Personal Accountability

This has always been an interesting topic to me. Some of the events of the last few weeks ranging from athletes punching one another out to kids returning to school seems to make it particularly relevant.

A colleague and I were discussing this topic the other day especially as it pertains to health care. Isn't it interesting for all the debate about whether there should be single payer, a public option, how much it will cost, etc. there is little discussion about the individuals role in the whole health care discussion other than as a beneficiary.

I have some pretty strong opinions on this topic. Among them I believe that all Americans should have access to a basic level of health care much like public education and that until we provide that the costs will never really be managed.

I also believe that individuals have a right and responsibility to participate in the management of their own well being and health. We don't talk about that very much. I would venture to say that the majority of Americans who have health insurance are also covered by a group plan- employer, government agency, association, etc. so they have little understanding of how much their health care actually costs and care less until it impacts them in the way of increased co- insurance, higher deductibles, denied claims, or related activities.

I have mentioned a couple of other related concepts regarding health care like our inefficient delivery and focus on the costs of processes rather than paying for outcome based management, but this is a different issue.

I remember years ago when a new employer arrived in town and declared a tobacco free workplace. People were outraged. How interesting? An employer who took the position that if you knowingly contributed to the detriment of your own health they didn't care to subsidize your real or potential higher expenses so they wouldn't hire you.

We tried to pass a law recently requiring all restaurants to post calorie counts for everything on their menu, luckily it failed. Would we want to extend that to homes like the dram shop laws?

Dram shop laws extend liability to private individuals for serving intoxicated people or allowing them to depart your home intoxicated without at least attempting to intervene. Can you see requiring a menu with calorie counts at dinner parties?

I think a big part of the issue is that of personal competency. Personal competency is that "other" right that constitution provides us with in addition to the concept of personal property.

When we began to industrialize and people left the "farm" many went to work for large employers. Large employers responding to both collective bargaining and offering competitive compensation began offering "fringe benefits" including paid time off, retirement and pension plans, and group health insurance benefits. A few years ago it was not atypical for employers to pay all the costs for health insurance for employees and their dependents. Employees had no idea and didn't care what they cost. Add these third party payer systems to advance health care techniques, technology, and a few other things and we created a trillion dollar health insurance industry, and very high expectations.

Very few employers to my knowledge even today talk extensively with their employees about ways they can contribute to lowering health care costs. The idea of "mandated" health screening, enforced wellness, and sliding employer contribution rates based on lifestyle health care costs would probably be seen as some type of corporate fascism. Your employer shouldn't be able to tell you how to manage you lifestyle, right? Even if they pick up the majority of the cost....

I believe until we address the personal accountability issue and employers
actively engage and educate their employees about the root causes of many of the costs we will only be addressing part of the problem. What do you think?

Tipping Your Sacred Cows

I had a chance to do some reading from three different sources this week and all three in their own way examined some "sacred cows". Sacred Cows are those written or unwritten things that we just won't consider changing or even discuss changing.

One of my colleagues and mentors, Ty Warren of Savium, wrote a great book he titled White Hat Leadership. While it is a great book and I recommend you read it all, I especially liked Ty's discussion of two different personality and leadership styles: Explorers and Mappers. The concept of the explorer is pretty self explanatory. These are the idea people, the people who defy convention with charisma and the "big" ideas.

People like Steve Jobs and Bill Gates would probably be described as explorers.

Mappers on the other hand are those individuals who follow the map or implement the direction. They are the stabilizers.

In my experience few people want to be a mapper. We have almost defined leadership and explorer to be the same. Ty and I disagree with that premise. Both of us, he in his book White Hat Leadership and I in mine Managing Whole People, talk about the concept of transition. By that we believe that particular leadership styles and competencies are not only valuable, but critical depending on where the organization is in its life cycle and operating environment. We also talk about how while we adore the concept of explorers most of our succession models are based on Mapping. Look at how many of our CEOs are drawn from finance or engineering. Those are mapping disciplines! I was a practicing HR executive for years. HR practitioners worship concepts like consistency like a sacred trust. Sounds like mapping to me!

I want to make two points here; first, I am not advocating that only explorers should lead. In fact to the contrary explorers become restless and impatient. In many cases their role should be transitional.

My second point may seem contrary. We are in one of the worst economic declines we have ever experienced. Doing what we have always done contributed to getting us here. Do we want to count on that to get us out? This may be the season for explorers.


My second reading came from some articles on BNET. The first one dealt with re engineering management. The authors suggested five ideas to consider:

• Management's work should serve a higher purpose. Oh my, management should actually look beyond the bottom line and market share! They go so far as to say it should concern itself with achieving socially significant goals. Could they be talking about health care, education, homelessness, and other related things?


• Reconstruct the philosophical foundation. These gentlemen suggest that executives broaden their parameters to include theories and models as diverse as theology, philosophy, anthropology and others- not just business concepts. My son shared with me some of the writings of John O'Neil, who works with executives and suggests that many of our corporate leaders have lost their balance and sense of fulfillment because they don't allow time for family, social responsibility, and related activities. They have lost their essence.


• Redefine leadership and its product. They suggest that rather than being heroic decision makers exclusively (can you say explorers), that leaders should be societal architects who foster and model collaboration, innovation, and participation.


• De structure the organization. In this context they talk about small, malleable units. Large centralized structures inhibit shared, efficient decision making.


• Empower the renegades. We need to empower the employees who are passionately committed to our values and mission. They describe it as emotional equity, I refer to it as commitment or engagement. Recent studies that I have talked about in my articles The Business Case for Compliance to Commitment and The Spillover Effect describe the economic and productivity benefits of instituting these practices far beyond their philosophical or intrinsic value.

My last reading debates the merits of yet another management "sacred cow", Best Practices. The author cautions us not to leap to the conclusion that practices and models used by large, big names firms are applicable for us "regular" guys. He even takes a poke at my profession; consulting, and how many big name firms make their living schlepping these models from client to client. His point is to be sure that model or practice works for you! He suggests you examine some basic concepts and constructs:

• Timing and market conditions. Is the environment the same as it was when the "best practice" was created? He uses the example of mass media advertising to create brand. With cable, the Internet, and social networking has mass advertising become spam?


• Different Rules. If you are a well established "brand" major deviation from that brand position can cause you to alienate your core market and not capture new share.


• Differentiation is key. Unless you are ubiquitous why would people choose you over a competitor? If all your "best practices" were invented by them unless you offer a significant cost or location advantage why should people buy from you.

His point and mine is not to learn from the best, it is don't just plug it in. It needs to be tuned to your culture. I tell clients a lot; I have a model, but the implementation of that model is different for each client. It is tailored to their culture and norms. I go so far as to reject clients because they are looking for a "plug in"!

I have focused my career on creating engaged environments. The good news is that organizations that develop, implement, and maintain engaged cultures outperform their peers in every segment across a broad variety of metrics. The bad news is that engagement is a culture and a system. It takes time and energy to create and commitment to maintain!

We are in a time and place where I think we may want must recognize that many of the conventional wisdoms, (sacred cows), are going to have to be re-examined. Maybe it is time for a big ole Texas style barbecue? I heard once that sacred cows make the best hamburgers! What do you think?