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Do You Really Think?

April 19, 2009
by aguerra
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April Edit Memo

There are three kinds of people in the world (yes, a simplification I know): the first kind works the way they have been taught, the way they always have, not interested or capable of envisioning improvements. A half-step up are the individuals who can see the light, but quickly recoil from it, assuming they have no power to make that vision into reality.

Individuals of the first type might explain a particular aspect of their job by saying: “This is the way we do it” (with no further brain activity). While those of the second type may venture, “I would love to do it a different way, but this is the way we do it.”

And then there is the third type, ‘the Effective Worker’. These people pick up deficiencies in a workflow or process and conceive of better ways to handle them. From there, they make it their mission to effect change in a logical and persistent manner.

Such people might say the following: “This is the way we do it, but it no longer serves the needs of our (insert: readers, customers, patients, doctors, etc.). I have a better idea. I'll write up my idea with a rudimentary cost/benefit analysis, and I'll schedule a meeting with my manager. Let's see if I can communicate the benefits of the new way, along with the risks of the old. I'll pitch it.”

Is there a manager who would not snap up such an employee?

It's interesting that the effective worldview, while perhaps innate in early childhood, is often drummed out of young people from the first stages of formal schooling into the early years of their career. It is only when they reach a certain level (think organizational chart) that they are expected to suddenly break free from such rote thinking. How many of us know of checklist-obsessed tacticians in executive-level strategic positions? These poor souls (ignoring, for the moment, their even less fortunate reports) are like ship captains who would rather see their vessel sink in hurricane-whipped seas than chart a new course, simply because they can't imagine the course can be altered.

I reflect on this process because HCI has done some effective thinking which, we believe, materially improves our product. Immediately after the Stimulus Package was passed, with its $20 billion for healthcare IT, an avalanche of Webinars, articles and conferences started popping up. Of course, we quickly assigned our Policy Department reporter, David Raths, to do a story on what the package meant to CIOs, and how you can get your fair share of the loot.

Having taken that traditional step, we realized there would be about 1,000 of the aforementioned Webinars, articles, etc., before our article got to you. Seeing that, in this case, our workflow was broken, and appreciating that we had not just the power, but the responsibility, to fix it, we permanently converted David from a traditional one-story-a-month journalist (with a two-month lead time between assignment and delivery) to our first ever Online Policy Blogger (http://www.healthcare-informatics.com/david_raths), with a possible two-hour lag between assignment and delivery.

In fact, David doesn't have to wait for assignments, as he's been given general marching orders, with the power to make specific coverage decisions. In his first foray into the Blogosphere, David scored our top blog posting, in terms of visits, for that week.

As stated earlier, the most important part of the effective process is not the actual development and implementation of a new idea, but the appreciation that it is possible to do things differently. Has your CEO created such an environment? Have you instilled an effective worldview in your staff? Even before the Stimulus Package, the pace of change in this industry was dizzying. Now, more than ever, only those that think effectively will survive.


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Comments

I think we're in agreement. Ask first, then request and explain why, if necessary, tell (you must tell if it needs to get done). But remember that telling creates ill will and a loss of enthusiasm, so it better be worth it. On the employee side, refusing to go along with a request should be only be done when one is willing to accept what could be painful consequences. This is usually the case when principles or ethics are involved.

Great post Anthony! In my search firm, I place many candidates that have the characteristics of the 'the Effective Worker'. These are the next leaders in our space (and in all industries). They are always trying to find new ways to make things better for the organizatrion. And... don't mind change. Organizations will always be looking to hire, promote and pay these type of workers very well. You can't say always the say about the other 2 types you mentioned.

Thanks guys. I think John Halamka had a great post the other day, in which he perfectly described the nature of leadership and effectiveness (outside the military). To be an effective leader requires charisma and persuasion, not positional authority. It makes me think of the expression that once you're in court, you've already lost. Once you've fallen back on your positional authority to get something done, you've already lost. You've failed as a communicator.

An excerpt here:


You rarely use formal authority

In many societies, policy can be made by benign dictators at an accelerated pace without debate. That's not the way policy is made in the US. Whether in institutions like Harvard University or in government, there is a process for everything. A leader can communicate a vision or assemble a guiding coalition, but rarely can a public figure just declare an action to be done by fiat.

Anthony,

You articulated an ideal: "the Effective Worker" who innovates, and overcomes the trap that you called type 1. Here, the person retreats from innovation, "... assuming they have no power to make that vision into reality."

You closed the piece "Has your CEO created such an environment?" Sprinkled throughout, however, is really the sources of personal power (and influence). Your example with David Raths highlights this, as do my comments from Kleiner on dealing with power.

If an individual's power comes from a combination of
1) Personal, (technical skills, expertise, wealth, track record, education, soft-skills, attractive charisma)
2) Positional, (control of resources, ability to hire/fire/promote, title, access to information) 
3) Relational,
then much of your theme is really continual development and innovation in personal power.

I'm calling this out because I'm troubled by your last comment, focusing on abuse of positional power, and specifically formal authority.

In plain terms, you cannot and should not tell an adult to do anything. You should listen to them. Really listen. And, then ask them for what you want. (At least in current US professional culture.)

If there is an organizational hierarchy in place, and if the asker and askee are competent in their roles, this is healthy, appropriate and necessary. The alternative is to expect superiors and subordinates to read each others minds. Or otherwise avoid conflict through absent communication.

I am 'asked' to do things all the time. There is formal authority in play, although it's almost always implicit as described above. This is, of course, equally true at home as it is at work.

I think John Halamka's astute observations are appropriate for policy. I think your astute observations are most appropriate for development of individuals, both self-development and development of subordinates. In the later case, formal authority, in the form of clear planning and communication is essential. Big distinction.

What do you think?

Actually, Anthony, there are only two kinds of people. Those who divide people up into two groups, and those who don't. :-)

Seriously though, your post, especially the question "Has your CEO created such an environment?" reminded me of my Making a Better World post. It's more general than the "CIO title" issue that introduces the topic.  I think it's more concordant with your argument.

The issue is recourse if or when one finds themselves in an anti-favorable bureaucracy.  There is pragmatic guidance there, taken from Art Kleiner.  It reflects, in part, his learnings working with The Fifth Discipline / Peter Senge, when they were called into many fortune 100 firms with CEOs frustrated by their organization's inability to learn.

aguerra

Anthony Guerra is Editor-in-Chief of Healthcare Informatics. His blog contains story lineups for...