive provides their hospital clients for the bedside collection of co-pays prior to the delivery of services.  Techniques that are allegedly so coercive and psychologically abusive to the hospitals’ patients legal actions are emerging in response.  Now, there’s bad practice in every industry, but Accretive booked over $250 million in revenue in the first quarter of this year, up 50% over prior year.  What this is telling me is there are enough health care executives buying into this approach that this company was tracking to book a billion dollars in revenue in 2012.  I sincerely appreciate the fiduciary responsibility executives have to their shareholders, but is this the answer to creating long-term relationships that will benefit the hospital, community and customers of health care services?

I portend that, on a whole and greatly due to the peculiarities of the provider/customer relationship, health care really doesn’t understand the underlying drivers of their business model in the 21st century.  Have you seen the automated billboards in your community that update the waiting time in a particular hospital’s emergency room?  Really?  Many even post the current waiting times on their websites.  Now I ask you, if you’re in such a condition that you require the services of an emergency room or trauma center are you really going to stop to compare waiting times?  If you look into the peer-reviewed research as to how and why people choose a hospital you’ll discover it is relationship and emotionally driven.  People make their decisions on where they will purchase health care services based upon the advice and experiences of their primary care physician, family members and friends.  Research from the field of Applied Behavioral Economics clearly indicates 70% of economic decision making is emotionally based, with the remaining 30% based in rational thought.  This is not an industry-specific behavior; it is human-specific behavior.

How people feel about a hospital is just as, if not more important than, what they think about that hospital.  This underlying factor is also revealed when you look into the research surrounding why people file malpractice law suits.  People don’t sue because of the mistake, they sue because of how they were treated once the mistake occurred.  Want to solve the malpractice crisis?  Practice a bit more authentic empathy.  Want to drive down the number of adverse events (of which the Department of Health and Human Services recently reported 7 of 8 are going unreported, despite the law), lower costs at discharge, improve patient outcomes, and create sustainable, competitive advantage?  Begin investing in your nurses.  We uncovered two dozen, yes two dozen, peer-reviewed, published research studies that clearly demonstrated the clinical and financial benefits of cultivating emotional intelligence competencies in nurses and the critical impact of maintaining proper nurse-to-patient ratios.  Yet, we still see nurses being laid off, over-worked, burned-out, and leaving the field entirely.  The cost to hospitals of nurse turnover in Florida alone is $1 billion a year.  Costs that could easily be avoided by practicing mindful, transformational, clinical leadership.

The answers to solving our health care challenges require health care leadership to embrace a shift in perspective.  The answers are not casually lying around waiting to be opportunistically picked up along the way.  Many of the answers to these daunting questions lie right in the midst of the hospitals themselves.  In their nurses.  They’re the hospital’s frontline touchpoint with their customers!  Nurse/patient interactions are the single most important driver of competitive advantage for a hospital.  Take care of your nurses and they’ll take care of your customers.  In turn, your customers will take care of you.

© 2012, Terry Murray.

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Leading in the New Economic Ecology of Ideas

I just finished re-reading Dr. Amit Goswami‘s book, “How Quantum Activism Can Save Civilization”, and if you haven’t read it, I highly recommend it.  Dr. Goswami is a quantum physicists that explores the societal implications of downward causality, the non-locality of consciousness, tangled hierarchy and discontinuity; all experimentally proven tenets of quantum physics.  We integrate his work into our professional development workshops and coaching programs, as it introduces novel concepts (which sparks neurogenesis, new neural connections, and creative thinking) which are critical if we are to lead and manage business from a higher place of consciousness.

This is no longer becoming a choice.  We’ve migrated out of the Industrial Age and into what can best be described as the Idea Age.  Ideas emerge from the quantum field of our minds, and when creative ideas intermingle in the right environment (i.e. organizational culture) and within the right context, innovation and subsequent value creation is not far behind.  This isn’t new information.  We can see how the change has effected nearly every aspect of our lives.  Yet many sectors of the economy still cling to outmoded models of leadership, strategic planning, and organizational culture that actually hobble the cultivation of creative ideas and innovation.

In Goswami’s book, he explores the fundamental shift that must occur in light of this new economic ecology.  As he discussed his perspective, he went into the etymology, or original meaning, of the two words.  I think it adds some poignancy to the conversation of leading in this new era as well.  The root meaning of the word economic is the management of place.  The root meaning of the word ecology is the place of knowledge.  The raw materials, or value producing inputs, of the Industrial Age were natural resources, labor and capital.  Customer demands and needs were met via mass production, where economies of scale, command-and-control hierarchy and process controls ruled the day.  Large corporations evolved to leverage these drivers of success.  The ecology, or place of knowledge, leveraged value through the scarcity of goods, services or capabilities; and the economics, or management of that place of value, evolved to suit both its opportunities and constraints.  Companies grew to guard their tacit knowledge, or know how, very carefully, as its scarcity helped firms maintain competitive advantage.

The ecology, however, has shifted dramatically with major implications as to how we lead, organize and plan for success in this Age of Ideas.  Technology, the internet and social media have combined to virtually dissolve the scarcity of knowledge.  The combination of these forces is accelerating the transformation of tacit knowledge into explicit knowledge and the resulting rate of innovation.  Economies of scale have been displaced by economies of relationships and speed of talent (adaptability) is now more important than stability and control.  One no longer needs to create a monolithic corporation to create value.  Entrepreneurs, networks of professionals and relatively small teams of knowledge workers can, and do, create value at a much faster pace.

So here’s the question I ask of us all…

If the place of knowledge (the ecology) is no longer concentrated in the hands of a few industrialists and financiers, but opening up more, everyday, to the people of the world, mustn’t the management of place (the economics) evolve as well?

Source ~ Background materials for this blog were garnered from the report “The Innovation Driven Economic Development Model” by Collaborative Economics, 2008.

© 2012, Terry Murray.

 

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Terry Murray Discusses Leadership with Dan Forbes on Lead with Giants, Part III.

Here’s the final installment of my interview with Dan Forbes from Lead With Giants, exploring leadership in the 21st century.

10. When faced with two equally-qualified candidates, how do you determine whom to hire?

I look at the potential upside for professional growth, reflect, and then trust my intuition.

11. What is one characteristic that you believe every leader should possess?

Authentic empathy.  If you don’t truly care for others in a manner in which they can “feel” it as well as think about it, why would you expect them to care about you or the firm?  It’s the seed for building trust, engagement and creativity.

12. What are three words other people would use to describe your work style/ethic?

Passionate.  Persistent.  Visionary.

13. What do you see as the single-biggest stumbling block(s) for leaders?

A lack of awareness and emotional intelligence competencies.  For all of us, our greatest stumbling blocks are often erected by ourselves.  Engaging in personal development, elevating self-awareness which enables self-regulation, dialing in one’s sensitivity to the needs of those we lead (social awareness) all contribute to our ability to lead authentically.

The challenge we’re facing is we’re operating in a knowledge age while still clinging to transactional leadership optimized for the industrial age.  Creativity is the key driver of value creation today, and that requires a new approach to leadership; transformational leadership.  That’s a wide chasm to jump if you’ve been working from engrained management habits for twenty or thirty years.  Leaders, and companies, that make this quantum leap will be the winners in the 21st century.

 14. Are their people in your life, or in general, whom you particularly admire?

That’s a big question!  I recently took the fifty most influential books I’ve ever read and arranged them on a large, empty floor, trying to capture how one idea led to another.  How one author brought me to the next.  So, there is a long list of authors that have helped shape my philosophy (Christian de Quincy, Joseph Campbell, Daniel Goleman, Amit Goswami, Dan Ariely, Mark Twain, Susan Scott…I could go on).

More personally, I admire my wife and her commitment to continuous growth and compassion for all.  I admire Gail Clifton, who, for 25 years, has created and sustained a remarkable therapeutic riding center for disabled children (SMART) in Sarasota.  I admire the pioneers that set the foundation for realizing the transformational power of the horse/human relationship; Barbara Rector, Linda Kohanov, Lisa Walters, Carolyn Resnick, Arianna Strozzi.

Most of all, I admire every combat veteran and their spouses that come through our Warriors in Transition  program.  Their presence never ceases to humble me.

 15. Which book or books have influenced you the most?

Writing my own book was probably the most influential!  More than books, it’s the authors’ body of work that often moves me.  Anything by Joseph Campbell, Christian de Quincy, Dan Goleman, Amit Goswami, and Dan Ariely.  I also go to classic literature for an exploration of the human condition.  Literature holds wisdom.  For me, the essential reading list for leaders should include:

“Primal Leadership” by Goleman, Boyatzis, and McKee (The best book on leadership I’ve read).

“Leadership on the Line” by Heifetz and Linskey (They foresaw today; ten years ago).

“Fierce Leadership” by Susan Scott (Brilliant and to the point  Fiercely honest voice).

“Churchill on Leadership” by Steven Hayward (Who doesn’t love Winston?).

“Patton on Leadership” by Alan Axelrod (Snippets of insights from his journals with insightful commentary from Axelrod…fascinating).

“Tao Te Ching” Lao Tzu (Ancient wisdom of the leader as sage…great, reflective read that perhaps applies more today than when it was written).

“Predictably Irrational” by Dan Ariely (If you’re not aware of applied behavioral economics, it would serve you well to do so).

“How Quantum Activism Can Save Civilization” by Amit Goswami (Accessible explanation of quantum physics that pulls everything together).

“The Emotional Life of Your Brain” by Richard Davidson and Sharon Begley (Really up to date, great tools, a nice addition to Goleman’s, et. al.’s work).

“Pathways to Bliss” by Joseph Campbell (If you’re leading a multi-cultural, multi-generational organization then this is a must read!  Mr. Campbell enables us to look at the world through the lens of comparative mythology, isolating the folk from the elemental human condition.  Campbell also provides a very accessible introduction to the insightful work of Carl Jung).

 16. What do you see as your greatest strength as a leader?

My transformational mindset.  I’m here to serve those I have been given the privilege to lead and those that are paying for it; our customers.  If I take care of my people, they’ll take care of our customers.  In turn, our customers will take care of our investors and stakeholders.  It’s truly that simple.

17. What do you see as your greatest weakness as a leader?

Finding and practicing balance.  I must make time for being as well as doing.  Wisdom rarely appears through bleary eyes.

18. What are you doing to ensure you continue to grow and develop as a leader?

I’m so fortunate my work immerses me in the exploration, experimentation, and validation of thought leadership.  Coaching and developing leaders requires I continuously seek to improve myself.  Doing the work, traveling to meet kindred thinkers, it all pulls me forward.

19. What have you learned the hard way? Or, What role has failure played in your life? 

To see failure as opportunity.  When I look back at my failures and connect the dots I can see how failure often was just a bit of housecleaning, clearing the space for something much more rewarding and important to come into my life.  I didn’t always see it this way.

20. If you could give one piece of advice to young leaders from what you’ve learned by experience, what would it be?

I have to refer to Joseph Campbell’s advice, “Find your bliss.”  It’s everything, and if you are chosen to be a leader, leading from the heart and being of service to others will continuously renew your spirit and energy.  It keeps you going, even through the challenging times.

© 2012, Terry Murray.

© 2012, Dan Forbes.

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Terry Murray Discusses Leadership with Dan Forbes on Lead with Giants, Part II

Picking up where we left off yesterday, here’s part two of my interview with Dan Forbes from Lead With Giants exploring leadership in the 21st century.

5. What has been the most difficult decision you’ve had to make as a leader?

It was quite literally the very first decision I made as a rookie National Sales Manager.  It was my first, formal leadership position in business.  The sales force was totally dysfunctional; to the point of not being able to plan for a day of appointments or even show up to sales calls on time.  Sales were eroding, steadily and gaining momentum in the wrong direction and 60% of our business was with one customer.  Not only was this ship I had just joined rudderless (in terms of sales leadership), half the sail canvas was on the deck and what was raised was tattered and luffing!

I recommended to the President (and owner) that we needed to restructure our entire sales strategy and he gave me the green light to do so.  I let all 12 field-deployed sales reps go and replaced them with four sales reps that were stationed at the factory.  They would travel for a week and spend the next week in the office.  We immediately cut our cost of sales by more than 50% (it was pure cost, delivering no ROI) and within four months had turned the corner to profitable growth.  It also taught me a cultural lesson.  By bringing the sales reps into the factory, directly from a week of meeting customers, it re-invigorated the entire factory.  We brought the customer concerns right onto the factory floor, right into the quality meetings, right into engineering.  The resulting energy and engagement was palpable.  It woke up the entire company!

From that experience onward, I knew I would have to make difficult decisions, but I would do so for the right reasons and in the right manner…and always hold myself accountable.

6. How do you learn?

Continuously and in remarkably unanticipated ways.  Because of my days in the life sciences, I’m a voracious reader of peer-reviewed research studies.  We’ve built our entire approach on scientific evidence.  What continuously fascinates me is how I will learn things while investigating the research for one program that benefits another.

The most powerful modality for my learning is through teaching, coaching and facilitating our equine facilitated learning programs with the horses and our clients.  The more I engage in the work, the deeper my understanding becomes and the more I learn about human motivation and the power of authentic relationship.  The facilitation of the work requires the suspension of our Jungian ego.  Doing so engages me fully in the moment and enables me to be detached from the outcome.  Inevitably, this improves results dramatically.  As a former executive strategist, this is a challenge for me to incorporate in my daily business endeavors!

7. Where do the great ideas come from in your organization?

Everywhere, from within and outside of the firm.  Over the years we’ve cultivated great relationships with industry experts outside of our core competencies.  Maintaining these relationships through dynamic conversations has provided insights we would have otherwise missed along our journey.

8. How do you or other leaders in your organization communicate the “core values”?

By embodying them.  Congruency is a critical leadership attribute.  To paraphrase St. Francis of Assisi, “It is no use walking to preach unless your walking is your preaching.”  Again, our work developing leadership competencies with executives experiencing ground-based exercises with horses demands congruency.  The horses will accept no less, regardless of one’s title.  The herd holds us accountable!

9. How do you ensure your organization and its activities are aligned with your “core values”?

By creating a culture of trust, engagement and open dialogue.  I encourage people to challenge every assumption, every strategy, regardless of if it is my idea or somebody else’s idea.  Keep it open, dynamic and engaging and you’ll hear what’s going on every day.

It’s imperative to create a Professional Development Plan for each associate as well.  It creates a documented, open dialogue and illuminates a development path for the associate.  If you pull this document out every few months for a quick review of progress you can eliminate performance reviews, which inevitably focus on the negative.  Why not focus on someone’s growth instead?

© 2012, Terry Murray.
© 2012, Dan Forbes.

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Terry Murray Discusses Leadership with Dan Forbes on Lead With Giants

I recently had the privilege of being interviewed by Dan Forbes for his blog, Lead With Giants.  I’d like to share this interview with you, as it really bore down to the fundamentals of leading in today’s volatile world.  I’d also encourage a visit to Dan’s site.  I know you’ll enjoy it!  As this was an in depth interview, I’ll post it in installments over the coming days.  As always, your thoughts and comments are welcome!

1. What was your first recollection of experiencing great leadership? 

Without a doubt it has to be Bill Sanford, the founder and former CEO of STERIS Corporation.  His vision and execution took a concept (that didn’t quite work at the time) and a $1 million private equity investment and created a billion dollar company in twelve years.  While he was at it, the STERIS System 1® (the working device based on the original concept for sterilizing very expensive, sensitive surgical endoscopes, using cold-liquid, in the O.R., in less than 30 minutes) revolutionized, actually enabled, the explosion in minimally invasive surgical procedures that are so common today.  His entrepreneurial leadership changed the world, relieved a myriad of human suffering, and introduced remarkable efficiencies in health care.  As an executive at STERIS during those high-growth and maturing-growth years, I had the wonderful opportunity to work closely with Mr. Sanford.  He was the dean of my experiential education!

2. Who had the most significant influence on shaping you as a leader? 

My father.  He was on his own since he was 13 years old.  He took responsibility for his own life at a very young age.  He had to find the leadership within to guide him and he created a successful, meaningful life.  His consistency of values and congruency of action left a lasting impression on me.

3. What do you believe are the qualities of leadership?

Transformational leadership is what our businesses and civilization are calling out for in the 21st century.  Leadership is a sacred trust; one of mindful stewardship and service to those we lead.  For me, this begins with one’s ability     to feel and express authentic empathy.  Being visionary, tempered with experiential wisdom, and extensive dialoging with associates is also key.  Notice I didn’t say communicating…I want dialogue…meaning open discourse and passionate engagement throughout the organization.  This requires inclusiveness and parking the ego at the door.  Unwavering congruency would be next; being impeccable with my word and ensuring my behaviors resonate and amplify the intention of our shared vision.

4. What were the turning points in your life?

It’s been a circuitous journey, so most of the tacks were more along the lines of  sweeping arcs rather than individual flash points.  Enlisting in Naval Intelligence at 17 years old was the launch point.  Serving my country at such a young age really set my perspective towards team cohesion, unity, mission, purpose.  We were accountable for each others’ lives out there; we were literally in the same boat.  That obligation to others never leaves you.

More than turning points I look back at the resonant moments I’ve had the privilege to be a part of throughout my career.  Being in the labs at M.I.T. at the outset of the Human Genome Project.  Leading the strategic market launch of the first human, umbilical cord blood-derived stem cell.  Seeing these cells differentiated into single heart cells, inborn with the wisdom to beat, even by themselves.  Peering through the microscope at these same stem cells as they differentiated into oligodendrocytes and begin seeking inter-connection, creating new neural pathways in real time.  Wandering up a hill in New Jersey, between meetings with researchers at the old Bell Labs, to see the Horn Telescope, the device that discovered the background radiation that proved the Big Bang Theory as correct.  Meeting and speaking with James D. Watson, the co-discoverer of DNA, at a scientific symposium.  When I look back upon my journey, I sometimes feel like the Forrest Gump of the sciences!

The most significant epiphany I’ve experienced is discovering the transformational power working with horses can have on human beings.  This occurred four years ago and it has shifted the entire trajectory of my work and life.

to be continued…

© 2012, Terry Murray.

© 2012, Dan Forbes.

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Explorations in Leadership ~ A New Model for Contemporary Times

Our perception of exceptional leadership has changed over time.  Leadership has historically reflected the culture from which it emerged.  Different times, different leadership…different culture, different leadership.  As times evolve, leadership must evolve to keep step.  Unfortunately, the calibration of leadership to dramatic shifts in culture and now, technology and the strategic imperative of creativity throughout the workforce today’s pace of change demands, lags significantly behind such upheavals.

We need not look far for a striking example of this phenomena.  Leaders at the helm of business today were, for the most part, molded out of the model of leadership that was optimized for the Industrial Age.  Command-and-control leadership, often referred to as transactional leadership, was a highly effective approach for mobilizing and managing tens of thousands of factory workers.  Factory workers who were simply an extension of the assembly line.  No need for creativity in this environment, simple dexterity and focus on the task-at-hand was the worker’s input to value creation at that time.  This approach to leading business activities really took root in the sale function.  It was binary; hit your number and you’re rewarded, miss your number and you may be fired.  The famous scene with Alec Baldwin from the film, “Glenngary Glen Ross” epitomizes the extremes this type of fear-leveraging created in sales.

We’ve come a long ways in broad fields of technology.  I cut my sales teeth in the nascent biotechnology industry in the 1980s in Cambridge, Massachusetts.  I was more or less at ground-zero for the seismic shift from an industrial-based economy to the knowledge-based economy.  Similar shifts were occurring along the Rt. 128 belt around Boston, dubbed America’s technology highway, as well as in Silicon Valley, the San Francisco Bay area, and in other small pockets around the country and the world.  Many of the sales people from that day and age are now at the helm of large organizations.  As they gravitated up the command chain, they often became more and more isolated from the frontline trenches of the business.  They may have witnessed the birth of this shift, but over time the organizational culture of transactional businesses forced them to focus more on career and managing internal politics than focusing on the needs of their customers and associates, thus losing touch with the very dynamics of value creation in our knowledge based economy.

Technology, and especially science, has progressed to a remarkable degree of granularity of knowledge in many fields.  In biotech, for example, I quickly learned researchers were in the separation and isolation business.  They were constantly drilling down for a deeper understanding of the fundamental mechanisms of biological function.  The combination of investigation, isolation of causality, and experimentation of potential solutions to disease states created an explosion of information and knowledge now being applied today.  In leadership, we’ve seen little in advancement over the same period of time.  We need to approach leadership with the same level of granularity that we’ve seen in evolve in the sciences.

The good news is the advancements in the sciences is giving us new insights into the neurology of human behavior, the importance of emotional intelligence at work and in life, the role of the Core Mammalian Emotional System, and the power of Applied Behavioral Economics.  Integrating the lessons from a broad range of investigative sciences provides us with a much more granular view of what engages and inspires human beings to perform and create at their optimal level.  The mountain of peer-reviewed, published research, provides us with ample evidence regarding human behavior.  It provides a clear roadmap for how we can lead from both the head and the heart to create highly motivated associates, a thriving, inclusive culture, and mindful, nimble strategies for today’s global economy.

When we integrate all that we’ve learned over the past few years, and look around at our continuous struggles to gain momentum coming out of the Great Recession, we clearly see a need for a new approach to leadership.  One that aligns more closely with human nature and that is based upon scientific evidence.  A shift from transactional to transformational leadership.  An approach of service to those we lead and those our firms’ serve.  Humankind’s intellect has outpaced our emotional and psychological evolution, creating a complex, cacophonous world.  Until we embrace a more evolved approach to leadership, I’m afraid we’ll continue to struggle our way back to prosperity.

© 2012, Terry Murray.

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Terry Murray Discusses the Strategic Imperative of Creativity in the Workplace on the CBS Radio Network

The need for creative thinking has moved well out of R&D and marketing departments.  The speed and dynamics of today’s economic world require adaptive solutions to unprecedented challenges at every touch point within the organization.  I recently had the opportunity to discuss how to go about cultivating the type of organizational agility successful companies require in the 21st century.

You can listen to the interview on the player below:

For more insights on how to cultivate creative thinking throughout your organization, please visit Igniting Creativity in Business.

© 2012, Terry Murray.

© 2012, CBS Radio Network.

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